Saturday, December 09, 2006



It's time once again for the Hajj pilgrimage in Saudi Arabia, so that means the now standard annual warning of a possible flu pandemic breaking out amongst the millions of Muslim worshippers is being sounded.

The difference this year is the rising call for worshippers to be vaccinated before they arrive in Saudi Arabia. Not only is the call being promoted as a necessity, but some experts are demanding the vaccinations become mandatory.

From The Australian :

Experts have now urged flu vaccination to be made mandatory for worshippers embarking on the pilgrimage, a trip expected of every Muslim who can afford it at least once in their lifetime.

The next Hajj starts on 28 December and lasts for seven days. Between two and three million pilgrims from all over the world are expected to descend on Mecca and other holy sites, staying in extremely crowded conditions.

In terms of public health, “such a gathering makes the possible rampant spread of the influenza virus and a global pandemic... a potentially devastating prospect”, say experts writing in the latest British Medical Journal.

The authors said the crush of people meant it was “not unusual for 50-100 people to share a tent overnight” in desert camps, a degree of overcrowding that “greatly increases the spread of respiratory infections”.

They added the World Health Organisation “must work with the Saudi authorities to minimise the risk of the influenza virus spreading among pilgrims (and the rest of us)”.

Australian flu expert Alan Hampson - a member of the WHO's Pandemic Taskforce set up to counter a global flu outbreak - agreed the risk was real.

“If we were unfortunate enough to see the start of an avian flu outbreak during the Hajj, there's no doubt that would be a great way to spread it to other people quickly, and then spread it around the world when they return home,” he said.

As far as the possibility of a bird flu pandemic breaking out amongst worshippers on the Hajj, experts remain divided whether existing vacinnations would be of any use, as they will not be tailored to fight a virus that has not yet fully shown itself.

While dire predictions late last year and earlier this year about the likelihood of a human bird flu pandemic becoming a reality have proven to be misplaced, avian influenza virus experts are warning the threat is not yet over. While Indonesia is, officially, still clocking up three or four human deaths per month from avian influenza, there have been no more than a handful of deaths elsewhere in the world.

However, experts agree that this does not mean it is time to become complacent about the possible devastating outbreak of a bird flu pandemic amongst humans.

The virus may have gone quiet in recent months, but some experts fear this is because the virus is now "smouldering"; not yet extinguished, and ready to burst back into the human population.

From CNN :
A year ago, headlines were screaming about a looming disaster: the rapid spread of bird flu across two-thirds of the globe. The H5N1 strain of the virus was killing more than half its human victims. Experts were urging the government to stockpile medicine and experimental vaccines.

Dr. Robert Webster, whose vaccine the U.S. government plans to use in case of an outbreak, told CNN at the time, "If this virus learns to transmit human to human and maintains that level of killing, we've got a global catastrophe."

That worldwide pandemic hasn't yet materialized, and bird flu has been out of the headlines for a while. But we may be in for another round of news.

Last week South Korea announced two new outbreaks in poultry.

...Dr. Timothy Uyeki of the U.S. Centers for Disease Control and Prevention said he's bracing for another surge in human infections.

Three recent papers in the New England Journal of Medicine illustrate serious roadblocks to understanding and controlling the virus. The first describes three clusters of cases within families in Indonesia, eight patients in all. In two of the clusters, the authors said it's quite possible one person caught the disease, then passed it to family members.

One of those families was profiled in "Killer Flu," a CNN program last December. Rini Dina, a 37-year-old woman in a Jakarta suburb, died of an H5N1 infection, and her 8-year-old nephew, Firdaus, was hospitalized with fever for 10 days.

Worldwide, about a third of all cases involve family clusters and there are a handful of cases where the virus likely passed from person to person, he said.

As a clinician, Uyeki has also helped to examine bird flu patients in Indonesia and Vietnam, the only U.S. doctor to do so.

As the virus evolves, he said, its symptoms are evolving as well.

"The clinical features in 1997 were different than what they are now. We're seeing less diarrhea, and in Indonesia, it's been much more fatal."

Other, more common symptoms are hard to distinguish from other infections -- fever, aches and coughing, and shortness of breath and pneumonia as the illness progresses.

In a commentary published with the two articles, Webster and another prominent flu expert said efforts to eradicate the virus, through killing infected chicken flocks or by vaccinating poultry, have largely failed.

Worse, they said, many vaccines used in Asia are of poor quality and are pushing the virus to mutate faster, in potentially more dangerous directions.

Go Here For The Full Story

Donors Pledge Nearly $500 Million More To Battle Bird Flu

Chicken Traditions Expose Africans To Bird Flu

Bird Flu Only Tip Of The Iceberg When It Comes To Deadly Diseases That Threaten Humans, Animals

Global Warming, Intensive Farming, Fast Travel Allow Easier Transmission, Growth And Spread Of Killer Viruses

Bird Flu Specialists Focus On Africa & Asia

For American Media, Bird Flu Appears To Have Flown The Coup

World Health Organisation Claims Bird Flu Vaccine Could Be Available Within Twelve Months

Researchers Claim To Have Found Bird Flu Virus' "Weak Spot"

Swiss Claim Success In Vaccinating Birds In Zoos

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