Talk:Influenza A virus subtype H5N1/Archive 3

H5N1

H5N1 was reported to probably be in Turkey, then reported probably not in Turkey, and now as of Jan.4 back to probably in Turkey. But reports say "probably" [1], "The WHO said it has yet to confirm the Turkey cases, but it is checking into them." [2], " The Associated Press reports that more tests are being carried out." [3].

Confirmation one way or another will be available in a day or so. But looks like H5N1 to me. WAS 4.250 00:39, 5 January 2006 (UTC)

Wikinews

This article is linked to from Wikinews, we have an infobox that links directly to the section currently titled "Global spread". This is referenced to obtain the current confirmed death toll. Could this please stay with the same sub-section title so I don't repeatedly have to re-read the article and find the new section heading for the bit that contains the table? --213.193.176.101 21:22, 5 January 2006 (UTC)

I have no idea what you just asked to have happen. WAS 4.250 21:44, 5 January 2006 (UTC)

wikinews relied on the table that used to be present in the Global Spread section, see this infobox. Where now can I find the current figure for the official death toll? --Brianmc 12:55, 9 April 2006 (UTC)

Nevermind, I found out some had mangled the template. --Brianmc 12:58, 9 April 2006 (UTC)

Updates to Global Spread grid

Hi people!

Just wondering, how many times a week is the global spread grid of figures updated? Reasom am asking is because we at the World Wide Help Group are going to be putting up a snapshot of the h5n1 outbreak on the Avian Flu Help blog and we're thinking of getting a wiki of help resources and the like going soon just like this one that we did during the tsunami. Any ideas?

thanks, Angelo EmbuldeniyaWorldWideHelpGroup 16:13, 11 January 2006 (UTC)

answer

Feel free to link to our major H5N1 pages: H5N1, Template:H5N1 cases, Template:H5N1, Transmission and infection of H5N1, Global spread of H5N1, and Influenza pandemic.

THE CONTENTS OF THE TABLE ARE SOURCED FROM

http://www.who.int/csr/disease/avian_influenza/country/en/

THE WORLD HEALTH ORGANIZATION (WHO) IS TASKED WITH MAINTAINING AN ACCURATE UP TO DATE ACCOUNT OF CONFIRMED HUMAN CASES AND DEATHS. THEY ARE OUR SOURCE. THEY SHOULD BE YOUR SOURCE.

The World Health Organization announces the current phase of the pandemic alert here.

See "Assessing the pandemic threat" at [4]. WHO published a first edition of the Global Influenza Preparedness Plan in 1999, and updated it in April 2005. See [5] and [6] which define the responsibilities of WHO and national authorities in case of an influenza pandemic. This is the first time a pandemic has been anticipated and is being prepared for. WAS 4.250 17:14, 11 January 2006 (UTC)

thanks!

your suggestions have been taken, thanks a lot & keep up the great work! WorldWideHelpGroup 08:32, 12 January 2006 (UTC)

H7

mentioned once... Unfamiliar. Is it a misreading for H1? Or does one see it in birds Midgley 01:00, 13 January 2006 (UTC)

Thank you for bringing this to my attention. I tried to make it as accurate as possible. Now I'm trying to communicate as well as possible. H7 is best explained by reading Avian influenza. The short version is that avian flu is a disease and avian flu virus is a species and that virus's subtypes are labeled according to an H number and an N number. (And flu=influenza.) WAS 4.250 03:43, 13 January 2006 (UTC)

WHO H5N1 Ref Labs Info

We have information on WHO's H5N1 reference Labs also known as National Influenza Centers for each country which includes the doctors'/experts' names & contact details -- this info would be vital for sampling tests and the like, cross checking if you will.

We are planning on either getting another wiki page going for the ref labs and linking it here to this article or do you prefer including it straght in this article, there are over 20 labs along with their details. Your suggestions are most appreciated.

thanks! WorldWideHelpGroup 14:47, 13 January 2006 (UTC)

Referring to the size recommendations for articles, I would think a separate page might be preferred (this is mostly meant to help the large number of people with slow internet access). Just my 2 cents. Awolf002 14:51, 13 January 2006 (UTC)

Yes, we are already as large as Wikipedia articles are recommended to get. Additional information gets hived off into seperate articles like you see in the H5N1 box at the top right of this article. WAS 4.250 16:34, 13 January 2006 (UTC)

Wikipedia is an encyclopedia, not a database, so any article is supposed to be an encyclopedia article and not a list, unless its a list of related encyclopedia articles (actual or potential). National Influenza Centers doesn't yet exist, you might want to place your data there. I just googled the term and it definitly qualifies to be an article. And if informamation on any one of the centers becomes too big, it can be hived off into its own article. Don't worry about getting everything perfect, but always "save page" with the contents in a readable state. Connecting it to the existing H5N1 series of articles can be done in many ways. I'll be happy to do that. WAS 4.250 16:34, 13 January 2006 (UTC)

Link to page containing below added to article

WHO Collaborating Centres and Reference Laboratories involved in annual influenza vaccine composition recommendations

Reference Laboratories

WHO Collaborating Centres

Dr I.D. Gust WHO Collaborating Centre for Reference and Research on Influenza 45 Poplar Rd Parkville Victoria 3052 Australia Telephone: +61 3 8344 3963 Fax: +61 3 9347 1540 Influenza news on: http://www.influenzacentre.org/index.htm

Dr M. Tashiro WHO Collaborating Centre for Reference and Research on Influenza Department of Viral Diseases and Vaccine Control National Institute of Infectious Diseases Gakuen 4-7-2 Musashi-Murayama Tokyo 208-0011 Japan Telephone: +81 42 565 2498 Fax: +81 42 565 2498 http://idsc.nih.go.jp/index.html

Dr A. Hay WHO Collaborating Centre for Reference and Research on Influenza National Institute for Medical Research The Ridgeway, Mill Hill London NW7 1AA United Kingdom Telephone: +44 208 959 3666 Fax: +44 208 906 44 77

Dr N. Cox WHO Collaborating Centre for Surveillance, Epidemiology and Control of Influenza Influenza Branch Division of Viral and Rickettsial Diseases National Centers for Infectious Diseases Centers for Disease Control and Prevention 1600 Clifton Road, Mailstop G16 Atlanta, Georgia 30333 United States of America Telephone: +1 404 639 3591 Fax: +1 404 639 2334 Influenza news on:http://www.cdc.gov/flu/weekly/fluactivity.htm

Reference Laboratories

Dr G. Grohmann Immunology and Vaccines Therapeutic Goods Administration Laboratories P.O. Box 100, Woden ACT, 2606 Australia Telephone: +61 2 6232 8490 Fax: +61 2 6232 8564 http://www.tga.gov.au

Dr J. Wood Division of Virology National Institute for Biological Standards and Control Blanche Lane, South Mimms, Potters Bar, Hertfordshire EN6 3QG United Kingdom Telephone: +44 1 707 641 000 Fax: +44 1 707 646 730 e-mail: enquiries@nibsc.ac.uk

Dr R. Levandowski Division of Viral Products Centre for Biologics Evaluation and Research Food and Drug Administration 1401 Rockville Pike, Rockville, MD 20852 United States of America Telephone: +1 301 827 1908 Fax: +1 301 402 5128 http://www.fda.gov/cber

WAS 4.250 17:54, 13 January 2006 (UTC)

H5N1 Ref Labs -- listings info

Thanks for the suggestions, last night i started on a wiki page and named it H5N1RefLabs: http://en.wikipedia.org/wiki/H5N1RefLabs

and I just saw the suggestion for national influenza centers, so I've copied the contents there as well: http://en.wikipedia.org/wiki/National_Influenza_Centers

So we've ended up with 2 duplicate pages, more prone to go with national influenza centers as mentioned above -- could someone please sorta' absorb the centers' info into the h5n1 article? If there's going to be a url change, please mention it here as we're currently linking to the national influenza centers wiki page from the blog.

thanks! Angelo Embuldeniya

WorldWideHelpGroup 16:35, 14 January 2006 (UTC)

I moved the contents and placed a redirect at the old article. Please help with adding information. If it remains a list and not more of an article, it will rightfully be deleted. To not be deleted, enough encyclopedic content needs to be added to SOME of the centers so that it's obvious that in time, all the centers could similarly be expanded. I'll start. But if no one helps adds a few relevant sentences to the more prominant centers, it WILL wind up being deleted. I'll also add a link in a couple of the H5N1 articles. WAS 4.250 17:30, 14 January 2006 (UTC)

Please see Talk:National Influenza Centers. WAS 4.250 18:42, 14 January 2006 (UTC)

A concerns about Italy and Olympic...

I have a concern that I'd like to be addressed... Because Olympic is currently being hosted in Turin, Italy while same time we discovers that Italy just got its first bird flu case (not sure if it's first or not, since I noticed that the article mentioned the bird flu as orginating in 1959 but I think it said ti's really similar, not same one). Because bird flu apparently has been spreading without even stopping at all despite all the efforts to contain it, isn't it possible that this bird flu may reach Turin, Italy sometimes later? This would be castrosphere, because, while professional atheles, VIPs, and officials may be better off and well-insulated from this such outbreak, the tourists are at far greater risks because they aren't much controlled and that they're foreigners in most respects.

In effect, if bird flu made it there, it may be possible that spread will get even bigger or so, since those tourists will be returning home after Olympic completed, which means many, many countries, including, but not limited to, United States, Canada, Australia, and many other countries, even those that are still unaffected by the spread at this time. Olympic being held in same country as where bird flu is reported in Sicily is really a bad timing. It was really coincidence since this could not have been anticipated, especially considering the fact that the decision to accept the bid from Turin was actually made way before this bird flu even made bigger concern. Bird flu, while a major media piece, did not reached the highest level of concern until about late 2005 or early 2006. Too late for such change or at least even being prepared at all.

I have yet to see any information about any preparation in anticipation of this bird flu if a human case is reported in Turin during Olympic events. Obviously, the person infected would be guarantined, I think, but it will take time before it's discovered and thus spread may widen, making it difficult to aggressively combats it.

I mean, I want this concern to be addressed with respect to this coincidence or, even worse, a bad luck. Thanks and I will appreciate if anyone can address this concern. I'm feeling uneasy about this situation I'm imagining in my mind. -_-

Respectfully Yours, Legion 16:43, 13 February 2006 (UTC)

A LOT of people are having the same MISUNDERSTANDING. BIRDS NOT PEOPLE are catching and transmitting and causing the global spread of H5N1. People only catch it if they act in inappropriate ways (eat sick birds, play with sick birds, etc.) or in a couple of cases lovingly cared for a sick relative (who caught it from a bird) in a very hands on way (no professional health givers have caught the disease). Currently, it is VERY hard for humans to catch. It is very EASY for birds to catch it one from another. some species of birds don't usually die from it. Poulty usually DOES die from it. The biggest worry is that it MIGHT someday mutate into a form that IS easy to pass from human to human. If it does, governments around the world will be quaranteining, stopping large gatherings, cancelling international travel, and other very dratic things. You won't need wikipedia to tell you about it if it becomes a person to person transmissible illness - you'll hear about it from everyone. WAS 4.250 17:02, 13 February 2006 (UTC)

RNA molecule

I removed this part as I don't think it's very useful:

For example its NS RNA molecule looks like this:

gtgacaaaga cataatggat tccaacacga taacctcgtt tcaggtagat tgttatctat
ggcacataag aaagctactc agtatgagag acatgtgtga tgcccccttt gatgacaggc
tccgaagaga ccaaaaggca ttaaagggaa gaggcagcac acttggactc gatttaagag
tggctacaat ggaggggaaa aagatcgttg aggacatcct gaagagtgag acaaatgaaa
acctcaaaat agccattgct tccagtcctg ctcctcggta tatcaccgat atgagcatag
aggagatgag ccgagaatgg tacatgctga tgcctaggca gaaaataact ggaggcctta
tggtgaaaat ggaccaagcc ataatggata aaagaattat ccttaaagca aatttctcag
ttctatttga tcaactagag acattagtct ctctgagggc attcacagaa agtggtgcta
ttgtggctga aatatttccc attccctccg taccaggaca ttttacagag gatgtcaaaa
atgcaattgg aatcctcatc ggtggacttg aatggaatga taactcaatt cgagcgtctg
aaaatataca gagattcgct tggggaatcc atgatgagaa tgggggacct tcactccctc
caaaacagaa acgctacatg gcgaaacgag ttgagtcaga agtttgaaga gatcagatgg
ctcattgctg aatgtagaaa tatactgaca aagactgaaa atagctttga acagataaca
tttttgcaag cattgcaact cttacttgaa gttgagagtg agataaggac cttctctttt
cagcttattt aatactaaaa aacac

Plus, it might be a copyvio (assuming Intelligent design <evil grin>) bogdan 10:59, 15 February 2006 (UTC)

Even assuming that, the copyright would have long expired. 82.103.206.128 16:36, 8 August 2006 (UTC)

Nah, it's open source- that's why the gnu was created (or intelligently designed). - unsigned

It's the derivative versions, not the exact copies, that are the problem. If it would just stop evolving, it wouldn't be a problem. WAS 4.250 20:27, 21 February 2007 (UTC)

Domestic or wild birds responsible

I found this article worth mentioning here. The author seems to think wild birds are unreasonable victimized. The argument is also good, infection is not following the wild birds migrating trajectory. Now, if we are placing the blame on the wrong victim for personal reason, wouldn't that allow the disease to grow? Does anyone think its worth mentioning it on the article? This paragraph would then be modified:

A highly pathogenic variation of H5N1 is currently spreading across the world from areas where it is endemic. Migrating waterfowl (wild ducks, geese, and swans) carry H5N1, often without themselves becoming sick. - unsigned

Infection IS following the wild birds migrating trajectory. It just took a while for the relevent governments to admit it. WAS 4.250 03:34, 19 February 2006 (UTC)

Is the bird flu deadly to all mammals?

Bird flu is deadly to humans. My question is: Is it deadly to all mammals? --84.146.195.25 14:47, 22 February 2006 (UTC)

No. It is not. WAS 4.250 15:54, 22 February 2006 (UTC)

The problem is animals that don't die from it can walk round looking healthy and spreading it to animals and people who do die from it, in particular cats are a real problem.--Hontogaichiban 11:57, 21 May 2006 (UTC)

While that is largely true, the bigger problem is the lack of good data on H5N1's spread in both wild bird and wild mammal species and the lack of even a clue as to its future spread because H5N1 is uniquely deadly and contagious to so many species. It acts differently in each species it infects and adapts differently in each species; creating ever more new varieties. We don't have a clue to exactly how many bird species can harbor this virus. H5N1 is the first HPAI Avian influenza virus to just keep spreading and not automaticlly die out when its domestic bird hosts were killed. WAS 4.250 13:49, 21 May 2006 (UTC)

Fatality rate amongst birds

Is there any way of knowing what proportion of infected birds are killed by the virus? I imagine it's a difficult question to answer (especially since there are thousands of different species of birds), but I'm curious. Has there been research done on chickens, for example? Just wondering. Harry R 07:53, 25 February 2006 (UTC)

The "highly pathogenic" part of the description {of this strain of this subtype (H5N1) of the species called avian flu virus} refers specifically to chickens. It kills close to 100% of chickens that are not vaccinated. It varies in other species of birds from near 100% also in turkeys to no known dead birds by it in other species. Pigeons can catch it, but they aren't dying mostly, so if you find a single dead pigeon and it checks positive for H5N1 how do you know if it was the H5N1 that killed it or something else? Roughly, the pathogenicity in bird species runs from near 100% to near 0 %. WAS 4.250 15:37, 25 February 2006 (UTC)

Somewhere in the 0-100% range? I could have come up with that for myself. :) Seriously, though, thanks for the info. Harry R 13:05, 26 February 2006 (UTC)

New report

This new report Fowl play: The poultry industry's central role in the bird flu crisis from GRAIN should be noted and added. I'll not do it myself as H5N1 isn't a subject I know a lot about - MPF 15:56, 27 February 2006 (UTC)

It should not be noted. It should not be added. It is ignorant lying bullshit without an ounce of scientific credibility. There are significant issues relating to the H5N1 evolution and China's poultry practices, but they are entirely conjectural so far, and this article doesn't address even one of the real issues. Further a proper addressing of the real issues would not go here but in articles on Poultry farming and Livestock vaccination. WAS 4.250 16:51, 27 February 2006 (UTC)

That's your POV, and you shouldn't impose it on the article. It is well referenced, and very detailed. By all means mention conflicting POVs, but wikipedia should reflect NPOV and cite all sides of the debate. - MPF 17:01, 27 February 2006 (UTC)

You say "H5N1 isn't a subject I know a lot about". On the other hand, H5N1 is a subject I do know a lot about. My assertion to you is that the references supplied by the article do not back up its major conclusion (because for several months now, I have literally read everything I could on the subject from the most reliable sources - the scientists doing the research). This is readily dealt with by not using this article as a source; but instead, using good sources (which you claim it uses; and at this point, I am not disputing; as what is a good source depends on the use to which it is put). Further, any real addressing of the issues would not go here but at Poultry farming and Livestock vaccination. It is neither censorship nor inappropriate to put data in the right Wikipedia article and to require a source to be trustworthy. This article may quote good sources, but it is not itself a good source. Blogs and the Recombinomics site (see the section with that name above) are also untrustworthy though they may themselves reference good sources. For more good sources than you can shake a stick at check out the on line links in the "Sources" and "Further reading" sections of H5N1. I've read them. I highly recommend them. WAS 4.250 17:58, 27 February 2006 (UTC)

The article advocates against commercial poultry. Some points may be valid, but are certainly cherrypicked and it doesnt consider any alternate explanation - just one argument after another (and not very well referenced, actually). It may be compelling reading but its not science. Unfortunately, advocacy groups are using the public interest in H5N1 as a "vector" for airing their own cause. If we see human to human transmission then expect this to increase 1000-fold. Dont fall for it. 66.236.150.178 20:30, 27 February 2006 (UTC)

Dead cat with H5N1 in Germany

Today they found H5N1 in a dead cat in Germany on the island Rügen.(heute-news 16:00)Stone 15:02, 28 February 2006 (UTC)

Maybe the cat that ate the canary. (gives the phrase a whole new meaning...) Istvan 15:07, 28 February 2006 (UTC)

See Global spread of H5N1#Tigers, leopards, domestic cats. Among other things it says "The spread to more and more types and populations of birds and the ability of cats to catch H5N1 from eating this natural prey means the creation of a reservoir for H5N1 in cats where the virus can adapt to mammals is one of the many possible pathways to a pandemic." People who say it really isn't a pandemic threat just don't know the facts. There are so many pathways to a pandemic and this is such a unique case in terms of its speed of mutation, cross species pathogenicity, and ability to be spread by wild birds that all the experts believe its a matter of time. And the bit about maybe the pandemic when it comes may not be H5N1 simply acknowledges the fact that a genetic shift can cause a virus of the H5N1 subtype to mutate into another even more deadly (to humans) other H5 or H7 subtype (the other H subtypes are not, so far, highly pathogenic). WAS 4.250 16:02, 28 February 2006 (UTC)

Bird cases confirmed in sweden

FYI several birds have been confirmed to carry the H5M1 virus. http://www.thelocal.se/article.php?ID=3187&date=20060303&PHPSESSID=3f96814948fdcb9df12916b8e570eff9 It would be good if someone familiar with this topic can check official sources and maybe utpdate the article. Sorry, I'm not too familiar with this virus but the article didn't say it wasn't confirmed to be the aggressive variant. I haven't myself read through the H5N1 article so the suffix N1 maybe tells that it's aggressive? Anyway H5 was confirmed. Maybe stick low with this for some days to see what it's really like. Aqualize 17:45, 3 March 2006 (UTC)

Hi, Aqualize. Global spread of H5N1 is the article you are looking for. That's the encyclopedia article that is dealing with the latest spread data. All "aggressive" varients are H5 or H7 (the N# is not involved with this, basically). But not all H5 or H7 are aggressive (i.e. "high pathological" or "deadly"). Currently, ALMOST the ONLY "aggressive" avian flu is H5N1. So being H5 and being "aggressive" is close to 100% saying it is H5N1. WAS 4.250 20:19, 3 March 2006 (UTC)

Link to H5N1 article on right side.

Is this supposed to redirect to the "Transmission and Infection of H5N1" article, or not? Shouldn't it just redirect to the main H5N1 article? 63.192.190.119 19:17, 7 March 2006 (UTC)

"H5N1" refers to a virus. "H5N1 flu" refers to a disease. The Wikipedia article entitled H5N1 is about the virus mostly; but it also introduces and links to articles related to the virus. The Wikipedia article H5N1 flu is a redirect to to the wikipedia article Transmission and infection of H5N1 because that is the Wikipedia article that is most about the illness that H5N1 causes. When the illness and the illness agent (e.g. virus) have too little content to warrent two seperate articles, both are often conflated into one article (e.g. H3N2 and Hong Kong Flu). WAS 4.250 19:51, 7 March 2006 (UTC)

spam spam spam spam spam

I just started a forum on H5N1. looks like this is going to be a huge problem soon... http://www.allaboutflu.com Trimmer56 04:43, 10 March 2006 (UTC)

Read WP:WWIN. WAS 4.250 11:07, 10 March 2006 (UTC)

Good Article Collaboration of the week

Three people agreed to make this article the Good Article Collaboration of the week [7]. WAS 4.250 02:41, 20 March 2006 (UTC)

Help all you want but don't spam the article space. WAS 4.250 02:41, 20 March 2006 (UTC)

Doesn't the tag go on the article page instead of the talk page? Homestarmy 14:42, 20 March 2006 (UTC)

Comments for users go in article space. Comments for editors go in talk space. So this tag goes in talk space. WAS 4.250 20:53, 20 March 2006 (UTC)

Ok, here's the way im seeing this, reading the FA nomination page for this, it looks like every single objection people raised has been fixed awhile ago, I don't see any external links and inline citations are everywhere, the 1997 thing has a source and is down there now, the intro doesn't appear to me to have any "usually" situations, it also seems to note why H5N1 is a concern, what are we supposed to be fixing? :/ Homestarmy 14:59, 20 March 2006 (UTC)

Maybe help the whole series of H5N1 and flu articles go together better? Or pick the one that needs the most help? Or change the referencing style in H5N1 to

this?

WAS 4.250 20:53, 20 March 2006 (UTC)

I think we're just supposed to be improving one article over the course of one week, the thing is our collaboration isn't very good yet, I don't even think anybody showed up for the first article :/. And for the refs, are you saying all the blue looking superscripts should turn purple via the ref thing? Homestarmy 21:53, 20 March 2006 (UTC)

People who show up can help any way they want. As for the refs, it has nothing to do with the color of anything. I am talking about changing the referencing codes used from ones that have the referencing data seperated from what ir references to referencing codes (style) that allows the data to be next to what it references in the source yet shows up at the bottom during normal reading. This second style makes moving thing around easier. WAS 4.250 01:27, 21 March 2006 (UTC)

No Human to Human infection

I think the sentence "Most humans known to have become infected had a lot of physical contact with infected birds, or, rarely, an infected relative" should be reworded so it is clear that H5N1 is not (yet) human-to-human transmittable. Or in other words, a infected human cannot infect another human by e.g. sneezing at him. (Should H5N1 mutate to a strain that is Human-to-Human transmittable, things will become very ugly very fast - see Spanish Flu) CharonX 21:47, 20 March 2006 (UTC)

We keep trying. What you see is our best effort to achieve the objective you indicated. Perhaps you'd like to try your hand at it? WAS 4.250 01:29, 21 March 2006 (UTC)

-This is not verifiable, but apparently there have been 7 cases of human to human transmission in China, and a cover-up, resulting in +- 5 medical officials being jailed. I would not expect news like this to be easily verifiable.

H5N1 virus structure

Avian influenza viruses have 10 genes on eight separate RNA molecules (called: PB2, PB1, PA, HA, NP, NA, M, and NS)?? Is this technically correct?? Avian influenza viruses have only 8 genes on 8 segments encoding for 10 proteins. Some genes encode for 2 proteins using different reading frames. May be we can use the genetics part from Influenzavirus_A#Genetics. It is well written there. Also, isn't better to arrange genes(& their proteins) according to their actual arrangement on the segments i.e. first, Pb2 which is encoded by segment 1 then Pb1 encoded by segment 2 and so on? Please refer to Figure 2 and table 1 on [8] or [9]. If there is no objection i'll rewrite it. --Wedian 23:35, 20 March 2006 (UTC)

It is accurate as it stands, and the organization is functional. Please don't rewrite it. Please feel free to add sourced data. Maybe how "gene" can mean different things so some sources call it "10 genes" and others call it "8 genes"? WAS 4.250 01:40, 21 March 2006 (UTC)

About risk of pandemic

"In 2004, scientists pointed out that the avian influenza virus might undergo an antigenic shift with the human flu virus and cause a global influenza pandemic like the one in 1918." (from Antigenic shift).The condition for that is there to be an epidemic as the one of influenza type A concomitant with infection of the birds (H5N1 virus). Berton 18:24, 22 March 2006 (UTC)

No. There are many possible pathways to a flu pandemic. WAS 4.250 19:01, 22 March 2006 (UTC)

Then which are they? Berton 19:40, 22 March 2006 (UTC)

To have a flu pandemic several distinct phases must happen. H5N1's next phase is easy person to person transmition, which is what both our comments are about. After that occurs, it is theoretically possible to stop it before it becomes an epidemic, or if that opportunity is missed, to stop the epidemic before it becomes a pandemic. It is widely believed by the experts that it will not be possible to prevent any of these phases from occuring with H5N1, but if we are lucky enough to delay it for a few years, we might come up with a solution (eg flu vaccine).

Now to the issue of what are the possible pathways for easy person to person transmission of a deadly flu virus like H5N1. First H5N1 is just one of the many subtypes of the species influenza A virus. Any one of them can combine with each other or with different varient genotypes within its own subtype creating new varients, any one of which could become a pandemic strain. We know enough about the genetics to know what stains to fear most (H5 and H7 subtypes) and we know what genetic factors make a flu virus a human virus (ie easily passed human to human); so we know H5N1 is the biggest pandemic threat of all the stains in circulation and we know it is only one antigenic shift mutation or a couple of antigenic drift mutations from changing from being an avian flu virus to a human flu virus (when it does this it may or may not still be in the H5N1 subtype). Both the drift and the shift can happen in any infected animal and then be passed to a human and spread like wildfire. The most likely shift scenerio is for the shift to occur in humans or pigs (but it could occur in cats). To aquire the needed mutation through drift, it simply has to continue being an epidemic in birds long enough for the mutations to occur and then be passed to a human. It appears H5N1 isn't going away. It probably already did mutate to a human flu virus in some bird somewhere, but without being passed to a human, it is outcompeted inside the bird populations and dies out. WAS 4.250 20:53, 22 March 2006 (UTC)~

Thank you very much for the explanations. Berton 21:07, 22 March 2006 (UTC)

Why h5n1 does not spread easily human to human

As to why - in headline news on ctv.ca - two studies, one published today in Nature and one to be published online tomorrow in Science have revealed the following:

Scientists have provided a clue as to why a virus so deadly to birds doesn't pass easily from person to person. The H5N1 strain of bird flu lodges itself too deeply in the respiratory tract of humans to be easily expelled by coughing and sneezing. University of Wisconsin-Madison virologist Yoshihiro Kawaoka and a team from Japan reported the finding in Thursday's issue of the journal Nature. A similar study from the Erasmus Medical Center in Rotterdam, the Netherlands, will be published online Thursday by the journal Science. "What (scientists) have been able to do is find out that the H5N1 virus, when it attacks humans, goes deep into the lungs . . . like a pneumonia," explained CTV's medical correspondent Avis Favaro, "whereas the normal flu attaches to cells up closer towards the throat and the mouth, where it's more easily coughed up."

I don't know enough about the virus to feel comfortable adding this info, but I thought you folks might want to know about the recent information.....DonaNobisPacem 05:43, 23 March 2006 (UTC)

I read a while back that easy transmission human to human would require nasal infection rather than lung infection, so this is not news.

To be easily transmissible human to human it is believed that the PB2 polymerase position 627 must have a lysine and H5N1 does while no other avian flu virus does (but all human flu viruses do).

To be easily transmissible human to human it is believed that the hemagglutinin must bind alpha 2-6 sialic acid receptors, which it doesn't - yet. When it does, it is expected to be easily transmissible person to person. WAS 4.250 06:57, 23 March 2006 (UTC)

This story reports that there is already one H5N1 strain that can attach to both 2-3 and 2-6 receptors. -- Avenue 10:48, 24 March 2006 (UTC)

The genotype of that isolate (Hong Kong/213/03 or HK/213/03) is called Z+. It died out so far as anyone is saying. [10] [11] [12] A vaccine was made from it using reverse genetics. [13] China told some tall tales about possible human deaths from this geneotype, so maybe it didn't die out in China. WHO WHO WHO WHO WAS 4.250 14:19, 24 March 2006 (UTC)

None the less, I disbelieve "Only one H5N1 strain--A/Hong Kong/213/03--showed the ability to latch onto either type of receptor and thus gain such access." from here because this says "Amino acid residues at positions 226 and 228 of the receptor binding pocket of HA1 appear to determine binding affinity to cell surface receptors and to influence the selective binding of the virus to avian (sialic acid -2,3-NeuAcGal) or human (sialic acid -2,6-NeuAcGal) cell surface receptors. The human A/HK/212/03 and A/HK/213/03 isolates retain the signature associated with avian receptor binding, but they have a unique amino acid substitution (Ser227Ile) within the receptor binding pocket that was not present even in the closely related A/Gs/HK/739.2/02 (genotype Z+) virus. Although the biological significance of this change is unclear, a Ser-to-Ile substitution at this position has been shown (16) to alter the virulence of human H5N1/97 viruses in mice. Interestingly, the A/HK/213/03 and A/Gs/HK/739.2/02 showed markedly different pathogenicity in mice." WAS 4.250 14:40, 24 March 2006 (UTC)

cous someone change the locations of where bird flu is, as the UK had just confirmed it has found a swan with HN51.

Images

Apparently User:WAS 4.250 has asserted ownership of this page, and I am not allowed to edit it, unless I make a full explanation here first. So, here goes:

This article's layout has several problems:

1. Wikipedia:Infobox templates states that infoboxes should be inserted at the top of the article, however in this article the infobox has been pushed down by an image, which creates confusion and pushes important information that we want readily available out of view.
2. In order to put the infobox at the top, I moved the map to a different section.
3. Image #1841 (the colorized transmission electron micrograph of H5N1) is displayed twice, once in the infobox, and once below. We only need to display this image once.
4. Wikinews templates are typically placed at the end or beginning of an article, not in the middle. I moved this so it was directly under the infobox, a fairly standard position. - - - unsigned by User:Hetar

1. I don't "own" the page.
2. I object to your gratuitous insult.
3. I have as much a right to delete as you do to add.
4. The issue is what is best for the article, not ownership.
5. Insults are a poor way to begin a conversation.
6. I believe the map belongs at the top regardless of what Wikipedia:Infobox templates says.
7. We don't need to display an image twice but the image with the box doesn't have a description, so it's not the same thing twice. Do you have a better image for the box?
8. The wikinews box was put where it seemed most applicable, although this is debateable. Why do you feel it is better placed somewhere else? Where it is "typically" placed is not relevant. What counts is what works best for this article, and maybe you can provide a fresh eye for that. WAS 4.250 04:33, 6 April 2006 (UTC)

1. I don't "own" the page.

Reverting my change without explanation, and then when I asked for a reason replying, "You changed MY work before I changed yours. Explain yourself on the talk page please." when I made changes to the whole article, implies that you own the article. Stipulating that I explain edits on the talk page before I make them implies ownership, you made that implication, not me. --Hetar 05:24, 6 April 2006 (UTC)

1. I object to your gratuitous insult.
2. I have as much a right to delete as you do to add.

Of course, but WP:CIVIL would seem to indicate that you should at least attempt to explain a wholesale revert of another editor's changes. --Hetar 05:24, 6 April 2006 (UTC)

1. The issue is what is best for the article, not ownership.
2. Insults are a poor way to begin a conversation.
3. I believe the map belongs at the top regardless of what Wikipedia:Infobox templates says.

Is there a reason behind this? Does the map provide more comprehensive info than the infobox? --Hetar 05:24, 6 April 2006 (UTC)

1. We don't need to display an image twice but the image with the box doesn't have a description, so it's not the same thing twice. Do you have a better image for the box?

The image is obviously of H5N1 - if readers need a more detailed explanation, they can simply click on the image. --Hetar 05:24, 6 April 2006 (UTC)

1. The wikinews box was put where it seemed most applicable, although this is debateable. Why do you feel it is better placed somewhere else? Where it is "typically" placed is not relevant. What counts is what works best for this article, and maybe you can provide a fresh eye for that. WAS 4.250 04:33, 6 April 2006 (UTC)

On the contrary, where it is typically placed is very relevant, because users who are looking for specific types of information (in this case news) will look there, and should be able to quickly and easily find it without having to read the whole article. --Hetar 05:24, 6 April 2006 (UTC)

• This map is there to inform, while this box is there to provide links to related articles - informing the reader to go there if they are looking for that.

Everything in the infobox relates directly to the article's subject. It gives access to a broad range of information about H5N1 while the map provides a pretty image. --Hetar 07:07, 6 April 2006 (UTC)

• How can they know what will happen if they click? Maybe no data. Why should they have to click? They shouldn't have to. The same logic can be used to hide any and all data. And click what if you delete the image they are supposed to click? You aren't making sense.

The image in the infobox is clickable - and again, there isn't any crucial information in its little caption. It's a natural reaction that if you want more info on an image, you click on it. One additional link for non-essential content is not a big deal, however a confusing/nonstandard layout is much worse.--Hetar 07:07, 6 April 2006 (UTC)

• Suppose we do decide to place it where it typically goes; where is the data to inform us of where that is? WAS 4.250 05:52, 6 April 2006 (UTC)

From Wikipedia:Sister projects, "Links to sister projects are best placed in the actual section of the article that they relate to. (Such as, for examples: next to any discussion of quotations for a link to Wikiquote, or next to the event that they source for a link to Wikinews.) Otherwise, they are usually placed in the External links section (not the "See also" section)." --Hetar 07:07, 6 April 2006 (UTC)

Third opinion: Frankly, I have to say that I agree with most of Hetar's points. The infoboxes and images, quite frankly, look a mess just now; that's why we have standards, so that they are where you expect them to be, and don't jar. The map's probably better off in the global spread section, and we certainly don't need the image in the infobox twice. Perhaps reducing the size of a couple of the other images would help, too. --Scott Wilson 09:36, 6 April 2006 (UTC)

OK, let's vote on it. Vote open. It's two to one. I lose. Vote closed. You two implement your victory. Go for it. :) WAS 4.250 16:04, 6 April 2006 (UTC)

Woah, I just moved the images around in my edit on April 3, 2006 because I remembered reading somewhere (I tried to find that page just know but I couldn't) that images should alternate left and right on the page to make it more interesting and easier to read, and also that way the images don't get all stacked up on the right the way they were. I didn't know this would cause such a problem :). In general, I think if there is no official guideline for whatever the problem is, then it's up to the individuals themselves to format the page the way they want. And we're all individuals, so remember, diff'rent strokes for different folks. If you like something one way, make it so. If somebody wants it more, then turn to him the other cheek, that's what I say :) J. Finkelstein 21:04, 6 April 2006 (UTC)

Factory Farm v Migratory Birds as Vectors

A reference was removed to this study suggesting that industrial poultry operations - not migrating birds - are the main vector for transmission of avian flu: http://grain.org/briefings/?id=194

The Lancet (Vol 6, April 2006, in Leading Edge) has picked up the story and backs the GRAIN study. Here is some relevant, and important, text:

Since mid-2005, the Food and Agriculture Organisation(FAO) and WHO have given wide prominence to the theory that migratory birds are carrying the H5N1 virus and infecting poultry fl ocks in areas that lie along their migratory route. Indeed, this is probably how the virus reached Europe. Unusually cold weather in the wetlands near the Black Sea, where the disease is now entrenched, drove migrating birds, notably swans, much further west than usual. But despite extensive testing of wild birds for the disease, scientists have only rarely identifi ed live birds carrying bird flu in a highly pathogenic form, suggesting these birds are not efficient vectors of the virus. Furthermore, the geographic spread of the disease does not correlate with migratory routes and seasons. The pattern of outbreaks follows major road and rail routes, not fl yways.

Far more likely to be perpetuating the spread of the virus is the movement of poultry, poultry products, or infected material from poultry farms—eg, animal feed and manure. But this mode of transmission has been down-played by international agencies, who admit that migratory birds are an easy target since nobody is to blame. However, GRAIN, an international, non-governmental organisation that promotes the sustainable management and use of agricultural biodiversity, recently launched a critical report titled Fowl play: the poultry industry’s central role in the bird fl u crisis. GRAIN points a finger at the transnational poultry industry as fuelling the epidemic. Over the years, large concentrations of (presumably stressed) birds have facilitated an increased affinity of the virus to chickens and other domestic poultry, with an increase in pathogenicity. Since the 1980s, the intensification of chicken production in eastern Asia has gained momentum, changing the whole dynamic of avian influenza viruses in the southern China epicentre, which has had far-reaching consequences for the rest of the world.

The Lancet story can be found here (subscription only): http://www.thelancet.com/journals/laninf/section?volume=6&issue=4&section=Leading+Edge Mackinaw 11:56, 7 April 2006 (UTC)

I moved it to the H5N1 impact article in its Political sub-section. Feel free to add to it. Don't worry about proportions, as when and if it gets too big it can be split off into a seperate article. Just don't delete anything that is sourced. Feel free to spin it differently than I have, just try to be NPOV and always supply a neutral source or else clearly identify the source's biases. WAS 4.250 16:59, 7 April 2006 (UTC)

Hmm. The issue is a scientific one, not political (though it does have political implications). GRAIN comes from a political perspective, of course, but their evidence for their claims are scientific - ie studying infection routes, which correlate with transport networks (rail & road) and not migratory paths. If GRAIN is a political group, so they are POV; but when Lancet, a (perhaps the) leading global medical journal agree that the focus on migratory birds as a vector is probably spurious, then it would indicate an issue here more than just spin, but rather science. that is: what are the causes of the outbreak; and what are the vectors of transmission? I guess the wikipedia article does focus on both, so fair enough, but the issue of virus spreading routes (human transport networks and not migratory paths) seem to me of relvance in this article, not on the politics page. Mackinaw 18:54, 7 April 2006 (UTC)

The best scientific evidence is that migratory birds play a part but no one has data on whether it is a small or large part. Any statements saying to ignore the migratory bird transmission path is political not scientific, as there is no scientific data to back up such a claim. The spurious claim that "most" transmission is not migratory is beside the point since most transmission is within countries not between countries and the issue of world-wide spread is an issue of between borders and between continents. A migratory bird just needs to cross a border once and nonmigratory bird transmission can spread it from there. The migratory bird issue was about can we contain it to south east asia or not and with knowledge that wild ducks wee transmitting it , it was clear to scientists that it could not be contained, only delayed. They were right. WAS 4.250 20:13, 7 April 2006 (UTC)

October 2004: Researchers discover H5N1 is far more dangerous than previously believed. "In the past, outbreaks of highly pathogenic avian influenza in poultry began following the primary introduction of a virus, of low pathogenicity, probably carried by a wild bird. The virus then required several months of circulation in domestic poultry in order to mutate from a form causing very mild disease to a form causing highly pathogenic disease, with a mortality approaching 100%. Only viruses of the H5 and H7 subtypes are capable of mutating to cause highly pathogenic disease. In the present outbreaks, however, asymptomatic domestic ducks can directly introduce the virus, in its highly pathogenic form, to poultry flocks."WHO Limiting this conclusion to domestic waterfowl proved to be wishful thinking, as in later months it became clear that nondomestic waterfowl were also directly spreading the highly pathogenic strain of H5N1 to chickens, crows, pigeons, and other birds and that it was increasing its ability to infect mammals as well. From this point on, avian flu experts increasingly refer to containment as a strategy that can delay but not prevent a future avian flu pandemic. November 2004: The U.S.'s National Institutes of Health's (NIH) National Institute of Allergy and Infectious Diseases's (NIAID) Influenza Genome Sequencing Project to provide complete sequence data for selected human and avian influenza isolates begins.Nature article: "Race against time" from Global spread of H5N1 WAS 4.250 20:18, 7 April 2006 (UTC)

OK makes sense. One point though - cross-border transmission *has* been linked to transport of domestic chickens, eg Nigerian imports of day-old chicks from China & Turkey (ref: same Lancet article).Mackinaw 16:38, 9 April 2006 (UTC)

Yes. And not just live poultry. Check out Environmental survival at Transmission and infection of H5N1 and you'll see why everything from frozen chicken to chickenshit (or even things just contaminated with chickenshit) are potential sources of spread. Chickenfeathers from chickens that died weeks ago can carry live H5N1! Trucks must get their tires decomtaminated when moving from an H5N1 contaminated area. Also I read that some chicken farms' chickenshit is used as food for fish farms where migrating ducks frequent picking up the H5N1 from the shit (this example was from China, but other countries probably do this too). It's all interwoven and pointing a finger at one piece of the puzzle and saying ignore that piece is not helpful but is merely propaganda. WAS 4.250 17:46, 9 April 2006 (UTC)

agreed. though the worry is if there's not enough finger-pointing at major source of problems, which is propaganda of a different kind. but the wikipedia article seems to cover all bases, so that's not a worry here - though it does seem to be a problem in most media coverage. Mackinaw 19:03, 9 April 2006 (UTC)

Structural problems

Hi, this article has a lot of potential but IMO the structure is problematic (I may have temporarily worsened this w/my edits from 4/10/06, sorry). The article is not about flu viruses in general, orthomyxoviruses, other influenza pandemics, the Spanish flu, etc. It is about a particular subtype of a virus, which is known to cause "bird flu" and which is considered a major pandemic threat. The article should open with (1) what h5n1 is (a subtype of the species influenza A virus), (2) what the structure is (basic info about capsid, proteins, etc). (3) what it does (infect lots of birds everywhere and some people, (4) why it matters (global risk), and (5) what can be done (treatment & preparation). That's my view, anyway. I will make an effort to pare down the extraneous information, as long as consensus agrees with this. Kaisershatner 18:50, 11 April 2006 (UTC)

Go for it! WAS 4.250 19:04, 11 April 2006 (UTC)

Thanks. I think that's a pretty good first pass. Expect some continued copyedits but I think the major structure is in better order now. Kaisershatner 20:17, 11 April 2006 (UTC)

OK. It is now much better than it was. Anybody have ideas for making this or related articles even better? Or do we continue improving as the muse moves us? WAS 4.250 16:38, 12 April 2006 (UTC)

I still feel that there are some structural problems with the article. I actually came across this article while looking at the featured article list, and is one of the points that I was going to raise before deciding to work a little on the article first (BTW, I don't feel that it is comprehensive enough to be a FA just yet, but it is almost there). I would suggest Reorganising the article structure so that the epidmiology of natural H5N1 infection comes just after the introduction. Within this subsection the prevalence of H5N1 infection in the wild, routes of transmission, cross-species transmission (including frequency, restriction factors and clinical outcome) can be discussed. Then we move on to virology of H5N1. Briefly, orthomyxoviruses, the genomic organsiation, phylogenetic clusters, reassortment and mutation, co-receptor usage and dynamics of viral replication may be discussed. Then we can go onto the immunological features which would include pathology and symptoms in both humans and birds. Cats and ferrets should also have a mention here as they are the prime animal model for invectigation of the virus. Then go onto the macroeconomic impact of the possible pandemic and the current situation. At the moment, there is substantial repitition within the article, which, I feel, is a result of the current structure. What do people think? --Bob 20:33, 20 April 2006 (UTC)

We just had a major reorganization by someone else in which H5N1 genetic structure and Flu research were spun off by me. I'm sure the article will be better after you complete your proposed rereorganization, but I would like to be reassured that you've read the sister H5N1 and Flu articles (the ones in those templates) and would recommend implementing your proposed rereorganization in steps others can follow rather than too much all at once. Seem sensible? WAS 4.250 21:29, 20 April 2006 (UTC)

Of course. I won't be implementing too much at one point, and I doubt I'll have time to do that much soon, but rest assured, I will read around the subject on Wikipedia like I did for the HIV and AIDS articles. --Bob 21:35, 20 April 2006 (UTC)

That's exactly the reassurance I was looking for. WAS 4.250 00:41, 21 April 2006 (UTC)

Praise

Congrats! —Encephalon 21:13, 14 April 2006 (UTC)

Up to date?

I haven't heard anything on the Bird Flu in quite some time on the news, and while it's obviously still out there, I was wondering if it simmered down a little or if people just lost interest in it? But being as the article says people are (the general public) 'stockpiling food stores' etc., makes me think this article is a little out of date; if it isn't, than it should at least reflect that many people have kind of put it out of their minds or something to that extent. This should be particularly important if it is being considered for Featured Status. - A.J. 23:09, 15 April 2006 (UTC)

Supply an unbiased source. WAS 4.250 00:36, 16 April 2006 (UTC)

"Human pandemic" and other changes

I've made a number of smallish changes which should be self-explanatory; for example, adding Relenza, which appears to be similar in effectiveness to Tamiflu. A specific point which was questioned was my changing "pandemic" to "human pandemic". While the added adjective is clearly redundant, it is not incorrect. My reason for adding it: H5N1 is very much in the news, and this article is likely to be seen by many people. At As of mid-April 2006, there H5N1 has become worrying widespread in avian populations (i.e., birds). The non-expert can easily think of this as a pandemic. Even if the difference is explained elsewhere in the article, I think that it makes sense to spell out that "the human pandemic remains only a potential".

I changed "at present" to "As of April 2006". The phrase can be updated, or a specific day added, as required. This is an encyclopaedia, a work of reference, to be read at any time. While this article is probably, in practice, updated frequently, there are a lot of articles using "currently" or "at oresent" to refer to out-of-date information.

All the changes I made are sensible, neither vandalistic nor outrageous, even if there may be disagreement (which I didn't expect in this straightforward case). Please comment or Talk before reverting. Remember that "we are doing here. We are building a free encyclopedia for every single person on the planet. We are trying to do it in an atmosphere of fun, love, and respect for others" etc.

Pol098 09:22, 19 April 2006 (UTC)

My opinion of your edits:

• As of April 2006, is best deleted. This could be added to every sentence. There is no point for it to be here in particular.
• but no obvious contact with birds is not true
• human pandemic implies there is another kind of pandemic, thus misinforms by implication
• and zanamivir (commercially marketed by GlaxoSmithKline as Relenza is not especially relevant and is better dealy with elsewhere ; H5N1 flu for example
• In Britain it was reported in October 2005 that the government was to order 120 million doses of Tamiflu[14]. The government forecasts about 50,000 deaths, but warns that 700,000 are possible is an inadequate and misrepresentative overview of UK pandemic preperations. WAS 4.250 16:54, 19 April 2006 (UTC)

Some of the above has become moot, as other changes have been made to the article, improving it. By the way, As of April 2006 may not have belonged there, but it was less bad than the today which it replaced, which should be avoided in a work of reference as distinct from news. The present text avoids both. I don't see why Tamiflu is relevant and Relenza isn't; they seem to be about equally effective. Re preparations in Britain, I think you have better information than I do; perhaps you could add brief information? As other people are contributing and will presumably see this, I'll leave it to them to reinstate Relenza or not. Pol098 23:26, 19 April 2006 (UTC)

They are very definitely not equally effective.

The pandemic preparations section is merely an intro/overview of a sister article and should not single out the UK anymore than California, Texas or France. The EU does deserve a paragraph, tho. The rest of the world simply is not making noteable preparations other than through international organizations (which are already mentioned in the subsection). Sometimes I think China wants a flu pandemic, the way it behaves; but the section is about preparing against a pandemic, not preparations for creating one, so its efforts in that regard don't go here. WAS 4.250 18:33, 20 April 2006 (UTC)

He said, she said

At the moment there are a little too many direct quotations for my liking. These should be summarised and linked to. Ideas? --Bob 20:37, 20 April 2006 (UTC)

I far prefer quotes, but everyone else has your point of view on this issue, so you should feel free to summarize and link. I'll hate it, but everyone else will love it. WAS 4.250 21:22, 20 April 2006 (UTC)

Conspiracy theories

I have read many sites claiming that the bird flu is just a mass panic started by Roche to sell lots of medicine for high profits, there should be a section about these rumours too. Lapinmies 23:01, 30 April 2006 (UTC)

See the last section of this article and that section's main article H5N1 impact. Please provide encyclopedic sources for "mass panic started by Roche" so it can be added to H5N1 impact. WAS 4.250 02:02, 1 May 2006 (UTC)

Negative. Lapinmies 22:09, 1 May 2006 (UTC)

How does your family plan to prepare against bird flu?

I'm not sure if Wikipedia talk pages could double as a discussion forum, but I think if they don't anymore, they sure as were meant to. So, at the risk of having this deleted, let me just ask: how do you plan to protect your family against this disease? 70.240.86.52 01:27, 10 May 2006 (UTC)

See Influenza pandemic for advice in that regard. As for me, I am doing what the world's top expert in the subject (Robert Webster) is doing: I have two months of water and food in my home. WAS 4.250 01:38, 10 May 2006 (UTC)

There has been quite a lot of confusion about what mask to use, should the virus mutate into a human-transmitted disease. It depends on the actual size of the virus, which I've read could be one micron or possibly three microns. I'd like to see that information on this site. I'm also skeptical of sites saying a particular mask is the minimum required. I would want something better than that.69.6.162.160 15:03, 10 May 2006 (UTC)Brian Pearson

No one knows. People have guesses, but no valid scientific tests have been done thay conclusively validate a way to be sure not to catch a flu virus. You could wear a friggin space-suit to not catch it, hose down the suit in bleach before steping inside to remove the suit, breathe only air heated to some very high temperature, and wind up catching a humanized H5N1 from washing your hands in tap water. Avian H5N1 is spread bird to bird by methods including drinking lake water other birds shit in - the same lake water cities use. As long as H5N1 is not human adapted, you can not get it from drinking tap water. But can you get regular flu from drinking lake water birds with regular flu shit it - know one can answer that because H5N1 is the first flu virus that is so deadly and so contagious among so many species - and it survives longer at higher temperatures than others. We are simply dealing with way too many unknowns including that the pandemic flu mutation from H5N1 has not yet occured. One quote from an expert was something like "I know how not to get AIDS; but I don't know how not to catch a flu virus for which there is no vaccine." WAS 4.250 15:53, 10 May 2006 (UTC)

Most flu viruses die on contact with water and I seriously doubt a flu virus could survive the chlorine used in water treatment alone.--Hontogaichiban 11:55, 21 May 2006 (UTC)

They do not die on contact with water. Water treatments vary. See H5N1 flu for details on what kills H5N1 and what doesn't. H5N1 survives better than other known flu viruses. WAS 4.250 13:40, 21 May 2006 (UTC)

I have read an encouraging article by a company[15] that makes the virus vaccine. They report they can make it in adequate quantities in the space of ten to twelve weeks, once they have a sample of any new mutations. Also, it can be injected without a needle.69.6.162.160 00:42, 11 May 2006 (UTC)Brian Pearson

You need to learn how to tell when people are probably lying to you. Follow the money is an ancient hint. See H5N1 clinical trials for what is probably more accurate. You will note I don't guarantee they are lying. It is also possible they have geneticaly engineered pigs to fly. WAS 4.250 03:20, 11 May 2006 (UTC)

I should have worded that to say, "...that makes virus vaccines," instead of "...that makes the virus vaccine." I don't have any reason to doubt it, but it wouldn't hurt to check their past performance. There should be a way of doing that, objectively. I did check your link. I'm sure the company did not include trials in that timeframe. In an emergency, I would not worry about it... 69.6.162.160 02:07, 18 May 2006 (UTC)Brian Pearson

Recoveries?

Can somebody please tell me whether there were any recoveries? At least put it up! Thanks. - unsigned

Everyone who caught it that didn't die recovered. Around half die. Around half recover. The article has a table that gives the details. WAS 4.250 13:36, 21 May 2006 (UTC)

The Future of H5N1...

Shouldn't someone include what could happen in the future if the bird flu mutated and such? - unsigned

We do include it. This article says:

"In 2003, world-renowned virologist Robert Webster published an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist calling for adequate resources to fight what he sees as a major world threat to possibly billions of lives."

Global spread of H5N1 says:

"Perhaps the most extreme maximum has come from renowned virus expert, Robert Webster, who believes H5N1 has the capacity to mutate into a form that could kill a third of the human population" using the source This source says that in 2003 world renowned virologist Robert Webster published The world is teetering on the edge of a pandemic that could kill a large fraction of the human population in American Scientist saying "a third of the human population" could die from H5N1. In ABC News article on March 14, 2006 he is quoted as saying "Society just can't accept the idea that 50 percent of the population could die. And I think we have to face that possibility." WAS 4.250 02:40, 25 May 2006 (UTC)

The idea that a virus would mutate in a specific way, especially in the near future, seems unlikely. That it is possible is one thing. It is another to say we are 'teetering on the edge' of catastrophe.69.6.162.160 03:03, 28 May 2006 (UTC)Brian Pearson

The likelihood of the virus mutating in a specific way increases cumulatively as the virus spreads, and the virus is currently spreading incredibly rapidly (both in terms of global scope and in terms of what species are susceptible to it). Viruses that are able to successfully spread to new species will, naturally, be more likely to survive and propagate than ones that cannot, and this virus has shown a remarkable capacity for mutation, so all the evidence indicates that it is simply a matter of time before a strain of H5N1 gains human-to-human infectivity. "Teetering on the edge of catastrophe" is indeed a melodramatic way to put it, and most experts feel that Robert Webster's estimates for the likely maximum death toll were overblown, but there is nonetheless wide scientific consensus that an H5N1 epidemic is just about inevitable. The real question is not "will H5N1 gain the capacity for human-to-human transmission?", but "when will H5N1 gain the capacity for humant-to-human transmission?"; no evidence suggests that this is an unlikely eventuality, much less an impossible one. -Silence 03:20, 28 May 2006 (UTC)

I think Silence has it exactly right. Please read our sources and judge for yourself. WAS 4.250 03:53, 28 May 2006 (UTC)

Timing of Pandemic H5N1

Of course, I agree that it is a matter of time and that it will happen. It could be this year, or a thousand years. It's also possible we will be destroyed by an asteroid before that happens. I don't see a way to figure the odds on this particular mutation occurring. There are millions of ways a virus can mutate.69.6.162.160 02:32, 29 May 2006 (UTC)Brian Pearson

That's why we (society in general) pay experts to figure this stuff out for us. Our sources are those experts. Those experts have atom by atom knowledge of many of H5N1's genetic variations both realized and potential. Not enough knowledge to know for sure what will happen. But enough to warn us exactly as they have. And their credibility is such that governments are spending BILLIONS of dollars based on their warnings and advice. If you chose to ignore expert advice that governments are heeding, that is your choice. WAS 4.250 11:25, 29 May 2006 (UTC)

Brian, you've made a common perceptial error regarding the likelyhood of events. The odds of a large astroid hitting earth in any given year are approximatley of the order of magnitude 1 in 50 million, as you only live around 80 years, you don't need to worry too much. In terms of bird flu the odds are more like 1 in 25. So you are likely to encounter pandemic bird flu three times in your lifetime. We also know the odds are currently much higher than that as we are aware of events happening now that mirror the build up to previous pandemic flu.

The other point you make is about the chance of a virus mutating to infect humans. There are millions of ways an individual virus can mutate, which is the danger. In just one infected individual billions of virus's will be produced, each one with its own mutations. We already know that H5N1 will infect humans, so for the virus to become pandemic it only needs to learn to pass from human to human more effeciently. We know that only a small change is required for this to happen, so while H5N1 continues to infect humans we can calculate that pandemic flu is imminent. In addition influenza virus is cabable of a form of sexual reproduction whereby it can mix its genetic material with other flu viruses such as human flu viruses. This happened when H5N1 and a human flu virus infect the same cell as the same time. The resulting "offspring" could be viruses with the ability to jump easily from human to human and the ability kill like H5N1.

One way to imagine what is happening is that once the virus has infected a human, it generates billions of copies of itself, each one slightly different. Some will be, by chance, capable of jumping from human to human. If that particular virus finds itself in the right place at the right time it will be the one to infect another human, in that human a far higher proportion, if not all, of the virus's produced will be capable of infecting other humans making that individual and all subsequently infected humans victims and carriers of pandemic flu. Viruses essentially spend their whole time trying to break the combination that will allow them to infect another reservoir of victims.--Hontogaichiban 13:28, 29 May 2006 (UTC)

Yes, absolutely right. WAS 4.250 15:03, 29 May 2006 (UTC)

Thanks, Hontagichiban, that was a very helpful explanation! It'd be great if something like that could find its way into one of the main articles! Waitak 15:14, 29 May 2006 (UTC)

Could you be specific about exactly what information you would like to see in what article? This kind of feedback is very important for us. Thank you. WAS 4.250 17:27, 29 May 2006 (UTC)

In rereading H5N1 it seems to me that we pretty much say what he said above, so maybe you could tell us where in H5N1 you missed the part about the virus' mutation rate. Or maybe its the statistics that made it all click for you. What sentence could we add where in the article that would have helped you? WAS 4.250 17:35, 29 May 2006 (UTC)

I agree there are millions of ways a virus can mutate. Just the same, there are one or two specific mutation necessary to achieve human-human transmission. It has to be able to stick to the lining of the lungs in humans while still being transmitted from one bird to another. I realize I sound to the rest here as if I'm trying to be stubborn. I suppose I could better visualize how such a combination could result in a specific time period, say, within X number of years, given its mutation rate -- whatever that is. The previous pandemic, in 1917/1918, was the result of the fusing of two viruses, not your usual run of the mill mutation.

By the way, I had recently read this:

"Virology doctrine suggests that in order to become an effective and transmissible human pathogen, H5N1 would have to trade in some of its virulence cards. Highly virulent viruses don't spread very well. Dead hosts are dead ends." [16] That seems to give us some hope that a pandemic may be milder than feared. As it stands, there are 36,000 people killed every year in the United States, alone, from influenzas. That is bad enough. That translates to over 2.5 million killed from the average flu we see in the intervening period between pandemics, in one country.69.6.162.160 03:09, 30 May 2006 (UTC)Brian Pearson

We do know that the mutation required to produce pandemic flu is going to only be very small, this is because the H5N1 virus in its current form can infect Humans and can in absolutely ideal situations pass from Human to Human. So we are only talking about a very slight refinement, rather than a revolutionary change. Due to the vast number of viruses produced within just one infected Human, there will be thousands if not millions of viruses that have the necessary adaptations to easily infect Humans, it's just a question of chance as to whether one of those viruses gets out and manages to infect another Human, once that happends the virus will very rapidly become more adapted to Humans.

As for the combination, we know from historic examples and from looking at the virus and how it has already behaved in Humans that Pandemic flu is likely to arise any time now. It's a bit like a lottery, only in this one the probability is that the numbers will come up sometime in the next three years - that could be tomorrow or three years, but it could happen tomorrow, there are not necessarily any more intermediate stages to give further warning, hence the high level of concern over the Indonesian family wiped out in the last two weeks. As for fusing of flu viruses, I'm afraid this is very much run of the mill and is the primary source for annual flu variations.

The virology doctrine you quote is relevant in some circumstances, but is normally only relevant in terms of the long term survival of the virus. It is true that a viruses which incapacitate and kill their victim within a couple of hours would be forced to evolve into a less virulent one to give each victim the time to spread the virus. However H5N1 already gives its victims ample time to spread itself to new hosts. The doctrine kicks in where the resevoir of potential new victims becomes limited. So for example when Humans lived in isolated villages the virus would have to become less virulent to ensure that at least a few individuals would travel to the next village while carrying the virus. Of course this is not a problem for the virus in modern society, where someone can travel from Thailand to London in less time than the virus takes to incubate. History suggests that pandemic viruses continue to spread across the world until they have exhausted the supply of hosts with no immunity and then they more or less disappear/become extinct. (the 1917/1918 Flu is not still around to day for example.) This is because the virus has no way of knowing that the Human population has a limit. Everytime the virus moves to another Human it becomes slightly more adapted to Humans, but not necessarily less lethal, by the time it reaches the last uninfected Human, it's genetic programming assumes there are more Humans, but failing to find one it dies out. The bottom line is that the 1917/1918 flu was extrememly lethal and would be quite bad enough. The current H5N1 is even more lethal, so any resulting pandemic flu would probably be somewhere between the two in terms of death rate. Even a repeat of the Spanish Flu of 1917 would warrent more than the current concern given to H5N1. Incidently there were two more pandemic flus, albeit slightly less lethal than the Spanish flu in the 1960's. Hope this helps!--Hontogaichiban 06:03, 30 May 2006 (UTC)

Well, thank you, Hontogaichiban. I still see quite a bit of uncertainty among the experts cited. Reading the article again, I see it could be anywhere from 5 million to 150 million people killed according to one guy, and up to billions according to another guy. This tells me that the prediction business is a little fuzzy. Nevertheless, I agree this H5N1 is nothing to sneeze at.69.6.162.160 02:52, 14 June 2006 (UTC)Brian Pearson

Well we do know that the Black Death wiped out half the world population. If that happened today that would be 3 Billion, so that's a historical number we can be sure is possible. Flu itself has wiped out 10s of %, so that would be at least 600million people. But worst case scenario, imagine a virus that kills the victim after 9 months (like a fast acting aids), and spread like the flu. Such a virus could infect almost the entire world population possibly before we detected it, but certainly before we found a cure. A small number of people will be immune to any virus, but such a combination could wipe out almost everyone, but that's not what we are dealing with in terms of H5N1, it is much more likely such a virus would be deliberatly genetically engineered (Bio weapons scientists have made a version of HIV that spreads by airborne transmision.)--Hontogaichiban 17:23, 14 June 2006 (UTC)

It's also worth bearing in mind that reinsurance companies like Munich Re and Swiss Re have been keeping a very close eye on this, running different scenarios to try and gauge the possible impact of a pandemic. It is worth bearing in mind the fact that the baseline assumption that a pandemic could be as bad as the 1919 Spanish Flu Epidemic is somewhat flawed - the effects of the First World War on the human population did have an effect in terms of basic nutrition and sanitation. That said, any pandemic is going to lead to millions of deaths. Darkmind1970 09:54, 18 April 2007 (UTC)

WHO Suspects Human-to-Human Transmission Occured in Indonesia

I edited the article to incorporate a recent WHO statement that Drudge broke: http://drudgereport.com/flash1.htm

User WAS 4.250

User:WAS 4.240 would prefer various links be in daughter articles, and removes them here repeatedly, using the insulting term "spam" in the process. He'd prefer not to explain why on the talk page. I suggest he do so, and then we can get the opinion of others on his reasoning. - Nunh-huh 17:34, 25 June 2006 (UTC)

I disagree with your argument and its style. First, the linked pages do not seem to match the scope of this article and also seem to provide just a collection of other news sources. Secondly, WAS 4.250 originally reverted your additions inviting you to discuss them in the talk pages, which you ignored until you added the above. I think, these links should be removed. Awolf002 11:45, 26 June 2006 (UTC)

I put the links where I would expect to find them. They were reverted with the insulting, and untrue, edit summary that they were spam. Repeatedly. The matter was then taken to an administrators noticeboard by WAS 4.250 and characterized as a global threat to the functioning of Wikipedia. And WAS 4.250 has yet to comment on the talk page. I'm not sure why you like WAS's style more than mine, but your opinion is noted. Your implication that I should have "assumed good faith" in response to a charge of "spamming", an actual demonstration of bad faith, is mistaken, and your implication that I've made a personal attack is also wrong. - Nunh-huh 14:32, 26 June 2006 (UTC)

Thanks for your explanation! I hope you both realize that this discussion does belong in the talk pages and not anywhere else. That discussion should consider the usefulness of the proposed links to the topic of the article and whether the referenced site can be considered a reliable source. I hope you both can reverse this worrying trend of escalation, that is very unnecessary. Awolf002 15:32, 26 June 2006 (UTC)

I'm perfectly calm, thank you. Please don't be "worried". And there doesn't seem to be a "both" here. - Nunh-huh 15:37, 26 June 2006 (UTC)

Nunh-huh, please explain why you would expect to find the links you added where you added them, why you believe they are not spam, why you feel the linked pages match the scope of this article, why your link to a collection of news sources belongs on this article, and why we should not remove them. WAS 4.250 06:12, 27 June 2006 (UTC)

Since you are the one who called them spam, you owe an explanation of why you applied the term. I don't have to explain what you said! I'll be happy to respond to your explanation.- Nunh-huh 14:07, 27 June 2006 (UTC)

Just as the H5N1 and Flu articles are spread over two suites Flu (Flu, Flu season, Flu vaccine, Flu treatment, Avian flu, H5N1 flu, Flu research) - H5N1 (H5N1, H5N1 genetic structure, Transmission and infection of H5N1, Global spread of H5N1, Social impact of H5N1, Influenza Pandemic)); so too should the links be placed in the most appropriate article, not in as many articles as someone thinks they can get away with. Your links do not belong at H5N1. The exact location you added your links recommends Global spread of H5N1 as a proper place for good and useful links about H5N1 in the category of News and General information. WAS 4.250 17:21, 27 June 2006 (UTC)

Once again you voice your snide suggestion that I added links to "as many articles as I thought I could get away with". Your presumption of bad faith is obnoxious and offensive and is not helpful. I expect to find sources for news about H5N1 in the H5N1 article. Tell me how that is naïve. Perhaps the problem here is that there are too many articles treating of the subject, and they should be merged. One shouldn't have to hunt through multiple articles on a single subject to find information. - Nunh-huh 17:27, 27 June 2006 (UTC)

Articles in wikipedia have a recommended size therefore articles above a certain size need to be split into more than one article. Your expectation to find news links in an encyclopedia article is troubling. See what wikipedia is not. H5N1 in the news concerns its global spread mostly, its social impact sometimes, its pandemic potential as a repeated non-news item, and rarely new genetic information. We have seperate articles for each of those. We have enough information and enough links to fill several articles. Categorizing what goes where is an encyclopedic editorial responsibility that you make light of assuming bad faith on my part. WAS 4.250 17:58, 27 June 2006 (UTC)

Links to further sources and further reading are, of course, expected in encyclopedias and are most assuredly not "what Wikipedia is not". As you are no doubt aware, the arbitrary size limit was originally set to prevent substandard Microsoft browsers from cutting off the ends of articles while editing, and are gradually being abandoned (as those browsers disappear). Having an encyclopedia article on "H5N1 in the news" separate from "H5N1" makes very little sense. And I am not assuming your bad faith, you have demonstrated it, by mischaracterizing my additions here, and my motivations, and by turning what could have been a reasonable discussion about how best to present information into a "forest fire", posting it as an "incident" on the administrators board, all without a single word from you on the talk page. - Nunh-huh 18:26, 27 June 2006 (UTC)

Further reading is expected, but not further reading on subjects primarily covered in other articles. Your links cover subjects primarily covered in other articles. Please move them to the appropriate article. WAS 4.250 18:32, 27 June 2006 (UTC)

You seem to have once again removed some links unilaterally while they were under discussion here, and placed only one of them elsewhere. I've rectified that. And your use of the term spam remains objectionable. - Nunh-huh 18:52, 27 June 2006 (UTC)

Maybe we have a communication problem. We don't need to reproduce a list of links all over the place, we only need to link to the list. I replaced what was there with the below hoping this helps improve communication. People can add to the list that is linked to. Adding it both here and there is spamming. WAS 4.250 19:31, 27 June 2006 (UTC)

Technical

See list of links at H5N1 genetic structure#Further reading.

News and General information

See list of links at Global spread of H5N1#Further reading

I'm quite certain we have a communication problem. At least a part of that problem is that you seem to have no idea that accusing someone of "spamming" is a certain way to offend them: fine, if that is your intention, and non-productive at best if it is not. Another part of that problem is that you expect people to intuit (in some way) the way you have deemed appropriate to add links, and apparently consider it beneath yourself to explain it on talk pages. Since people do not read minds, it is incumbent on you to explain your system rather than merely enforce it, and then go into high dudgeon if your mind has been incorrectly read. - Nunh-huh 20:12, 27 June 2006 (UTC)

Would this be even better? WAS 4.250 15:54, 28 June 2006 (UTC)

Technical

The list of links that goes here is at H5N1 genetic structure#Further reading.

News and General information

The list of links that goes here is at Global spread of H5N1#Further reading.

That seems confusing to me (if they "go here" they should be here). How about:

Technical

External links dealing with technical aspects can be found here.

News and General information

External links dealing with news and general information can be found here.
-Nunh-huh 21:27, 28 June 2006 (UTC)

That's an excellent suggestion. I just implemented it. Thanks. WAS 4.250 09:01, 29 June 2006 (UTC)

Vaccine production without eggs

There will soon be a faster way of producing vaccines, without the use of eggs, which will also be purer. People who are allergic to eggs will not be affected.[17]69.6.162.160 04:51, 12 July 2006 (UTC)Brian Pearson

See Flu research and Cell culture. WAS 4.250 16:11, 12 July 2006 (UTC)

NPOV issue

This article presents a range of information in support of the theory that H5N1 is about to become a disaster. Yet this is a disease which has not, according to the article killed even a hundred people in any year. By those numbers you are 40 times more likely to be executed by the state. Of the 57 million people who die in a year (figure for 2002), this is about 2 in a million. The evidence provided does establish that it is possible a pandemic could occur, but provides nothing more than repetition of speculation about what the probability of that happening is because it is not something that is known. At the same time it ignores entirely the considerable body of opposing opinion that suggests the whole thing is overblown and results in a misapplication of "billions of dollars" much needed for other health issues that are actually killing people like the 16 million people a year who die from cardio vascular disease or the 1 million people who die every year from each of TB, malaria, lung cancer or road accidents. For a sample of the opposing point of view check here1, here2 here3, here4, here5, [http://www.dailyreckoning.co.uk/article/020820063.html here6], here7, here8, here9, here10, here11, here12. KenWalker | Talk 08:32, 10 September 2006 (UTC)

here1: didn't download.

• Works here. "Dr. Marc Siegel is a practicing internist and an associate professor of medicine and a fellow in the Master Scholars Society at New York University School of Medicine" He suggests this is "a doomsday scenario that is packaged and sold to the public by the media, which consequently makes some undeserving manufacturer rich or collects votes for an undeserving leader." Seems to have the credentials to warrant taking his opinion into account. KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • I've followed this day by day for a year now and I know for a fact it is not "packaged and sold to the public by the media". Change "media" to "flu experts" and the man would have a point. Are the flu experts genuinely afraid for public safety or out to send money and publicity to their field or just biased because it is what they see everyday? Without more data, I would guess all three. WAS 4.250 02:12, 11 September 2006 (UTC)

here2: True. Our article says this too.

• This article expresses a point of view directly contrary to the view in our article. The points this article makes should be set out in appropriate places throughout our article to give it balance. KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • Edit the article to add data or a quote to one place using this as your source and let's see where we go from there. Or suggest below the exact changes you have in mind. NPOV is important. This article by Time is accurate. But our other sources are also accurate. So let's add, not delete. WAS 4.250 02:12, 11 September 2006 (UTC)
    • I agree, it is not a matter generally of deleting. With the obvious quality and the considerable work that has gone into this article I don't plan to make any changes without discussing them here first. Reading back my comments, you may think I have a negative opinion overall about this article which is not the case. My concerns are specific, the article, overall is an excellent piece of work.KenWalker | Talk 04:00, 13 September 2006 (UTC)

here3: no facts to support your position

• This site seems to be a collection of media sources advanced by a lobby group for the poultry industry. They are entitled to take a point of view. That said, it does provide many opinions from people that seem to have credentials warranting attention that challenge the inevitable catastrophe conclusion that our article, by ignoring these views, seems calculated to support. KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • See our article on the Social impact of H5N1. It deals with points of view by interested parties and could use your help in fleshing out details like the one you just raised. It needs your help! WAS 4.250 02:12, 11 September 2006 (UTC)

• • • I had looked at that article but looking at it again, I agree that some of what I have a concern about does fit better there. Thanks for that suggestion. KenWalker | Talk 04:00, 13 September 2006 (UTC)

here4: says " a small group of skeptics say the bird flu hype is overblown and ultimately harmful to the public’s health. " Small goups say the world is flat. You can find a small goup to claim anything.

• Presuming that you are right that these are a "small group of skeptics", we should remember that the view that the world is round was also held by a small group of skeptics for many years. That fear of pandemic has become popular does not, of itself, mean it will happen. But even this confuses. If we agreed on who the 100 leading scientists in this field are and asked them "Is there a credible risk that many people will die from H5N1?" we might well get an answer that matches the point of view of this article. But if you asked them "Is the likelihood that more than a million people will die in the next 5 years from H5N1 more than 50%?" do you think a majority would agree? Our article, like much of the popular media takes a positive answer to the first question as equivalent to a positive answer to the second question. By adopting a point of view, we give the impression this feared event it going to happen, when all we can really say is that it might happen. KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • The article should be quite clear that the biggest problem is a lack of knowledge and no one knows what happens next with H5N1 from killing a billion people to fizzling out and just going away. Please add a sentence to the introduction if you believe this point has not been made adequately clear. WAS 4.250 02:12, 11 September 2006 (UTC)

• • • I have in mind the addition of a sentence either quoting or referring to one or two sources along the lines of: "On the other hand, there are others who question whether the mutation necessary for this virus to become capable of human to human transmission is likely and suggest that resources allocated to this H5N1 would be better applied to other health risks." That is the idea, a quote will be better, but that is the general idea. I will do more work on it (may be a while off) and come back with something more concrete. The other change I suggest is under the heading Symptoms in Humans. The sentence "No one knows if these or other symptoms will be the symptoms of a humanized H5N1 flu." This sentence ought to have something added to it like, " . . . if one should occur." Since the likihood of it happening is not know, there needs to be some "if" in it somewhere. KenWalker | Talk 04:00, 13 September 2006 (UTC)

here5: Article says "Dr. Blatherwick rates smoking and lack of seat-belt use as far greater public-health issues." Western governments are spending money to prevent a loss of control should the worst happen. Public health is not their goal in the first place. Spending less on avian flu will not result in spending more on seat belt use.

• This article should not be so summarily dismissed. If you are saying that spending billions of dollars on this risk has no impact on other spending, well, all I can say is that flies in the face of common sense. Dr Blatherwick is a highly respected expert with long experience in public health for a large city. A million people a year die in auto accidents. Less than a hundred die of H5N1. Our article, taken at face value, supports the dedication of resources to face this challenge on the theory that something new is going to happen. It does that skipping the question of how likely it is to happen. At the same time there are many things killing people that, with the resources this question absorbs, would save the lives of many people whose lives are actually ending now rather than some who might die in the future. KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • What you say is skipped is covered in the related articles linked to this one. The H5N1 genetic structure and Influenza pandemic articles might contain what you are looking for. If not be more specific. Other points you just made would be welcome at Social impact of H5N1. Please add them there. WAS 4.250 02:12, 11 September 2006 (UTC)

• • • I think the article as written goes to far and needs some reference to this point (along the lines I suggest above) to balance it, but agree that if it is to be dealt with in detail, there is a better place for that. KenWalker | Talk 04:00, 13 September 2006 (UTC)

[http://www.dailyreckoning.co.uk/article/020820063.html here6]: Commentator opines "If scientists can anticipate the epigenetic shift (gene-swapping mutations), which would make the virus spread between humans, we could certainly ramp up efforts to design a vaccine against such an outbreak." This shows he is drawing conclusions from misinformation.

• Could you point me to the information he relies on that is not correct? The quote you provide does not seem to me to contain information or conclusion. It says that if scientists find that this virus will spread between humans, we should design a vaccine for it. That seems reasonable to me. What conclusion and what misinformation do you find in that? KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • The biggest problem with H5N1 is a severe lack of data. We can not "anticipate the epigenetic shift (gene-swapping mutations), which would make the virus spread between humans". We are trying our best and our best is sucking so bad the scientists who know the most are very scared because they know we don't know what happens next and we don't gave the knowledge to defeat it. Read Flu research and Flu vaccine and H5N1 clinical trials for insight into what is and is not known. Reporting disease cases says "Dr. David Nabarro, chief avian flu coordinator for the United Nations, says avian flu has too many unanswered questions:
• No knows how many could die.
• No one knows how far it has spread. In Africa "surveillance is so poor that deaths of chickens or humans could easily go undiagnosed for weeks."
• No one knows much about future pandemic mutations, except they are increasingly likely due to millions more birds in many more countries leading "to an exponential increase of the load of virus in the world [...] Each infected bird and person is actually awash in minutely different strains, and it takes lengthy genetic testing to sequence each one - so if a pandemic strain were to appear it might be quite difficult for us to pick up that change when it happens."
• No one knows why "the disease, after years of smoldering in poultry, suddenly start hitchhiking in migratory birds."
• No one knows why "the northern China strain - the one now spreading westward - cause[s] so many false negatives in diagnostic tests".
• No one knows why so many people fell sick so quickly in Turkey.
• No one knows the significance of H5N1 spread by mammals such as cats.
• No one knows enough about what virus strains are in which bird species to make useful predictions.
• No one knows enough about bird migration patterns to make useful predictions. Bird species' migration strategies can vary according to age, sex, weather and season, among other things.
• No one knows how lethal the next influenza pandemic will be.
• No one knows when it will occur.
• No one knows if any of the prepandemic vaccines now being tested will have been of any use when the pandemic happens.
• No one knows if any of the nonvaccine drugs will be of any use against the pandemic virus when it comes.
• No one knows if H5N1 will ever go away." from sources NYT article picked up by IHT and International Institute for Sustainable Development (IISD) SCIENTIFIC SEMINAR ON AVIAN INFLUENZA, THE ENVIRONMENT AND MIGRATORY BIRDS ON 10-11 APRIL 2006 published 14 April 2006. WAS 4.250 02:12, 11 September 2006 (UTC)

here7: Everything in the article except the title is accurate.

• Yes, it adds little. KenWalker | Talk 19:59, 10 September 2006 (UTC)

here8: Everything in the article except the title is accurate.

• Well, the title is a conclusion that is not something to advance or deny in our article. But the information in the article has information you concede is accurate and a point of view that our article ignores. KenWalker | Talk 19:59, 10 September 2006 (UTC)

here9: Article says "There has been no change in the behaviour of the H5N1 virus in the last 10 years." He is wrong. Read our article. Read our sources.

• Wrong. Perhaps. I have read the article and will delve further into the sources. You regard Ontario's former chief medical officer of health for 10 years, Dr. Richard Schabas as wrong when he says there have been no changes. The article shows that there have been some changes. The question is what significance the changes have. KenWalker | Talk 19:59, 10 September 2006 (UTC)

here10: Article about canada says "The Conservative government's first budget, unveiled this month, devoted $1-billion over five years to pandemic readiness, compared with $250-million for a new cancer-control strategy." Money for the one does not lessen the money for the other.

• I challenge you to support the statement "Money for the one does not lessen the money for the other." KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • I would rather you add the data to Social impact of H5N1. Let's let our readers make up their own minds. WAS 4.250 02:12, 11 September 2006 (UTC)

• • • I agree. I will do some work there on this point. KenWalker | Talk 04:00, 13 September 2006 (UTC)

here11: Article says "The real trouble, these skeptics say, is that bird flu hysteria is sapping money and attention away from more important health threats. I have a bunch of patients coming in here who are more worried about bird flu than they are about heart disease" Some people are overconcerned. Some people are underconcerned. But no money is going to avian flu that would otherwise be going to some other health risk. The Iraq war for example is getting a thousand times as much funding.

• It also says, "But public health funding is a zero-sum game, both Orent and Siegel note. Money that’s being poured into short-term bird flu preparations isn’t available for long-term fixes that would, for example, increase hospitals’ ability to handle a surge of patients in a national emergency."KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • Add the data to Social impact of H5N1. Let's let our readers make up their own minds. WAS 4.250 02:12, 11 September 2006 (UTC)

here12: Misrepresents what the experts say. Is an idiot. Presents no facts.

• Your view that Mr Noel, is an idiot is not a useful contribution to this discussion. I do not know of this individual, but he apparently has some expertise. His views, like many others, suggest that our article is avoiding this issue. The advise offered, that hand washing matters, is the very point. In the face of mounting hysteria, this RN points out that what would make more difference is hand washing. KenWalker | Talk 19:59, 10 September 2006 (UTC)

• • We cover handwashing at Transmission and infection of H5N1. WAS 4.250 02:12, 11 September 2006 (UTC)

WAS 4.250 09:55, 10 September 2006 (UTC)

Experts have identified key events (creating new clades, infecting new species, spreading to new areas) marking the progression of an avian flu virus towards becoming pandemic, and many of those key events have occurred more rapidly than expected. Due to the high lethality and virulence of HPAI A(H5N1), its endemic presence, its increasingly large host reservoir, and its significant ongoing mutations, the H5N1 virus is the world's largest current pandemic threat. H5N1 is easily transmissible between birds facilitating a potential global spread of H5N1. H5N1 is undergoing specific mutations and reassorting creating variations which infect species not previously known to carry the virus. H5N1 has mutated into a variety of strains with differing pathogenic profiles, some pathogenic to one species but not others, some pathogenic to multiple species. It is endemic in birds in Southeast Asia, has created at least two clades that can infect humans, and is spreading across the globe in bird populations. Mutations are occurring within this genotype that are increasing their pathogenicity. Birds are also able to shed the virus for longer periods of time before their death, increasing the transmissibility of the virus. Because migratory birds are among the carriers of the highly pathogenic H5N1 virus, it is spreading to all parts of the world. H5N1 is different from all previously known highly pathogenic avian flu viruses in its ability to be spread by animals other than poultry. Since 1997, studies of influenza A (H5N1) indicate that these viruses continue to evolve, with changes in antigenicity and internal gene constellations; an expanded host range in avian species and the ability to infect felids; enhanced pathogenicity in experimentally infected mice and ferrets, in which they cause systemic infections; and increased environmental stability. There is no highly effective treatment for H5N1 flu. All H5N1 vaccines for human use are based on a Vietnam strain that no longer exists, so their effectiveness is already known to be minimal (at best they might keep one from dying). WAS 4.250 10:07, 10 September 2006 (UTC)

• I take at face value the well expressed points you make. I lack the knowledge to challenge the science involved so for these purposes I will assume the science is valid. I believe that I understand the scientific analysis well enough to say that no credible source expresses the view that a pandemic killing millions of people is a certainty within, say, 10 years. Instead what they say is that there is a risk. The article (and the WHO, the media and much of popular opinion for that matter) faced with this science adopt the point of view reflected in this article. For H5N1 to kill millions of people requires a series of many discrete events, each with their own liklihood. Some of these event are certain (eg ducks migrate) and some are less certain (that a mutation with a particular combination of characteristics will happen). Consider the probability of rolling sevens on a pair of dice 10 times in a row. Even if most of the throws have produced a string of sevens, a couple of remaing throws makes the full string very unlikley. And even though the first 8 rolls have produced sevens in succession does not increase the likelihood that the next roll will be a seven beyond its own discrete probability. Events like a particular mutation occuring are not one in 12 probabilities. I suspect (for what little that is worth) that this article should be wrapped in something that says "This article describes an event which is very unlikely to occur and should be regarded accordingly." Since my suspicions are not verifiable that counts for nothing. But with no acknowledgement that there is a real possibility (probability?) that the feared conclusion will not occur, I think there is POV issue and a future item for the category "Scares that never came to be and wasted billions of dollars that would have been better spent on something else." I appreciate the good faith tone of the discussion and hope my remarks come across the same way. KenWalker | Talk 17:55, 10 September 2006 (UTC)

From H5N1 genetic structure "Influenza viruses have a relatively high mutation rate that is characteristic of RNA viruses. The H5N1 virus has mutated into a variety of types with differing pathogenic profiles; some pathogenic to one species but not others, some pathogenic to multiple species. The ability of various influenza strains to show species-selectivity is largely due to variation in the hemagglutinin genes. Genetic mutations in the hemagglutinin gene that cause single amino acid substitutions can significantly alter the ability of viral hemagglutinin proteins to bind to receptors on the surface of host cells. Such mutations in avian H5N1 viruses can change virus strains from being inefficient at infecting human cells to being as efficient in causing human infections as more common human influenza virus types. This doesn't mean one amino acid substitution can cause a pandemic but it does mean one amino acid substitution can cause an avian flu virus that is not pathogenic in humans to become pathogenic in humans. In July 2004, researchers led by H. Deng of the Harbin Veterinary Research Institute, Harbin, China and Professor Robert Webster of the St Jude Children's Research Hospital, Memphis, Tennessee, reported results of experiments in which mice had been exposed to 21 isolates of confirmed H5N1 strains obtained from ducks in China between 1999 and 2002. They found "a clear temporal pattern of progressively increasing pathogenicity". Results reported by Dr. Webster in July 2005 reveal further progression toward pathogenicity in mice and longer virus shedding by ducks." WAS 4.250 02:12, 11 September 2006 (UTC)

Any mutation that makes the virus more pathogenic to humans can also very easily make it less lethal. Viruses usually do become less lethal, not more, as they mutate. 71.203.209.0 09:16, 12 July 2007 (UTC)