Text 7658, 301 rader
Skriven 2005-10-15 21:48:02 av Mike '/m' (1:379/45)
   Kommentar till text 7214 av Mike '/m' (1:379/45)
Ärende: Re: Avian Flu: Is the Government Ready for an Epidemic?
===============================================================
From: Mike '/m' <mike@barkto.com>


From today's NYTimes, page A10

"Strains of avian influenza virus that are resistant to the anitflu drug
Tamiflu have been isolated from a patient in Vietnam, scientists reported
yesterday...."

The rest of the article suggests that other treatments are still valid but...

...(IMHO) this is going from worse to worser.

 /m


On Sun, 18 Sep 2005 11:57:39 -0400, Mike '/m' <mike@barkto.com> wrote:

>
>http://abcnews.go.com/Primetime/print?id=1130392
>
>===
> It could kill a billion people worldwide, make ghost towns out of parts
>of major cities, and there is not enough medicine to fight it. It is
>called the avian flu.
>
>This week, the U.S. government agreed to stockpile $100 million worth of
>a still-experimental vaccine, while at the United Nations Summit in New
>York, both the head of the U.N. World Health Organization and President
>Bush warned of the virus' deadly potential.
>
>"We must also remain on the offensive against new threats to public
>health, such as the Avian influenza," Bush said in his speech to world
>leaders. "If left unchallenged, the virus could become the first
>pandemic of the 21st century."
>
>According to Dr. Irwin Redlener, director of the National Center for
>Disaster Preparedness at Columbia University's Mailman School of Public
>Health, Bush's call to remain on the offensive has come too late.
>
>"If we had a significant worldwide epidemic of this particular avian
>flu, the H5N1 virus, and it hit the United States and the world, because
>it would be everywhere at once, I think we would see outcomes that would
>be virtually impossible to imagine," he warns.
>
>Already, officials in London are quietly looking for extra morgue space
>to house the victims of the H5N1 virus, a never-before-seen strain of
>flu. Scientists say this virus could pose a far greater threat than
>smallpox, AIDS or anthrax.
>
>"Right now in human beings, it kills 55 percent of the people it
>infects," says Laurie Garrett, a senior fellow on global health policy
>at the Council on Foreign Relations. "That makes it the most lethal flu
>we know of that has ever been on planet Earth affecting human beings."
>
>No Natural Immunity
>
>The Council on Foreign Relations devoted its most recent issue of the
>prestigious journal, Foreign Affairs, to what it called the coming
>global epidemic, a pandemic.
>
>"Each year different flus come, but your immune system says, 'Ah, I've
>seen that guy before. No problem. Crank out some antibodies, and I might
>not feel great for a couple of days, but I'll recover,'" Garrett says.
>"Now what's scaring us is that this constellation of H number 5 and N
>number 1, to our knowledge, has never in history been in our species. So
>absolutely nobody watching this has any natural immunity to this form of
>flu."
>
>Like most flu viruses, this form started in wild birds -- such as geese,
>ducks and swans -- in Asia.
>
>"They die of a pneumonia, just like people," says William Karesh, the
>lead veterinarian for the Wildlife Conservation Society. "When you open
>them up, you do a post-mortem exam. Their lungs are just full of fluid
>and full of blood."
>
>Karesh has been tracking this flu strain for the last several years as
>it has gained strength, spreading from wild birds to chickens to humans.
>"We start at a market somewhere in Guangdong Province in China,"
>explains Karesh. "And it's packed with cages, and you'll have chickens,
>and you'll have ducks. You might have some other animals -- cats, dogs,
>turtles, snakes -- and they're all stacked in cages, and they're all
>spreading their germs to each other."
>
>In response, Asian governments have killed millions of chickens in
>futile attempts to stop the flu's spread to humans.
>
>"The tipping point, the place where it becomes something of an immediate
>concern, is where that virus changes, we call it mutates, to something
>that is able to go from human to human," says Redlener, director of the
>National Center for Disaster Preparedness.
>
>Echoes of the 'Spanish Flu' Epidemic
>
>Scientists in Asia and around the world are now working around the clock
>as they wait for that tipping point.
>
>"Unlike the normal human flu, where the virus is predominantly in the
>upper respiratory tract so you get a runny nose, sore throat, the H5N1
>virus seems to go directly deep into the lungs so it goes down into the
>lung tissue and causes severe pneumonia," says Dr. Malik Peiris, the
>scientist who first discovered the so-called SARS virus, which killed
>700 people and drew worldwide attention.
>
>To date, there have been 57 confirmed human deaths, and another
>suspected one last week in Indonesia. Scientists say the humans have
>only been infected by birds. However, they add, every infected person
>represents one step closer to the tipping point.
>
>"Once that virus is capable of not needing the birds to infect humans,
>then we have the beginnings of what can turn out to be this worldwide
>epidemic problem that the experts call 'pandemics,'" Redlener says.
>
>That is exactly what happened in 1918 when the global epidemic called
>the Spanish flu struck.
>
>"The Spanish flu was killing people in two or three days once they got
>sick," said Bill Karesh of the Wildlife Conservation Society.
>
>"In 1918, my now-quite-elderly uncle was a young boy, living in
>Baltimore, Maryland," says Garrett of the Council on Foreign Relations.
>"And the flu came through, and his family insisted that he could not go
>outside for any reason until the whole epidemic was over. He spent
>afternoons looking out the window and counting the hearses going up and
>down the neighborhood and trying to guess which of his schoolmates had
>died."
>
>Disaster Would Require Massive Quarantines
>
>Unlike the avian flu, the Spanish flu spread long before the
>international air travel routes of today. At that time, there were no
>nonstop flights from flu ground zero to the United States. But not
>anymore.
>
>Karesh believes the avian flu could travel from China to Japan to New
>York to San Francisco within the first week.
>
>"It's on people's hands. You shake hands. You touch a doorknob that
>somebody recently touched," Garrett says, referring to how the flu is
>spread.
>
>Redlener, who is stationed at Mailman School of Public Health at
>Columbia University, has been working with New York City officials to
>get ready for the deadly epidemic.
>
>"The city would look like a science fiction movie," according to him.
>"It's extremely possible we'd have to quarantine hospitals. We'd have to
>quarantine sections of the city."
>
>"I could imagine that you could look at Grand Central Station and not
>see much of anybody wandering around at all," Garrett agrees. "People
>would be afraid to take the subways, because who wants to be in an
>enclosed air space with a whole lot of strangers, never knowing which
>ones are carrying the flu?"
>
>As for the hospitals, there would be scenes like the ones this past
>month in the stadiums of New Orleans and Houston after Hurricane
>Katrina.
>
>"There wouldn't be equipment and personnel to staff them adequately that
>you could really call them a hospital," Garrett predicts. "You might
>more or less call them warehouses for the ailing."
>
>And, as happened in New Orleans, there would be no place for the dead.
>
>"If you look at the expected number of deaths that could occur in cities
>across the United States, we are wholly unprepared to process those
>bodies in a dignified and respectful way," asserts Michael Osterholm,
>director of the Center for Infectious Disease Research and Policy. "We
>will run out of caskets literally within days."
>
>The prospects have become so bleak that in planning meetings held in New
>York City, veteran emergency responders have walked away.
>
>"They just don't know how we're going to get through," says Osterholm of
>those responders. "If we have a repeat of the 1918 life experience, I
>can't imagine anything to be closer to a living hell than that
>experience of 12 to 24 months of pandemic influenza."
>
>If the flu does strike, victims at first would not know if it is the
>kind of easily treated flu that comes every year or the killer flu,
>known as H5N1.
>
>The man in charge of making sure Americans are prepared in the event of
>a killer flu epidemic is the secretary of Health and Human Services.
>
>"We would do all we could to quarantine," says Secretary Michael
>Leavitt. "It's not a happy thought. It's something that keeps the
>president of the United States awake. It keeps me awake."
>
>The preparedness plan calls for Leavitt to run operations out of a
>crisis room in Washington.
>
>When pressed as to how ready the country actually is, Leavitt replied,
>"Not as prepared as we need to be. We're better prepared than we were
>yesterday; we'll be better prepared tomorrow than we are today."
>
>The draft report of the federal government's emergency plan, obtained
>and examined by ABC News' "Primetime," predicts as many as 200,000
>Americans will die within a few months. This is considered a
>conservative estimate.
>
>"The first thing is everybody in America's going to say, 'Where's the
>vaccine?' And they're going to find out that it's really darned hard to
>make a vaccine. It takes a really long time," said Garrett of the
>Council on Foreign Relations.
>
>In fact, the draft report says it will not be until six months after the
>first outbreak that any vaccine will be available, and then only in a
>limited supply.
>
>"I imagine that not a lot of poor people will get vaccinated," Garrett
>says. "If you think about New Orleans, this is a similar situation."
>
>'Inadequate' Stockpile of Medicine
>
>While there is no vaccine to stop the flu, there is one medicine to
>treat it. Called Tamiflu, it is made by the Roche pharmaceutical company
>in Switzerland. Roche has been selling Tamiflu for years.
>
>Only recently, however, did scientists learn of its potential to work
>against the killer flu, H5N1. That has since created a huge demand and a
>critical shortage.
>
>"All of the wealthiest countries in the world are trying to purchase
>stockpiles of Tamiflu," says Garrett. "Our current stockpile is around
>2.5 million courses of treatment."
>
>According to Leavitt, that is a long way from the country's ideal
>stockpile. "Our objective is to have 20 million doses of Tamiflu or
>enough for 20 million people," he says.
>
>He later admitted that only 2 million are currently on hand, but
>asserted that no other country is in a better position.
>
>Officials in Australia, however, have 3.5 million courses of treatment,
>and in Great Britain, officials say they have ordered enough to cover a
>quarter of their population.
>
>"I think at the moment, with 2.5 million doses, you are pretty
>vulnerable," warns professor John Oxford of the Royal London Hospital.
>
>"The lack of advanced planning up until the moment in the United States,
>in the sense of not having a huge stockpile I think your citizens
>deserve, has surprised me and has dismayed me," he admits.
>
>Faced with worldwide demand, the Roche company, which produces Tamiflu,
>has organized a first-come, first-served waiting list. The United States
>is nowhere near the top.
>
>"The way we are approaching the discussions with governments is that we
>are operating on a first-come, first-serve basis," says Dr. David Reddy,
>head of the pandemic task force at Roche.
>
>"Do we wish we had ordered it sooner and more of it? I suspect one could
>say yes," admits Leavitt. "Are we moving rapidly to assure that we have
>it? The answer is also yes."
>
>When asked why the United States did not place its orders for Tamiflu
>sooner, Leavitt replied, "I can't answer that. I don't know the answer
>to that."
>
>Even leading Republicans in Congress say the Bush administration has not
>handled the planning for a possible flu epidemic well.
>
>Senate Majority Leader Bill Frist, R-Tenn., says the current Tamiflu
>stockpile of 2 million could spell disaster.
>
>"That's totally inadequate. Totally inadequate today," says Frist, who
>is also a physician. "The Tamiflu is what people would go after. It's
>what you're going to ask for, I'm going to ask for, immediately."
>
>Leavitt says deciding who gets the 2.5 million doses of Tamiflu
>currently on hand in the United States is part of the federal
>government's response plan. However, he also admits that thought has
>motivated the government to move rapidly in securing more doses of the
>medicine.
>
>"It isn't going to happen tomorrow, but if it happened the day after
>that, we would not be in as good as a position as we will be in six
>months," he says.
>
>However, in the end, even the country's top health officials concede
>that a killer flu epidemic this winter would make the scenes of Katrina
>pale in comparison.
>
>"You know, I was down in New Orleans in that crowded airport now a
>couple weeks ago," Frist says. "And this could be not just equal to
>that, but many multiple times that. Hundreds of people laid out, all
>dying, because there was no therapy. And a lot of people don't realize
>for this avian flu virus, there will be very little effective therapy
>available early on."
>===
>
>yikes.
>
> /m

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