The so called "bird flu" is a form of the Influenza A virus. It is what's known as
a highly pathogenic avian influenza (HPAI). The current virus is a subtype of
Influenza A known as H5, and more specifically H5N1. Because it chiefly infects
avian creatures it is commonly called the "bird flu".
This virus is terrifically virulent and extremely contagious, especially among
domestic poultry. According to the World Health Organization (WHO), there is
mounting evidence that the H5N1 strain is uniquely able to jump the species
barrier and cause severe disease, with high mortality, in people. Humans have
actually contacted the disease as well as birds, but in very much smaller
numbers, 125 as of mid November, 2005. The problem is that this virus has
an extremely high mortality rate, currently over 50%!
At the present time, there is little or no evidence the H5N1 virus can be
transmitted from person to person. A pandemic will occur when the virus
mutates into a slightly new strain that easily allows transmission among
humans.
The avian, or bird flu is shaping up to be one of the most lethal
pathogens with wide exposure, in human history.
It's so serious that president Bush announced that he would ask Congress
for $7.1 billion in emergency funding to prepare the country for a possible flu
pandemic. Bush said he would ask for $1.2 billion to buy enough bird flu
vaccine for 20 million people. He admitted the vaccine would not be a perfect
match for a mutated strain of the virus that causes the flu, known as H5N1,
but it would be better than no vaccine at all.
"A vaccine against the current avian flu virus would likely offer some protection
against a pandemic strain and possibly save many lives in the first critical
months of an outbreak," Bush said.
He also is asking Congress for $2.8 billion for a "crash program" to accelerate
the development of new technology to speed vaccine makers' ability to
produce enough vaccine to protect every American. Obviously, an effective
vaccine must be developed first.
According to Klaus Stöhr, coordinator of the World Health Organization's
global influenza program, "This fear is real, it's scientifically substantiated, and
we have enough historical data to tell us that the pandemic that would come
out of this mutation would lead to a global health emergency, with millions of
deaths, a global spread in less than three months and people in the
developing countries being hardest-hit. It'd be inappropriate and wrong to
disregard these signals. The chances of it causing a pandemic are
logarithmically higher than the chances it's not going to cause a pandemic."
Method of the H5N1 Virus' Transmission
At this time, the method of transmission appears to be restricted to avian to
human. All reported cases are believed to be traced back to direct human
contact with some type of bird. In many countries, poultry farming is a way of
life for a large percentage of residents, who are constantly in close contact
with the animals. This is how the majority of human cases of the bird flu have
been contracted to date.
It spreads to domestic poultry around the world through migratory birds,
such as ducks, many of whom seem to suffer no ill effects of the disease.
They are just carriers. Birds shed the virus in secretions such as feces and
saliva. This contaminates other birds and spreads the disease. Many countries
have destroyed thousands or millions of domestic fowl in an attempt to
contain the disease. On November 21st, 2005, China announced a further
tightening of rules concerning domestic birds. This is the latest containment
step from the Asian country. China has already vaccinated millions of birds as
a disease containment measure.
This virus sometimes remains viable in contaminated droppings for long
periods. As such, it can be spread among birds, and from birds to other
animals, through ingestion or inhalation. It may also can be contracted from
eating infected birds.
According to the U.S. Center for Disease Control (CDC) H5N1 viruses have
been documented to transmit to a number of different animal species. That
includes tigers and leopards and domestic cats. H5N1 has also been confirmed
to have infected pigs in China. The first confirmed human cases of the bird flu
in China were reported on November 16th, 2005.
Is a Vaccine the Answer?
It would be very nice if one could just take a shot and just be done with the
whole thing. This is definitely a possibility in the future. The problem is that it
takes 4 - 6 months on average to produce an effective vaccine. On November
3rd, Michael Leavitt, secretary of the U.S. Department of Health and Human
Services announced the following:
"The good news is we have a vaccine,” said the secretary. “The scientists at
NIH have developed a vaccine with sufficient immune response that it can
protect a human being when given in proper dosage. The bad news is we
fundamentally lack the capacity to manufacture it in sufficient volumes in time."
The production of a vaccine requires that immunologists know exactly what
strain of virus they are dealing with in order for the vaccine to be most
effective. It will almost require that the virus undergo the pandemic causing
mutation to really know what the population needs to be vaccinated against."
One of President Bush's action items is to develop a faster method of
producing a vaccine when one becomes available. Hopefully the new vaccine is
the one. Thankfully, with this pandemic, there is a warning. With previous
pandemics, no warning was available, they just killed millions.
Recently, Michael Leavitt also indicated the U.S. would not have the ability to
produce enough vaccine to protect all 300 million Americans for 3 to 5 years.
He reiterated it would take six months or so to produce an effective vaccine
once a pandemic vaccine is isolated.
What about Antiviral Drugs?
While having an admirable record developing antibiotics that are effective
against bacteria, medical has had much greater difficulties developing effective
antiviral medications. Antiviral drugs effective against the bird flu would
protect the population if administered immediately following the onset of the
disease.
The most popular medication in this category,Tamiflu, is probably not
completely effective against the bird flu. First introduced by the Roche
Corporation of Switzerland in 1999, it was the first oral anti influenza
medication. It works by inhibiting neuramindase, a critical protein on the
surface membrane of the influenza virus. You can download Roche's product
data sheet here. Tamiflu has been hampered by a supply shortage and
hording, despite it's limited effectiveness. It is very expensive and the demand
has been inflating the price even further. You can get some Tamiflu here.
There is work ongoing concerning creating antiviral cocktails, similar to those
used to fight AIDS, using Tamiflu and other antiviral medication. One of the
combinations showing promise is the combination of Tamiflu and amantadine.
The H5N1 virus recovered from Vietnam and Thiland has shown resistance to
Amantadine by itself. Another antiviral drug is rimantadine. It appears that
rimantadine is not very effective against the H5N1 virus. Both of these drugs
are classified as "entry inhibitors". You can get some amantadine here.
Two drugs that may have some effectiveness are oseltamavir and zanamavir.
Zanamavir is marketed by Glaxo Smith Kline under the trade name Relenza.
These are classified as "release inhibitors", similar to Tamiflu. Relenza is
delivered via an inhaler instead of orally, as with Tamiflu. Originally Relenza had
a 50% market share in the category, but this has dropped to less than 3%.
These antivirals work by blocking the activity of neuraminidase, a common
name for the protein Acetyl-neuraminyl hydrolase. This protein is vital in
allowing the virus to spread inside the human body because it facilitates the
viral transmission from one cell to another. Some countries, including Great
Britain, have begun stockpiling oseltamavir (Tamiflu), according to the BBC.
newsletter with up to
date news and tips on
surviving the bird flu
pandemic.
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Bird Flu Forum
health officials
reported on
November 28th,
2005 they have
evidence the bird flu
virus is mutating.
They indicate the H5N1
virus is "genetically
mutating compared
with the strain found
in Vietnam's human
cases". It is important,
however the virus still
has not mutated to
the extent it allows
easy human-human
transmission.
Officials report a 15yr
old girl has died from
the H5N1 virus in
northern Iraq. Reported
on Jan, 30th, 2006, the
Kurdish girl died earlier
in the month. This is
the first confirmed bird
flu death in the middle
east.
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