We could put it like this: the virus has now moved from candidate to member status.

Greece said on Monday it had detected one turkey with birdflu on the eastern Aegean island of Chios, becoming the first EU country where the virus has spread to.The ministry said the turkey came from a small private poultry farm of about 20 turkeys on the tiny island of Inousses off Chios which belongs to the Chios prefecture.”It was a small farm with about 20 turkeys. But any transport of birds, people, vehicles and eggs has been forbidden.”

The small farm bit seems to confirm Olivers point (above).

One, this virus still isn’t transmitted from human to human directly. As long as that hasn’t happened it means more time can be invested in creating vaccines and other preventive measures.

Two, this is still a flu virus, not some sort of super ebola. Even a normal flu vaccine should offer some protection.

Three, it’s good there’s more awareness among the general public about a (possible) pandemic but the way it’s represented by the press now is like of one the four riders of the apocalypse is planning a world tour. Good for headlines but not the way how one should keep things in perspective.

Certainly not, please go ahead :).

“Quarantines do not”

I think what he is talking about is punitive quaranteening. Voluntary targeted quarantines form an important part of an effective public health policy.

There’s some very good sense from a biologist here on what works and what doesn’t for H5N1. Quarantines do not. Every man for himself does not. A vaccine will, but present means of distribution even in the rich countries needs work.

Edward, would you mind if I add a link to this article as an update to the main entry?

Romania’s Agriculture Ministry said Saturday that British lab tests confirmed that the deadly H5N1 strain of bird flu had been found in Romania.

Agriculture Ministry spokesman Adrian Tibu said agriculture and veterinary officials were holding an emergency meeting Saturday morning with Interior Ministry officials and local leaders to decide how to respond to the outbreak.

Matbe this is a bit subjective, but I can’t help getting the feeling that Turkey has actually responed more rapidly and more effectively to the situation than Romania has.

“Industrial agriculture is good”

I never said it wasn’t, my point was that the huge increase in animal and human populations means that the rate of viral mutation accelerates due to the size of the host populations, in this sense comparisons with 1918 (when everything was on a much smaller scale) are not applicable.

Industrial agriculture has its pluses and minuses, but obviously we would have no hope of feeding 9 billion people without it.

Industrial agriculture is good. If one of these animals gets ill, there will be a veterinary to diagnose the virus and the population will be killed off. Furthermore, in that setting fowl and pigs are not reared together. The problem are poor farmers in Asia who have to work even if ill and own only a few animals of both kinds.

Obviously I think we all agree, the difficult part is knowing what to do to get ready, since you can’t prepare an effective vaccine till you know the strain (if it ever evolves). And there is a danger of overkill in public awareness, since if the health authorities push too hard this year, and then the problem arises next year, or the year after.. then you may not get the same response.

So being prepared in an effective sense may be hard and Oliver’s points about good procedures for isolating cases, following up, ring fencing etc will be important. In this sense SARS was an important dry run, and many parts of Asia did fairly well eventually and will have learnt a lot.

“But flu is a far bigger danger than SARS because it moves so much faster.”

This is one of the important points, it is the transmission mechanism which is everything, and flu obviously moves from one human to another fairly easily. Sars was much more containable.

“A PAIR of dice, rolled again and again, will eventually produce two sixes. Similarly, the virus that causes influenza is constantly changing at random and, one day, will mutate in a way that will enable it to infect billions of people, and to kill millions.”

Well yes, but in this case a lot (really a lot) of days might be needed. OTOH the large chicken and pig populations the planet currently supports due to industrial agriculture means that there are a lot more shakes of the dice. I mention pigs since they seems to be considered to be a favourable host where a strain which is transmissible from human to human might develop. So the line would be from birds to pigs (who are of course often in large numbers in close proximity to poultry) and then from pigs to humans. All in all, not a good time to be a farmworker.

Up to a point. We cannot depend on being able to contain a pandemic. If that fails, we need to use the standard techniques of public health, like finding contact persons, banning public gatherings, etc…

Incidentally, here is the downside of a high participation in the labor force. Closing schools and kindergartens will really hurt today.

“A PAIR of dice, rolled again and again, will eventually produce two sixes. Similarly, the virus that causes influenza is constantly changing at random and, one day, will mutate in a way that will enable it to infect billions of people, and to kill millions. Many experts now believe a global outbreak of pandemic flu is overdue, and that the next one could be as bad as the one in 1918, which killed somewhere between 25m and 50m people. Today, however, advances in medicine offer real hope that another such outbreak can be contained—if governments start preparing now.

New research published this week (see article) suggests that a relatively small stockpile of an anti-viral drug—as little as 3m doses—could be enough to limit sharply a flu pandemic if the drugs were deployed quickly to people in the area surrounding the initial outbreak. The drug’s manufacturer, Roche, is talking to the World Health Organisation about donating such a stockpile.”

This is good news. But much more needs to be done, especially with a nasty strain of avian flu spreading in Asia which could mutate into a threat to humans. Since the SARS outbreak in 2003 a few countries have developed plans in preparation for similar episodes. But progress has been shamefully patchy, and there is still far too little international co-ordination.

Rich countries tend to be better prepared than poor ones, but this should be no consolation to them. Flu does not respect borders. It is in everyone’s interest to make sure that developing countries, especially in Asia, are also well prepared. Many may bridle at interference from outside. But if richer nations were willing to donate anti-viral drugs and guarantee a supply of any vaccine that becomes available, poorer nations might be willing to reach agreements over surveillance and preparedness.

Simply sorting out a few details now will save lives (and recriminations) later. Will there be enough ventilators, masks and drugs? Where will people be treated if the hospitals overflow? Will food be delivered as normal? Too many countries have no answers to these questions.

Get moving

Given how much money rich countries have spent on preparing for bioterror attacks, it is surprising how little attention they have paid to the possibility of a flu pandemic, which may be likelier and which, if it happens, would probably kill more people. The costs of buying more anti-viral drugs, investing in vaccines, preparing national responses and forging an international plan would not be very high, but these things could make all the difference.

Some suggest that SARS was a useful warning. And yet it has left many with the unfortunate impression that, even after a bit of bungling, a new disease can be easily contained. But flu is a far bigger danger than SARS because it moves so much faster. So, too, must the world’s governments if they are to prevent death on a massive scale.”