avian flu?

[HOWMAR]

You sound like a FEMA public relations spokesperson... Are you telling us that we should just sit back and trust our governments to defend us from this coming pandemic? Avian Flu human infection has a mortality rate of around 50%, and the only known agent being used to treat it is Tamiflu. The US expects to have 2.5 million treatment courses of this antibiotic within a year, for a populations of over 270 million. Also, there's new evidence that the strain of the H5N1 avian flu virus infecting humans is showing increasing resistence to Tamiflu.

No I am not saying sit back. But to create a panic only causes more death. Yes, there are only 2.5 million doses of Tamiflu (an antiviral, not an antibiotic)currently available in the US, with an additional 500,000 doses being produced weekly. CDC researchers (yes government employees) are showing that an older drug Amantadine (Symmetrel) is equally effective as Tamiflu. Amantadine is in fact easy to produce and costs 10% of Tamiflu. The CDC is in the process of securing manufacturers of a stockpile.
As a medical first responder in the US, I can assure you that all local agencies in the US have plans in the event of an outbreak (For bird flu as well as bio-terrorism). Isolation is just one part of that plan.
As far as the 50% mortallity rate. Remember that the population infected so far is in 4 Asian countries. US public health experts don't believe that the US mortality rate will be a fraction of that due to a better health care delivery system.

To read on Amantadine:
http://www.medicalnewstoday.com/medicalnews.php?newsid=30189

The only thing that panic will cause is the hording of the available Tamiflu is regions that it is not needed and use by people who are not at the greatest risk of the disease. Much like last years flu vaccine shortage, those with the highest medical risk should receive the drug first.

How many doses of Tamiflu do you have in your medicine chest?

 

[Mirador]

...
How many doses of Tamiflu do you have in your medicine chest?

I have none, nor my neighbors, who cannot afford pharmaceuticals and when they're treated at the local hospital, here in Azua, and in San Juan de la Maguana, they're issued prescriptions for commercial drugs. However, I have baskets, bags, and containers full of herbs, and/or know where to find them.

Regarding treatment for H5N1 viral infection, the pandemia will be caused once H5N1 mutates into a strain that is transmissible human-to-human. Until now transmission has only been bird-to-human. Since the human-to-human strain is yet non existant, there is no proof that current antiviral treatments will work once it mutates. There is no scientist (or 'medical first responder') worth his/her salt that can guarantee that Tamiflu (or Amantadine) will work once the person-to-person strain of H5N1 is unleashed.

Also, we can assume that we in DR1 are not a bunch of restless natives who are going to run and exhaust the insufficient facilities and resources that our governments have shortchanged us with. I witnessed our own 'New Orleans' about 8 years ago, when the communities down river from the Sabaneta dam were not warned about the impending break caused by hurricane George, for bureaucratic reasons. Thousands drowned. Just outside of Copei (south of San Juan) my cousins and I burried 23 uncollected corpses in an unmarked grave next to the ceiba tree (the one on the side of the dirt road were an old tire marks the entrance to the village, where there's still no electricity nor running water...).

Two years ago I came down with dengue. I didn't know what I had, and weeks later I found out that the area had been stricken, and local health authorities hid the fact. Some of my neighbors who got the hemorrhagic version died as a consequence of ingesting aspirin for the symptoms, even after having consulted at the local hospital.

Panic?

 

[HOWMAR]

I have none, nor my neighbors, who cannot afford pharmaceuticals and when they're treated at the local hospital, here in Azua, and in San Juan de la Maguana, they're issued prescriptions for commercial drugs. However, I have baskets, bags, and containers full of herbs, and/or know where to find them.

Regarding treatment for H5N1 viral infection, the pandemia will be caused once H5N1 mutates into a strain that is transmissible human-to-human. Until now transmission has only been bird-to-human. Since the human-to-human strain is yet non existant, there is no proof that current antiviral treatments will work once it mutates. There is no scientist (or 'medical first responder') worth his/her salt that can guarantee that Tamiflu (or Amantadine) will work once the person-to-person strain of H5N1 is unleashed.

Also, we can assume that we in DR1 are not a bunch of restless natives who are going to run and exhaust the insufficient facilities and resources that our governments have shortchanged us with. I witnessed our own 'New Orleans' about 8 years ago, when the communities down river from the Sabaneta dam were not warned about the impending break caused by hurricane George, for bureaucratic reasons. Thousands drowned. Just outside of Copei (south of San Juan) my cousins and I burried 23 uncollected corpses in an unmarked grave next to the ceiba tree (the one on the side of the dirt road were an old tire marks the entrance to the village, where there's still no electricity nor running water...).



Panic?

I simply don't understand your points. I responded to the poster who said that the US was no more or less prepared than the DR for a possible epidemic. I disputed this statement as the US is committing large amounts of resources into this. Both the CDC and NIH have made major committments to this potential problem. In fact, yesterday the NIH announced that they have broken the gentic code for the virus and it is identical to the 1918 virus (which they maintained a sample in their lab). You then repsonded that the US is "Totally unprepared and contemplating a military solution". In fact the "military solution" was just part of the US's preparedness. In addition to treatment and support, isolation is a major tactic in control of a communicable disease.
Now you say that the DR is totally unprepared....My point exactly.

Also, we can assume that we in DR1 are not a bunch of restless natives who are going to run and exhaust the insufficient facilities and resources that our governments have shortchanged us with

No, you can assume we will just overwhelm the insufficient private facilities.

Two years ago I came down with dengue. I didn't know what I had, and weeks later I found out that the area had been stricken, and local health authorities hid the fact. Some of my neighbors who got the hemorrhagic version died as a consequence of ingesting aspirin for the symptoms, even after having consulted at the local hospital.

It really made no difference that you didn't know that you had Dengue. TTreatment is the same for any viral syndrome, supportive therapy, fluids and control of fever. It's a shame that your friends took aspirin. Nobody today should take Aspirin for any viral syndrome as it is related with hemmorhage and Reyes Syndrome. Acetominphen is the antipyretic of choice due to its safety. I guess it is safer to cosult webMD than a DR MD.

 

[Keith R]

Guys, don't let this degenerate into a debate about the state of readiness in the US. Keep it DR-related. So far you more-or-les have, but I can detect the temptation to off on the tangent...

The Environment Forum Moderator

 

[mami]

well being we have to keep it Dr related...

with all this talk on cnn and other newscasts about a impending pandemic that could take place in regards to the avian flu..i was wondering what sort of measures the goverment in the dr is taking to prevent this from happening on that beautiful island. the dominican people need to be informed of this danger that these birds ( chickens) pose to their health..some countries even monitor cockfights.

The DR is doing nothing about it and won't as it does for most things

 

[Mirador]

The DR is doing nothing about it and won't as it does for most things

Exactly!, and in the hypothetical case that H5N1 outbreaks in the DR, our government is going to hide the fact, like we now hide our dengue, malaria, our increasing crime rate, etc., in order to not 'scare away the tourists'. And now with President Bush's proposed military solution the DR has even more reason to hide a potential outbreak of H5N1. I'm sure that many countries in Asia will also go this route. Who would want to be quarantined?, more so if the virus is so deadly, and you don't have access to the treatments available for the developed world?.

 

[Keith R]

Hiding it would be extremely stupid of the Dominican or any other government of a nation with a heavy tourism industry, given the predictions of how communicable this disease could be once it starts passing among humans. Without quarantine measures, an infected tourist could easily and unknowningly take the disease back to his home country (Canada, US, UK, etc.), spreading the crisis.

 

[HOWMAR]

Exactly!, and in the hypothetical case that H5N1 outbreaks in the DR, our government is going to hide the fact, like we now hide our dengue, malaria, our increasing crime rate, etc., in order to not 'scare away the tourists'. And now with President Bush's proposed military solution the DR has even more reason to hide a potential outbreak of H5N1. I'm sure that many countries in Asia will also go this route. Who would want to be quarantined?, more so if the virus is so deadly, and you don't have access to the treatments available for the developed world?.

This just shows that the addage "what goes around, comes around" is true. If you remember about a year ago, the DR placed an embargo on the import of beef from the US due to a reported case of Mad Cow Disease. Despite this being an isolated case that didn't enter the food chain, it took months of negotiation (probably payoffs of public officials) to reopen the DR market to US beef. I am sure the US government won't hesitate to isolate the DR if any cases of bird flu are reported.

 

[mami]

i just think the DR has the resources to do anything

 

[Keith R]

I am sure the US government won't hesitate to isolate the DR if any cases of bird flu are reported.

Especially if they feel that Dominican authorities have been hiding cases. I would expect Canada to do likewise, quickly. Given the large daily flow of tourists between these two countries and the DR, neither could afford to have a tourist to unwittingly bring the contagion back to North America. Cruel as it may sound, from a public health point of view, if bird flu is found in the DR or any other Caribbean island, the smartest move would be to quickly isolate it to the island in question and send in medicine and PAHO specialists in handling epidemics.

 

[HOWMAR]

i just think the DR has the resources to do anything

Did you leave out the word "don't" as in "I just don't think"

 

[mami]

sorry

Did you leave out the word "don't" as in "I just don't think"

yes sorry but i think everyone got the drift.

 

[mami]

Canada could actually afford the medicine and the quarantine

Especially if they feel that Dominican authorities have been hiding cases. I would expect Canada to do likewise, quickly. Given the large daily flow of tourists between these two countries and the DR, neither could afford to have a tourist to unwittingly bring the contagion back to North America. Cruel as it may sound, from a public health point of view, if bird flu is found in the DR or any other Caribbean island, the smartest move would be to quickly isolate it to the island in question and send in medicine and PAHO specialists in handling epidemics.

the higher up in the DR would probably abandon the island.

 

[Mirador]

... I am sure the US government won't hesitate to isolate the DR if any cases of bird flu are reported.

"A contract worker with the Canadian Food Inspection Agency is believed to be the first human in Canada to develop avian flu.Health officials in British Columbia said the male employee was inspecting a poultry farm in the Fraser Valley."

Canadian Avian Flu case

Maybe Canada will be isolated first. Who knows if they are already hiding their bird flu cases... I would start banning all Canadians from travelling to the DR...

 

[Keith R]

Maybe Canada will be isolated first. Who knows if they are already hiding their bird flu cases... I would start banning all Canadians from travelling to the DR...

LOL. Point taken. If bird flu shows up in humans in Canada, I would expect many nations to seek assurances from Canada that they have the case isolated and health safeguards in place. I would trust public health authorities to get the job done far more than I would Dominican authorities, sorry to say.

And in any case, it is easier to quarantine an island than it is a country with a long, porous border like Canada's.

 

[paddy]

Nothing like yelling fire in a movie theater. The military proposal is just part of the planning, which includes the military as well as the public health sector. Isolation is only one proposal. Thought not likely to be very effective in a society such as the US. There are other plans, such as stockpiling of anti-viral agents, supportive therapy agents (IV fluids, etc.) and mobile mass casualty hospitals. All in the event the virus does mutate to heman to human transmission and a vaccine is not developed. The high death rate of the 1916 epidemic probably will be lessened by the advances in supportive therapy of the 21st century. Even though there may be no vaccine to prevent the infection, good hospital care will probably save many which would have died in the past. To say the US is totally unprepared is probably not correct. To say the DR is on the same level of preparedness as the US is not correct also.

how loud can you yell in the dr to let ALL the people know that there is in fact a health threat out there that is related to chickens..a mainstay in their culture and cusine? in the us we call that a "heads up". are the dominican newspapers and tv programs even mentioning avian flu?

 

[paddy]

the higher up in the DR would probably abandon the island.

you're right...it would be like turning the light on in a kitchen full of cockroaches...not only in the dr but in other countries as well...the haves will head to the airport..the have nots will stay....ala new orleans.

 

[Mirador]

you're right...it would be like turning the light on in a kitchen full of cockroaches...not only in the dr but in other countries as well...the haves will head to the airport..the have nots will stay....ala new orleans.

You won't have to travel. There could be 'avian flu-free' enclaves in the country. Sosua could be one of these...

Also, by the time a bonafide certified avian-flu case is detected in the DR, there will be nowhere else to go. Avian flu is being disseminated worldwide by migratory birds, and there's no place on earth that these birds don't land. By the way, have you been to 'Laguna de los Reyes', a picturesque lagoon hidden between rolling hills north of the town of Juan Barón (Sabana Grande de Palenque) close to Nizao? It's a favorite for seasonal duck hunters. If you go, don't forget to take your shotgun, and you can leave your conscience at home, since you won't be killing birds but saving the DR from Avian flu.

 

[paddy]

heads up

http://today.reuters.co.uk/news/new...9695_RTRIDST_0_SCIENCE-BIRDFLU-ROMANIA-DC.XML

 

[canadian bob]

Mirador, I am interested to learn what you actually mean re: "I have baskets, bags, containers full of herbs & / or know where to find them." Is this for real, or am I missing a hidden meaning here ...? Curious & hoping for your explanation....Canadian Bob.