ZURICH (Reuters) - Swiss drug firm Roche said on Tuesday it had reached a deal with Africa's top generic drugs firm Aspen Pharmacare to produce a generic version of flu treatment oseltamivir, also known as Tamiflu. The deal will speed up production and increase the availability of oseltamivir as governments rush to prepare for the possibility of a pandemic outbreak of avian influenza, Roche said. "The agreement with Aspen is focused on providing oseltamivir for pandemic use to further help to address the needs of governments and other not-for-profit organisations in the African sub-continent," Roche said. As part of the deal, Roche will provide API -- the active pharmaceutical ingredient used in oseltamivir production -- to Aspen. No financial details were released. Roche declined to comment on earnings implications.
Warning bird flu may decimate workforce
May 16, 2006 - 1:54PM
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A bird flu pandemic could sideline up to 40 per cent of the
Australian workforce and businesses must prepare for an outbreak,
an infection specialist has warned.
Avian flu is any flu caused by a virus adapted to birds. It is also called bird flu, avian influenza and bird influenza.
The only known such viruses are Influenzavirus A. All subtypes (but not all strains of all subtypes) of this species are adapted to birds, so for many purposes avian flu virus is the Influenza A virus (the "A" does not stand for "avian").
As of 2006, "avian flu" is being commonly used to refer to the H5N1 subtype of Influenza A virus, the world's major flu pandemic threat.
In an article in the Iranian, titled it's not the flu, Iqbal Latif raises the prospect that Avian flu may be the latest scares that merely frighten populations but in actuality is much ado about nothing. He writes. 'If one starts testing wild ducks and goose for viruses, one will definitely find some. These ducks and wild birds have lived with flu and viruses since time immemorial, we are here with our longevities that we ever enjoyed as humans race and huge increase in migratory populations of birds as a result of natural selection of species that can survive that change the best. Look at the American national symbol, the bald eagle, it has been rescued from the brink of extinction and from the status of endangered it is now listed as threatened, soon it is expected that it will be delisted. Avian flu threat amongst human beings would only erupt if there is a massive flu amongst birds and the bird migratory patterns may see a clear decline.'
Avian influenza viruses do not normally infect species other than
birds and pigs. The first documented infection of humans with an avian influenza
virus occurred in Hong Kong in 1997, when the H5N1 strain caused severe
respiratory disease in 18 humans, of whom 6 died. The infection of humans
coincided with an epidemic of highly pathogenic avian influenza, caused by the
same strain, in Hong Kong’s poultry population.
Extensive investigation of that outbreak determined that close
contact with live infected poultry was the source of human infection. Studies at
the genetic level further determined that the virus had jumped directly from
birds to humans. Limited transmission to health care workers occurred, but did
not cause severe disease.
Rapid destruction – within three days – of Hong Kong’s entire
poultry population, estimated at around 1.5 million birds, reduced opportunities
for further direct transmission to humans, and may have averted a pandemic.
That event alarmed public health authorities, as it marked the
first time that an avian influenza virus was transmitted directly to humans and
caused severe illness with high mortality. Alarm mounted again in February 2003,
when an outbreak of H5N1 avian influenza in Hong Kong caused 2 cases and 1 death
in members of a family who had recently travelled to southern China. Another
child in the family died during that visit, but the cause of death is not
known.
Two other avian influenza viruses have recently caused illness in
humans. An outbreak of highly pathogenic H7N7 avian influenza, which began in
the Netherlands in February 2003, caused the death of one veterinarian two
months later, and mild illness in 83 other humans. Mild cases of avian influenza
H9N2 in children occurred in Hong Kong in 1999 (two cases) and in mid-December
2003 (one case). H9N2 is not highly pathogenic in birds.
The most recent cause for alarm occurred in January 2004, when
laboratory tests confirmed the presence of H5N1 avian influenza virus in human
cases of severe respiratory disease in the northern part of Viet Nam.
Based on historical patterns, influenza pandemics can be expected
to occur, on average, three to four times each century when new virus subtypes
emerge and are readily transmitted from person to person. However, the
occurrence of influenza pandemics is unpredictable. In the 20th century, the
great influenza pandemic of 1918–1919, which caused an estimated 40 to 50
million deaths worldwide, was followed by pandemics in 1957–1958 and
1968–1969.
Experts agree that another influenza pandemic is inevitable and
possibly imminent.
Most influenza experts also agree that the prompt culling of Hong
Kong’s entire poultry population in 1997 probably averted a pandemic.
Several measures can help minimize the global public health risks
that could arise from large outbreaks of highly pathogenic H5N1 avian influenza
in birds. An immediate priority is to halt further spread of epidemics in
poultry populations. This strategy works to reduce opportunities for human
exposure to the virus. Vaccination of persons at high risk of exposure to
infected poultry, using existing vaccines effective against currently
circulating human influenza strains, can reduce the likelihood of co-infection
of humans with avian and influenza strains, and thus reduce the risk that genes
will be exchanged. Workers involved in the culling of poultry flocks must be
protected, by proper clothing and equipment, against infection. These workers
should also receive antiviral drugs as a prophylactic measure.
When cases of avian influenza in humans occur, information on the
extent of influenza infection in animals as well as humans and on circulating
influenza viruses is urgently needed to aid the assessment of risks to public
health and to guide the best protective measures. Thorough investigation of each
case is also essential. While WHO and the members of its global influenza
network, together with other international agencies, can assist with many of
these activities, the successful containment of public health risks also depends
on the epidemiological and laboratory capacity of affected countries and the
adequacy of surveillance systems already in place.
While all these activities can reduce the likelihood that a
pandemic strain will emerge, the question of whether another influenza pandemic
can be averted cannot be answered with certainty.
WASHINGTON (AP)--The nation's first vaccine against bird flu is only modestly
effective, producing apparent protection in slightly over half the people who
receive two mega-dose shots, initial testing shows. The worrisome findings
underscore the urgency of brewing a better vaccine.
The bird flu virus, known as A(H5N1), belongs to a group of influenza viruses
known as Type A, which are the only ones that have caused pandemics. It has been
steadily advancing around the world, first appearing in Asia, then Europe and
Africa. The apparent lethality of A(H5N1), combined with its inexorable spread,
are what have made scientists take it seriously. The virus lacks just one trait
that could turn it into a pandemic: transmissibility, the ability to spread
easily from person to person. If the virus acquires that ability, a worldwide
epidemic could erupt.
When a Disease Loses Its Most Potent Ally, Fear
Katharina Hesse/Getty Images, left; Jean-Christophe
Kahn/Reuters
STORM BEFORE THE CALM A quarantined medical
worker wears a protective mask against SARS in Beijing in 2004, and mad cow
testing in western France in 2000. Both diseases are now seen as less of a
threat.
ANCHORAGE, Alaska -- Federal scientists have started testing migratory birds for signs of a dangerous bird flu that could show up on this continent this spring.
As bird flu spreads across parts of Asia, Africa and Europe, public jitters are growing about the potential for a flu pandemic closer to home. So far, not a single case of the virulent strain of Avian flu -- which has caused about 100 deaths in other parts of the world -- has been reported in the United States.
Lance Peterson, a professor of pathology and medicine at Northwestern University, said the Avian virus is predominantly in Asia and Africa, in agricultural areas with large chicken populations. Peterson said it could be months or years before the virus reaches the United States and for now the virus can't be caught by human transmission.
The Spanish Flu Pandemic, also known as La Grippe Espagnole, La Pesadilla, or the 1918 flu, was a
pandemic caused by an unusually
severe and deadly strain of the subtype H1N1 of the species Influenza A virus. In that pandemic, 50
million to 100 million people worldwide were killed during about a year in 1918 and 1919 [1].
The Allies of World War I called it the
"Spanish Flu". This was mainly because the pandemic received greater
press attention in Spain than in the rest of the world, as Spain was not involved in the war and there was no
wartime censorship in Spain.
One theory is that the virus strain originated at Fort Riley, Kansas, by two genetic mechanisms — genetic drift and antigenic shift — in viruses in poultry and
swine which the fort bred for local consumption. But evidence from a recent
reconstruction of the virus suggests that it jumped directly from birds to
humans, without traveling through swine.
In February 1998, The Molecular
Pathology Division of the US Armed
Forces Institute of Pathology (AFIP) recovered samples of the 1918 influenza
from the frozen corpse of a Native Alaskan woman buried for nearly eight decades
in permafrost near Brevig Mission, Alaska. Brevig Mission lost approximately
85% of its population to the Spanish flu in November 1918. One of the four
recovered samples contained viable genetic material of the virus. This sample
provided scientists a first-hand opportunity to study the virus, which was
inactivated with guanidinium thiocyanate before
transport. This sample and others found in AFIP archives allowed researchers to
completely analyze the critical gene
structures of the 1918 virus.
Flu epidemics. Influenza tends to occur in epidemics. Each outbreak is
caused by a virus slightly different from the earlier ones. Scientists often
name the different strains (types) of the virus after the place where the
strain was first identified. For example, A/Sydney/97 refers to a type A
influenza strain that was first identified in Sydney, Australia, in 1997.
One of the worst global epidemics, called a pandemic, of influenza
occurred in 1918-1919. In this pandemic, known as the Spanish flu, about 20
million people, including more than 500,000 Americans, died. In 1957-1958, a
strain called Asian flu caused a pandemic, as did the Hong Kong flu in
1968-1969. In each instance, the pandemics have been caused by new subtypes of
the type A influenza virus.
The 1918 influenza virus, one of the
most lethal viruses of all time, has been
raised from the dead—literally. During the week of October 3, 2005, a group of
researchers published two reports (one in Science and one in
Nature) detailing how they sequenced the genetic code of the virus using
DNA fragments from
preserved tissue samples more than 80
years old. They then used the information to reconstruct the virus in a lab.
Though some believe that the risks of the research outweigh the benefits, others
have hailed the group's work as a tremendous breakthrough. In addition to
helping reveal why the 1918 pandemic was so deadly, the
information gleaned from the study may yield powerful new weapons in the fight
against avian flu.
In March 1918, an Army cook in Fort Riley, Texas reported to the camp
hospital with symptoms of fever, headache and sore throat. By the end of the
day, more than 100 soldiers had visited the camp hospital with similar
complaints, and within two days, more than 500 had fallen ill. During the
summer, the infection grew more deadly; in August, an extremely lethal version
of the virus broke out simultaneously in the United States, France and Sierra
Leone. Over the course of the next year, the pandemic spread around the world,
often killing as many as one third of the people it infected. Most of the flu's victims were otherwise healthy people between 15 and 34
years old. Known by various names, including the Spanish Flu Pandemic, the Great
Influenza Pandemic, the 1918 Flu Epidemic and La
Grippe, the viral outbreak killed an estimated 50 million people in a number of
months. By contrast, the AIDS epidemic has killed
about 25 million people over the course of 25 years.
In addition to the risk of the virus escaping, there is a concern that it
could be used as a biological weapon. Taubenberger and Tumpey plan to publish
the flu's genetic code in a public database called
GenBank, giving almost anyone with the necessary tools the information needed to
synthesize the virus. As Ebright told Nature, "There most definitely is
reason for concern. Tumpey et al have constructed, and provided
procedures for others to construct, a virus that represents perhaps the most
effective bioweapons agent now known."
Not so, unfortunately, for the H5N1 avian flu, which
appears poised to spark the next global epidemic. Flu
experts hope that decoding the 1918 bug may help generate new ways to fight
H5N1. Already, researchers have found that replacing the polymerase genes
significantly reduces the flu's virulence. Furthermore,
now that they know which amino acid changes to watch for, scientists can monitor
the mutations of the H5N1 flu far more efficiently. In
a joint statement, Fauci and Julie Gerberding, the directors of the NIAID and
the CDC, respectively, told the Times, "The new studies could have an
immediate impact by helping scientists focus on detecting changes in the
evolving H5N1 virus that might make widespread transmission among humans more
likely."
At the United Nations Assembly on September 14, 2005, President George W. Bush
announced a new International Partnership on Avian Influenza [See Bush Addresses Assembly, September
2005].. As the President stated in his address, "The Partnership requires
countries that face an outbreak to immediately share information and provide
samples to the World Health Organization. By requiring transparency, we can
respond more rapidly to dangerous outbreaks and stop them on time. Many nations
have already joined this partnership; we invite all nations to participate. It
is essential we work together."
Influenza Epidemiology; Spanish influenza-related mortality from 1918-19 associated with class difference
But many struck by Spanish influenza in that same month of October, 1918, perished in the prime of their lives. In Kitchener, Waterloo and area, households lost their breadwinners, parents buried babies and even physicians fell ill and died.
The flu pandemic killed more than 20 million people worldwide. It was unwittingly transported to North America by soldiers returning home from The First World War.
Experts say the threat of another flu pandemic is now at its highest level since the last, much less severe one struck in 1968. There is fear that the H5N1 virus, or bird flu, now circulating in many countries could be the source of the next one, in part because it has some genetic similarities to the 1918 virus.
Since 2003, the H5N1 virus has killed more than 103 people. But the dead were in direct contact with infected birds. The worry is that the virus will find a way to jump easily from human to human, sparking a global pandemic.
This study explores media portrayal of collective "American anxiety" by examining magazine coverage of a domestic crisis that should have made Americans anxious, the 1918 influenza epidemic, to seek references to anxiety, and to try to understand why this scourge, which killed more people than did World War I, has been lost to public memory. The coverage suggests that the nature of epidemic itself offers clues to why it has been virtually "forgotten." It had no beginning or end, no definable enemies, no amplified heroes who fit an early twentieth-century male definition of the concept, and no institutionalized commemoration,
Study of the coverage of three influenza pandemics examined the social construction of influenza over time. Applying three broad frames to 835 New York Times articles, the study demonstrated that the social construction of influenza did change over time, and that these changes were reflected in public-health policy frames. This research demonstrates how the popularization of science changed the social construction of disease in America.
The History of Influenza Pandemics
Pandemics occur on average 3 times a century, and the last pandemic due to influenza A was over 50 years ago (Monto, 2005; WHO, CSR, 2005a). The 20th century had three influenza pandemics: the 1918 "Spanish flu" previously mentioned; and two less lethal pandemics, the 19571958 "Asian flu," an H2N2 virus that killed 70,000 people in the united States; and the 1968-1969 "Hong Kong flu," an H3N2 influenza A virus that killed 34,000 people in the U.S. and resulted in world-wide health and economic disruption (CDC, 2005d). The last two pandemics resulted in deaths primarily in the traditional at-risk groups, the elderly, and infirmed; but the 1918 pandemic and the current H5N1 infections have shown a higher mortality in the otherwise healthy young child and young adult (WHO, CSR, 2005a; Writing Committee of the World Health Organization [WHO] Consultation on Human Influenza A/H5, 2005).
The World Health Organization has labeled the current H5N1 situation a "Phase 3 Pandemic Alert," (human infection with a new subtype has occurred but no, or limited, human-to-human spread) (WHO, CSR, 2005c). Phase 4 of the Pandemic Alert would involve small clusters of humanto-human transmission with only localized spread and the hope of containment, while Phase 5 would involve larger clusters of human infections and the scientific belief that the virus is more compatible to human transmission (WHO, CSR, 2005c). Phase 6 is the pandemic phase with sustained transmission in the general population.
Although the world is better prepared today to monitor and attempt to control a new pandemic, the lack of a recent viral pandemic similar to the H5N1 influenza A virus means that the world population has little to no preexisting natural immunity to protect against this serious illness. A pandemic of even moderate severity is estimated to affect a quarter of the U.S. population (67 million), with almost 550,000 deaths, and 2,358,000 hospitalizations (Trust for America's Health, 2005). The health care costs in the United States alone have been estimated to be $181 billion for a moderate pandemic (Neergaad, 2005), with the World Bank estimating the loss of $800 billion in gross domestic production world-wide if a pandemic strikes (Brahmbhatt, 2005). Even industrialized countries like the United States would be overwhelmed by the burden on the health care system, lack of adequate intensive care facilities, respirators, medications, medical supplies, and healthy health professionals able to provide care. A pandemic, by definition, affects the whole world, and consequently all nations would be affected, and the usual effort by developed countries to assist less developed countries in time of disaster may not be possible or a political priority.
Homeland Security Chief: Bird Flu Could Migrate to U.S. Soon |
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