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Looming Flu Pandemic?

I feel a rant coming on. A potential spanner has been thrown into my travel plans/emigration dreams, similar to the one that had me worried about my trip to SE Asia last year.

This is the time of year that, invariably, Bird Flu gets talked up in the press. It’s not in the news as much as last autumn, but lest we grow complacent, yesterday ‘Horizon’ featured a movie-length episode about the course and consequence of a pandemic caused by a ‘humanised’ H5N1 virus (will that still be haemaglutinin 5-neuroamidase 1, or are we talking a different subtype?)

Don’t get me wrong: the risk is very real and the consequences are dire.

What rubs me up the wrong way is how such an event is dealt with.

For starters, too much hope is placed on Tamiflu and similar drugs—to the delight of the companies who hold the patents, no doubt. Tamiflu is not ‘to viruses what antibiotics are [used to be] to bacteria’. It’s efficacy against H-whatever-N1 isn’t clear. So far, it does not seem to have made much difference to those who actually got sick.

But even if the drugs protect us from infection, we will run out of stockpiles and then the fun starts. Horizon got that right.

The next thing that bothers me is that at long last it has filtered into the medical group mind that fatalities are primarily due to an overreaction by the immune system, as was the case for the 1918 influenza pandemic: it was the young and fit who tended to die. Now they’ve even given it a buzzword. The H5N1 virus appears to cause a ‘cytokine storm’, a phenomenon recently made famous by the TGN1412 scandal.

“Once that happens”, the docs were quoted as saying, “there is nothing we can do.” Wrong. There is plenty they can do, but medics are notoriously uncomfortable with thinking out of the box. I was just looking up the basic scientific leads which I myself have on this sort of thing (and which I would be applying for grants to look into if I still had a lab, although it would be a bit of a long shot) when—bugger me, I see that people have already been working on this for years (the link offers just one example, plenty of smaller biotech companies are sniffing the air). Yes, it is a long way from mice to humans, but apparently, some treatments for the cytokine release syndrome are already available. Treating the syndrome is just not recommended by the WHO which still pimps antivirals that don’t have much of a beneficial effect at this stage.

However, it doesn’t help when sensationalist, self promoting crackpots get involved. The woman may actually have something to say, but she is addressing the wrong people. This sort of thing tends to cause the people who issue treatment recommendations to sneer.

The final part of my rant concerns vaccines. Yes, it will be a while before they become available, many months in fact, and part of the reason is the use of outmoded technology in vaccine production. But, say that in the end we have a working vaccine—even with flat-out, problem-free (ha!) production, there will only be enough for a fraction of the population. Even worse, comparatively high doses of H5N1 antigen are required when compared to ordinary flu jabs (H5N1 has to serve for trials since we—fortunately—don’t have the ‘humanised’ strain, yet).

Unless, that is, you add an adjuvant. But would you believe it? There was initial resistance against this, until eventually the widely-used alum adjuvant was trialled, with mixed results. Squabbling has already delayed the research effort and pharmaceutical companies entering the trial races with their ‘top-secret, non-disclosure’ formulations are doing nothing to help the human race prepare for the onslaught. They don’t even have the capacity to roll out enough product, should they come up trumps. But at least, new trials are in progress. Good that the pandemic hasn’t hit yet, because two years ago, we weren’t as prepared as we are now. We’re not prepared now, either.

People say we’re living in the 21st century—why has so little progress been made? They won’t accept that there could be a plague in this day and age. Alas, the scientific research effort tends to be reactionary. Since auditors and shareholders got excited about the economic consequences/benefits of a world-wide pandemic, a lot of progress has been (is being) made. Just not by basic science ‘blue sky’ academics who lack the means, funded by governments who lack the will. I hope that in future, that will change (with Labour in power, apparently things have much improved in the UK, but I wouldn’t know. My last job was funded by industry).

What does all this have to do with travel? It is us—travellers—who will spread this disease across the globe in a matter of weeks. When it hits, stay at home.

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2 Responses to “Looming Flu Pandemic?”

  1. The-Best-Bird-Flu-Blogs-team. Says:

    It is obvious from your posting, that you did not like the presentation of the Horizon program.

    However, it is not clear if you agreed with the CONTENT of the Horizon program.

    Horizon is one of the most respected of the Brit documentary makers, (even though the part fiction & part documentary is not their normal format).

    Most of what was said in the film was disturbing, as it was meant to be, but it was also well within the range of possibility.

    It would be really great if you could pin point the errors made by the Horizon team so that the visitors to our site can have the benefit of your point of view.

    We have to day added the “Looming Flu Pandemic” posting of your blog to The-Best-Bird-Flu-Blogs section of our site.

    The-Best-Bird-Flu-Blogs-team.
    http://www.birdflubreakingnews.com

  2. admin Says:

    In case the previous comment appears on this site (it was approved by me ;)), here’s the reply:

    The part fiction/part fact format of the new Horizon series (previous programs in the current series have tended to dramatise/sensationalise) is a disturbing development for BBC 2’s foremost scientific documentary program.

    In this edition of Horizon, it was at times unclear what was fiction, and what was fact.

    Apart from the clearly dramatical elements, there were no glaring errors as far as I can determine. Scientific and medical opinion as how to tackle the looming pandemic is split. But it is at best misleading to compare Tamiflu (and other currently available antivirals) to antibiotics and it should be made clear that, so far, they have shown little efficacy in treating acutely ill patients.

    I’m worried about some of the statistics. New adjuvant vaccine formulations are in trails and it may be possible to increase the stockpile of vaccines considerably, once they become available–although it won’t be enough for the entire population. The mortality rate is unclear, the assumption seems to hover around 1-2%.

    I’m sure there is plenty more I could pick on, but I’m not in a position to review the program. Scaremongering? Perhaps, but the problem is real. Misinformation? Possibly. A clearer distinction between documentary and drama would be welcome, or else a follow-up show which analyses the previous program, and presents the facts and base for the current predictions in a clearer format.