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Human-to-Human Bird Flu

The bad news that I thought might never happen is now official: H5N1 has gone human-to-human on the island of Sumatra in Indonesia.

The WHO has more detail on this particular case. This moves the danger up one notch in the normal progression from a non-human flu virus toward a pandemic; we're on the cusp between what WHO calls phase 3 and phase 4. It can still fizzle out, and the lethality of the virus may keep it from establishing itself fully (if it kills victims faster than it infects new ones).

There's also good news from the CDC on the genetic makeup of the Sumatra isolates:

genetic analyses by WHO reference laboratories at CDC and the University of Hong Kong indicate no unusual changes in these viruses compared with other H5N1 viruses isolated recently.....efficient (easily transmitted) and sustained human-to-human transmission would be needed to trigger a pandemic. There is no indication that this is what is happening in Indonesia.

If the genetic haven't changed, the virus hasn't evolved anything new to encourage faster transmission. It got lucky on Sumatra.

But there's bad news embedded right in the WHO FAQ as well:
Is the world adequately prepared?
No. Despite an advance warning that has lasted almost two years, the world is ill-prepared to defend itself during a pandemic. WHO has urged all countries to develop preparedness plans, but only around 40 have done so.


( 4 sutras — Your wisdom )
May. 25th, 2006 12:03 am (UTC)
Yeah, I remember back when we were going through this with hantavirus -- there was a good year or so with scientists going back and forth on whether viable human-to-human transmission was being achieved and sustained, or whether it was staying zoonotic.

In the years since, I've often been very glad that I got out of zoonoses work. Lots of really interesting research there, but it would be such an insanely frustrating field because it's so difficult to get the government and the public on board in time to have the resources in place.
May. 25th, 2006 02:25 am (UTC)
I'm afraid it's just a very human approach to things: put flood barriers up in New Orleans after Katrina (they're almost done!), or retrofit buildings after the earthquake.

Pay for vaccines and research after the pandemic. Alas. But I think the scientists who do work as, essentially, lobbyists for public health are doing excellent work with the resources they have.
May. 26th, 2006 01:24 am (UTC)
*breaks out the plastic sheets and duct tape*
...oh wait that was for anthrax. $hit, what will we do now?!

(I know what I'm going to do. Sit on my ass and do nothing just like I did for Ebola Zaire and Ebola Reston.)

May. 26th, 2006 02:02 am (UTC)
I think doing nothing is exactly the right response. It's a plague that hasn't happened, and in any case, we've survived plagues before.

But it's good to know the next one is out there. I've got a plan just in case, which involves a little stored food and water, and not much else.
( 4 sutras — Your wisdom )

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