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May 11, 2005

It's serious, Klaus

Guest post by Revere

In a news story to appear in tomorrow's  Nature  (May 12), it is reported WHO has received no samples of bird flu virus (influenza A/H5N1) from poultry for close to eight months. We have been reporting the dozens of  human cases, primarily in Vietnam but also Cambodia here (see left sidebar for links to many posts), but of those, only six samples capable of producing sequence data have been obtained by WHO, and of those six, several have shown mutational change of concern. WHO's UN sister agency, the Food and Agriculture Organization (FAO), has not obtained animal samples for months either, and according to WHO, hasn't been sharing what they have, so WHO is trying to obtain samples independently in Vietnam, Cambodia and Laos.

Knowledge of the genetic make-up of circulating virus provides a critical warning sign regarding an impending pandemic. The countries involved have resource and facility limitations but also may wish to control information because of impact on trade and tourism. We recently posted on the testing problem and suggested pressure or incentives be applied to increase cooperation.  Nature also reports Vietnam may ship a large number of samples to the WHO flu center at CDC sometime soon. It's a start but it hasn't happened yet. The situation is urgent. WHO needs to get it in gear.

Several of the six H5N1 isolates contain a mutated form of the virus, but with so few samples to work on, it is impossible to judge how worried to be, says Klaus Stöhr, coordinator of the WHO's flu programme. "It's as if you hear a noise in your car engine, but you keep driving, not knowing whether it's serious."

Memo to Klaus: It's serious.

[Cross-posted on Effect Measure]


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So bottom line this for an only nominal science geek: are these mutations making it easier for it to jump species, or making it more deadly to humans?

And if that is the case, why isn't every public health organization in the known world currently at red alert?

mojo sends

The mutations involved concern the polybasic cleavage site in the HA gene which has gotten shorter. This makes it easier to infect cells. In the north of Vietnam the lethality has gotten less but the clusters more numerous and perhaps increased in size. These are all warning signs that mutations have occurred to make human to human transmission easier. At Effect Measure we have been following all this carefully. Look in the left sidebar for the bird flu posts (there are over 100) and most are relatively non-technical.

Some national public health assoc. and govts (UK for example) have moved into action. Not the case here, however. Absent leadership in public health for the most part and an administration that cares more about phantom terrorists than real threats.

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