BIRD FLU UPDATE: THE REPORT FROM ISIS

1
1. There follows below a critique of the overdeveloped Bird Flu Alarm by
ISIS, the The Institute of Science in Society

2. Appended below is a URL reference to "Fuss and Feathers - Pandemic
Panic over the Avian Flu" By Michael Fumento in The Weekly Standard,
November 21, 2005. This looks is a breathtaking 9 page piece of
investigative journalism with lots of pics - including two chicken
cartoons - as attached hereto.

3. What has been learned as a result of the worldwide critical appraisal
of the pandemic of undue alarms?

[An aside: Authorities must be thinking 'damned if we do; damned if we
don't'.
But heads only roll in the event warnings ignored result in deaths
deemed to be attributed to ignored warnings.
Such is the 'blame' game ]
------------------------------------------------------------------------
The Institute of Science in Society

< https://www.i-sis.org.uk>


Science Society Sustainability https://www.i-sis.org.uk

General Enquiries sam@i-sis.org.uk sam@i-sis.org.uk> Website/
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Director m.w.ho@i-sis.org.uk m.w.ho@i-sis.org.uk>
UNSUBSCRIBE HERE < https://www.i-sis.org.uk/mailinglist/unsubscribe.php>


*This article can be found on the I-SIS website at
https://www.i-sis.org.uk/WTBFP.php *


ISIS Press Release 11/05/06


Where's the Bird Flu Pandemic?

/The hype over bird flu pandemic has greatly profited the drug
industry with
little sign of an effective vaccine or cure /


/Dr. Mae-Wan Ho /

* Sources < https://www.i-sis.org.uk/full/WTBFPFull.php> for this
report are
available in the ISIS members site. Full details here
< https://www.i-sis.org.uk/membership.php>*


Bird flu pandemic could kill up to 150 million and lose US$800 billion

Top UN public health expert Dr. David Nabarro of World Health
Organisation (WHO) warned in September 2005 that a mutated bird flu
virus pandemic could kill up to 150 million people [1]. He was just
taking up his appointment as the new UN
coordinator to lead a global drive to counter a human flu pandemic.
Nabarro said that with the “almost certainty” of another influenza
pandemic soon, and with experts saying there is a high likelihood of the
H5N1 virus mutating, it would be “extremely wrong” to ignore the serious
possibility of a global outbreak.

The 1918 influenza pandemic killed more than 40 million; the range of
deaths in the next pandemic could be anything “between 5 and 150
million, ” Nabarro said.

The World Bank issued its own dire warning that economic losses due to
pandemic bird flu could top US $800 billion [2].

In a letter to the nation, president George W. Bush announced his
National
Strategy for Pandemic Influenza Preparedness and Response [3], which is
determined to detect outbreaks that occur anywhere in the world, to
protect the American People by stockpiling vaccines and antiviral drugs,
and improve the US' ability to rapidly produce new vaccines against a
pandemic strain, and to be ready to respond at the federal, state and
local levels in the event that a
pandemic reaches the USA.

Because a pandemic could strike at any time, President Bush requested
$7.1
billion in emergency funding , which includes $251 million to detect and
contain outbreaks before they spread around the world; $2.8 billion to
accelerate
development of cell-culture technology; $800 million for development
of new
treatments and vaccines; $1.519 billion for the Departments of Health
and Human Services and Defense to purchase influenza vaccines; $1.029
billion to stockpile antiviral medications; and $644 million to ensure
that all levels of government are prepared to respond to a pandemic
outbreak.

In January 2006, the United States announced in Beijing China that it
would
provide $334 million to support the global campaign against the avian
flu virus [4]. This funding is part of a broader commitment of the
United States that
totals £3.98 billion recently appropriated by Congress.


“There is no pandemic flu in Louisiana”

But by 15 April 2006, Dr. Julie Gerberding, head of the Centers for
Disease
Control and Prevention, told a conference of 1 200 of mostly health
department officials from across the state of Georgia gathered in Tacoma
that [5] there is no evidence bird flu will be the next pandemic and
there is “no evidence it is evolving in a direction that is becoming
more transmissible to people.”

This was in sharp contrast to the November letter from President Bush,
which encouraged the public to prepare the nation and the world “to
fight this
potentially devastating outbreak of infectious disease.” The president's
letter created so much anxiety that the audience at the Tacoma
conference wanted to know about buying surgical masks and stockpiling
food at question time.

Gerberding and other federal officials said H5N1 bird flu is likely to
reach the United States; but when that happens, “it does not signal the
start of a
pandemic” or a threat to the food supply, said Richard Raymond, an
undersecretary at the US Department of Agriculture.

Less than a week later, a press release for the ‘Louisiana State Summit'
carried the headline: “There Is No Pandemic Flu in Louisiana” [6]. “Flu
season is coming to an end, and there have not been any widespread
outbreaks of the flu in
Louisiana. Nor have there been any confirmed cases of avian flu in human
in the United States. Finally, although there has been much attention,
there has not been a flu epidemic, much less a flu pandemic.”

The flu pandemic is yet to happen. The number of human cases of bird flu
has been rather modest so far – 204 with 113 deaths over three years
(see Box 1) - in comparison with the most recent pandemic SARS, which
made 8439 ill and killed 812 in just four months in 2003 [7]. Part of
the reason is that while SARS was transmitted from person-to-person,
bird flu is still transmitted from infected poultry to people.

But we are told that this could change at any time. The H5N1 virus could
gain the ability for human transmission by mutation or by picking up the
right genes (see “Fowl play in bird flu”, this series).


Box 1


Global status of bird flu [8, 9]


*Domestic poultry *

There have been 4253 outbreaks since 2003 in 28 countries in Asia,
Europe, and Africa: Topping the list are: Vietnam (2 312, 54.4 percent),
Thailand (1 078, 25.3 percent), Indonesia (209, 4.9 percent), Turkey
(176, 4.1 percent) Russia (121, 2.8 percent), and People's Republic of
China (79, 1.9 percent).


*Human *

There have been a total of 204 cases of H5N1 bird flu resulting in 113
deaths.

*Country*



*Cases*



*Deaths*

------------------------------------------------------------------------
--------
------------------------------------------------------------------------
--------

*Vietnam *

93 42

*Indonesia *

32 24

*Thailand *

22 14

*China*

17 12

*Turkey *

12 4

*Egypt *

12 4

*Azerbaijan *

8 5

*Cambodia*

6 6

*Iraq*

2 2
------------------------------------------------------------------------
--------

------------------------------------------------------------------------
--------

------------------------------------------------------------------------
--------

*Total*



*204*



*113*

**


The bird flu hoax

Dr. Joseph Mercola, who runs a popular health website, has been
referring to “the bird flu hoax” [10] ever since Bush first announced
his National Strategy in early October 2005. The hoax was perpetrated,
Mercola and others claim, to justify the huge sums of money given away
to pharmaceutical corporations to make vaccines and antiviral drugs.

There is currently no effective vaccine against H5N1, or indeed against
any new strain of viruses such as the influenza virus, which mutates and
evolves
rapidly. Last August, the US National Institutes of Health (NIH)
announced
preliminary results of a H5N1 vaccine trial [11]. But the vaccine was
only
effective at such large doses of the flu antigen (90 m g compared to the
usual 15 m g) that critics said even if the entire US vaccine production
capacity were employed, it could produce enough only for 15 million
people, or barely 5
percent of the US population .

But the US government had already bought 2 million of the H5N1 vaccine
from the company Sanofi Pasteur based in Pennsylvania; and intended to
buy 20 million more. The test results meant that would provide
protection for 333 000 to 3.4 million people, far short of the original
20 million goal.

So, it is down to treatments with antiviral drugs such as ribavirin
(action not understood) and inhibitors of the viral neuraminidase -
oseltamivir and
zanamivir – sometimes used in combination with corticosteroids. Other
drugs such as amantadine, which targets the viral protein M2, an ion
channel needed for the viral particle to become uncoated once it is
taken into the cell [12], are often not effective [13]. The presence of
amino acid residue Asp31 in the M2 protein of H5N1 virus invariably
confers resistance to amantadine treatment, so
oseltamivir or Tamiflus (brand name) appears to be about the only
treatment (see Box 2). It does not cure or prevent the disease, however.

Recently, H5N1 viruses with an aminoacid substitution in neuramindase
that
confers high-level resistance to oseltamirvir have been isolated from
two of eight Vietnamese patients, and both died despite early initiation
of treatment in one patient.

Nevertheless, US Defence Secretary Donald Rumsfeld, for one, has made
more than $5 million out of bird flu by selling shares in the biotech
firm that discovered and developed Tamiflu [14]. Tamiflu is being bought
up in massive amounts by governments all over the world in anticipation
of a pandemic. More than 60
countries have ordered large stocks.


Box 2


What is Tamiflu?

Tamiflu is practically the only drug against bird flu. A website run by
Swiss drug giant Roche describes Tamiflu as “The #1 doctor-prescribed
flu medicine”, recommended to be taken within the first two days from
the onset of flu symptoms [15].

Tamiflu is the brand name for oseltamivir, an antiviral that acts by
inhibiting the viral enzyme neuraminidase as an analogue of it
substrate, thereby
preventing new viruses emerging from infected cells [16]. It does not
cure or prevent the disease, but claims to prevent death.



The drug was developed by a California biotech company, Gilead Sciences,
and is now made and sold by pharmaceutical giant Roche, which pays a
royalty on every tablet sold, amounting to about a fifth of its price.

Rumsfeld was on the board of Gilead from 1988 to 2001, and was its
chairman from 1997. He left to join the Bush administration in 2001, but
retained a huge
shareholding. The firm made a loss in 2003, the year before concern
about bird flu started. Then revenues from Tamiflu almost quadrupled to
$44.6 million.
Sales almost quadrupled again, to $161 million last year and the share
price trebled.

Rumsfeld sold some of his Gilead shares in 2004, resulting in capital
gains or more than $5 million, according to the financial disclosure
report he is obliged to make each year, which also showed that he still
held up at least $25 m worth of shares.

Roche's sale of Tamiflu was forecast to reach £1 billion by 2007.
Patients will need two 75 mg capsules a day for five days, costing a
total of £60-£100 [17].

Britain has ordered 14.6 million courses at £180 m, enough for a quarter
of the population. Germany has ordered 6m doses. France, New Zealand and
Norway planned to purchase enough to treat 20 to 25 percent of their
population.

Indeed, “experts are still predicting that the world will soon face a
flu
pandemic,” and ‘summits' such as the one in Baton Rouge, Louisiana, are
held in each state to ensure the entire country is ready for a
widespread outbreak of the flu [6].

**To reinforce this message, an article was published online 28 April
2006 in /Nature /, on strategies for mitigating an influenza pandemic
based on
simulations with a mathematical model [18]. The researchers found that
border restrictions and/or internal travel restrictions are unlikely to
delay spread by more than 2-3 weeks unless they are more than 99 percent
effective. Closing
schools during the peak of a pandemic can reduce the peak attack rates
by up to 40 percent, but it would have little impact on overall attack
rates. Case
isolation, or household quarantine could have a significant impact on
reducing overall attack rates. Treatment of clinical cases can reduce
transmission, but only if antivirals are given within a day of symptoms
starting.

The researchers also found that given enough drugs for 50 percent of the
population, household-based prophylaxis (taking drugs in advance of
being ill) coupled with school closure could reduce clinical attack
rates by 40 to 50
percent. Vaccine stockpiled in advance of a pandemic could significantly
reduce attack rates even if the vaccines are of low (70 percent)
efficacy.

Those results are good news for the drug companies; the bird flu hoax
lives on.

**


Bird flu disease in humans

Highly pathogenic avian influenza virus subtype H5N1 first caused
disease in 18 patients with 6 deaths in Hong Kong in 1997.

A family of five from Hong Kong visited Fujian province in Mainland
China on 26 January 2003. The two year-old daughter developed high fever
and respiratory symptoms two days after arriving there and died of a
pneumonia-like illness
seven days after the onset of symptoms. The family returned to Hong Kong
on 9 February. The father, a 33 year-old, was admitted on 11 February
after suffering fever and malaise for four days, as well as sore throat,
cough with
blood-stained sputum and bone pain. He had low lymphocyte count and
evidence of consolidation in the right lower-lobe of the lung. He died
six days after
admission. Influenza A subtype H5N1 was identified, and autopsy revealed
oedema, haemorrhage and other evidence of lung disease characteristic of
severe
pneumonia. No other organ showed signs of disease.

On 12 February, the family's previously healthy 8-year-old son was
admitted
after three days with an influenza-like illness and symptoms similar
to the
father. He said he had close contact with live chickens during his
visit to
China. He recovered.

The patients with H5N1 disease had unusually high serum levels of
chemokines (signalling molecules of the immune system), and fits in with
a previous report that the H5N1 virus induces large amounts of
pro-inflammatory cytokines from macrophage cultures, suggesting that
cytokine dysfunction, a ‘cytokine storm contributes to the H5N1 disease
[18, 19].

According to conventional wisdom, avian influenza viruses generally have
little affinity for human respiratory tissues, because the
haemagglutinin (HA) on the surface of the virus prefers carbohydrate
side chains on the cell surface
receptors that end in SA- a -2,3-gal, whereas the HA of human influenza
viruses prefer those terminating in SA- a -2,6-gal.

Genetic analysis indicates that H5N1 is basically an avian virus [20],
and its HA has affinity for SA- a -2,3-gal, although isolates from birds
and humans show genetic differences indicating that the virus has
changed on infecting humans.

In mammals including humans, influenza A viruses that can replicate are
generally recovered only from the superficial epithelium of the
respiratory
tract, reflecting the anatomical distribution of trypsin-like proteases
that cleave the viral haemagglutinin, which is an essential step for
making new
replicating viruses in the infectious process. In contrast, cleavage of
the H5 haemagglutinin tends to be independent of the anatomical
distribution of
protease, because of the insertion of a run of basic amino acids at the
cleavage site. This is characteristic of the HA of all highly pathogenic
avian influenza viruses, and may contribute to the tendency of H5N1
viruses to localize to the brain [19].

It turns out that H5N1 can cause infection of the lower respiratory
tract and severe pneumonia in humans because the virus binds to several
kinds of cells in the human lung and lower respiratory tract [22]. These
cells have surface
receptors with carbohydrate chains ending in SA- a -2,3-gal instead of
SA- a -2,6-gal typical of human cells.

Many scientists consider H5N1 dangerous enough as it is, as it has
killed more than 50 percent of the people infected. They also believe
that if H5N1 should mutate or pick up a HA gene that enables it to
recognize SA- a -2,6-gal instead of SA- a -2,3-gal, then the virus would
replicate rapidly in human hosts and become transmitted from person to
person. Then, there would be no stopping a flu pandemic reminiscent of
the one in 1918 estimated to have killed 40 million
worldwide.

How dangerous is the H5N1 infecting poultry? Should we worry about
consuming infected poultry products? How likely is the virus to become
the agent of the next flu pandemic? Read the next article in this
series, “What can you believe about bird flu?”

**
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