So if identifying the exact strain of virus is expected to cost thousands of dollars, how do they know progression of the flu through the country? Do they actually perform those tests, or are they guessing?

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"Oh no no no I'm a rocket man Rocket man burning out his fuse up here alone." -- Sir Elton John

J Pax

Depends on which virus you are identifying whether or not there is a cheap commercial lab test or whether or not you have to do extensive DNA testing. Then there is the issue of collecting the specimen, preserving and transporting the specimen.

First comes the research. Viruses are identified after extensive work. For SARS it was the first time a new virus was found so quickly. For HIV it took years to find. Then you can test for that virus with extensive processes and DNA evaluation.

When it is useful to do, next comes development of commercially available tests. Finally, if the market will pay for one comes the availability of less expensive commercial tests.

We do not have those tests for the 100+ viruses that have been identified as sources of respiratory infections. So identification of the majority of them is only done for research. Your doctor cannot order the test. That would cost you thousands of dollars to do without an inexpensive commercial test.

For influenza there is a commercially available test that costs about $100.oo. It is useful if you are deciding to prescribe Tamiflu since you need to start it on the first day of symptoms for it to do any good. As far as flu monitoring goes, the CDC, WHO and other countries' equivalent of the CDC all collect samples from what are called sentinel sites. Those samples are tested for flu and a small percentage of them are subtyped as to the specific strains. By doing the sampling and monitoring other things like school absenteeism it is possible to determine when flu outbreaks are occurring. This endeavor costs thousands of dollars per total specimens of flu detected since the majority of tested specimens are always 'not flu.'

It's time for you to quit asking me and do some research on your own since you seem to think I am making the answers up.

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The real news, including science news corporations may not allow on stations they own. http://www.democracynow.org/

I never wrote that and I don't think that.

I thought I had an answer and you suggested I was wrong, so you doubted me first. As I wrote in a previous post, I thought I knew who I got it from and since I got sick with the same symptoms immediately thereafter, and that person's doctor told them it was the flu. You're right that I could be mistaken, but it seemed fairly straightforward. Besides, I did some research, but you told me it wasn't helpful and that I would need to see a doc for an accurate diagnosis anyways, except that a specificity test would probably not be needed and treatment would be based on examination of symptoms instead of pathogenic identification. At least that's how it appeares from my perspective. I don't doubt your expertise and likely correct judgement in the issue, but I think this is a common experience non-healthcare people have with medical professionals. I'm sorry if you think I am trying to argue with you. I'm not. But I'm running a fever again and it tends to make me irritable.

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"Oh no no no I'm a rocket man Rocket man burning out his fuse up here alone." -- Sir Elton John

J Pax

It sounded like you were being sarcastic when you said, "if identifying the exact strain of virus is expected to cost thousands of dollars, how do they know...." And, I didn't doubt you, I knew you were wrong. You are talking my area of expertise. But don't take it the wrong way. I'm sure there are plenty of things you know more about than I do, this just isn't one of them.

This wasn't your fault. It's the fault of 99% of the doctors who don't take the time to explain anything to their patients.

That's true. But you didn't go to a doctor. You kept guessing what you might have.

And I was crabby from not enough sleep so I'm sorry as well.

Triggers that cause people to see a doctor include failure to get well in the expected time. Maybe you do need to see someone. You could have a secondary infection caused by bacteria that were able to infect you after a virus set the situation up. It is possible though, you've just been unlucky enough to get two things in a row.

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The real news, including science news corporations may not allow on stations they own. http://www.democracynow.org/

Really the Bird flu is very critical problem it causes lots of casualties in most of the countries .A large number of population is affected due to this disorder .Especially in Asia this is in very serious form .It needs to be control .Actually this is viral disease so it spreads easily .Relenza is the medication which is mostly used in that situation.

Please see the link for more...

http://www.drugdelivery.ca/s33713-s-RELENZA.aspx

Well, remember the killer bees? We are all supposed to be dead of bee stings by this time. Then there was the whatever it was called when all the worlds computers were going to crash at midnight at the beginning of this century creating utter chaos from which we could never recover. But we are here. Then the Goat sucker was working it's way north and was going to kill all the cattle on it's way, but I'm still eating steak.

We are, however, suffering from one plague that those on this board recognise, but which the less enlightened, even though highly educated public cannot recognise. I, of course, am refering to the ignorance and superstition that lurks under the euphemism, religion. Intelligence and education seem inneffective against this disease. I call it the SWI syndrome, for Selective Wilfull Ignorance.

Is there any hope? Is there balm in Gilead? I don't think so. I'm glad I'm not young anymore.

The Admiral

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Dave(The Admiral)Nelson

As I understand this, the potential for a major threat is definitely there. There are a great many birds dying of a very virulent influenza virus (identified as H5N1, referring to sequence motifs in two of the virus's surface proteins). The virus has infected people and has killed people, but its current form does not seem able to pass from person to person.

However, if the virus mutates in such a way as to become transmissible from person to person, or if a person becomes infected with both the avian H5N1 and a human influenza virus at the same time (in which case they could recombine into a new form that has the H5N1 virulence and the ability to pass from person to person), then the threat will become very real very quickly.

There are several "if"s and "could"s there, but the time to act is now, because there will not be time after the virus has mutated. Avian H5N1 has arrived in the EU (at least one of the Greek islands in the Aegean, and a bird held in quarantine upon its arrival in the UK). Be concerned, but don't panic.

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The quarrelsome oarsmen were rowing,
The great violinist was bowing;
But how is the sage
To tell, from the page:
Was it pigs or seeds that were sowing?

I voted "not afraid" - I'm a doctor, not a poultry farmer in southeast Asia. Otherwise, I would have voted very concerned, and rightly so.

But ask me again if/when the first human-to-human outbreak of more than anecdotal proportion comes up. Then we are talking fear.

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Non sunt multiplicanda entia praeter necessitatem.

One thing i do when there's this type of nebulous discussion is look at the location of the posters. With a couple exceptions, Americans often seem more 'frightened' or concerned about general threats....whether it be bird flu, the guy on the street corner, terrorism, etc. Non-americans (like me) take a bit more of a stand-off attitude and express a little more skepticism that things aren't quite as dire as they may seem in the media. No need to lock the door, invade a country or worry about where to line up for vaccine.

Now I admit that Avian flu and related topics are not my forte and my opionion of the actual flu bug isn't worth 2 cents. I just wouldn't get too worked up, however, by the way the American press presents impending crisis or doom and gloom scenarios.

Seems to be a lot of opinion here about risk. How about considering the science instead of the news for your sources of information?

I don't walk in fear of the next Cascadia subduction zone earthquake but that doesn't mean I don't believe the next one is as inevitable as the last 10. Clearly the geological science is overwhelmingly predicting the next one sometime most likely in the next 200 or so years.

Who cares what the news reports? Name one recent event when the majority of reporters got the science right.

Pandemics have occurred regularly in history for many reasons which I will not bother to rehash. There will be another one and more after that until medical science advances a bit more.

We did avert the SARS pandemic that would have most certainly occurred had medical science not been as advanced as it currently is. The things which came into play that were not present in history were international cooperation and a level of treatment capability in countries such as China and Vietnam that were not previously there. In addition, the ability to identify the infectious agent in a matter of months and then contain all cases and contacts had not previously been done before.

Now we are closely following a potential mega-pandemic in its earliest phases. This hasn't been done before so we have, 1) the news media reporting all sorts of non-scientific stuff in nonscientific ways, and, 2) no idea if these early phases are going to continue or fade away and on what time table.

At the same time, a flu pandemic will not be as containable as SARS because there will be too many persons with mild or no symptoms that will spread the virus. With SARS, since everyone infected was critically ill, there was no problem isolating and tracing contacts of those afflicted. (There were problems with effective isolation but those problems were eventually overcome.)

The current status of this potential pandemic is the disease has now moved into huge numbers of birds that are both being transported and smuggled long distances as well as into huge numbers of migrating birds whose migration ranges overlap in such a way as to take this virus to all corners of the planet in the next few months. We were unsuccessful containing it despite several very thorough attempts in 1997 and 1999 when it was still a localized disease in China. Containment was completely lost by 2003 and just since July of 2005, the virus spread beyond Asia across Eastern Europe in a very short time. The virus is expanding its territory on a logarithmic scale.

Bird species of all types, pigs and many members of the cat family have been infected as well as a few humans.

So, the virus is deadly, infects multiple species, is now widespread and is very soon to be worldwide. All attempts to stop its spread have failed. The number of chances for both mutations to occur and for more human contact with the virus is increasing exponentially. That is the science, not the news.

I'm not losing any more sleep over it than I am worrying about the inevitable next great earthquake my hometown will eventually experience. But I am certainly taking it seriously and working on plans to deal with it when the time comes. It would be foolish to overreact but also foolish chalk it up to media hype and ignore the possibility.

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The real news, including science news corporations may not allow on stations they own. http://www.democracynow.org/

would it be possible for a human to contract this flu but to be immune to it and so spread it more effectively. I know that some people are immune to the AIDS virus.

I think in fact that these `lucky` folk are in fact the people who cause the most problems on a societal level. It really is unfortunate that those who perhaps have least to fear (although of course people don't know this sort of thing in advance), are in fact the vectors from which others have most to fear. An interesting paradox if you will.

Both my paternal grandparents died in the 1918 epidemic, so this interests me somewhat.
Sorry to be skeptical, Beskeptical (well not really skeptical, just curious); but how rigorous is the evidence for a long term cycle, and how would it operate in the modern demographic situation?

The world is much more populous than ever before; that means more people, and quite possibly many more domestic fowl; do you think that will have an influence on thse cyclic nature of this sort of pandemic?

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I was surprised this thread dated back to February since I hadn't seen the media take much notice until the last month or so. Now they're screaming about it.

My answer to the original question would be:
More than the media concern a year ago. Much less than the media concern now. And more than the media concern in six months or so when they'll haved forgotten it and moved on to something else.

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Cum catapultae proscribeantur tum soli proscripti catapultas habeant.

No one has been found to be completely immune to HIV-AIDS. Be careful what you read.

There is a genetic mutation that makes it difficult to get infected with HIV and if you inherit 2 copies, one from each parent, you have a lot of resistance but it turns out the virus can still infect even those people.

There are also what are termed "slow progressors" who have gone a long time with HIV that hasn't progressed to AIDS but those folks are still infected.

Lots of people will have 'bird flu' (H5N1 strain) and may have no symptoms at all if past experience is any indication. They can spread the infection after an incubation time. They may not be the most 'effective' spreaders though. But silent spreaders create different problems.

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The real news, including science news corporations may not allow on stations they own. http://www.democracynow.org/

There are multiple factors that make for cycles of disease. It isn't just that viruses or bacteria have some cycle of pandemics.

Some organisms cause epidemics in waves. That usually has to do with the fact they 'burn themselves out of fuel' so to speak. When enough people have been infected the chain of spread can no longer be sustained. After a few years pass there is a whole new crop of susceptible people born into the population. When the numbers reach enough for sustained transmission we have a new epidemic.

Some epidemics occur when certain conditions come together. Since those conditions recur, epidemics recur but each new one may not be related to past epidemics.

The 1918 flu pandemic occurred because conditions came together, but there may also have been such time since any previous pandemic that the majority of the population was susceptible. That is the condition we are facing now as well. And, yes, the conditions today, while different than 1918, may have the same result in easy spread of disease around the world. The close monitoring may have an impact on the human cases but we have been unable to stop the animal cases (birds) despite watching it happen.

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I may have posted something on this as far back as 1997 on the BABB forum IIRC.

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The real news, including science news corporations may not allow on stations they own. http://www.democracynow.org/