Is bird flu dead and gone?

[tetano]

?Bird flu? What bird flu? That was last year, right??

So spoke my rental car driver, commenting on the purpose of my June visit to Riau?s capital, Pekanbaru.

He did not know that a four-year-old girl had died of the deadly disease a few weeks before my arrival. One of the managing editors of the Riau Post, the province?s leading newspaper, was not aware of the child?s death either.

?I?m almost sure the latest bird flu fatality in Riau was in 2009,? the editor told me.

Risk communication expert Peter Sandman once said that the level of media attention equals the level of public attention. The fewer reports the media publishes on bird flu, the less people notice that it is still around.

In the public mind, bird flu has died down. Nobody pays attention to the once-global threat anymore ? not even those who were in charge of controlling it during its outbreak from 2005 to 2009, when Indonesia was ground zero for avian influenza.

When the central government decided to dissolve the national committee on avian influenza control and pandemic preparedness (Komnas FBPI) last year, people assumed the war against H5N1 was over.
And when both the international community and the country?s leaders claim that Indonesia has done well in controlling bird flu, Indonesians have even more reason to dismiss the worry from their minds.

Reality bites. The virulent bug is still around, searching for more hosts and breeding places to multiply, looking for ways to spread more rapidly, infect humans more easily and kill them more quickly ? to accomplish the virus? most outstanding achievement: high morbidity and high mortality.

The death of the Riau toddler serves as a warning for us to remain vigilant.


...

http://www.thejakartapost.com/news/2010/08/31/is-bird-flu-dead-and-gone.html

[gsgs]

Re: Is bird flu dead and gone?

it's still around, but less dynamic in spreading than in 2006
and starting to reduce in virulence

[Laidback Al]

Re: Is bird flu dead and gone?

it's still around, but less dynamic in spreading than in 2006
and starting to reduce in virulence

Human H5N1 CFR in 2006 was about 68%. Since January 2009 the CFR for confirmed human H5N1 cases is hovering around 45%. Certainly a decline, but a worldwide disaster if the circulating strains go pandemic.

[JJackson]

Re: Is bird flu dead and gone?

The communication problem with HP H5N1 has been bothering me too. I had hoped that the H1N1 pandemic would lead to the public informing themselves more about flu, and pandemics in general, but that does not seem to be what has happened.

The current state seems to be a general apathy. There seem to multiple causes which together have lead to an unfounded complacency which I will try and take individually.

Long before the pandemic started a sustained H5N1 threat had faded from view as MSM editors were finding it hard to sustain interest in yet another 'man dies of bird flu story'. The constant drip of cases had ceased to be news worthy like a road fatality or a death in Baghdad, it is not that they stopped they just stopped being covered, a distinction often lost on the public.

Another problem was a general drumming into the the subconscious that flu pandemics occur once a generation, or so, as if this was some kind of firm rule with an explainable causative factor like the seasons. I know of no reason for this belief other than it is a fair description of a small data set of known events. I know of nothing to stop another pandemic starting now, as long as it is sufficiently genetically distinct from recent exposures.

The next, ongoing, problem is an old one relating to the variability of flus and failure to get over just how radically differently it can present. The public have not grasped that a disease called flu can be as dangerous as either a common cold or Ebola depending which strain you catch. The fact that all previous human pandemics have been caused by LP forms and that HP forms - like HP H5N1 - can infect most cell type and are not limited to the lungs has been understood by very few.

Then there is the 2009 pandemic. This has been a disaster for the preparedness for which so many of us have worked for so long. The residents of California seem to have grasped that each time they have a tremor it does not mean that the seismologists have been lying to them about the fact a big quake will come, they just count themselves lucky that this was not it. The public seem to be taking a rather different view of the pandemic. They seem to think 'you warned us this was coming but it was not as big a deal as you said'. They seem to have misunderstood that the pandemic threat is not only regarding flu, it is ongoing and covers many different types of event. This was a relatively minor event, within the possible range, and has neither the long term potential of a slow burner like HIV or the potential for explosive disruption like SARS or an HP H5N1 pandemic.

The problem now is the 'teachable moment' has past and the public are no-longer listening to pandemic preparedness messages. The message is not that complicated.
This was a pandemic not the pandemic. If you had a small house fire would then cancel your fire insurance?
We got lucky we had a small test of our systems it is clear that they coped with this scale of event but, had we had a virulent strain to deal with, our vaccine production was far too slow and having a single, easily deliverable, antiviral was a massive gamble should resistance emerge.

The other main failing is not really relevant to the the public and is of a more technical nature. A failure to standardise the data collection system. While lots of data was being collected in real-time it was generally not directly comparable or easy to aggregate. There were not clearly pre agreed definitions of suspect cases, confirmed cases, confirmed deaths etc. which made it very difficult to determine if alarming data coming out of one region denoted a mutation effecting virulence or transmissiblity or was due to data collection practices. In one instance a sudden spike in case fatalities turned out to be due to the far quicker publishing of statistics from mortuaries (which had a sample testing fast track) than via the swamped 'suspect cases' lab queue.