Talk:Influenza A virus/Archive 1

This is an archive, and should not be modified. If you have any comments, please make them at Talk:Avian influenza.

initial comments
Wikipedia was used as a place for collective reaction regarding the tsunami. I thought it could be used for same regarding an influenza pandemic. Apparently it's not the case.

So here we may discuss how we could proceed with having a "social preparedness plan" that may be "work in progress" and as such not suited for wikipedia, but that is nevertheless very important in the face of a (factual and documented) substantial risk of a pandemic.

So let's keep the facts here and look for a "preparedness place" somewhere else.

lugon

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This page needs lots of work:


 * A better classification of the ways to prevent a pandemic and for damage-control.
 * More and better organised links to preparedness plans (by country), and maybe (if we can document it) "what is needed where".
 * A link to "the teachable moment" and the context for such a link.
 * Links to the basics of epidemiological surveillance so readers may understand the concepts and what the goals are and how to make better systems where they are needed.
 * A pandemic will do lots of harm in places where there's no surveillance and response system at all. How do we document that and what links do we provide so that those who can act locally can set up "some kind of system" (maybe informal but possibly useful)?

lugon

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Some people think......
That this avian influenza is an overhyped government scam to increase phamacudical industries profits, that the only deaths in two years have been 62 people and it was from direct contact with the infected chickens. Also human-to-human spreading does NOT happen. I personally agree. -Anon A Mouse
 * Although human-to-human transmission obviously did occur during the 1918 avian influenza epidemic, we don't know if it will happen with H5N1. We do know that the virus is constantly mutating. I doubt that anyone's making piles of money from avian flu especially since even Tamiflu appears to be losing its effectiveness. Scientists have been anticipating another big flu ever since 1918. This isn't driven by government. --Lee Hunter 02:57, 6 October 2005 (UTC)
 * But if they've been anticipating it since 1918 why hasn't anything happened untill now? See I am all into the organic, no medicine, no vacine thing, and this article dosn't seem to include all views.
 * You seem to be confused. Scientists have been aware for a long long time the 1918 pandemic could easily happen again. However, no one knows which virus will be the one which mutates into the pandemic if it does occur. There are probably many that have good potential but our aim is to ensure they never get the oppurtunity! Previously, for example in 1997 in HK there have been scares but this is probably the scariest event so far. Currently H5N1 is a very good candidate given number of cases and the way it is spreading throughout the world. It is really difficult to produce medicines/drugs against viruses, of course there has been some success, what do you think tamiflu etc are? Of course, there is little incentive to produce a drug specifically for avian influenze but then again, given the number of possible targets it's not clear if such a move will be much use. Unless we know the precise virus which will create the pandemic, it's impossible to be sure it will be effective (actually if we are successful enough our drug may prevent the pandemic in the first place). Having said that, work is going on to create more drugs effective against influenze, and avian influenze and H5N1 in particular which will hopefully be effective should the pandemic strain arise. Vaccines are more successful in general but much trickier. A vaccine against one strain is likely to be very ineffective against another strain. It is hope the vaccine against H5N1 will be at least partially effective against the pandemic H5N1 should it ever arise but we don't know. However the vaccines which have been or are being created will be effective in stopping people in Asia etc getting the current non-pandemic strain and in stopping the spread between birds. Of course, there has been a lot of work on vaccines in general and vaccines for influenze since 1918. Currently vaccines for influenze save countless lives especially over the winter (albeit mainly in rich countries that can afford them). BTW, these vaccines have to be created every year because the previous vaccines is likely not effective against this year strain (many people will already be resistant to last years strain anyway). If you really want to start up conspirary theories, you'll need more credible sources then 'some people' and you'll also need someone who better understand what they're talking about (maybe not a prerequieste, some of the AIDS conspiracy theorists don't seem to). The ironic thing is that if scientists are successful in helping evert the potential catastrophe, there are probably going to be lots of people like you saying it was one big money making conspiracy and if we fail, everyones going to blame scientists etc for failing! P.S. As someone who can perhaps be considered a scientist even if not involved in H5N1, I'm deeply offended by you apparent suggestion that we're all working together with the gov and the big drug companies in some conspiracy theory. I'm not saying scientists, govs and especially drug companies are angels but some of the claims people make are just plain ridiculous). P.P.S. Perhaps I'm not clear but when we are talking about these things, we aren't talking about a few set strains in this world that are defined by God or whatever. Strains are continually changing. Even the word strain may be a bit confusing since a strain. It's hard for me to explain, read up a bit and perhaps you'll understand. Nil Einne 13:38, 10 October 2005 (UTC)

Should all the general pandemic stuff be placed under the pandemic area? Avian flu is not uniquely prone to pandemics.

Response: not sure. I think influenza pandemics are peculiar, very different from AIDS, much worse than SARS. See "The overall picture" below for a suggested outline on how to organise this. lugon

btw there was a very good http://www.sarswatch.org

History or a timeline
There should be a timeline section added chronicalling its deadly and repeated history. - RoyBoy 800 16:46, 13 Jun 2005 (UTC)

US Centric
Perhaps the comments about what a U.S. citizen can do before and while travelling should be generalised to include people from other countries?

Which masks work
The current text on masks reads, "Masks. Not any kind of mask works. 'Weak' masks may even provide a false sense of security." How can a layperson tell whether a mask works? Is there any kind of mask that's worth using during a pandemic, even if it doesn't provide complete protection? &mdash; Rootbeer (Tom) (U 19:17, 14 Jun 2005 (UTC)

NanoMasks are best to use against the Avian Influenza. They are only a false sense of security if they are not put on correctly.

Pictures
This article could be slightly improved with some non-copyrighted or fair-use pictures of the virus under a microscope or of the disease's effects on whichever animals it produces symptoms in. Or better yet, a map of its global distribution. Mr. Billion 02:34, 15 Jun 2005 (UTC)

Agree: a map with global distribution will improve the aricle User:Quattrop 10:41, 23 Aug 2005 (SGT)

The overall picture
What do people need to know? The overall picture could be like this ... and obviously needs work!

Influenza pandemics:
 * Influenza
 * Influenza viri
 * Description
 * Types (A, B, C)
 * Species (birds, pigs, humans, etc)
 * Epidemiology of influenza (clinical stages, transmission, factors affecting spread, etc)
 * Symptoms, outcome, statistics
 * (Influenza) Pandemics
 * History, timeline, how previous pandemics have unfolded
 * Lessons learned (what worked and what didn't)
 * Impact scenarios for the future (with scientific references), web calculators (what it might be like given certain conditions)
 * Stages (as defined by World Health Organization)
 * (Influenza) Pandemic preparedness
 * Elements for a plan (governance, information, antivirals and vaccines, appropriate masks, other non-pharmaceutical actions, non-health actions)
 * Activities (prevention, slow down, healthcare, society ...)
 * Plans (or lack of) in each country etc
 * What needs further work
 * How to protect people in countries without vaccine production etc
 * Faster ways to produce vaccines
 * Communication of effective prevention practices
 * Current situation
 * Current stage according to World Health Organisation
 * Avian epidemics in countries
 * Human cases in countries
 * Vaccine developement
 * Sources of information
 * Official news
 * Blogs
 * Official news
 * Blogs

Some questions:
 * What else do we need to fit in?
 * How do we improve the outline?
 * Maybe all this needs a page of its own ("influenza pandemics")?
 * How are these things done at wikipedia?

Lugon 12:52, 16 Jun 2005 (UTC)

Avian Influenza + Influenza + Pandemic
Three pages that need to interact somehow, or maybe this begs for a fresh page: What do you think? What should we do? Is it as easy as creating a new article and moving content apropriately?
 * I guess Influenza should have all the information related to the virus itself: types, Neuraminidase, Haemaglutinin, etc.
 * Pandemic is a general term so I suggest let's not touch it. The term "pandemic" can be atatched to AIDS, SARS, tobacco, overweight ...
 * Avian Influenza is a bird disease which affects a small number of humans.
 * When avian influenza starts a pandemic it's no longer avian flu: it becomes Influenza Pandemic which stands on its own.

Lugon 11:07, 17 Jun 2005 (UTC)

amantadine resistance
The WP has a big article about avian flu developing amantadine resistance due to widespread use of amantadine to vaccinate chickens in China. Could someone knowledgeable edit the pandemic-related part of this article? I did a little bit but I think more is needed and I don't have the expertise. This is a serious development and is reminiscent of the mis-handling of SARS, but potentially far worse. 63.203.206.121 11:27, 18 Jun 2005 (UTC)

Suggested new page: Influenza pandemic
Influenza pandemics: = Influenza =

Influenza viri
influenza

Species (birds, pigs, humans, etc)
A table with all different subtypes and which are in which species

Epidemiology of influenza
Things may change if a pandemic starts, but until now, influenza has behaved like this.

Clinical stages
(herd immunity)
 * Susceptible
 * Incubation
 * Symptoms / Few symptoms / No symptoms
 * Recovery
 * Resistant

Transmission

 * Airborne
 * Since day -1 of symptoms until day 5 of symptoms

Factors affecting spread

 * Age: children are a source of infection for a longer period
 * Air temperature?

Symptoms, outcome, statistics
= Influenza pandemics = pandemic
 * Fever, cough, sneezing ...
 * Fatality case ratio

History, timeline, how previous pandemics have unfolded
see pandemics

Lessons learned (what worked and what didn't)

 * Did closing down schools work?
 * Did closing fronteers work?

Impact scenarios for the future (with scientific references), web calculators (what it might be like given certain conditions)
CDC

Risk assessment
Agreement and disagreement = Influenza andemic preparedness =

Elements for plans
Draw up a Plan.

Outline the steps you and your family need to take, both pre-pandemic and during. Identify responsibilities for each family member. Make lists of supplies required. Find appropriate sources. Develop a realistic timeline. By establishing a plan now, you will avoid becoming a victim of the panic that will grip the general population, resulting in civil chaos and pandemonium.

Keep Informed.

If and when the virus mutates so that it is being spread from human to human, it is likely to start in Southeast Asia. Pay attention to the news. When you hear that this has taken place, it's time to act. We might have two or three months before the pandemic reaches North America, but with international travel so fast and easy it could be much sooner.

Do not travel to areas where you know the flu virus is found.

The Center for Disease Control has a website that will give you this information. It's at http://www.cdc.gov/flu/weekly/fluactivity.htm

Prepare your Children for Homeschooling.

Most flu outbreaks get their start at schools. You can be certain that the schools will be closed. And even if they're not, you should give very serious thought to keeping your children at home.

Minimize Contact with Others.

The H5N1 avian flu virus can be transmitted for two days before a person is showing any symptoms and for a week after symptoms have disappeared. You never know who isn't and who might be infected.

Wash Your Hands.

Did you know that sneeze particles can travel across a room at 600 miles per hour? If the person sneezing has the flu, everything in that room is covered with flu virus. And when you touch anything, the virus is transmitted to your hand. Eventually it will be transmitted to your mouth. Your only protection is to wash your hands, well and often. Each washing should involve vigorous scrubbing with soap for at least 20 seconds.

KLEENEX® Anti-Viral* Tissue has a moisture-activated middle layer that is scientifically proven to kill cold and flu viruses.* When moisture from a runny nose, cough or sneeze comes in contact with KLEENEX® Anti-Viral Tissue's special middle layer, cold and flu viruses are trapped and killed. Carry them with you and use them to open and close public doors, handle money, etc. Be sure to discard them in a trash container after use.

Avoid using public washrooms and pay phones whenever possible.

Stock up on Food and Water.

Most supermakets only have enough food for about a week. It's critical that you stock up on enough food to last you for the duration which could be 3-4 months.

Update your Will.

Hopefully this won't be necessary but not all of us are going to survive.

Get a Flu Vaccination.

There is no vaccination yet for this particular strain of avian flu but a vaccination will give you protection from contracting any other flu which could weaken your system, making you more prone to fall victim to the deadlier H5N1 strain.

Buy Enough Anti-Viral Medication for Every Member of your Family.

Currently the only drug that can help mitigate the effects of the avian flu virus is oseltamivir, otherwise known as Tamiflu. The world supply is very low, and not nearly adequate to provide sufficient protection for everyone, so you should stock up on this drug immediately. You can buy it online, but do your shopping because the price varies considerably. And once a pandemic strikes, it will be impossible to buy tamiflu at any price.

Life Insurance.

Make sure your life insurance is adequate, and check the fine print. Some policies have clauses that don't cover you in the event of a pandemic.

Stock up on face masks.

You will need to wear these when you absolutely have to come into close contact with others. It's likely that any public businesses or government offices that remain open will make it mandatory that you wear a mask before entering. Make sure that your mask has a rating of N100. The more common N95 masks will not give you enough protection.

There is one mask -- the NanoMask® -- which not only blocks the H5N1 virus, but kills it as well.

Prepare a quarantine room.

If anyone in your family becomes stricken, he/she should be immediately moved to a location that is isolated from the rest of the house. This room should be as far away as possible and should be stocked with food and water, medical supplies, sanitation facilities, communication, cleaning tools, entertainment (books, radio, TV, etc.)

Communication.

There's a good chance that TV and radio stations will no longer be able to broadcast if there is a power failure in your area. A good quality battery operated radio, capable of receiving short wave stations will enable you to stay informed of developments in the outside world.

Power.

There could be an extended interruption to your electric power. You should consider alternative lighting and heating methods. Battery, propane, kerosine, and gasoline generators are possible options.

Protection.

New Orleans showed us how quickly civilization breaks down under catastrophic conditions. And that was mild in comparison to what we could be facing in a pandemic. The bottom line is this: most people won't take the necessary steps to prepare for disaster. And once it hits, they will be panic stricken. And they will do anything to try to save themselves. Which includes trying to take whatever you have that they might want.

You will need to have some means toprotect your family. If you own firearms, makesure you are stocked up with ammunition. Remember, you won't be able to call a patrolman if you find an intruder on your property.

Find a Place in the Country.

If you live in the city, you will be surrounded by anarchy. Catastrophes such as this always lead to civil disorder. If you can escape the city you will be much safer. If you don't have one, consider purchasing a trailer. If you can't afford it, consider a tent.

Plans (or lack of) in each country etc
= What needs further work =

Communication of effective prevention practices
= Current situation =

Vaccine developement
= Sources of information =

Wikis
The Flu Wiki

Blogs
The flu blog of Declan Butler, senior reporter at Nature, the international weekly journal of science

Henry Niman's Recombinomics Site (not really a blog, but similar daily+ updates)

"Effect Measure" a public health related blog closely following H5N1