Article to peruse on migration

Nation
Bird migration set to bring flu to U.S., experts warn
Wire reports
Tucson, Arizona | Published: 03.09.2006

Avian flu is likely to spread to birds inside the United States by midyear and could produce an epidemic among humans "at any time," said the U.N. official who monitors global efforts to fight the disease.
Wild birds migrating over the Arctic Circle from Africa and Europe in the next few months would carry the H5N1 virus to Alaska, said the official, David Nabarro, a physician with the World Health Organization.
The virus probably would be carried to the rest of the United States six months later when other birds that picked it up in Alaska migrated south.
The prediction, the first by a top global health official pinpointing when birds carrying the flu will reach the lower 48 states, was buttressed Wednesday by U.S. officials who said testing for bird flu will expand dramatically.
The federal government is planning to test five to six times as many birds this year alone as it has screened since 1998.
Much of the effort will focus on Alaska, where scientists worry that birds arriving from Asia — beginning next month — will bring in the H5N1 virus and pass it along to other birds, which will fly south this fall.
Scientists already had been watching for the deadly flu strain in wild birds in Alaska and North American migratory flyways. But the effort is being dramatically stepped up this year, said John Clifford, chief veterinarian for the U.S. Department of Agriculture, which is working with other agencies on the program.
Scientists will study live birds, others that are found dead or killed by hunters, and environmental samples that might carry the worrisome form of bird flu.
The goal is to test 75,000 to 100,000 live or dead birds this year, said Angela Harless of the USDA. At the same time, Clifford said, officials will continue to monitor other activities that may introduce the virus to the United States: importing and smuggling of birds.

There's the rub...

Handwashing. We have been told to do it since we were tiny children. We know we need to wash our hands before we eat or after we use the restroom. Handwashing is an extremely effective way of preventing colds and flu, but only when done effectively and only when done on a frequent basis. Children today are taught to sing the verses of "Row, Row, Row your boat" or of the alphabet song " A,B,C,D,E,F,G..." in order to promote handwashing for the proper amount of time.

From the CDC website:
The most important thing that you can do to keep from getting sick is to wash your hands.

By frequently washing your hands you wash away germs that you have picked up from other people, or from contaminated surfaces, or from animals and animal waste.

What happens if you do not wash your hands frequently?
You pick up germs from other sources and then you infect yourself when you

• Touch your eyes
• Or your nose
• Or your mouth.

One of the most common ways people catch colds is by rubbing their nose or their eyes after their hands have been contaminated with the cold virus.

You can also spread germs directly to others or onto surfaces that other people touch. And before you know it, everybody around you is getting sick.

The important thing to remember is that, in addition to colds, some pretty serious diseases -- like hepatitis A, meningitis, and infectious diarrhea -- can easily be prevented if people make a habit of washing their hands.

When should you wash your hands?
You should wash your hands often. Probably more often than you do now because you can't see germs with the naked eye or smell them, so you do not really know where they are hiding.

It is especially important to wash your hands

• Before, during, and after you prepare food
• Before you eat, and after you use the bathroom
• After handling animals or animal waste
• When your hands are dirty, and
• More frequently when someone in your home is sick.

What is the correct way to wash your hands?

• First wet your hands and apply liquid or clean bar soap. Place the bar soap on a rack and allow it to drain.
• Next rub your hands vigorously together and scrub all surfaces.
• Continue for 10 - 15 seconds or about the length of a little tune. It is the soap combined with the scrubbing action that helps dislodge and remove germs.
• Rinse well and dry your hands.

It is estimated that one out of three people do not wash their hands after using the restroom. So these tips are also important when you are out in public.

I now carry the liquid hand sanitizer in my car, as well as antibacterial baby type wipes. After going to the bank, the grocery store or the pharmacy, I wash my hands before staring to drive. Since I wear glasses, I am very conscious now of how often my hands go my face, and I have increased my handwashing in response to this.

The other place I am becoming a little obsessive about cleanliness is at work. I work with many other people coming in contact with the surfaces that I touch. I start out my workday, by cleaning the phone, the computer and keyboard, the desk and other items that I know I will be touching throughout my shift. I place a fresh box of Kleenex on the desk, so everyone can use and cover the sneezes or coughs. (If you do not have tissue, the proper way to cough is into your elbow area, not into your hands. Your hand will take the germs from your cough and pass it to the next surface they touch). To clean surfaces at work I use an antibacterial wipe that comes prepackaged in individual packs, but any good cleanser and rubbing will reduce the germs markedly. Good way just to prevent colds from spreading. Dont't forget wash your hands frequently!

ANOTHER FIRST FOR CALIFORNIA

Bird-Flu Pandemic Would Likely Start in California
03.30.06, 12:00 AM ET

THURSDAY, March 30 (HealthDay News) -- If a bird-flu pandemic does hit the United States, it may well start in California and spread across the country in just two to four weeks.

And the best way to slow its spread would be to have workers stay at home.

That's the scenario drawn from results of a computer model created by researchers at the U.S. National Institutes of Health's Fogarty International Center. And while the results of that computer model should be interpreted with caution, it is based on data from ordinary flu epidemics for the last three decades, said study author Dr. Mark A. Miller, associate director for research at the center.

"The unique feature of this model is that it challenges conventional wisdom, which says that flu is spread by children bringing it back to the household," Miller said. "That may be true at the household level, but regionally it is spread by adults."

That's why measures to keep people at home could slow the spread of infection, Miller said. Another finding in the study is that states with large populations, such as California, are more likely to reach epidemic levels of the flu at the same time than less-populous states, where transmission tends to be more erratic, he said.

So California, the most populous state, would be the most logical place for a pandemic to start, Miller said. Another factor pointing toward California is that bird -- also called avian -- flu is expected to arrive from Asia, he said.

As for the speed of spread, the estimate is based on ordinary epidemics. "What we see is that epidemics with more pathogenic viruses spread more quickly, two to four weeks versus five to seven weeks for less pathogenic viruses nationwide," Miller said.

The findings appear in the March 31 issue of the journal Science.

The Fogarty researchers used epidemiological data on seasonal flu epidemics that have occurred yearly in the United States since 1972. They connected that information with data from the Census Bureau and the federal Department of Transportation, looking at variations in yearly epidemics from state to state and links with local flows of people to workplaces.

Bird flu is pathogenic, but it does not yet spread easily from person to person; close exposure to an infected bird is needed to cause a human infection. The danger will come when, and if, a mutation makes human-to-human transmission easy.

Since 2003, the H5N1 bird flu virus has been detected in 45 countries in Africa, Asia, and Europe. More than 100 people have died after coming into contact with infected poultry.

The model developed by the Fogarty researchers can go just so far in predicting what might happen if such a mutation occurs, Miller said. This model notably doesn't include previous pandemics, just ordinary epidemics, and a pandemic might have different characteristics, he said.

Still, the model can help plan for ordinary, predictable epidemics by showing how they start and spread, Miller said. It's also not the first of its kind, he said: "We did a similar model to explain the spread of measles."

More information

For more on bird flu, visit the U.S. Centers for Disease Control and Prevention.

Not so good, so far

Sanofi-Aventis Aims to Fix Bird-Flu Vaccine, Now 53% Effective

March 30 (Bloomberg) -- Sanofi-Aventis SA said improving its bird-flu vaccine is a priority after a study found an early version of the product was only about 50 percent effective.

The U.S. Department of Health and Human Services has spent $250 million to date on avian-flu vaccine, mostly from Sanofi, HHS spokesman William Hall said in an interview yesterday. The agency is hoping to stockpile enough vaccine for 20 million people. The new study results released yesterday means the supply of vaccine ordered by the U.S. will protect only about 4 million people, Hall said

At the dose that worked best in the study, the vaccine triggered a protective immune response in 53 percent of test subjects, researchers reported in today's issue of the New England Journal of Medicine released late yesterday.

Improving the vaccine is ``a top priority for our company,'' said Len Lavenda, a spokesman at Sanofi's vaccine unit in Swiftwater, Pennsylvania. ``We want to protect as many people as possible, as soon as possible. To conclude that this result is as good as it gets would be premature, at least.'' He said Sanofi, based in Paris, is also planning to add production capacity.

At least 186 confirmed cases of H5N1 avian flu have occurred in humans since late 2003, and 105 persons died, said the World Health Organization. Most victims evidently had contact with infected birds or their blood or excrement.

Confirmed Cases

The amount of vaccine needed to protect about half of recipients in the study was so high that existing labs worldwide could produce only enough to supply about 1.3 percent of the world's population, wrote Gregory Poland, 50, head of the vaccine research group at the Mayo Clinic College of Medicine in Rochester, Minnesota, in a journal commentary.

As a result, Poland wrote, the effectiveness of the vaccine was ``poor to moderate at best,''

The vaccine studied, which was based on a virus collected in Vietnam in 2004, didn't cause any ``severe'' side effects, the study said. All of the subjects have been given a third dose whose effect isn't known yet, said researcher John Treanor, 51, an infectious-diseases physician at the University of Rochester in upstate New York.

Bird Flu Defies Control Efforts
The culling of flocks has failed to slow the rapid spread of the virus, due in North America this year. Vaccination of poultry is under study.

By Jia-Rui Chong, Times Staff WriterMarch 27, 2006

The spread of avian influenza to at least 29 new countries in the last seven weeks — one of the biggest outbreaks of the virus since it emerged nine years ago — is prompting a sobering reassessment of the strategy that has guided efforts to contain the disease.Since February, the virus has cut a wide swath across the globe, felling tens of thousands of birds in Nigeria, Israel, India, Sweden and elsewhere. Health officials in the United States say bird flu is likely to arrive in North America this year, carried by wild birds migrating thousands of miles to their summer breeding grounds.
The speed of its migration, and the vast area it has infected, has forced scientists to concede there is little that can be done to stop its spread across the globe."We expected it to move, but not any of us thought it would move quite like this," said Dr. David Nabarro, the United Nations' coordinator on bird flu efforts.

From the WHO website:

Why are pandemics such dreaded events?
Influenza pandemics are remarkable events that can rapidly infect virtually all countries. Once international spread begins, pandemics are considered unstoppable, caused as they are by a virus that spreads very rapidly by coughing or sneezing. The fact that infected people can shed virus before symptoms appear adds to the risk of international spread via asymptomatic air travellers.
The severity of disease and the number of deaths caused by a pandemic virus vary greatly, and cannot be known prior to the emergence of the virus. During past pandemics, attack rates reached 25-35% of the total population. Under the best circumstances, assuming that the new virus causes mild disease, the world could still experience an estimated 2 million to 7.4 million deaths (projected from data obtained during the 1957 pandemic). Projections for a more virulent virus are much higher. The 1918 pandemic, which was exceptional, killed at least 40 million people. In the USA, the mortality rate during that pandemic was around 2.5%.
Pandemics can cause large surges in the numbers of people requiring or seeking medical or hospital treatment, temporarily overwhelming health services. High rates of worker absenteeism can also interrupt other essential services, such as law enforcement, transportation, and communications. Because populations will be fully susceptible to an H5N1-like virus, rates of illness could peak fairly rapidly within a given community. This means that local social and economic disruptions may be temporary. They may, however, be amplified in today’s closely interrelated and interdependent systems of trade and commerce. Based on past experience, a second wave of global spread should be anticipated within a year.
As all countries are likely to experience emergency conditions during a pandemic, opportunities for inter-country assistance, as seen during natural disasters or localized disease outbreaks, may be curtailed once international spread has begun and governments focus on protecting domestic populations.

What are the most important warning signals that a pandemic is about to start?
The most important warning signal comes when clusters of patients with clinical symptoms of influenza, closely related in time and place, are detected, as this suggests human-to-human transmission is taking place. For similar reasons, the detection of cases in health workers caring for H5N1 patients would suggest human-to-human transmission. Detection of such events should be followed by immediate field investigation of every possible case to confirm the diagnosis, identify the source, and determine whether human-to-human transmission is occurring.
Studies of viruses, conducted by specialized WHO reference laboratories, can corroborate field investigations by spotting genetic and other changes in the virus indicative of an improved ability to infect humans. This is why WHO repeatedly asks affected countries to share viruses with the international research community.

What is the status of vaccine development and production?
Vaccines effective against a pandemic virus are not yet available. Vaccines are produced each year for seasonal influenza but will not protect against pandemic influenza. Although a vaccine against the H5N1 virus is under development in several countries, no vaccine is ready for commercial production and no vaccines are expected to be widely available until several months after the start of a pandemic.
Some clinical trials are now under way to test whether experimental vaccines will be fully protective and to determine whether different formulations can economize on the amount of antigen required, thus boosting production capacity. Because the vaccine needs to closely match the pandemic virus, large-scale commercial production will not start until the new virus has emerged and a pandemic has been declared. Current global production capacity falls far short of the demand expected during a pandemic.

Getting ready to get ready

Since I have been working on getting together my emergency supplies for the past few weeks, I thought now would be a good time to discuss. My emergency kit will work for a terrorist attack, an earthquake (likely where I live) or a pandemic flu, if it comes. It would be easy to gather supplies if you had money to spare and space to put them in, but most of us do not have those luxuries. On my sidebar I have included websites which offer many different lists of supplies that you should have. No one list seems to be the same as another. I can just share mine with you and tell you that the cost was not overwhelming, although I would rather have spent the money on other things.

Water. Water. Water. More Water.

This seems to be the recurring theme from all the emergency preparedness sites. At first I was thinking just to use bottled water, the 5 gallon kind from the delivery truck. I realized that it would be a huge waste of money, as some of the use is not for drinking, but for washing, cleaning, laundering and doing dishes. I found Coleman plastic water containers at several stores. I purchased mine through Amazon, just because they always come through in a timely fashion. If you Google search for Coleman water containers, stores are available all over. I bought the 5 gallon jugs. I purchased 10 of them for my non-drinking water supply. I filled them with tap water, after cleaning, and stored them on the back patio. These containers should probably be dumped and refilled after 3 to 6 months, but remember this is not drinking water!

Don't forget the other places in your house that have water stored, such as the water heater and the toilet tanks. Water can be decontaminated using household bleach (unscented). There are purification kits, but I'll just use bleach for mine.

My drinking water supply is going to be the bottled water. I have "hoarded" seven 5 gallon bottles of drinking water. I also purchased at Costco the 24 bottle boxes of individual bottled water. I have about 5 of these collected so far. These are stackable and do not take up to much space, so again, they are stored on my patio, under a tarp. Don't forget the pets when you are planning your water consumption needs. My dogs are my family too, so I need to provide for them. (Who can forget the heartrending pictures following Katrina of survivors and their animals?)

I am figuring, that if some type of quarantine exists and we do not leave the house for an extended period of time, I do not need to do laundry for quite awhile. Since nothing would be wrong with our clothes, sheets,underwear and the like, we could use them until it becomes necessary to wash clothes. I think water would be quite precious, and if you don't know how long you need to make it last, do not waste it. I read recently that you should drink the necessary amount of water and not try to save water by rationing it. If you run out, you will just need to find more. If you become too dehydrated by rationing water, you won't be able to go out and find it. Made a lot of sense to me.

Since I live in the traffic jammed Southern California area and since I spend a lot of time in my car, I keep bottled water in the car at all times. I used to just keep one flat, now I keep two (48 bottles). My car also has a change of clothes, a good pair of walking shoes and a backpack. I'll walk if I have to in order to get home.

Tomorrow I'll get into supplies (non-food items). Any comments on the water ideas?

Acceptance is the Key

The avian flu virus (H5N1) pictured on the right is currently affecting birds and other wildlife in many parts of the world. No confirmed cases have been seen in the United States or Canada. However, wild bird migration this spring will probably bring the disease home. It still is not a human disease, only a bird virus. If the avian flu comes to my homestate of California, plans are in place to deal with it. The states have been mandated to come up with plans to deal with this crisis and you can find information on your own states plan at the department of public health for your state.

I need to go to work tonight (12 hour shift at a local hospital critical care unit). One thing I plan to do this week is find out what my employers plans are for the possible (likely) pandemic. Do they have drugs for us health care providers to take, is there food and water stored, etc. Bad answers could lead me to want to stay home in my house where I have prepared some.

Avian influenza

Pretty well accepted now that avian influenza will come to the United States via the migratory birds. The real question is whether the virus will mutate and become capable of infecting humans. Then will it really cause a pandemic flu? Will millions of people sicken and die. Will society as we know it truly be disrupted? Some good news out last week indicates that it may not be easy for human beings to contract avian flu. NPR has a thorough look at avian flu with stories current and from the last year. They offer this study to demonstrate the difficulty in transmission the virus faces.

Taken directly from the World Health Organization Website: Ten things you need to know about pandemic influenza.

Is bird flu another Y2K scare?

I really don't think that it is. For the last 6 weeks or so I have been following closely the news about outbreaks and deaths from bird flu. For the most part, the people (including children), who have died have been intimately involved with chickens or other sickened birds (swans in 7 deaths). The news reveals that cats have been infected with the fatal form of H5N1 and housecats and tigers have died from this. Several cats in a kennel in Germany have tested positive. One dog at least has died. Swans, ducks,and other wild birds are migratory, so they are bringing the disease home with them. On the pandemic flu website, sponsored by the CDC, there is a map of North American bird migration flight paths. Pretty spooky to me.

I was initially confused about what exactly we are dealing with disease wise. I don't sleep with chickens, or pluck feathers from dead swans, or drink duck's blood, so I felt I really did not need to worry about bird flu. Turns out I was very wrong and I am glad I did some research. I utilized the Communicable Disease Center of the United States and the World Health Organization's websites along with multiple news reports and websites dedicated to emergency preparedness. I would like to briefly share what I have learned and then tell you what I have done to prepare for the pandemic flu. If it does not come this year from the birds, we will have a pandemic sometime soon. As far as preparing goes, most of us live someplace where there could be a natural disaster, so preparing for bird flu, also prepares us for earthquakes, flood, hurricaines, etc. To say nothing about preparing for a terrorist attack. I don't think I am that much different than other Southern Californians, I have experienced several large earthquakes and really have done nothing to prepare for them.

What you need to know and understand in order to prepare your family for a possible emergency. According to the CDC:
Avian flu is caused by avian influenza viruses, which occur naturally among birds.

Pandemic flu is flu that causes a global outbreak, or pandemic, of serious illness that spreads easily from person to person. Currently there is no pandemic flu.
Seasonal flu is a contagious respiratory illness caused by influenza viruses.
Probably most of us have had seasonal flu. We get it from someone else, usually by touching a contaminated item and spreading it to ourselves. People do die of the flu every year. The difference between an outbreak of the flu and a pandemic flu is the number of people involved. Pandemic flu in 1918 was called the Spanish flu. A Stanford website offers these numbers:

"The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe" the influenza of 1918-1919 was a global disaster."

Other flu pandemics have followed this killer. According to Wikipedia, which has some excellent information on its website:http://en.wikipedia.org/wiki/Pandemic

• The "Asian Flu", 1957–58. An H2N2 caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.
• The "Hong Kong Flu", 1968–69. An H3N2 caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968 and spread to the United States later that year. Influenza A (H3N2) viruses still circulate today.

Today we are faced with another pandemic virus. Currently according to the WHO we are at a level 3 which means that the scientists have seen some changes in the virus AND THERE HAVE BEEN CASES OF POSSIBLE HUMAN TO HUMAN TRANSMISSION. The bird flu has spread faster than was anticipated and is now affecting birds (both wild and farmed) in many countries. The CDC continually updates information on the locales affected and has information posted here.

More tomorrow.

Number 1 dog

Thought I'd share my Charlie with you. She is officially an American Staffordshire Terrier, but you know her as a pit bull. She is a very sweet and loving dog, but boy are her jaws and teeth strong. To say nothing of her ability to pull things. I just went out in the back yard and found her digging holes to China in the flower bed. I don't have a clue what she is looking for.

Inolesco debuts.

I finally decided to bite the bullet and share my words with all the others of the blogosphere. Some of the things I plan to cover are the war in Iraq (I support it and Presdent Bush), the upcoming flu pandemic and what I am doing about it, the joys of life in Los Angeles and my animals (dogs and cats). I have a feeling I may end up sharing some of the trials and tribulations of my job too.

I'll do my best to post some good, thinking links to other bloggers. I will never forget that humor is essential to my well-being, so occasionally there may be a link to something cute or funny I or others have found on the web. If you need to be serious all the time this blog is probably not for you. If you want to have a debate about an issue, it probably is for you.

Funny, I planned to name my blog Eureka! only to find it was taken. Therefore it is INOLESCO which is Latin for to grow in or on. I plan on growing in this sphere and learning as I go along. I will probably make some mistakes, but I will learn and grow.