- "All of this shows the virus remains unstable, unpredictable
and very versatile," Omi told a news conference."It may have
new and unpleasant surprises in store for all of us." .
- Omi said the virus appeared to be moving in different
ways in different places, apparently becoming more transmissable but less
fatal in Vietnam while becoming more pathogenic in China.
- "It is very difficult to predict what will happen
under these circumstances, but the best thing I can say is to keep our
vigilance high," he said.
- Sharing information, making virus samples available to
WHO laboratories and improving animal husbandry practices were all key
to preventing a pandemic, Omi said.
- But the disease usually appears in rural areas where
surveillance is harder and involves both health and agriculture sectors,
making a coordinated response a challenge.
- The above WHO comments highlight the need to gather additional
data. H5N1 evolves via recombination within hosts that are infected with
two viruses. As the number of hosts infected with H5N1 increase, the number
of possible new recombinants also increase. New emerging strains can be
predicted based on the current gene pool, but the holes in the database
are substantial. WHO and FAO should be encouraging affected countries to
get more serious about collecting and sharing data.
- The two most glaring examples are China and India. China
has almost certainly generated sequence data for the Qinghai Lake isolates.
This data should be publicly available via deposits at GenBank. Currently
there are no 2005 H5N1 sequences. China, Vietnam, Thailand, and Indonesia
certainly have sequences data, even if only from birds. The 2004 H5N1 bird
sequences are virtually identical to the human sequences, so bird sequences
will be quite useful.
- The initial reports from Qinghai Lake described bar headed
geese as the only bird flu victims. Although the number of species expanded,
the bar headed geese are key. They winter in northern India and can fly
1000 miles in 24 hours (the distance from northern India to Qinghai Lake).
There are almost certainly H5N1 sequences in India. Although India has
claimed to lack facilities to isolate and sequence H5N1 they can simply
pack up bird dropping and ship them off if they can't come up with the
- Similarly the meningitis cases in northern India as well
as the dying crows in western India should be tested for H5N1. WHO has
previously indicated they will test unexplained deaths fro H5N1. So for
there is little evidence that Meningitis / meningococcal deaths in the
Philippines and India have been tested for H5N1.
- Like China's blanket denials of human H5N1 cases, WHO
blanket calls for vigilance are inadequate. Media reports quote Chinese
official as saying WHO is welcome to visit all areas of China. Similarly,
India has not told WHO or FAO to stay out.
- It is time for WHO to get off the phone and get on the
ground in China and India to get real data on increasingly ominous developments.
- Media source
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