Flu Pandemic Could Kill 62m With Poorer Countries Most Affected

http://www.medicalnewstoday.com/healthnews.php?newsid=59714

If a worldwide flu pandemic like the one in 1918-20 were to strike today it could kill between 51 and 81 million people, with 96 per cent of deaths being in poorer countries. This was the conclusion of a US study led by Professor Chris Murray of the Harvard Initiative for Global Health.

snip

The researchers used high-quality vital registration data of deaths occuring at the time of the 1918-20 pandemic. From these figures they estimated what the likely globaly mortality would be from a flu pandemic if it happened today.

In a podcast interview, Professor Murray says that the impetus for the research came from listening to colleagues talk at meetings about what the death toll from a flu pandemic might be. Estimates ranged from 50 to 100 million to as many as 1 billion deaths worldwide, but nobody had yet made a systematic attempt to quantify it.

snip

Professor Murray pointed out that this 62 million should be viewed as an upper limit since they did not take into account factors like improved symptom management, treatment of secondary pneumonia (which develops after the flu and was a major killer in the 1918-20 pandemic), vaccination, and so on.

more

using a smaller percentage than the 1918 pandemic had. A best case scenario and probably unrealistic esp. if the case fatality rate which is over 50 percent now does not drop way way low. Add to that collateral deaths if the grid goes down and it would be a nightmare.
I read that the insurance risk people give it a twenty percent chance it will happen within two years. Hope they are wrong.

not bird flu, although you're right that it would be far worse with bird flu. That's the problem- people keep dismissing a flu pandemic because they instantly think of bird flu, which right now is not a serious threat (although I agree it probably will be in the future, maybe even near future). However, we are long overdue for a regular old flu pandemic. The average is three per century, and we're due anytime.

For example, I'd like some links for the following statements...

"I read that the insurance risk people give it a twenty percent chance it will happen within two years."

"The average is three per century, and we're due anytime."

Those predictions are wildly inconsistent with each other.

I read it in the past two days but I am having an exacerbation of my MS and am having extreme vertigo.
Meanwhile Japan today announced they are going to have people stock up on food.
http://www.newsnow.co.uk/newsfeed/?name=Bird+Flu right hand side has link
It is suscription but the article
pretty much says
"The government plans to call on people to store a two-week supply of food so they can stay home if an influenza pandemic breaks out, it has been learned.

(snip)

"Experts have been on high alert for a possible outbreak of a new flu strain from, for example, a highly pathogenic virus of the avian flu.

"The guidelines will also lay down a strategy for containing new flu viruses as soon as possible to limit the spread of infection and a plan to build a sufficient supply system for antiviral drugs."


You might think it is over hyped but the rest of the world's govts don't think so.
It always reerupts in winter and in the past few weeks it is back in Vietnam, Four outbreaks in S Korea where they are killing birds, cats, dogs, and mice, In N Korea, Has spread all over Nigeria and Indonesia. Birdes are dying again in Turkey but tests are awaited to see if it has reoccured there.
Indonesia is percolating along with human cases, Egypt had one recently.

I'll keep looking for the article and will post it when I find it.
Hugs,
Mojorabbit

one I was talking of and I can't find it, that one was insurance risk acuary related. My brain is total fog today.
http://www.aapress.com/index.php?subaction=showfull&id=1166580747&archive=&start_from=&ucat=3&

It’s noon and the lunchroom is packed. Across from me sits Dr. Bob Gleeson, Northwestern Mutual’s bow-tie-wearing vice president and medical director. Despite the multiple conversations surrounding us, his words pierce through the lunchtime chatter.

“This is one of the rare moments in history where we actually have a chance to watch a global pandemic develop.”
snip

Over the last 25 years, Gleeson has become an expert in medical risk management: he predicts how long you will live.

“As of right now, the highly pathogenic H5N1 virus has mostly been transferred from bird to bird or bird to human,” said Gleeson. “We have calculated that there is 20 percent this virus becomes goes human to human in the next two years.”

This is what you said: "They figured the numbers using a smaller percentage than the 1918 pandemic had. A best case scenario and probably unrealistic esp. if the case fatality rate which is over 50 percent now does not drop way way low. Add to that collateral deaths if the grid goes down and it would be a nightmare.
I read that the insurance risk people give it a twenty percent chance it will happen within two years. Hope they are wrong."

You definitely were referring to the pandemic flu in your post, but the 20% figure was the potential for human-to-human transmission of bird flu. Two very different scenarios. The bird flu, which so far has not be shown to be transmitted from human to human (although bird to human cases have occurred) is very, very different from a pandemic. And has nothing to do with the study quoted.

The mixing of the pandemic study and the insurance executive's quote is what I call hysterical hype about flu.

transmission. It is old news and I guess because i have been following it for so long I though everyone was aware of it.
Here is an article.
http://www.iht.com/articles/2006/06/04/news/flu.php
SUNDAY, JUNE 4, 2006
In the wake of a cluster of avian flu cases that killed seven members of a rural Indonesian family, it appears likely that there have been many more human-to-human infections than the authorities have previously acknowledged.

The numbers are still relatively small, and they do not mean that the virus has mutated to pass easily between people - a change that could touch off a worldwide epidemic. All the clusters of cases have been among relatives or in nurses who were in long, close contact with patients.

But the clusters - in Indonesia, Thailand, Turkey, Azerbaijan, Iraq and Vietnam - paint a grimmer picture of the virus's potential to pass from human to human than is normally described by public health officials, who usually say such cases are "rare."

Until recently, World Health Organization representatives have said there were only two or three such cases.

On May 24, Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention in Atlanta, estimated that there had been "at least three." Then, on May 30, Maria Cheng, a spokeswoman for the UN health agency, said there were "probably about half a dozen." She added, "I don't think anybody's got a solid number."

And Dr. Angus Nicoll, chief of flu activities at the European Center for Disease Prevention and Control, Stockholm, acknowledged that "we are probably underestimating the extent of person-to-person transmission."

The handful of cases usually cited, he said, are "just the open-and-shut ones," like the infections of nurses in the 1997 Hong Kong outbreak and of a Bangkok office worker who died in 2004 after tending her daughter who fell sick on an aunt's farm.

Most clusters are hard to investigate, he said, because they may not even be noticed until a victim is hospitalized, and are often in remote villages where people fear talking about it. Also, he said, by the time doctors from Geneva arrive to take samples, the local authorities "have often killed all the chickens and covered everything with lime."

The WHO is generally conservative in its announcements and, as a UN agency, is sometimes limited by member states in what it is permitted to say about them.

Still, several scientists have noted that there are many clusters in which human-to-human infection may be a more logical explanation than the idea that relatives who fell sick days apart got the virus from the same dying bird.

For example, a letter published last November in the journal Emerging Infectious Diseases analyzed 15 family clusters from 2003 through mid-2005 in Southeast Asia. Scientists from the disease control centers, the WHO and several Asian health ministries noted that four clusters had gaps of more than seven days between in the time frame in which family members got sick.

They questioned conventional wisdom that only one, the Bangkok office worker, was "likely" human-to-human.

In one Vietnam cluster, not only did a young man, his teenage sister and 80-year- old grandfather test positive for H5N1 avian flu, but two nurses tending them developed severe pneumonia, and one tested positive.

In another questionable case, the Vietnamese government's assertion that a man developed the flu 16 days after eating raw duck-blood pudding was publicly ridiculed by a prominent flu specialist at Hong Kong University, who said it was more likely that he got it from his sick brother.
snip

And in a study published just last month about a village in Azerbaijan, scientists from WHO and the U.S. Navy said human-to-human transmission was possible.

more at the above article

I was answering your question re a link re 20 percent possibility it may go pandemic.

There was a recent article questioning the prevading thoughts that the case fatality rate had to drop. There is nothing that says it has to. I can dig that one up for you too. The 1918 pandemic had a 2-5 percent fatlity rate and 50 -100 million people died. Right now h5n1 has over a fifty percent fatality rate. Even if it dropped to 25 percent and went pandemic it would be a disaster. And the govt has said we would be on our own and not to expect help from the feds and to prepare. They say two weeks provisions which is ridiculous. Three months is what the state dept is telling the embassies overseas to tell their people there and that in my opinion is a minimum amt.

From the WHO geneva conference in Sept
http://www.who.int/csr/resources/publications/influenza/WHO_CDS_EPR_GIP_2006_3C.pdf
"One especially
important question that was discussed is whether the H5N1 virus is likely to retain
its present high lethality should it acquire an ability to spread easily from person to
person, and thus start a pandemic.
Should the virus improve its transmissibility by
acquiring, through a reassortment event, internal human genes, then the lethality of
the virus would most likely be reduced. However, should the virus improve its
transmissibility through adaptation as a wholly avian virus, then the present high
lethality could be maintained during a pandemic."

This caused quite a stir in the scientific community

If you have any questions I would be glad to direct you to more info.

changed their pandemic rating as originally human to human would have triggered phase four which would have caused major economic problems. So recently they changed it to sustained human to human for phase 4 which of course has not yet happened and I hope never does.

Dr Osterholm has a good presentation here
http://wilsoncenter.org/index.cfm?fuseaction=news.item&news_id=145329

DEAD WRONG.

Ten things you need to know about pandemic influenza

http://www.who.int/csr/disease/influenza/pandemic10things/en/index.html

Human to human transmission has occurred, but as of yet, H5N1 isn't contagious in the sense of your typical A strain. Better hope that it never reassorts or spontaniously mutates in such a way that it is, because at present, it's highly virulent.

Of course, pandemic influenza may well arise from another variant... it has before, and it will again.

and to show that now that that h5n1 bird flu is becoming endemic in so many countries and as more birds get it and as it constantly mutates the more chance it has of hitting the jackpot....Meanwhile sporadic human infections continue
Egypt reports two new human cases of bird flu
2 hours, 9 minutes ago

CAIRO (AFP) - Two Egyptians were taken to hospital after testing positive for the deadly H5N1 strain of bird flu in the central Nile delta region, the health ministry said.
ADVERTISEMENT

The latest cases brings to 17 the total number of Egyptians infected, including seven who were killed by the virus.

The two Egyptians from the village of Hanut in the Gharbiya governorate contracted the disease after coming into contact with infected ducks they had been rearing in their homes, according to a ministry statement carried by the official MENA agency.

All the birds in the house and in neighbouring homes were slaughtered and the area disinfected, MENA said.

Egypt -- the Arab world's most populous state -- is on a major route for migratory birds and has seen the third highest number of H5N1 cases after Indonesia and China according to Dr David Nabarro, the UN official charged with battling bird flu.

The H5N1 strain of bird flu was first diagnosed in birds in Egypt in February, and the first case in humans was announced on March 18.

You link to studies that show that the bird flu has probably been transmitted between humans. We've all heard about that. And there has been no outbreak. Your conclusions are all hype...

"and to show that now that that h5n1 bird flu is becoming endemic in so many countries"

No it isn't. It's a virus among a lot of viruses. It has occurred in a FEW countries. Your hype is intended to be scare-tactics, IMO.

" and as more birds get it and as it constantly mutates the more chance it has of hitting the jackpot....Meanwhile sporadic human infections continue"

That's cheerleading (i.e., "jackpot") for doom and gloom is very common. But the scientific position is that there is a risk of jumping, but it hasn't happened.

As I said in my other posts, scare-mongers try to take data from one circumstance (pandemic flu) and try to conflate that with another disease (bird flu) to confuse/conflate/hype the danger. You're guilt of that, mojo, IMO.

but your last post stated it had not been passed human to human. It has. It's a big DUH we are not in a pandemic situation yet.
This virus IS endemic in birds now in many countries. This is a fact.
It has been passed human to human. Fact.
It is mutating . Fact.
It lacks the ability to pass EASILY human to human so far.
Virologists all over the world are holding their breath that it does not obtain this ability while it is continually mutating. If it does THEN it is pandemic flu. 1918 flu was an avian flu that went pandemic.

You also say it has occured in a FEW countries.
It has occured in 35 countries in birds and is endemic in many of them including indonesia and in china who is vaccinating the heck out of their birds and because they have missed chickens there has been a drift and more mutations as the vaccination they are using is selecting for new strains that are resistant to their poultry vaccinations.

Here is your "few" countries
http://www.medicalnewstoday.com/healthnews.php?newsid=38569
n 2003 bird flu (H5N1) was found in Vietnam, South East Asia. It gradually moved its way further into Asia. Over the past few months the geographic spread has taken on a new speed, like a snowball going down a hill gaining momentum. Now (28 February, 2006) 35 countries have been hit by the bird flu virus.

Here is the list

-- Austria
-- Azerbaijan
-- Bulgaria
-- Cambodia
-- China (human cases confirmed)
-- Croatia
-- Cyprus
-- Egypt
-- France
-- Germany
-- Greece
-- Hungary
-- India
-- Indonesia (human cases confirmed)
-- Iran
-- Iraq (human cases confirmed)
-- Italy
-- Japan
-- Kazakhstan
-- Kuwait
-- Laos
-- Malaysia (human cases confirmed)
-- Mongolia
-- Niger
-- Nigeria
-- Romania
-- Russia
-- Slovakia
-- Slovenia
-- South Korea
-- Sweden
-- Thailand (human cases confirmed)
-- Turkey (human cases confirmed)
-- Ukraine
-- Vietnam (human cases confirmed)

Perhaps there are more, maybe there are some dead birds lying around in some other countries that we have not yet found, who knows? It is strange that North Korea, which borders countries that have reported bird flu in their territories (South Korea and China) does not appear on the list.

How many countries bordering Nigeria perhaps already have the virus? So far, only Niger has confirmed the presence of infected birds.

Is there anywhere that is safe from bird flu? According to ornithologists, only Australia and New Zealand stand a chance of staying out of this unpleasant league of bird flu infected countries. Australia and New Zealand do not lie in the paths of bird migration.

(The H5N1 virus itself was first detected in Hong Kong, in 1997)

This is an old list as human cases are not listed on it for egypt.

Virologists all over the world are worried this particular bird flu 'H5N1' has a good chance to go pandemic.Governments and business all over the world are making contingency plans. All the infectous disease doctors I know are worried about it and we have a lot of inf. dis docs as personal friends and as colleagues of my hubby.

I am watching it closely. OSHA has come out with new workplace recommendations for doctor's offices re this so my husband is in the process of complying with them for his family practice office. It is not a pleasant thing to think about but it is not fearmongering to be aware of the possibilities.
And I resent being called a cheerleader for presenting FACTS. I am a nurse and have been following this for several years and listening to what respected top virologists in the field are saying.I have educated myself.

8th Egyptian Dies of Avian influenza
-------------------------------------------
An Egyptian woman died of bird flu on Sun 24 Dec 2006, only hours
after tests confirmed she had been suffering from the highly
pathogenic H5N1 virus (see part <1> above), a World Health
Organization official said. Hassan el-Bushra, regional adviser for
communicable diseases surveillance at the WHO, said the 30-year-old
woman had been in hospital since mid-December 2006, but doctors had
not immediately suspected bird flu, as she denied having had contact
with poultry.

Her death brings the number of total human deaths from H5N1 in Egypt to 8.

--
ProMED-mail
<promed@promedmail.org>
two more still in hospital

2 hours, 47 minutes ago

CAIRO (AFP) - A 15-year-old girl has died from the H5N1 strain of bird flu, the second such death in as many days in Egypt, the health ministry in Cairo said.
ADVERTISEMENT

Her death brought to nine the number of people who have died in Egypt after contracting the deadly strain -- the previous victim being a 30-year-old woman from a village in the central Nile delta region who died on Sunday.

H5N1 was first diagnosed in birds in Egypt in February, and the first case in humans was announced on March 18. In its most aggressive form, it has killed more than 150 people worldwide, the
World Health Organization has said.
http://news.yahoo.com/s/afp/20061225/wl_africa_afp/healthfluegypt_061225162125

http://www.alertnet.org/thenews/newsdesk/L27501060.htm

More
CAIRO, Dec 27 (Reuters) - A 26-year-old Egyptian man died of bird flu on Wednesday after 10 days in hospital, an official of the World Health Organisation (WHO) told Reuters.

Brick factory worker Rida Farid Abdel Halim was the third member of an extended family in the Nile Delta province of Gharbia to die of the disease, said Hassan el-Bushra, WHO regional adviser for communicable diseases surveillance.

It was the 10th death from bird flu in Egypt since an outbreak of the deadly virus started in February

in the medical journals and as there have been several conferences of the experts lately it is making news as they are covered.

I'll chime in my two cents here for what it's worth.

Before we fall into a frenzy of mass hysteria about about the impending doom of flu pandemics and comparing it to the flu pandemic of 1918, we should perhaps do some reflecting about the conditions surrounding Patient 0, timelines, and the nature of the virus itself associated with the 1918 pandemic.

As well, the virus did not behave like normal flu viruses. This is a VERY noteworthy point.

It certainly is an interesting story if you do some digging and it forces you to ask yourself some very interesting questions.

No case of bird flu detected in IRI
-------------------------------------
Head of Iran Veterinary Organization Hossein Hassani said Sunday <24[br />Dec 2006] no case of bird flu has been detected in Iran yet.

Hassani told IRNA that the Islamic Republic of Iran is still among
those states which are "clean of the bird flu virus" (H5N1).

Asked what the reason was behind the culling of chickens in some of
the chicken farms around the country, the official said that the
Veterinary Organization decided to immediately destroy any suspicious
case, since avian flu has been pandemic in some (neighboring) countries.

Hassani added that the culling of the suspicious cases does not
necessarily mean that a case of bird flu was found in the country. He
said there was no reason to feel concerned about the outbreak of the
disease in Islamic Republic of Iran.

--
ProMED-mail
<promed@promedmail.

and a giant asteroid could rain down fire and wipe out 90 percent of life on earth in a day, hell, it happened before, so by all means let's run around like chickens w. heads cut off in case it happens again

this dude is out for funding $$$, which is fine, but he pretty much acknowledges that he is exaggerating for effect, which in is really lying for the dollar bill if you ask me

they did not take into account factors like improved symptom management, treatment of secondary pneumonia (which develops after the flu and was a major killer in the 1918-20 pandemic), vaccination, and so on.


in other ways, they straight up lied and exaggerated

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