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Q: Bird Flu (Fatalities, Tamiflu, etc) ( Answered,   1 Comment )
Subject: Bird Flu (Fatalities, Tamiflu, etc)
Category: Health > Conditions and Diseases
Asked by: tony8312-ga
List Price: $75.00
Posted: 08 May 2006 20:06 PDT
Expires: 07 Jun 2006 20:06 PDT
Question ID: 726769
There is so much junk about the bird flu, and its very disconcerting
to think about. Accepting a pandemic is not easy...

The press talked for months about building up a Tamiflu supply and
some drug that automatically doubles the effects of any drug... What's
the status on tamiflu supplies...?

I know its very lethal, are there any vitamins that will help in
resistance.. and what's the survival rate... Has anyone survived it?
Is it time to go into hiding?

Besides going into hiding, what are the best preparations a person can
make? If people survive, once they are immune, are they immune

Additional information would be appreciated...
Subject: Re: Bird Flu (Fatalities, Tamiflu, etc)
Answered By: hummer-ga on 09 May 2006 09:07 PDT
Hi tony8312,

Thank you for the very interesting and timely question. Following are
some excellent websites with reliable and up-to-date information on
Avian Influenza. Briefly, there is no need to panic as yet because
there is no evidence that  "bird flu" has the ability to spread easily
from person to person. In other words, it is highly infectious among
certain bird populations but it has not yet adapted to spread through
human populations.  I've copied and pasted some relevant sections
below but please click on the links for full details and more links to
follow (my answer assumes that you are in the U.S).

epidemic: A disease occurring suddenly in a community, region or
country in numbers clearly in excess of normal. See pandemic.
pandemic: The worldwide outbreak of a disease in numbers clearly in
excess of normal. See epidemic.


Your question -
1. There is so much junk about the bird flu,...

Epidemic and Pandemic Alert and Response (EPR)
Avian influenza




>>> H5N1

"It's one of 16 varieties of avian influenza or bird flu. So far, it's
the only one that's shown any ability to directly pass from one human
to another. It has spread from Southeast Asia to China, Russia and now

Q & A
Questions and Answers About Avian Influenza (Bird Flu) and Avian
Influenza A (H5N1) Virus
Avian Influenza
What is avian influenza (bird flu)?
"Avian influenza is an infection caused by avian (bird) influenza
(flu) viruses. These flu viruses occur naturally among birds. Wild
birds worldwide carry the viruses in their intestines, but usually do
not get sick from them. However, avian influenza is very contagious
among birds and can make some domesticated birds, including chickens,
ducks, and turkeys, very sick and kill them.
Infection with avian influenza viruses in domestic poultry causes two
main forms of disease that are distinguished by low and high extremes
of virulence. The ?low pathogenic? form may go undetected and usually
causes only mild symptoms (such as ruffled feathers and a drop in egg
production). However, the ?highly pathogenic? form spreads more
rapidly through flocks of poultry. This form may cause disease that
affects multiple internal organs and has a mortality rate that can
reach 90-100%, often within 48 hours."
Do avian influenza viruses infect humans?
"Bird flu viruses do not usually infect humans, but more than 190
confirmed cases of human infection with bird flu viruses have occurred
since 1997..."
How do people become infected with avian influenza viruses?
"Most cases of avian influenza infection in humans have resulted from
direct or close contact with infected poultry (e.g., domesticated
chicken, ducks, and turkeys) or surfaces contaminated with secretions
and excretions from infected birds. The spread of avian influenza
viruses from an ill person to another person has been reported very
rarely, and transmission has not been observed to continue beyond one
person. During an outbreak of avian influenza among poultry, there is
a possible risk to people who have direct or close contact with
infected birds or with surfaces that have been contaminated with
secretions and excretions from infected birds."
Is there a risk for becoming infected with avian influenza by eating poultry?
There is no evidence that properly cooked poultry or eggs can be a
source of infection for avian influenza viruses. For more information
about avian influenza and food safety issues, visit the World Health
Organization website."
We have a small flock of chickens. Is it safe to keep them?
"Yes. In the United States there is no need at present to remove a
flock of chickens because of concerns regarding avian influenza..."
What precautions can be taken to reduce the risk for infection from
wild birds in the United States?
"As a general rule, the public should observe wildlife, including wild
birds, from a distance. This protects you from possible exposure to
pathogens and minimizes disturbance to the animal. Avoid touching
wildlife. If there is contact with wildlife do not rub eyes, eat,
drink, or smoke before washing hands with soap and water. Do not pick
up diseased or dead wildlife. Contact your state, tribal, or federal
natural resource agency if a sick or dead animal is found."
Avian Influenza A (H5N1)
"What is the avian influenza A (H5N1) virus that has been reported in
Africa, Asia, Europe, and the Near East?
Influenza A (H5N1) virus - also called ?H5N1 virus? - is an influenza
A virus subtype that occurs mainly in birds, is highly contagious
among birds, and can be deadly to them."
"Human cases of influenza A (H5N1) infection have been reported in
Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey,
and Vietnam. For the most current information about avian influenza
and cumulative case numbers, see the World Health Organization Avian
Influenza website."
What are the risks to humans from the current H5N1 outbreak?
"H5N1 virus does not usually infect people, but more than 200 human
cases have been reported. Most of these cases have occurred from
direct or close contact with infected poultry or contaminated
surfaces; however, a few cases of human-to-human spread of H5N1 virus
have occurred.
So far, spread of H5N1 virus from person to person has been rare and
has not continued beyond one person. Nonetheless, because all
influenza viruses have the ability to change, scientists are concerned
that H5N1 virus one day could be able to infect humans and spread
easily from one person to another. Because these viruses do not
commonly infect humans, there is little or no immune protection
against them in the human population.
If H5N1 virus were to gain the capacity to spread easily from person
to person, an influenza pandemic (worldwide outbreak of disease) could
begin. No one can predict when a pandemic might occur. However,
experts from around the world are watching the H5N1 situation in Asia
and Europe very closely and are preparing for the possibility that the
virus may begin to spread more easily from person to person."
Is there a vaccine to protect humans from H5N1 virus?
"There currently is no commercially available vaccine to protect
humans against the H5N1 virus that is being detected in Asia and
Europe. However, vaccine development efforts are taking place.
Research studies to test a vaccine that will protect humans against
H5N1 virus began in April 2005, and a series of clinical trials is
under way..."
Can a person become infected with avian influenza A (H5N1) virus by
cleaning a bird feeder?
"There is no evidence of H5N1 having caused disease in birds or people
in the United States. At the present time, the risk of becoming
infected with H5N1 virus from bird feeders is low. Generally, perching
birds (Passeriformes) are the predominate type of birds at feeders.
While there are documented cases of H5N1 causing death in some
Passeriformes (e.g., house sparrow, Eurasian tree-sparrow, house
finch), in both free-ranging and experimental settings, most of the
wild birds that are traditionally associated with avian influenza
viruses are waterfowl and shore birds."
Influenza Pandemic Preparedness
What changes are needed for H5N1 or another avian influenza virus to
cause a pandemic?
"Three conditions must be met for a pandemic to start: 1) a new
influenza virus subtype must emerge for which there is little or no
human immunity; 2) it must infect humans and causes illness; and 3) it
must spread easily and sustainably (continue without interruption)
among humans. The H5N1 virus in Asia and Europe meets the first two
conditions: it is a new virus for humans (H5N1 viruses have never
circulated widely among people), and it has infected more than 190
humans, killing over half of them.
However, the third condition, the establishment of efficient and
sustained human-to-human transmission of the virus, has not occurred.
For this to take place, the H5N1 virus would need to improve its
transmissibility among humans. This could occur either by
?reassortment? or adaptive mutation."

Avian Influenza A (H5N1) Infection in Humans
"Human influenza is transmitted by inhalation of infectious droplets
and droplet nuclei, by direct contact, and perhaps, by indirect
(fomite) contact, with self-inoculation onto the upper respiratory
tract or conjunctival mucosa.4,5 The relative efficiency of the
different routes of transmission has not been defined. For human
influenza A (H5N1) infections, evidence is consistent with
bird-to-human, possibly environment-to-human, and limited,
nonsustained human-to-human transmission to date."

Current Situation
"Influenza A (H5N1) is an influenza A virus subtype that occurs mainly
in birds, is highly contagious among birds, and can be deadly to them.
Outbreaks of H5N1 among poultry are ongoing in a number of countries.
While H5N1 does not usually infect people, human cases of H5N1
infection associated with these outbreaks have been reported. Most of
these cases have occurred from direct or close contact with infected
poultry or contaminated surfaces; however, rare cases of
human-to-human spread of H5N1 virus may have occurred. There is no
evidence of transmission beyond one person.
Nonetheless, because all influenza viruses have the ability to change,
scientists are concerned that H5N1 virus one day could be able to
infect humans and spread easily from one person to another. Because
these viruses do not commonly infect humans, there is little or no
immune protection against them in the human population and an
influenza pandemic (worldwide outbreak of disease) could begin.
Experts from around the world are watching the H5N1 situation in Asia
and Europe very closely and are preparing for the possibility that the
virus may begin to spread more easily from person to person."

H5N1 avian influenza

World : Affected countries with confirmed cases of H5N1 avian
influenza since January 2006


1. Pandemic influenza is different from avian influenza.
"Avian influenza refers to a large group of different influenza
viruses that primarily affect birds. On rare occasions, these bird
viruses can infect other species, including pigs and humans. The vast
majority of avian influenza viruses do not infect humans. An influenza
pandemic happens when a new subtype emerges that has not previously
circulated in humans.
For this reason, avian H5N1 is a strain with pandemic potential, since
it might ultimately adapt into a strain that is contagious among
humans. Once this adaptation occurs, it will no longer be a bird
virus--it will be a human influenza virus. Influenza pandemics are
caused by new influenza viruses that have adapted to humans."
2. Influenza pandemics are recurring events.
"An influenza pandemic is a rare but recurrent event. Three pandemics
occurred in the previous century: ?Spanish influenza? in 1918, ?Asian
influenza? in 1957, and ?Hong Kong influenza? in 1968. The 1918
pandemic killed an estimated 40-50 million people worldwide. That
pandemic, which was exceptional, is considered one of the deadliest
disease events in human history. Subsequent pandemics were much
milder, with an estimated 2 million deaths in 1957 and 1 million
deaths in 1968.
A pandemic occurs when a new influenza virus emerges and starts
spreading as easily as normal influenza - by coughing and sneezing.
Because the virus is new, the human immune system will have no
pre-existing immunity. This makes it likely that people who contract
pandemic influenza will experience more serious disease than that
caused by normal influenza."
3. The world may be on the brink of another pandemic.
"Health experts have been monitoring a new and extremely severe
influenza virus - the H5N1 strain - for almost eight years. The H5N1
strain first infected humans in Hong Kong in 1997, causing 18 cases,
including six deaths. Since mid-2003, this virus has caused the
largest and most severe outbreaks in poultry on record. In December
2003, infections in people exposed to sick birds were identified.
Since then, over 100 human cases have been laboratory confirmed in
four Asian countries (Cambodia, Indonesia, Thailand, and Viet Nam),
and more than half of these people have died. Most cases have occurred
in previously healthy children and young adults. Fortunately, the
virus does not jump easily from birds to humans or spread readily and
sustainably among humans. Should H5N1 evolve to a form as contagious
as normal influenza, a pandemic could begin."
4. All countries will be affected.
5. Widespread illness will occur.
6. Medical supplies will be inadequate.
7. Large numbers of deaths will occur.
8. Economic and social disruption will be great.
9. Every country must be prepared.
10. WHO will alert the world when the pandemic threat increases.

The symptoms of avian flu in humans are similar to other strains of
the flu and include:
Sore throat
Eye infections
Muscle aches


Your questions - 
2. What's the survival rate      [55%]  
3. Has anyone survived it?       [Yes]  
4. Is it time to go into hiding? [No]

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1)
Reported to WHO
8 May 2006
             Cases       Deaths
2003           3           3 	
2004          46          32 	 
2005          95          41 	 
2006          63          39 	 
Total        207         115
Azerbaijan - Cambodia - China - Egypt - Indonesia - Iraq - Thailand -
Turkey - Viet Nam

Table 3. Presentation and Outcomes among Patients with Confirmed Avian
Influenza A (H5N1).

>>> TAMIFLU (Oseltamivir phosphate)

Your question - 
5. What's the status on tamiflu supplies...?

"FDA approved Tamiflu (oseltamivir phosphate), an oral anti-viral drug
for the treatment of uncomplicated influenza in patients one year and
older whose flu symptoms have not lasted more than two days. This
product is approved to treat Type A and B influenza; however, the
majority of patients included in the studies were infected with type
A, the most common in the U.S.  Efficacy of Tamiflu in the treatment
of influenza in subjects with chronic cardiac disease and/or
respiratory disease has not been established."

Guidelines for the establishment and use of the Stockpile of Oseltamivir
2.3 "Presently, only oseltamivir is considered effective against all
subtypes of influenza A virus and is recommended for stockpiling and
use during the outbreak and to pre-empt the pandemic. However, as of 6
January 2006, oseltamivir is manufactured only by one company. The
manufacturing capacity, although being augmented remains limited
compared to the world demand. It is believed that currently there is a
lag period of more than one year between ordering oseltamivir and its
supply. Some of pharmaceutical manufacturing companies from India,
Thailand and Indonesia have shown interest in manufacturing the drug
but, it is unlikely to alter present situation at least up to middle
of 2006."

We hear of the drug Tamiflu as a possible treatment for influenza.
It's also reported to have an effect preventing the disease. How long
does that preventive action last?
"Tamiflu can be used two ways, as a treatment when someone is sick
with the flu and as a preventive to keep you from getting infected in
the first place. In a perfect world, we'd all have enough Tamiflu to
take one pill every day that the pandemic virus is circulating in our
One pill protects you for one day. Based on the history of other
pandemic influenzas, experts believe the first wave in a given area
would last up to 100 days. So if you were trying to protect yourself
from infection, you would need to stockpile about 100 doses of Tamiflu
and start taking them from the moment you hear the virus is
circulating in your region."

Should agencies or FOH stockpile antiviral agents such as TamilfuŽ
Current studies suggest that some agents currently approved for human
flu viruses should also work in preventing bird flu infection in
humans. For this reason, production of osetamivir or TamifluŽ is being
increased and stockpiled by the government for potential use in a
pandemic. Like the vaccine, the CDC would control distribution of the
stockpile during such an event and would probably limit it to
high-risk priority groups. However, it is important to note that
viruses mutate rapidly and some bird flu viruses have already shown
resistance to available medications. There is no way of knowing if the
strain of the virus that would cause a pandemic would be susceptible
to those stockpiled. Additional studies are needed to prove the
effectiveness of these medicines and the CDC is not currently
recommending that any other agencies develop stockpiles of their own"


Your questions -
 6. I know its very lethal, are there any vitamins that will help in resistance 
[no, not really, although living a healthy lifestyle to keep your
immune system strong can't hurt]
 7. Besides going into hiding, what are the best preparations a person can make? 
[Stay clear of dead birds, don't travel to infected regions, wash your
hands well, and follow the "Five Keys to Safe Food" below]
8. If people survive, once they are immune, are they immune forever...? 
[Well, only for that particular strain, and not "forever"]

"There currently is no commercially available vaccine to protect
humans against H5N1 virus that is being seen in Asia and Europe."

"Vaccination is one of the most effective ways to minimize suffering
and death from influenza. However, there is currently no vaccine
available to protect humans against the H5N1 avian influenza, a virus
that commonly affects birds and has been transmitted to humans in a
number of countries.
In FY 2006, President Bush approved an unprecedented amount of
resources to fund vaccine research, development, and procurement. That
funding will support research on faster and more efficient ways to
produce vaccine as well as ways to extend a given supply of vaccine.
There is also research into effective antivirals, seeking medications
that can effectively reduce the severity of an influenza attack.
Recent increases in the number and promotion of antiviral drugs for
influenza have increased interest in the role of specific antiviral
drugs for this condition. Use of antiviral drugs does not eliminate
the risk of complications, and some complications (as well as other
medical conditions that could be confused with influenza) can be life

Wednesday, March 29, 2006 		
Media Contact: NIAID News Office
(301) 402-1663
H5N1 Avian Flu Virus Vaccine Induces Immune Responses in Healthy Adults
"Results from a clinical trial demonstrate that high doses of an
experimental H5N1 avian influenza vaccine can induce immune responses
in healthy adults. Approximately half of those volunteers who received
an initial and a booster dose of the highest dosage of the vaccine
tested in the trial developed levels of infection-fighting antibodies
that current tests predict would neutralize the virus. The National
Institute of Allergy and Infectious Diseases (NIAID), part of the
National Institutes of Health, funded the study, published in the
current issue of The New England Journal of Medicine. Preliminary
results from this trial were first disclosed late last summer."
?These findings represent an important step forward in the nation?s
efforts to prepare for the possible emergence of a human pandemic of
H5N1 avian influenza,? notes NIH Director Elias A. Zerhouni, M.D.

Pandemic Flu Planning Checklist for Individuals and Families

Family Emergency Health Information Sheet

State Pandemic Plans

Why the five keys?
"WHO has long been aware of the need to educate all food handlers,
including professionals and ordinary consumers, about their
responsibility for food safety. After nearly a year of consultations
with food safety experts and risk communicators, WHO introduced in
2001 the Five Keys, simple rules elaborated to promote safer food
handling and preparation practices. Following the five keys not only
prevents illness from eating contaminated food but also contributes to
the prevention of diseases caused by handling infected animals, such
as avian influenza."


Well, that should keep you busy for awhile! I've enjoyed researching
this for you and I hope it relieves your mind a bit. If you have any
questions, please post a clarification request and wait for me to
respond before closing/rating my answer.

Thank you,

Google Search Terms Used: 

avian influenza
bird flu
tamiflu oseltamivir 
avian influenza survival
avian influenza prevention
avian influenza 
H5N1 vaccine
H5N1 immunity
Subject: Re: Bird Flu (Fatalities, Tamiflu, etc)
From: frde-ga on 09 May 2006 02:32 PDT
The Bird Flu problem is quite nasty.

The experts (I know one personally) reckon that it is just a matter of
time until we get another outbreak of a similar strain to the 1918

Normal flu strains are not much of a problem from a callous point of
view, they tend to affect the weak, the very young and the old. The
strains are pretty well known, and each year there is an international
decision on which of them to put into the vaccine cocktail for the
following year.
Production lead times are quite long - the viruse are bred in eggs.

The 1918 strain affected the fit, active members of society, not just
that but the mortality rates were very high. More people died of flu,
than died in combat or other reasons in WWI.
You get problems when your doctors, nurses, power station workers,
water engineers, delivery drivers etc, fall sick or drop dead.

So far H5N1 has not proved particularly lethal, although we don't
really know how many people have been affected as it has tended to
turn up in remote areas.
It is quite possible that thousands of people have felt a little off
colour for a few days.

Tamiflu (as I understand it) is something that makes life hard for
viruse in general, it is not a vaccine.  I gather it is made from Star
Anise, which is not in great supply, and that the production process
is very lengthy.

It has not been thoroughly tested on H5N1 in humans, I remember that a
Vietnamese was treated with it and died.

My view is that stocking up on Tamiflu is a public relations exercize
- it might prove useful, but ... who knows

Virologists are not concerned about H5N1, but they are worried that it
will mutate into something different. They can't make a vaccine for
something that does not yet exist.

I've heard something about another faster method of making vaccines,
even so a virulent flu could be everywhere within a few weeks so
vaccines would only really be useful for combatting the second wave.

The problem with flu is that it mutates very fast, so one can be
immune to one strain (through exposure or vaccination) but not immune
to its next variation.

There is not much one can do to avoid catching flu, apart from
avoiding contact with people. There is some belief that vitamin D
helps which is generated by the body from sunlight and is in fish

Personally if there were a serious outbreak I would lock myself away - if possible.

It is very likely that H5N1 will just die out, but it is also unlikely
that we will never face a strain similar to the 1918 variety.

This is an interesting article :-

|"There will be another pandemic," says Michael Osterholm, director of
the Center for Infectious Disease Research & Policy at the University
of Minnesota. "But I can't tell you it will be H5N1."|

Death Estimates For Major Flu 
Pandemics of the 20th Century

Year       Worldwide United States  
1918-1919 50,000,000   675,000 
1957-1958  2,000,000    60,000 
1968-1969  1,000,000    40,000

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