H5N1 again - this time for real

[pyotr]

I wanted to link to the raw data of H5N1 cases in humans since 1997.. This chart is from the New England Journal of Medicine last Nov 2005. Since then, this bug has become more resistant to therapy, and has broken through the bird-human trans-species infectivity barrier. An alarming outbreak of human-human transmission has occurred in Indonesia these past couple of weeks. , and unfortunately just before the recent earthquakes which have attracted international aid to this region . We will thus probably soon see this strain of Avian H5N1 in the US and the rest of the world.

Some highlights from data 2004-2005: median ages in the outbreaks among families: 14 to 22 years old. Percentage that go into respiratory failure 70-100%, and percentage that die 70-100%. That is, even among the young and healthy, most who came down with the illness in SE Asia developed respiratory failure, and most of these people died. This is not to say that this same pattern will definitely be seen wherever an outbreak occurs, but so far, the more recent outbreaks in humans since '97 have been more virulent rather than more benign. Almost certainly, a population of people who are inherently resistant to this strain exists and will survive exposures to it. Based on the recent history in SE Asia, such a population of people are likely to be a smaller subgroup of humanity.

Ways to protect yourself: stay away from crowds, vigorously wash your hands after all contact with public surfaces. Avoid restaurants, etc. The most likely mode of transmission is still fecal-oral, but aerosolized transmission cannot be ruled out. Keeping a supply of N95 respirators would not be a bad idea. Tamiflu will quickly become worthless as this H5N1 will become resistant to it. Recent cases have required a doubled dose for efficacy (75mg twice daily for 7-10days). Please don't try to stockpile this drug for your family as it will 1)be useless in the long run for you and 2)create drastic shortages and 3)result in many more deaths early on in the sickest people who might need this drug right away and 4)potentially explosively accelerate the spread of this strain by #2-3 and from earlier recruitment of resistance genes in the H5N1. Vaccines for any pandemic strains will only be available at the earliest around 6 months post outbreak. Bleach will kill the virus from surfaces.

Let's hope this scare passes without incident, but if you hear more bad news in the next few weeks to months, BE PREPARED.