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Dude
SFN Die Hard
USA
6891 Posts |
 Posted - 09/28/2006 : 14:09:38
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http://www.msnbc.msn.com/id/15044065/
Remember the uproar last year when this virus was reincarnated for work in the lab?
Well, it appears that the work is already giving us results and clues on how to save lives if/when H5N1 becomes pandemic in humans.
Link to the paper abstract.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 09/29/2006 : 06:24:14 [Permalink]
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quote:
Originally posted by Dude
http://www.msnbc.msn.com/id/15044065/
Remember the uproar last year when this virus was reincarnated for work in the lab?
Well, it appears that the work is already giving us results and clues on how to save lives if/when H5N1 becomes pandemic in humans.
Link to the paper abstract.
The problem with this is akin to the problem with nuclear power, although a bit safer because it dosen't destroy the land.....
A problem that occured very close to home. They sent these samples by mail!!!!! Some firms had them for months and did not even know about it.
Definitly not a safe way of doing things, and I am not throwing accusations at companies blindly, but the safety precautions are definitly wanting with such dangerous things.
Peace
Joe |
The Circus of Carnage... because you should be able to deal with politicians like you do pissant noobs. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 09/29/2006 : 10:22:59 [Permalink]
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That was the 1957 H2N2 “Asian flu” strain, OI, not the H1N1 "Spanish flu" of 1918. While H2N2 was also dangerous, it was on quite a different scale. The idea anyone would even have a large quantity of HPAI H1N1 let alone have it in an area it could be mixed up with other viruses is inconceivable.
Flu virus stocks are maintained at CDC and sent to vaccine manufacturers every year to base their vaccine off of. In addition, flu virus samples are sent all over the place for research purposes. China just sent a batch of HPAI H5N1 samples to the WHO for current research, but this virus is not yet in a human contagious form.
We manage small pox virus for research so having HPAI H1N1 may not have been much riskier than that. The current ability to look so specifically at the genetic make up of these viruses made it worth the risk in my opinion. They have determined the likely place on the gene and how many changes are needed before the current HPAI H5N1 virus will become more deadly to humans. It gave us information about which genetic changes to monitor. And, changes are indeed occurring with HPAI H5N1 so monitoring those changes is very useful.
The latest virus samples from China will be analyzed in the next few weeks and we'll have an update on the risk assessment. |
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 09/29/2006 : 14:56:39 [Permalink]
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quote:
Originally posted by beskeptigal
That was the 1957 H2N2 “Asian flu” strain, OI, not the H1N1 "Spanish flu" of 1918. While H2N2 was also dangerous, it was on quite a different scale. The idea anyone would even have a large quantity of HPAI H1N1 let alone have it in an area it could be mixed up with other viruses is inconceivable.
Flu virus stocks are maintained at CDC and sent to vaccine manufacturers every year to base their vaccine off of. In addition, flu virus samples are sent all over the place for research purposes. China just sent a batch of HPAI H5N1 samples to the WHO for current research, but this virus is not yet in a human contagious form.
We manage small pox virus for research so having HPAI H1N1 may not have been much riskier than that. The current ability to look so specifically at the genetic make up of these viruses made it worth the risk in my opinion. They have determined the likely place on the gene and how many changes are needed before the current HPAI H5N1 virus will become more deadly to humans. It gave us information about which genetic changes to monitor. And, changes are indeed occurring with HPAI H5N1 so monitoring those changes is very useful.
The latest virus samples from China will be analyzed in the next few weeks and we'll have an update on the risk assessment.
I do realize it was a difirent strain. The point of my post is that there aren't enough responsible people to handle anything like H1N1. If experimentation is to be done, then it should be done in one location to limit the idiot factor.
Even the most brilliant make mistakes, and the CDC is a political machine, and open to political pressures. It s far too dangerous.
Peace
Joe |
The Circus of Carnage... because you should be able to deal with politicians like you do pissant noobs. |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 09/29/2006 : 15:41:58 [Permalink]
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I'm positive that work with the H1N1 virus is being done in a facility where containment is not managed by the investigators alone. Probably with level 2 or 3 containment.
The benefits are, imo, and evidenced by the results so far, worth the risk.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 09/30/2006 : 12:00:35 [Permalink]
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They used biosafety level 3. People are generally able to maintain due care when they have something novel like a reconstituted Spanish flu H1N1. It's the things we handle routinely in this case which are more susceptible to human error. (Not to say novelty doesn't increase risk because in some cases it does.)
I was more concerned about this before I became more educated observing the SARS outbreak and the new pandemic flu risk monitoring. We have the movie version of such outbreaks plus the historical record which doesn't include interventions that would occur today as examples from which to draw a picture of the potential events. But, of course, it doesn't happen like in the movies and we have better health system in place now than in 1918.
The CDC and a lab in England have small pox virus contained. It is equally contagious and dangerous. Several labs have SARS virus stored and for continued research. Both small pox and SARS each infected one person after a lab accident and SARS was then transmitted to another. The lab accident with small pox actually released virus out a window and it infected someone in a room below the lab. In neither case did the releases result in a new wave of disease. An inadvertent infection with the H1N1 Spanish flu wouldn't be any more likely to start a new pandemic than the inadvertent escapes of small pox and SARS viruses.
You can think of it like a wildfire. It doesn't take much and once it gets going, you can't easily stop it. But if you catch the fire before a critical time, you can stop it.
With the current pandemic flu risk, the estimate is if person to person spread is detected within the first couple weeks, then there is a chance to stop it by contact tracing. This of course depends on the public health infrastructure so don't count on an outbreak of H5N1 being easily stopped in most African countries.
We (as in the world's health systems) were able to contain the SARS epidemic. That was truly an historical event, akin to stopping an incoming asteroid. We would not have been able to stop SARS if every patient was as infectious as the so called "super spreaders", if there had been a large number of patients with mild or no symptoms, or if the period of contagion before onset of severe disease was longer than it was.
With SARS, those infected showed up in EDs with obviously serious disease allowing rapid identification, isolation, and contact tracing. Tragically it took the deaths of over 200 health care workers before we figured out there was a new disease spreading and just what that isolation required.
SARS smoldered in China for a few months killing hospital workers there before it reached Hong Kong. That's what we can expect from this new flu if/when it mutates. As mutations bring it closer and closer to the critical point, you can expect more than one version to make the critical leap. The outbreaks in countries with close monitoring might be able to contain each one but eventually an outbreak will occur in some rural area in a poor country that goes unnoticed until it is too far gone to stop.
It was worth looking at what made the Spanish flu so deadly. We have a better idea how close the new H5N1 is to becoming highly infectious. And, we have a better idea which part of the genetic make up is responsible for the high lethality. The latter is allowing construction by reverse engineering of an attenuated strain from which to develop a vaccine. |
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 09/30/2006 : 15:24:21 [Permalink]
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The problem is each and every person down the line has to do their job correctly, efficiently, and right, from the handleing of a virus in a lab, to the jhandleing of an outbreak.
I was a paramedic during medicines hay-day in a city with some of the best hospitals in the World (University of Cincinnati is/was one of the best teaching hospials, THe Childrens Hosptal Medical Center was world renowned for transplants, and a couple of other things I forget, the Christ Hospital, which is still one of the best heart hospitals in the US, and the Otto E. Epp hospital, which before the Jewish Hospitals took it over was one of the few remaining osteopathic hospitals).
When I started (1987) there was a resistant staph(MRSA) which pretty much showed up shortly after the introduction of PCN. That was pretty much the only resisteant bug we had to deal with reguarly. It was managed with contact and/or repiratory isolation. Now, a lot of places don't even worry about it because it is nearly assumed. Hell, it's killing people outside of medical establishments. Some kids in Detroit picked it up at a playground.
Around 1993(?) an resistent enterococi(sp?) showed up, VRE. This spread like wildfire. There was no reason for it, as it could have been contained a bit had everyone done their job. From the paramedics who didn't change their sheets / clean their equipment to the nurses and aids who didn't wash their hands, to the "enviornmental services) (pc for housekeeping) cleaned things properly.
I also saw several times what flu does when it runs through nursing homes. Hospitals become overwhelmed with flu patients spreading the flu to people who are already sick with something else. There were a couple of times when the hospitals became dangerously overcrowded with one of the smaller flus. Imagine a serious one.
It only takes a couple of overworked, underpaid, and/or lazy folks anywhere in the chain to nearly destroy any planning.
Sure, we have fancy new drugs, some of which actually do something that a similar old drug didn't do. Sure we have MRIs and hyperbaric chambers, 3-D radiation machines, and a slew of new toys with which to save people. Shame we are saving them to let some lazy bastard kill them.
I prey I am wrong, but I think we are more ready then we were, but it won't matter as we will not be nearly efficient enough. We will worry about the dollars..... Do we really need 3 nurses and 15 aids... How about 2 nurses and 12 aids???? Maybe 1 nurse, 12 aids, and one of these new-fangled certified medication aids they are trying to push out...... Really good nurses aids are few and far between. Too many are just too lazy and careless.
Maybe it could work, but we would need the Fire Departments Mass-casualty Incident expertise, and another bug that attaacks only cost-cutting bigwigs, insurance CEO's, and lawyers.....
Sorry for the rant. I just do not believe in politicians and people enough.
Peace
Joe
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The Circus of Carnage... because you should be able to deal with politicians like you do pissant noobs. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 09/30/2006 : 21:27:52 [Permalink]
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You are mixing apples and oranges, my friend. When the next deadly flu pandemic arrives, it will be chaos. But the research which rebuilt the 1918 H1N1 flu wasn't any more dangerous than keeping smallpox stocks in storage. How many smallpox outbreaks have you seen since we quit vaccinating the average person in 72?
Antibiotic resistance is the accumulation of the use of antibiotics all over the world. It isn't the result of any single careless person. It's as much evolution and natural consequences as it is errors in practice. Even if we always handled antibiotics perfectly, resistance would evolve more slowly, but it would still arrive. When you take your whole course of antibiotics as instructed, there are still a number of additional ways drug resistance can develop.
And despite all the medical errors and sloppy care, there is still enough good medicine we are curing many more diseases and people are living longer healthier lives than before. |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 09/30/2006 : 22:50:13 [Permalink]
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O.I. said:
quote:
The problem is each and every person down the line has to do their job correctly, efficiently, and right, from the handleing of a virus in a lab, to the jhandleing of an outbreak.
Well, the world hasn't come to and end yet. People work with deadly and contagious microbes every day. They will continue to do so, to the benefit of us all. The risks are measurably outweighed by the benefits.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 10/01/2006 : 06:57:36 [Permalink]
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BGal, I was not talking about the development of the anti-biotic resistent strains, but the spread. It is completely redidculous that when VRE came to Cincinnati, that within a matter of a few years, it has spread the way it has. Sure we cure disease, but we give it too... And with the development of more and more nursing homes with entire wings specializing in vent patients, I would love to see a geriatric study showing mortality / quality of life from 1985 compared to 2005. Sure they are living longer.. but what is the quality of life?
Not to sound sarcastic, because I am truely interested, but how do reconcile your trust in political medical establishments with the current political situation. How can you be so trusting of it? I can't. I see the curroption at the top, and the curroption at the top runs the rest of it.
Peace
Joe |
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 10/01/2006 : 07:06:40 [Permalink]
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quote:
Originally posted by Dude
O.I. said:
quote:
The problem is each and every person down the line has to do their job correctly, efficiently, and right, from the handleing of a virus in a lab, to the jhandleing of an outbreak.
Well, the world hasn't come to and end yet. People work with deadly and contagious microbes every day. They will continue to do so, to the benefit of us all. The risks are measurably outweighed by the benefits.
I never worry about the world coming to end..... The Earth can shake off 99.999 or more of us, and it will go on.........
The risks outweighing the benefits is a paradigm that might need to be reconsidered. What are the benefits of keeping smallpox? We have the vaccine. If it shows up in the population again, we can get a new sample.
As far as H1N1, there are benefits to it, however the current handling of it needs to be discussed. We need absolute control over thee things. Every sample out there is a sample that can be exploited / sold / weaponized / or just plain released through incompetence.
It only takes one idiot in the chain, and the top link is a bit of an idiot.
Peace
Joe
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Dave W.
Info Junkie
USA
26022 Posts |
Posted - 10/01/2006 : 13:33:41 [Permalink]
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quote:
Originally posted by Original_Intent
We need absolute control over thee things.
There is no such thing as absolute control. In all things, we are forced to settle on "pretty good" control after appropriate risk/benefit analyses. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 10/02/2006 : 02:35:58 [Permalink]
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| There are two sides to the medical field, OI. Most people who deliver health care are not corporations with bottom line priorities. You might want to re-evaluate your position of "the curroption at the top runs the rest of it." That makes a nonsensical assumption there is a vertical power structure between big corporations and private medical providers. I've had a private practice for 16 years now and I don't work for any company. |
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 10/02/2006 : 05:03:00 [Permalink]
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quote:
Originally posted by beskeptigal
There are two sides to the medical field, OI. Most people who deliver health care are not corporations with bottom line priorities. You might want to re-evaluate your position of "the curroption at the top runs the rest of it." That makes a nonsensical assumption there is a vertical power structure between big corporations and private medical providers. I've had a private practice for 16 years now and I don't work for any company.
I was actually talking about the people who appoint control, either on a corporate or political basis If the Secretary stepped down, or the head of the Public Health Service, or the head of the CDC, who appoints their replacement? (rhetorical).
If a company needs more money, will they cut their own salaries, or lay off some of the board? Will they say "well, we need to cut one nurse and 2 aids a shift, so some of the stuff isn't going to get done?
Maybe you have been out of the corporations too long...... but a very clear majority of nurses aids are not in it to do a good job, however the corporations are lobbying many of the states to have them become certified medication aids... imagine that.... A lazy ass aid passing medication.
On a side note: Over here we have a good battle brewing. It seems that the Christ Hospital and the St. Luke hospitals thought that it would be a good idea to join with the University of Cincinnati Medical Center into the Health Alliance. (Three Hospitals who make a profit join one that is nothing but a drain). Now they want out because UCMC is not providing the resources they said they would, and they are all running a defecit.
So it's not only greed at the top, but sheer stupidity as well....
Peace
Joe
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Original_Intent
SFN Regular
USA
609 Posts |
Posted - 10/02/2006 : 05:04:14 [Permalink]
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quote:
Originally posted by Dave W.
quote:
Originally posted by Original_Intent
We need absolute control over thee things.
There is no such thing as absolute control. In all things, we are forced to settle on "pretty good" control after appropriate risk/benefit analyses.
Granted. However I question the risk/benefit........
Peace
Joe |
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Dave W.
Info Junkie
USA
26022 Posts |
Posted - 10/02/2006 : 11:33:25 [Permalink]
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quote:
Originally posted by Original_Intent
Granted. However I question the risk/benefit........
I understand. It's just inappropriate to enter a discussion of the risk/benefit analysis with the idea that absolute control is possible. It will certainly bias the analysis, since anything less than absolute control would have to be considered a sizeable - possibly unacceptable - risk. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
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