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View Full Version : How afraid are you of the Avian/'bird flu'?



banquo's_bumble_puppy
2005-Feb-25, 04:31 PM
How afraid are you of the Avian/'bird flu'? The news stories are getting scarier by the minute. Media hype/or a valid concern?

Nethius
2005-Feb-25, 04:37 PM
not at all, actually i havent even heard of it... then again, i dont watch news. I was about to say, maybe it wasn't around my area, but then I see you live in the same city!

I'm mostly worried about dying of cancer then anything else.

banquo's_bumble_puppy
2005-Feb-25, 04:39 PM
you live in Halifax??? cool lovely day eh?

CTM VT 2K
2005-Feb-25, 04:51 PM
I'm concerned enough to keep tabs on it, but not worried enough to put on my Bio/Chemical warfare suit. As a prudent analyst, I'm watching it, and reading up on what the professionals (Beskeptical, the CDC, et al) are saying/doing about it.

When it comes to things like this, I look at it like the Y2k prep: I'm a Computer Engineer, and was in college in the run-up to Y2k. All sorts of people were worried and fear-mongering (including the Media and certain members of my extended family). I looked around my industry, and saw no real worry or concern. Yes, we expected some problems. No, it wasn't going to be the end of the world - not even close. It wasn't.

I look at the CDC and medical community. If they're worried, it's time to be worried. Otherwise, it's overblown.

frogesque
2005-Feb-25, 04:54 PM
For myself not concerned at all but it could be a problem for me dear old mum who's in her eighties. Avian flu is at the moment only a threat, it's far from a pandemic and IIRC there have been 45 deaths (I won't say only 'cos that's a bit insulting) worldwide so far and the situation is being closely monitored.

ToSeek
2005-Feb-25, 07:41 PM
We're overdue for a 1918-scale flu outbreak. You've got to think we can't hold it off forever.

CTM VT 2K
2005-Feb-25, 07:53 PM
We're overdue for a 1918-scale flu outbreak. You've got to think we can't hold it off forever.

I don't think statsitics and averages quite works that way. 8-[

Doodler
2005-Feb-25, 07:55 PM
Personally, I wouldn't rate a death toll in 1918 terms a pandemic in the modern world. The overall toll will be drastic if there's another outbreak, but we're talking about a world with over 6 billion people on it to 1918's maybe a billion? (Keep in mind, the world's population was 2 billion when Neil left his footprints on the moon.)

W.F. Tomba
2005-Feb-25, 08:15 PM
Personally, I wouldn't rate a death toll in 1918 terms a pandemic in the modern world. The overall toll will be drastic if there's another outbreak, but we're talking about a world with over 6 billion people on it to 1918's maybe a billion? (Keep in mind, the world's population was 2 billion when Neil left his footprints on the moon.)
I thought the population was about 3 billion by the 60s. Anyway, more people in the world means more people to infect, especially if the disease starts in Asia, where population density is extremely high. So if the 1918 flu were released again today, I'd expect it to kill far more people than it did the first time.

beskeptical
2005-Feb-25, 08:32 PM
The media is not blowing it out of proportion, for once. But people tend to interpret what the media reports in different ways.

Avian flu is a very big hazard looming on the horizon. But so is the Cascadia subduction quake hazard, global warming climate based disasters, and many others.

But don't think it isn't a big deal because the 1918 flu pandemic certainly was. Modern medicine may not be advanced enough yet to handle a repeat.

beskeptical
2005-Feb-25, 08:38 PM
We're overdue for a 1918-scale flu outbreak. You've got to think we can't hold it off forever.

I don't think statsitics and averages quite works that way. 8-[Yes they do.

You are saying if we know the average and the range of years between flu pandemics we can't say one is overdue? Why not?

What we have is what looks like the beginning of a new pandemic but we don't know what the beginning looks like for sure. AND we have the historical average time between pandemics. Just one more piece of evidence to consider.

W.F. Tomba
2005-Feb-25, 09:01 PM
We're overdue for a 1918-scale flu outbreak. You've got to think we can't hold it off forever.

I don't think statsitics and averages quite works that way. 8-[Yes they do.

You are saying if we know the average and the range of years between flu pandemics we can't say one is overdue? Why not?

What we have is what looks like the beginning of a new pandemic but we don't know what the beginning looks like for sure. AND we have the historical average time between pandemics. Just one more piece of evidence to consider.
It depends on the situation. If there is some kind of cyclical mechanism that causes A to happen every x units of time on average, then the probability of A happening actually increases as you reach x time since the last occurrence. But if there is no cyclical mechanism, and the average timespan between occurrences is merely a function of the probability of A occurring at any one time, then that probability is always the same no matter when A last happened.

beskeptical
2005-Feb-26, 12:14 AM
.......
It depends on the situation. If there is some kind of cyclical mechanism that causes A to happen every x units of time on average, then the probability of A happening actually increases as you reach x time since the last occurrence. But if there is no cyclical mechanism, and the average timespan between occurrences is merely a function of the probability of A occurring at any one time, then that probability is always the same no matter when A last happened.But there is a reason for the cycle.

When an infectious disease works its way through a population some immunity is conferred. As the population is replaced by new and therefore not previously infected members, the potential for a new epidemic increases each year. With some diseases such as measles, (before vaccines), which does not mutate as readily as flu virus, local epidemics used to occur every 3-5 years. That's how long it took to add enough susceptible members to allow sustained transmission of virus.

With other diseases, these patterns are complicated by the organisms own cycle. As flu virus mutates, there is a potential for deadly combinations of its genetic components. Just as with a coin toss, it may not be predictable which side will face up with each toss, but it is predictable over time you will eventually get the other side.

So the mechanisms of pandemic flu are cyclic for biologic reasons and we are over due. As I said, you take range and average into account. What the longest period between pandemics is is unknown. The fact there is a limit is known. It is not if but when.

W.F. Tomba
2005-Feb-26, 01:19 AM
When an infectious disease works its way through a population some immunity is conferred. As the population is replaced by new and therefore not previously infected members, the potential for a new epidemic increases each year. With some diseases such as measles, (before vaccines), which does not mutate as readily as flu virus, local epidemics used to occur every 3-5 years. That's how long it took to add enough susceptible members to allow sustained transmission of virus.

With other diseases, these patterns are complicated by the organisms own cycle. As flu virus mutates, there is a potential for deadly combinations of its genetic components. Just as with a coin toss, it may not be predictable which side will face up with each toss, but it is predictable over time you will eventually get the other side.
I accept what you say about the cyclical behavior of epidemics, but do we know of a cyclical process for virus mutations? Or do we have evidence that there is one? Even if we don't, it's prudent to consider that there might be one, since cyclical processes are so common in biology. I'm just saying that it's not a given.

As for the coin toss, what you say is true, but note that the number of tosses that have elapsed since you last got heads has no bearing on your chances of getting heads over any future series of tosses. Because there is no cyclical mechanism behind coin tosses, you can never be overdue for heads. (Gambler's Fallacy (http://skepdic.com/gamblers.html))

Edited for clarity.

paulie jay
2005-Feb-26, 01:29 AM
As someone who works part time at Sydney Kingsford Smith International Airport and who comes into personal contact with literally hundreds of people every day from infected areas (a huge percentage of our incoming passengers fly in from Asia) it does concern me. Mind you, we've been aware and on guard against avian flu for over a year now, so it's nothging new to us.


spelling edit

W.F. Tomba
2005-Feb-26, 01:47 AM
I have trouble understanding how anyone could say that the media are blowing this out of proportion. From what I've seen of the national media recently, I've been surprised (and a little worried) at how little coverage there has been. Is there more of it on television or something? (I don't watch TV.)

Lurker
2005-Feb-26, 03:11 AM
I have trouble understanding how anyone could say that the media are blowing this out of proportion. From what I've seen of the national media recently, I've been surprised (and a little worried) at how little coverage there has been. Is there more of it on television or something? (I don't watch TV.)

I have never believed in getting my science from the news media. They are notorious for making mistakes and jumping to the wrong conclusions because sensational stories sell. As a senior systems developer I never believed in y2k and, I agree with some of the others here, I will be worried when the CDC and the medical community are.

W.F. Tomba
2005-Feb-26, 03:35 AM
I have trouble understanding how anyone could say that the media are blowing this out of proportion. From what I've seen of the national media recently, I've been surprised (and a little worried) at how little coverage there has been. Is there more of it on television or something? (I don't watch TV.)

I have never believed in getting my science from the news media. They are notorious for making mistakes and jumping to the wrong conclusions because sensational stories sell. As a senior systems developer I never believed in y2k and, I agree with some of the others here, I will be worried when the CDC and the medical community are.
What would you define as "worried"? Right now, they seem to be saying it's a major threat. They're never going to panic and run screaming through the streets, because they are professionals.

beskeptical
2005-Feb-26, 04:13 AM
When an infectious disease works its way through a population some immunity is conferred. As the population is replaced by new and therefore not previously infected members, the potential for a new epidemic increases each year. With some diseases such as measles, (before vaccines), which does not mutate as readily as flu virus, local epidemics used to occur every 3-5 years. That's how long it took to add enough susceptible members to allow sustained transmission of virus.

With other diseases, these patterns are complicated by the organisms own cycle. As flu virus mutates, there is a potential for deadly combinations of its genetic components. Just as with a coin toss, it may not be predictable which side will face up with each toss, but it is predictable over time you will eventually get the other side.
I accept what you say about the cyclical behavior of epidemics, but do we know of a cyclical process for virus mutations? Or do we have evidence that there is one? Even if we don't, it's prudent to consider that there might be one, since cyclical processes are so common in biology. I'm just saying that it's not a given.

As for the coin toss, what you say is true, but note that the number of tosses that have elapsed since you last got heads has no bearing on your chances of getting heads over any future series of tosses. Because there is no cyclical mechanism behind coin tosses, you can never be overdue for heads. (Gambler's Fallacy (http://skepdic.com/gamblers.html))

Edited for clarity.If you tossed that coin for a sufficient amount of time, you could collect reasonable data of the average time between getting the opposite side and the longest time one has ever gone only getting one side. For gambling and pure random coin tossing, each coin toss has a new 50:50 chance of landing on one side. But for biological systems the range and averages do rely on more than chance. You can often find the patterns before understanding the underlying mechanisms.

Some suggested mechanisms would be the life cycle of flu virus pandemics is such that it not only includes time for the susceptible population of humans to regenerate, but that there is also a pattern in wild birds and domestic poultry interacting with the human outbreaks. These cyclic avian outbreaks occur when they cross the species barrier. So the new viruses have to emerge first in the poultry, spread to ducks, then to pigs then to humans. Each new cycle takes x number of years on average with a range of y years. Once the virus emerges it is more pathogenic until milder versions are naturally selected. (Kills too fast, dies out, host survives, virus passed on.) The range of lethality could be from mild to severe. Any single new pandemic could cause mild or severe disease but the regularity of the pandemics could be very predictable.

What we have now is a pandemic overdue. The lethality might be unknown with each new pandemic but all signs are a doozy is forming.

Archer17
2005-Feb-26, 04:28 AM
I voted "somewhat concerned." IMO this avian flu thing has the potential to be nasty - I'm talking globally, it's already nasty to those in the Southeast Asian countries that are affected by this. The present mortality rates are not good at all.

Besides reading about it on the BBC world news site where cases have been reported for some time now, I haven't seen extensive media coverage about it here in the States besides the recent news items about the WHO and CDC concerns.

Jpax2003
2005-Feb-26, 06:24 AM
Why are you guys arguing when you're in agreement? #-o

I am mildly concerned at the lack of information in the states. When I turned on the 10pm news I saw a large banner that said "flu outbreak", but it turned out to be a status report on the current flu season. I found that odd since they made it out to be a big story, but all they said was that it was status quo for a normal season, but I don't recall them ever running a story on it before. Maybe it's just sweeps week.

The problem with these infectious diseases is that they move through suceptible populations like a fire will burn through a dry field. Isolated populations don't create a pandemic, but right now the population is like bunches of kindling lined up and ready for a big burn. Never doubt Malthus.

However, the regular flu seems to be acting odd this year. Everyone I know seems to have gotten it twice, as if they suffered a relapse about 4 weeks after the initial infection. I caught it on someone's 4 week relapse then got sick again 4 weeks after that. Anyone have the same experience?

W.F. Tomba
2005-Feb-26, 02:46 PM
I am mildly concerned at the lack of information in the states. When I turned on the 10pm news I saw a large banner that said "flu outbreak", but it turned out to be a status report on the current flu season. I found that odd since they made it out to be a big story, but all they said was that it was status quo for a normal season, but I don't recall them ever running a story on it before. Maybe it's just sweeps week.
That's sort of what I was getting at above. It's not that I want the coverage to be alarmist and sensational. I was saying that with all these people choosing the "media blowing it out of proportion" option, they must be seeing very different media than I, since from what I've seen the media are hardly covering it at all!

But I just realized that that's probably a bad interpretation, since there's no other option for "not afraid at all" in the poll, and no one has actually complained about excessive coverage in the thread.

beskeptical
2005-Feb-26, 07:06 PM
.........However, the regular flu seems to be acting odd this year. Everyone I know seems to have gotten it twice, as if they suffered a relapse about 4 weeks after the initial infection. I caught it on someone's 4 week relapse then got sick again 4 weeks after that. Anyone have the same experience?How do you know it was flu?

There are 200+ known organisms that cause upper respiratory infections. During flu outbreaks, you probably have flu if it:Starts rather suddenly.
First with fever >101F.
Then within a day or so, muscle aches, general malaise, anorexia, head ache.
And a day or so after that, cough and respiratory congestion.Most of the usual sore throats and runny nose, cough are not caused by flu viruses.

We had a very late flu season this year that is peaking in terms of numbers of cases right now (http://www.cdc.gov/flu/weekly/weeklyarchives2004-2005/images/usmap7.gif) in the USA.

beskeptical
2005-Feb-26, 07:18 PM
This article (http://story.news.yahoo.com/news?tmpl=story&cid=1507&e=6&u=/afp/20050226/hl_afp/healthfluvietnamconference_050226070331) on yahoo news today is written so you can choose to believe whatever suits you about the risk of flu. If you think the risk is overblown, you'll think the article agrees. If you think the risk is high, the article also agrees. #-o
..but experts admit they have no real idea of the potential impact of the disease."No real idea"? I don't think so. This makes it sound like we have no science rather than good science without certainty in the predictions.

For those of you waiting for the experts to weigh in:
"We at WHO believe that the world is now in the gravest possible danger of a pandemic," the director of World Health Organisation's Western Pacific office, Shigeru Omi, told the conference.

To mobilise media attention on the tsunami is possible," said FAO animal health director Joseph Domenech, referring to the huge sums pledged in the wake of the giant waves that ravaged coastlines around the Indian Ocean in December.

"But to mobilise long term assistance over animal health is more difficult," he said. I would have compared it to trying to mobilise resources for a tsunami warning system before the tsunami.

Jpax2003
2005-Feb-26, 07:30 PM
.........However, the regular flu seems to be acting odd this year. Everyone I know seems to have gotten it twice, as if they suffered a relapse about 4 weeks after the initial infection. I caught it on someone's 4 week relapse then got sick again 4 weeks after that. Anyone have the same experience?How do you know it was flu?I don't know really, I thought I figured out where I got it and what their doctor told them. However, after doing some research last night I wonder if it may not have been a mycoplasma/walking pneumonia. That seems to fit the symptoms better. I'd go see a doc, 'cept my company screwed up my insurance and I'm still waiting for them to reinstate it... and I'm feeling mostly better now. I know doctors like to track infections, but where I grew up, if you weren't bleeding, or if it wasn't broken, or if you weren't on the verge of death, you didn't need to see a doctor.

beskeptical
2005-Feb-26, 08:17 PM
.........However, the regular flu seems to be acting odd this year. Everyone I know seems to have gotten it twice, as if they suffered a relapse about 4 weeks after the initial infection. I caught it on someone's 4 week relapse then got sick again 4 weeks after that. Anyone have the same experience?How do you know it was flu?I don't know really, I thought I figured out where I got it and what their doctor told them. However, after doing some research last night I wonder if it may not have been a mycoplasma/walking pneumonia. That seems to fit the symptoms better. I'd go see a doc, 'cept my company screwed up my insurance and I'm still waiting for them to reinstate it... and I'm feeling mostly better now. I know doctors like to track infections, but where I grew up, if you weren't bleeding, or if it wasn't broken, or if you weren't on the verge of death, you didn't need to see a doctor.Be careful about deciding your symptoms match something you read. You don't know how many other diseases also have those symptoms. You don't know if your understanding of a symptom is the same as the medical description. You don't have access to tests which can help determine additional key signs to make a diagnosis.

There are only a few diseases with what are called pathoneumonic symptoms. That means a certain symptom is always that disease. A chicken pox rash for example is pathoneumonic. You cannot diagnose very much from the medical history alone.

Jpax2003
2005-Feb-26, 08:33 PM
Be careful about deciding your symptoms match something you read. You don't know how many other diseases also have those symptoms. You don't know if your understanding of a symptom is the same as the medical description. You don't have access to tests which can help determine additional key signs to make a diagnosis.

There are only a few diseases with what are called pathoneumonic symptoms. That means a certain symptom is always that disease. A chicken pox rash for example is pathoneumonic. You cannot diagnose very much from the medical history alone.I know, unfortunately most doctors I've met tend to act the same way. Several years ago I went in with symptoms of the flu and he didn't do any tests, just performed a cursory examination and wrote a prescription for antibiotics. I asked him why he was giving me antibiotics for a virus, but he just looked at me and said "do you want something or not?" I think I ended up taking them, as a defense against an opportunistic secondary infection, but he never said anything about that.

You are correct, I can't confirm anything, but I can rule many things out. Best I can do is an educated guess, which is the best I seem to be able to afford anyways. Besides, my guesses are usually right. Docs are always surprised when I tell them what I have and the tests prove me out. They tell me I should have been a doc, and they're right. I should have been (or maybe a pharmacist). BTW, Beskeptical, are you a medical professional? (Not that I doubt your advice, I'm just wondering.)

beskeptical
2005-Feb-26, 09:21 PM
..... BTW, Beskeptical, are you a medical professional? (Not that I doubt your advice, I'm just wondering.)Yes. I am an ARNP, and I specialize in occupational infectious disease hazards.

Pneumonia is almost always accompanied by fever, worse at night, night sweats, and extreme tiredness or shortness of breath. You cannot tell if pneumonia is present without listening to lung sounds and preferably an X-ray to confirm what you think you hear. You cannot 'guess' by your symptoms.

As to the doctor's quick Rx, well, there are a lot of crummy docs out there.

Jpax2003
2005-Feb-27, 12:33 AM
..... BTW, Beskeptical, are you a medical professional? (Not that I doubt your advice, I'm just wondering.)Yes. I am an ARNP, and I specialize in occupational infectious disease hazards.

Pneumonia is almost always accompanied by fever, worse at night, night sweats, and extreme tiredness or shortness of breath. You cannot tell if pneumonia is present without listening to lung sounds and preferably an X-ray to confirm what you think you hear. You cannot 'guess' by your symptoms.

As to the doctor's quick Rx, well, there are a lot of crummy docs out there.hmmm, I looked up to see if I had the cold or the flu and I had symptoms of both. Mild fever, fatigue, swollen nodes, night sweats, chest tightness, throat irritation and hoarseness, unproductive cough turning productive, then stuffy head and headache the whole time. It went away for a few weeks then came back. I still have an occasional non-productive cough and chest tightness... I can breath deep but it feels like the upper bronchial area is tight with what sounds like a bit of wheezing. Did I catch both a cold and a flu at the same time?

beskeptical
2005-Feb-27, 10:51 PM
hmmm, I looked up to see if I had the cold or the flu and I had symptoms of both. Mild fever, fatigue, swollen nodes, night sweats, chest tightness, throat irritation and hoarseness, unproductive cough turning productive, then stuffy head and headache the whole time. It went away for a few weeks then came back. I still have an occasional non-productive cough and chest tightness... I can breath deep but it feels like the upper bronchial area is tight with what sounds like a bit of wheezing. Did I catch both a cold and a flu at the same time?Fever 101F (flu) is not considered mild. Onset matters not just total symptoms. It matters what is prevalent in the community at the time. How do you know the same thing recurred as opposed to a new infection? And finally, you can't say what you have without cultures, other labs, x-rays, and a physical exam. I have said this but you still seem to think you can guess what you have with only half of the pieces.

When a patient comes in with certain symptom clusters one can make an educated guess. Low grade temp, negative strep throat screen and I'd send you home with no antibiotics. I would not recommend you spend a few thousand dollars to identify exactly which virus you had. If your lung sounds indicated, with a stethoscope not with wheezing you hear, I'd get a chest x-ray. If you had pneumonia I'd give that antibiotic even if it was possibly a viral cause because the consequences of not treating would be too risky. Yadda yadda yadda, lots of other scenarios and decision trees yadda yadda yadda. That's what I do based on years of experience and education.

Go to the doctor if your symptoms worry you otherwise don't bother trying to name your infectious agent. You can't do it accurately without labs.

Jpax2003
2005-Feb-28, 03:05 AM
So if identifying the exact strain of virus is expected to cost thousands of dollars, how do they know progression of the flu through the country? Do they actually perform those tests, or are they guessing?

beskeptical
2005-Feb-28, 04:17 AM
So if identifying the exact strain of virus is expected to cost thousands of dollars, how do they know progression of the flu through the country? Do they actually perform those tests, or are they guessing?Depends on which virus you are identifying whether or not there is a cheap commercial lab test or whether or not you have to do extensive DNA testing. Then there is the issue of collecting the specimen, preserving and transporting the specimen.

First comes the research. Viruses are identified after extensive work. For SARS it was the first time a new virus was found so quickly. For HIV it took years to find. Then you can test for that virus with extensive processes and DNA evaluation.

When it is useful to do, next comes development of commercially available tests. Finally, if the market will pay for one comes the availability of less expensive commercial tests.

We do not have those tests for the 100+ viruses that have been identified as sources of respiratory infections. So identification of the majority of them is only done for research. Your doctor cannot order the test. That would cost you thousands of dollars to do without an inexpensive commercial test.

For influenza there is a commercially available test that costs about $100.oo. It is useful if you are deciding to prescribe Tamiflu since you need to start it on the first day of symptoms for it to do any good. As far as flu monitoring goes, the CDC, WHO and other countries' equivalent of the CDC all collect samples from what are called sentinel sites. Those samples are tested for flu and a small percentage of them are subtyped as to the specific strains. By doing the sampling and monitoring other things like school absenteeism it is possible to determine when flu outbreaks are occurring. This endeavor costs thousands of dollars per total specimens of flu detected since the majority of tested specimens are always 'not flu.'

It's time for you to quit asking me and do some research on your own since you seem to think I am making the answers up.

Jpax2003
2005-Feb-28, 05:46 AM
It's time for you to quit asking me and do some research on your own since you seem to think I am making the answers up.I never wrote that and I don't think that.

I thought I had an answer and you suggested I was wrong, so you doubted me first. As I wrote in a previous post, I thought I knew who I got it from and since I got sick with the same symptoms immediately thereafter, and that person's doctor told them it was the flu. You're right that I could be mistaken, but it seemed fairly straightforward. Besides, I did some research, but you told me it wasn't helpful and that I would need to see a doc for an accurate diagnosis anyways, except that a specificity test would probably not be needed and treatment would be based on examination of symptoms instead of pathogenic identification. At least that's how it appeares from my perspective. I don't doubt your expertise and likely correct judgement in the issue, but I think this is a common experience non-healthcare people have with medical professionals. I'm sorry if you think I am trying to argue with you. I'm not. But I'm running a fever again and it tends to make me irritable.

beskeptical
2005-Feb-28, 08:37 AM
It's time for you to quit asking me and do some research on your own since you seem to think I am making the answers up.I never wrote that and I don't think that.

I thought I had an answer and you suggested I was wrong, so you doubted me first. It sounded like you were being sarcastic when you said, "if identifying the exact strain of virus is expected to cost thousands of dollars, how do they know...." And, I didn't doubt you, I knew you were wrong. You are talking my area of expertise. But don't take it the wrong way. I'm sure there are plenty of things you know more about than I do, this just isn't one of them.


As I wrote in a previous post, I thought I knew who I got it from and since I got sick with the same symptoms immediately thereafter, and that person's doctor told them it was the flu. You're right that I could be mistaken, but it seemed fairly straightforward.This wasn't your fault. It's the fault of 99% of the doctors who don't take the time to explain anything to their patients.


Besides, I did some research, but you told me it wasn't helpful and that I would need to see a doc for an accurate diagnosis anyways, except that a specificity test would probably not be needed and treatment would be based on examination of symptoms instead of pathogenic identification. At least that's how it appeares from my perspective. That's true. But you didn't go to a doctor. You kept guessing what you might have.


I don't doubt your expertise and likely correct judgement in the issue, but I think this is a common experience non-healthcare people have with medical professionals. I'm sorry if you think I am trying to argue with you. I'm not. But I'm running a fever again and it tends to make me irritable.And I was crabby from not enough sleep so I'm sorry as well.

Triggers that cause people to see a doctor include failure to get well in the expected time. Maybe you do need to see someone. You could have a secondary infection caused by bacteria that were able to infect you after a virus set the situation up. It is possible though, you've just been unlucky enough to get two things in a row.

jora
2005-Oct-29, 11:15 PM
Really the Bird flu is very critical problem it causes lots of casualties in most of the countries .A large number of population is affected due to this disorder .Especially in Asia this is in very serious form .It needs to be control .Actually this is viral disease so it spreads easily .Relenza is the medication which is mostly used in that situation.

Please see the link for more...

http://www.drugdelivery.ca/s33713-s-RELENZA.aspx

The Admiral
2005-Oct-29, 11:41 PM
Well, remember the killer bees? We are all supposed to be dead of bee stings by this time. Then there was the whatever it was called when all the worlds computers were going to crash at midnight at the beginning of this century creating utter chaos from which we could never recover. But we are here. Then the Goat sucker was working it's way north and was going to kill all the cattle on it's way, but I'm still eating steak.

We are, however, suffering from one plague that those on this board recognise, but which the less enlightened, even though highly educated public cannot recognise. I, of course, am refering to the ignorance and superstition that lurks under the euphemism, religion. Intelligence and education seem inneffective against this disease. I call it the SWI syndrome, for Selective Wilfull Ignorance.

Is there any hope? Is there balm in Gilead? I don't think so. I'm glad I'm not young anymore.

The Admiral

Dr Nigel
2005-Oct-30, 12:11 AM
As I understand this, the potential for a major threat is definitely there. There are a great many birds dying of a very virulent influenza virus (identified as H5N1, referring to sequence motifs in two of the virus's surface proteins). The virus has infected people and has killed people, but its current form does not seem able to pass from person to person.

However, if the virus mutates in such a way as to become transmissible from person to person, or if a person becomes infected with both the avian H5N1 and a human influenza virus at the same time (in which case they could recombine into a new form that has the H5N1 virulence and the ability to pass from person to person), then the threat will become very real very quickly.

There are several "if"s and "could"s there, but the time to act is now, because there will not be time after the virus has mutated. Avian H5N1 has arrived in the EU (at least one of the Greek islands in the Aegean, and a bird held in quarantine upon its arrival in the UK). Be concerned, but don't panic.

Arneb
2005-Oct-30, 12:20 AM
I voted "not afraid" - I'm a doctor, not a poultry farmer in southeast Asia. Otherwise, I would have voted very concerned, and rightly so.

But ask me again if/when the first human-to-human outbreak of more than anecdotal proportion comes up. Then we are talking fear.

fossilnut2
2005-Oct-30, 12:32 AM
One thing i do when there's this type of nebulous discussion is look at the location of the posters. With a couple exceptions, Americans often seem more 'frightened' or concerned about general threats....whether it be bird flu, the guy on the street corner, terrorism, etc. Non-americans (like me) take a bit more of a stand-off attitude and express a little more skepticism that things aren't quite as dire as they may seem in the media. No need to lock the door, invade a country or worry about where to line up for vaccine.

Now I admit that Avian flu and related topics are not my forte and my opionion of the actual flu bug isn't worth 2 cents. I just wouldn't get too worked up, however, by the way the American press presents impending crisis or doom and gloom scenarios.

beskeptical
2005-Oct-30, 06:01 AM
Seems to be a lot of opinion here about risk. How about considering the science instead of the news for your sources of information?

I don't walk in fear of the next Cascadia subduction zone earthquake but that doesn't mean I don't believe the next one is as inevitable as the last 10. Clearly the geological science is overwhelmingly predicting the next one sometime most likely in the next 200 or so years.

Who cares what the news reports? Name one recent event when the majority of reporters got the science right.

Pandemics have occurred regularly in history for many reasons which I will not bother to rehash. There will be another one and more after that until medical science advances a bit more.

We did avert the SARS pandemic that would have most certainly occurred had medical science not been as advanced as it currently is. The things which came into play that were not present in history were international cooperation and a level of treatment capability in countries such as China and Vietnam that were not previously there. In addition, the ability to identify the infectious agent in a matter of months and then contain all cases and contacts had not previously been done before.

Now we are closely following a potential mega-pandemic in its earliest phases. This hasn't been done before so we have, 1) the news media reporting all sorts of non-scientific stuff in nonscientific ways, and, 2) no idea if these early phases are going to continue or fade away and on what time table.

At the same time, a flu pandemic will not be as containable as SARS because there will be too many persons with mild or no symptoms that will spread the virus. With SARS, since everyone infected was critically ill, there was no problem isolating and tracing contacts of those afflicted. (There were problems with effective isolation but those problems were eventually overcome.)

The current status of this potential pandemic is the disease has now moved into huge numbers of birds that are both being transported and smuggled long distances as well as into huge numbers of migrating birds whose migration ranges overlap in such a way as to take this virus to all corners of the planet in the next few months. We were unsuccessful containing it despite several very thorough attempts in 1997 and 1999 when it was still a localized disease in China. Containment was completely lost by 2003 and just since July of 2005, the virus spread beyond Asia across Eastern Europe in a very short time. The virus is expanding its territory on a logarithmic scale.

Bird species of all types, pigs and many members of the cat family have been infected as well as a few humans.

So, the virus is deadly, infects multiple species, is now widespread and is very soon to be worldwide. All attempts to stop its spread have failed. The number of chances for both mutations to occur and for more human contact with the virus is increasing exponentially. That is the science, not the news.

I'm not losing any more sleep over it than I am worrying about the inevitable next great earthquake my hometown will eventually experience. But I am certainly taking it seriously and working on plans to deal with it when the time comes. It would be foolish to overreact but also foolish chalk it up to media hype and ignore the possibility.

WaxRubiks
2005-Oct-30, 09:53 AM
would it be possible for a human to contract this flu but to be immune to it and so spread it more effectively. I know that some people are immune to the AIDS virus.

jkmccrann
2005-Oct-30, 10:35 AM
would it be possible for a human to contract this flu but to be immune to it and so spread it more effectively. I know that some people are immune to the AIDS virus.

I think in fact that these `lucky` folk are in fact the people who cause the most problems on a societal level. It really is unfortunate that those who perhaps have least to fear (although of course people don't know this sort of thing in advance), are in fact the vectors from which others have most to fear. An interesting paradox if you will.

eburacum45
2005-Oct-30, 02:08 PM
Both my paternal grandparents died in the 1918 epidemic, so this interests me somewhat.

Seems to be a lot of opinion here about risk. How about considering the science instead of the news for your sources of information?
snip---
Pandemics have occurred regularly in history for many reasons which I will not bother to rehash.

Sorry to be skeptical, Beskeptical (well not really skeptical, just curious); but how rigorous is the evidence for a long term cycle, and how would it operate in the modern demographic situation?

The world is much more populous than ever before; that means more people, and quite possibly many more domestic fowl; do you think that will have an influence on thse cyclic nature of this sort of pandemic?

Trebuchet
2005-Oct-30, 04:38 PM
I was surprised this thread dated back to February since I hadn't seen the media take much notice until the last month or so. Now they're screaming about it.

My answer to the original question would be:
More than the media concern a year ago. Much less than the media concern now. And more than the media concern in six months or so when they'll haved forgotten it and moved on to something else.

beskeptical
2005-Oct-31, 11:49 PM
would it be possible for a human to contract this flu but to be immune to it and so spread it more effectively. I know that some people are immune to the AIDS virus.No one has been found to be completely immune to HIV-AIDS. Be careful what you read.

There is a genetic mutation that makes it difficult to get infected with HIV and if you inherit 2 copies, one from each parent, you have a lot of resistance but it turns out the virus can still infect even those people.

There are also what are termed "slow progressors" who have gone a long time with HIV that hasn't progressed to AIDS but those folks are still infected.

Lots of people will have 'bird flu' (H5N1 strain) and may have no symptoms at all if past experience is any indication. They can spread the infection after an incubation time. They may not be the most 'effective' spreaders though. But silent spreaders create different problems.

beskeptical
2005-Nov-01, 12:04 AM
Both my paternal grandparents died in the 1918 epidemic, so this interests me somewhat.


Sorry to be skeptical, Beskeptical (well not really skeptical, just curious); but how rigorous is the evidence for a long term cycle, and how would it operate in the modern demographic situation?

The world is much more populous than ever before; that means more people, and quite possibly many more domestic fowl; do you think that will have an influence on thse cyclic nature of this sort of pandemic?There are multiple factors that make for cycles of disease. It isn't just that viruses or bacteria have some cycle of pandemics.

Some organisms cause epidemics in waves. That usually has to do with the fact they 'burn themselves out of fuel' so to speak. When enough people have been infected the chain of spread can no longer be sustained. After a few years pass there is a whole new crop of susceptible people born into the population. When the numbers reach enough for sustained transmission we have a new epidemic.

Some epidemics occur when certain conditions come together. Since those conditions recur, epidemics recur but each new one may not be related to past epidemics.

The 1918 flu pandemic occurred because conditions came together, but there may also have been such time since any previous pandemic that the majority of the population was susceptible. That is the condition we are facing now as well. And, yes, the conditions today, while different than 1918, may have the same result in easy spread of disease around the world. The close monitoring may have an impact on the human cases but we have been unable to stop the animal cases (birds) despite watching it happen.

beskeptical
2005-Nov-01, 12:05 AM
I was surprised this thread dated back to February since I hadn't seen the media take much notice until the last month or so. Now they're screaming about it.

My answer to the original question would be:
More than the media concern a year ago. Much less than the media concern now. And more than the media concern in six months or so when they'll haved forgotten it and moved on to something else.I may have posted something on this as far back as 1997 on the BABB forum IIRC. :)