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Medical Forum / General / General / November 2005Flu Pandemic Timeline?
Assuming people are dying, or otherwise affected, by a new human-borne virus from a bird-flu mutation, how long would it take for early warnings to be issued by authorities? I am assuming cases reported have been sent to, tested and finally confirmed in a WHO lab, which seems to take at least a week from any initial infection. If a new virus goes human-borne, it seems to me that it would reach us before ANY warnings are even issued. Given also the symptoms may not develop for a few days, it seem that a new virulent human-borne virus could circle the globe before any scientists or health authorities issue public warnings? Am I wrong? What would the most likely timing scenarios be? Per mac@nospam.com: >Given also the symptoms may not develop for a few days, it seem that a >new [quoted text clipped - 3 lines] > >Am I wrong? What would the most likely timing scenarios be? I recall a reference somewhere to people doing computer models of this - but cannot recall the source or the conclusions. Maybe somebody can point us to it. My own feeling, as someone who knows nothing except that: - The 1957 pandemic circled the globe in less than six months, - Airline travel has increased exponentially since then, - People can spread the stuff for days before they even realize they're ill and - Physicians cannot readily determine which type of flu a patient has; is that if there is a reassortment even that it may well be upon us by the time authorities decide that there is a pandemic. The hopeful parts for a rearrangement event are that the virus may become less deadly and that it may lose resistance to the M2 inhibitors. "May"....  SignaturePeteCresswell One computer model... http://www.newstarget.com/011006.html >Assuming people are dying, or otherwise affected, by a new human-borne >virus [quoted text clipped - 17 lines] > >Am I wrong? What would the most likely timing scenarios be? That's why it is so important that _early_ warning systems be put in place. The variant flu would be somewhere, presumably localized, presumably some finite number of cases. It is overstatement to assume that it would circle the globe before being detected, because that would require wide travel by those few people -- who may well be in less developed areas, so less likely to travel, but also less sophisticated in terms of public health infrastructure. But the point you make is a useful way to frame the issue. bob Per Bob: >It is overstatement to assume that it >would circle the globe before being detected, because that would >require wide travel by those few people -- who may well be in less >developed areas, so less likely to travel, but also less sophisticated >in terms of public health infrastructure. For some reason that I don't fully grasp, I keep reading that a strain that arises via adaptive mutation would spread more slowly/detectably than a strain that arises from a reassortment event. The word I keep hearing in connection with spread following reassortment is "explosive". SignaturePeteCresswell >Per Bob: >>It is overstatement to assume that it [quoted text clipped - 6 lines] >arises via adaptive mutation would spread more slowly/detectably than a strain >that arises from a reassortment event. An adaptive mutation of the avian virus would probably result in a strain that was only somewhat better at infecting humans than the original so it wouldn't spread much or far until it had gradually acquired more effective mutations, selected by being passed through numerous human hosts. It's hoped that in this case spread could be stopped or substantially slowed by methods like quarantine and treatment of exposed people with antivirals. The drug manufacturers have donated 3 million doses of antivirals to the WHO for this purpose. In a reassortment event the same cell is infected by both an avian strain and a human influenza virus. A new virus may be assembled containing parts of each. In this case it's possible that a strain may arise incorporating the pathogenicity and antigens of the avian strain and some or all of the genetic kit for human infectivity from the human strain. This doesn't depend on gradual accumulation and selection of favorable mutations -- it could be an instant human virus with new and dangerous properties assembled in one go. One method of preventing a reassortment event is to vaccinate people exposed to the avian virus against common human flu viruses. This approach has been used for people who work destroying infected poultry flocks, and so far it may have helped significantly, but like many preventative efforts there's no way of knowing. >The word I keep hearing in connection with spread following reassortment is >"explosive". It could spread as explosively as any other human flu strain, or more so because there hasn't been an H5 human strain for so long that nobody has antibodies against it, as many do against more recent human flu viruses, so there's no population of resistant or partly resistant people to interfere with the spread. >Per Bob: >>It is overstatement to assume that it [quoted text clipped - 6 lines] >arises via adaptive mutation would spread more slowly/detectably than a strain >that arises from a reassortment event. I agree with what bae has already posted on this. In a sense, the point is that a serious strain would _arise_ more slowly by adaptive mutation (requiring multiple events) than by reassortment (possibly requiring only one event). Emphasize that there is considerable uncertainty about exactly what has to happen to create the feared strain. bob > Assuming people are dying, or otherwise affected, by a new human-borne > virus [quoted text clipped - 17 lines] > > Am I wrong? What would the most likely timing scenarios be? They interviewed an expert on television a couple of days ago. He stated that once bird-flu becomes a Pandemic--it would be front page news for at least a week or more. He also said that scientists would quickly develop a vaccine. They can't create a vaccine (according to the expert) until after the new virus goes human-borne. SignatureNEWSGROUP SUBSCRIBERS MOTTO We respect those subscribers that ask for advice or provide advice. We do NOT respect the subscribers that enjoy criticizing people. >> Assuming people are dying, or otherwise affected, by a new human-borne >> virus [quoted text clipped - 23 lines] >vaccine. They can't create a vaccine (according to the expert) until after >the new virus goes human-borne. That is sort of correct, but warrants clarification. There is active work to develop vaccines against H5N1 strains. For one thing, this gives some experience. But it is also _possible_ that there will be some cross protection against an emerging strain. That is, it is possible that the work will yield something useful (though probably not ideal) early in the spread of the new virus. When a new strain emerges, they can focus on it. To say that they can make a vaccine against it "quickly" is rather optimistic. Given the current procedures for making flu vaccines, it takes many months to make any substantial amounts. This is why each year's vaccine is something of a crapshoot -- it is designed based on an educated case of what flu will be important, well in advance. It also highlights the need for faster methods of vaccine development. It is not at all obvious that a new vaccine can be developed (and produced) "quickly" -- re the speed at which the virus itself may spread. So one should not interpret the comment quoted above as being particularly reassuring. bob >> Assuming people are dying, or otherwise affected, by a new >> human-borne virus from a bird-flu mutation, how long would it take [quoted text clipped - 16 lines] >stated that once bird-flu becomes a Pandemic--it would be front page >news for at least a week or more. A lot longer than a week, I'd think -- as long as people are getting sick or dying in large numbers, it'll be news. >He also said that scientists would quickly develop a vaccine. They >can't create a vaccine (according to the expert) until after the new >virus goes human-borne. It's not clear how fast a vaccine could be developed. Ordinary flu vaccines are created inside eggs, which may not work in this case because the virus kills the egg. In any event, developing flue vaccines, at least today, requires a long lead time, which is why so many people are looking for alternatives. We probably wouldn't have a long time. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth > In any event, developing flue [sic] > vaccines, at least today, requires a long lead time, which is why so > many people are looking for alternatives. Well, what are you waiting for, Quackpot? It is your baby. Just thought that you might want to know. >> In any event, developing flue [sic] >> vaccines, at least today, requires a long lead time, which is why so [quoted text clipped - 5 lines] > >Just thought that you might want to know. It's not MY baby. I'm not a medical person. Just thought you might want to know, though your incredibly low intelligence will probably keep you from remembering. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth > >> In any event, developing flue [sic] > >> vaccines, at least today, requires a long lead time, which is why so [quoted text clipped - 7 lines] > > It's not MY baby. I'm not a medical person. See, David Wrong just disowned the flu vaccination industry. You are an idiot, David. Just thought that you might want to know. >> In article <1132446664.395861.250060@g49g2000cwa.googlegroups.com>, >> johngohde@unnaturalactsperspective.com [quoted text clipped - 13 lines] > >See, David Wrong just disowned the flu vaccination industry. Nope. Just agreed that it'd be difficult to get a vaccine created in time to deal with an avian flu epidemic. Flu shots work fairly well for the annual type. Here's hoping you wind up flat on your back for a week or so this winter, totally wiped out by the flu, John-boy. >You are an idiot, David. Insults from an ignoramus like yourself do not bother me. >Just thought that you might want to know. Disabuse yourself of the idea that you have anything to say that anyone wants to know. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "If you can't say something nice, then sit next to me." -- Alice Roosevelt Longworth > >> In article <1132446664.395861.250060@g49g2000cwa.googlegroups.com>, > >> johngohde@unnaturalactsperspective.com [quoted text clipped - 18 lines] > for the annual type. Here's hoping you wind up flat on your back for > a week or so this winter, totally wiped out by the flu, John-boy. Just Glad to see that David Wrong knows what his name is. Ha, ... Hah, Ha! What a rube that David Wrong is! Just my opinion, but I am never Wrong (Pun Intended). Per Jason: >He also said that scientists would quickly develop a >vaccine. I would make distinctions between - developing a vaccine, - getting the newly-developed vaccine into production, - producing sufficient quantities of the new vaccine, and - getting the produced vaccine into people I claim no special knowledge, but to me "quickly", in the context of a rapidly-spreading pandemic, means within weeks... and if that is the case, No way Jose'. Unencumbered by any technical knowledge on the subject, I'd say the better part of a year - and that would still be subject to the same (extremely serious, from what I've read so far...) limitations we have today in production capacity. SignaturePeteCresswell
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