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A special "vaccine court" has finally closed the door on claims that vaccines containing thimerosol are not responsible for autism.

The ruling was aimed at the measles-mumps-rubella vaccine, more commonly known as the MMR vaccine. But its effect could just as well be applied to all approved vaccines, and should be.

As we all know, there is a new culture of opposition to vaccines that is both absurd and bad for public health. These parents, led by several celebrities (and gee whiz, how many times do we have celebrities abusing their status for such flat-earth initiatives?), have suddenly made it chic and cool to not vaccine children because of some perceived risk.

Here are two story links on the topic. The first is from Stacy Garfinkle's column On Parenting, which appears in the Washington Post.

http://voices.washingtonpost.com/parenting/2009/02/the_original_vaccineautism_stu.html?hpid=topnews

The Original Vaccine/Autism Study Debunked

Eleven years ago, a study appeared in The Lancet that linked the Measles, Mumps and Rubella vaccine to autism. On Sunday, The Times of London ran an investigative story saying that altered data was behind the study all along.

The Times' story isn't the first to dispute those original vaccine claims that sparked the continuing vaccine debates that still exist today. Study after study of MMR have shown no link of the vaccine to autism. But it is a reminder of just how easily we can all be played when it comes to our kids.

Just take a bunch of health news in recent weeks and years. Salmonella found in Peanut Corp. of America's processing plant and foods made from products from that plant are affecting sales of jarred peanut butter. Not that anything has been found to be wrong with jarred peanut butter; in fact, it's a pretty healthy food in small portions.

International studies on BPA and phthalates have made us question our use of plastics, from water bottles to cans of food lined with the chemicals. Mercury in fish makes us rethink what seafood to feed our pregnant selves and our families. Lead in toys has us scrambling to remove dangerous toxins from our toy bins. Our cleanliness and obsessions with Purell are causing some of our health issues. Recent news stories on potential dangers of high fructose corn syrup are being e-mailed friend to friend, sister to sister. And these are just the bigger topics.

While it's good to be informed and make the best choices we can for our kids, The Times' story is a reminder that life just is sometimes. We can't always explain why our kids may have allergies or asthma or autism or cancer or colic just as we can't explain why some kids are mellow and some are hyper, why some are clumsy and others are athletic. And we can't -- and shouldn't -- feel guilty for not preventing all the bad stuff.

So, while I won't be giving up our metal water bottles anytime soon, I don't have a problem if my kids eat a little dirt. And while I may not be a fan of corn syrup, I'm not going to snatch something out of their hands that has the stuff in it. And just as I continued to take my kids to the park in the midst of the sniper shootings in Maryland several years ago, I'm not going to yank peanut butter from the pantry.

Are there news stories that make you feel responsible for something in your child? How do you handle it? And what do you think of latest information about that original MMR vaccine study?

By Stacey Garfinkle| February 11, 2009; 9:00 AM ET |

Here is a post regarding the Washington Post story that pretty much sums the situation up:

Andrew Wakefield's falsified study has led to a resurgence in measles in Britain, as frightened parents have foregone the vaccine. Two children have died, with more undoubtedly to follow. That charlatan's lies have cost lives.

So the Lancet study was doctored! Sorry for the pun. And people took that doctored study and ran with it, and as a result children are dying. Now if there is any justice, those people will catch the disease and suffer mightily. And parents, perhaps otherwise normally well-educated, are just too damn smart for their own good and wind up doing something just plain stupid -- not inoculating their children.

Of course there are risks. There are risks when you leave your house, take a bath, and order food at a restaurant. There are risks on the playground and in the classroom. You can never eliminate all risks -- but you can surely make some terrible decisions which serve to magnify known risks. This is the road the anti-vaccine flat-earthers have taken.

Here is the MSNBC story:

Court says vaccine not to blame for autism

Blow for parents who claimed measles shots caused their children's disorder The Associated Press updated 4:01 p.m. ET, Thurs., Feb. 12, 2009

WASHINGTON - Vaccines aren’t to blame for autism, a special federal court declared Thursday in a blow to thousands of families hoping to win compensation and to many more who are convinced of a connection.

The special masters who decided the case expressed sympathy for the families, some of whom have made emotional pleas describing their children’s conditions, but the rulings were blunt: There’s little if any evidence to support claims of a vaccine-autism link.

The evidence “is weak, contradictory and unpersuasive,” concluded Special Master Denise Vowell. “Sadly, the petitioners in this litigation have been the victims of bad science conducted to support litigation rather than to advance medical and scientific understanding” of autism.

Science years ago reached the conclusion that there’s no connection, but Thursday’s rulings in a trio of cases still have far-reaching implications — offering reassurance to parents scared about vaccinating their babies because of a small but vocal anti-vaccine movement. Some vaccine-preventable diseases, including measles, are on the rise, and last fall a Minnesota baby who hadn’t been vaccinated against meningitis died of that disease.

The special court represented a chance for vindication for families who blame vaccines for their children’s autism. Known as “the people’s court,” the U.S. Court of Claims is different from many other courts: The families involved didn’t have to prove the inoculations definitely caused the complex neurological disorder, just that they probably did.

More than 5,500 claims have been filed by families seeking compensation through the government’s Vaccine Injury Compensation Program, and Thursday’s rulings dealt with the first three test cases to settle which if any claims had merit. The first cases argued that a combination of the measles-mumps-rubella vaccine plus other shots triggered autism.

“I must decide this case not on sentiment but by analyzing the evidence,” said Special Master George Hastings Jr., writing specifically about Michelle Cedillo of Yuma, Ariz., who is disabled with autism, inflammatory bowel disease and other disorders that her parents blame on a measles vaccine given at 15 months.

Disappointed families
“Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment,” Hastings concluded.

Attorneys for the families said they were disappointed and may appeal.

“There was certainly no scientific proof that vaccines caused autism, but that’s not the standard; the standard is likelihood,” said Kevin Conway of Boston who represented the Cedillos. “We thought our evidence was solid.”

“Certainly those three families are discouraged with the ruling,” added Tom Powers, a Portland, Ore., attorney overseeing all the claims. “It’s a big step, it’s a significant step but it’s not the last step.”

Indeed, the court’s ruling will do little to change the minds of parents who believe vaccines have harmed their children, said the head of a consumer group that questions vaccine safety, the National Vaccine Information Center.

“I think it is a mistake to conclude that because these few test cases were denied compensation, that it’s been decided vaccines don’t play any role in regressive autism,” said Barbara Loe Fisher, the center’s president.

The court still must rule on additional cases that argue a different link — that vaccines that once carried the mercury-containing preservative thimerosal are to blame, if the mercury reached and damaged brain cells — and Powers said families making those claims remain hopeful. The court has given no timetable for a ruling.

‘Great day for science’
But Thursday’s rulings clearly gave great credence to numerous large studies that have looked for but not found any link between the measles vaccine, other vaccines and autism.

“Hopefully, the determination by the special masters will help reassure parents that vaccines do not cause autism,” the Department of Health and Human Services said in a statement that pledged to continue research into possible causes and better treatments.

“It’s a great day for science, it’s a great day for America’s children when the court rules in favor of science,” said Dr. Paul Offit, an infectious disease expert at the Children’s Hospital of Philadelphia and developer of a vaccine for rotavirus.

“A choice not to get a vaccine is not a risk-free choice,” Offit added, pointing to recent outbreaks of vaccine-preventable diseases that authorities suspect are partly due to delayed or rejected vaccinations.

Autism is best known for impairing a child’s ability to communicate and interact. Recent data suggest a 10-fold increase in autism rates over the past decade, although it’s unclear how much of the surge reflects better diagnosis.

Worry about a vaccine link first arose in 1998 when a British physician, Dr. Andrew Wakefield, published a medical journal article linking a particular type of autism and bowel disease to the measles vaccine. The study was soon discredited, and British medical authorities now are investigating professional misconduct charges against Wakefield.

Then came questions about thimerosal, a preservative that manufacturers began removing from all vaccines given to infants in 2001. Today it is present only in certain formulations of the flu shot.

http://www.msnbc.msn.com/id/29160138/

Here's my proposal:  In addition to making MMR and other vaccines mandatory for entry into public school, make flu shots mandatory for all school-age children.  Give them at school or get them done at a doctor's office.  If someone objects on "religious grounds," say "fine,"and excuse them for all of flu season and send them home.  They can learn online, or they can be perpetually held back until they are old enough to make their own vaccine decisions.  Or, until they can ask for condoms, in which case a flu shot is a prerequisite for obtaining condoms from school. 

What does Panasonic know that we don't?

OK, we all saw the headlines earlier this week: Panasonic has acknowledged that is has sent orders to its Japanese executives living overseas that it's time to come home; all HELL is about to break loose.

For those who did not see the headline, and therefore missed the unusual sensation of having the hair stand up on the back of your neck, here's the article:

Panasonic to fly home workers' families over bird flu fears

TOKYO (AFP) — Panasonic Corp. has ordered Japanese employees in some foreign countries to send their families home to Japan in preparation for a possible bird flu pandemic, a spokesman said Tuesday.

Family members of Japanese employees in parts of Asia, the Middle East, Africa, Russia, former Soviet states and Latin America will fly back to Japan by the end of September, Panasonic spokesman Akira Kadota said.

The firm decided to take the rare measure "well ahead of possible confusion at the outbreak of a global pandemic," he said.

Eight people have contracted the H5N1 bird flu virus in China alone this year -- five of whom died.

"The bird flu cases reported so far are infections from bird to human, but once an infection between human beings is reported, things can get chaotic with many other companies trying to bring back their employees," Kadota said.

"We wanted to take action early before it gets difficult to book flight tickets," he said.

The company did not say how many family members would return to Japan. Employees and their families in North America, Western Europe, Australia, New Zealand and Singapore will not be affected.

http://www.google.com/hostednews/afp/article/ALeqM5jFX14blXVvoh4Q3z6XtKKFeydIug

But another repoort said Panasonic took this unprecedented and controversial step this past December. From the Taipei Times:

Panasonic orders families to return home on flu fears

AP, TOKYO
Wednesday, Feb 11, 2009, Page 10

Panasonic Corp said yesterday it had ordered families of its Japanese overseas employees to return home from emerging countries that the company believes may be at risk of an influenza pandemic.

The employees will stay, but families of those working in parts of Asia, the Middle East, Africa, Russia and South America were ordered in December to return to Japan by the end of September, spokesman Akira Kadota said. (bold and underline mine)

The Osaka-based company is not disclosing the number of the affected families or the employees.

Panasonic, the world’s biggest maker of plasma TVs, last week said it was cutting 15,000 employees from its work force over the next year and forecast its first annual net loss in six years.

Kadota denied the move to bring families home was related to cost-cutting. He said the company had been studying the risks from bird flu for some time and called the order “proactive.”

“It would be very difficult to quickly return home should a pandemic strike,” he said.

Panasonic has 200 affiliated companies overseas, about 70 in China, and 70 more in the rest of the Asia-Pacific region.

http://www.taipeitimes.com/News/worldbiz/archives/2009/02/11/2003435821

But the absolute best news story I have found is from CIDRAP:

Panasonic's Bird Flu Precautions Questioned

GLOBAL - News reports that Panasonic Corp. has asked some of its overseas employees to send their families home to Japan because of the threat of pandemic influenza fueled puzzlement and speculation about the global H5N1 risk and whether other companies might follow suit.

Bloomberg News reported that in December 2008 Panasonic asked employees in some of its Asian offices (excluding Singapore), Africa, Eastern Europe, and South America to send their families back to Japan by September.

Akira Kadota, a Panasonic spokesman, told Bloomberg that the request to employees is an element of its pandemic planning. "We chose areas after considering the prevalence of bird flu and the capability of medical facilities and access to them," he said.

Earlier this month, Panasonic announced that it was cutting 15,000 jobs and anticipated a loss this year. However, Kadota told Bloomberg that bringing the employee families home from certain areas wasn't a cost-cutting measure.

China and Egypt have recently reported human H5N1 cases, a typical pattern during cooler seasons, but avian flu experts have not reported any mutations that would make the virus more transmissible among humans, and global health officials have not raised the H5N1 alert level.

Gregory Hartl, a spokesman for the World Health Organization (WHO), told CIDRAP News that there has been no change in the perceived pandemic threat level that might explain Panasonic's action.

"We are still at pandemic phase 3," Hartl commented by e-mail. "The behavior of the virus remains the same now as in past years: an upturn in cases in the northern hemisphere winter months, but with the epidemiology remaining the same (little if any human to human transmission, and no sustained human to human transmission within the community). There is no public health justification for acting differently now from in previous years."

A senior US government official who asked to remain anonymous told CIDRAP News today that though the pandemic threat persists and the need for preparations is critical, officials see no increased threat that would prompt any revisions of their pandemic advice or warning messages to Americans living abroad.

Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of CIDRAP News and the CIDRAP Business Source, said he fielded a number of calls today from people in several business sectors who were worried about the significance of Panasonic's move. "They wanted to know if this is for real," he said.

Penny Turnbull, PhD, senior director for crisis management and business continuity planning for Marriott International, Inc., said she was surprised and perplexed by Panasonic's decision, given that there has been no significant change in the number, location, or transmission of avian flu infections in humans. She said the implications for other companies aren't clear.

"Companies might wonder on what intelligence Panasonic based this decision, but I find it hard to believe that any will be following suit in the near future, though they might start monitoring the news more closely for some time to come," said Turnbull, who is also an editorial board member of the CIDRAP Business Source.

Osterholm said heightened concern over the Panasonic news is a reminder that a company's decisions can have far-reaching unintended consequences and that in the early days a pandemic is likely to generate hysteria, not factual or science-based information.

He also said that Panasonic's decision isn't a breaking news story, because the company reportedly issued the new policy in December. "If this was a real pandemic concern, companies would have minutes to hours, not weeks to months, to prepare for this," he said. (bold and underline mine)

Panasonic's decision to repatriate the families of employees in some of its locations raises more questions about the company's motives or if its risk assessment is seriously flawed, Osterholm added. "This tells me how ill prepared some of these companies are," he said.

Bloomberg News published its initial story on Panasonic's request to its foreign employees last night, citing a Nikkei news story that did not quote any Panasonic sources. That prompted a handful of editors from prominent pandemic flu blogs, such as Avian Flu Diary and A Pandemic Chronicle, to swing into action, said Sharon Sanders, editor-in-chief of FluTrackers, a well-known Web message board that focuses on avian flu developments.

The editors met online late last night to coordinate their coverage of the story and ask their contributors to translate foreign-language information on the Panasonic development, Sanders told CIDRAP News. She said she connected with Panasonic's spokesman in Japan last night to flesh out some of the facts, which Bloomberg obtained and reported in today's updates of its stories.

http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/feb1009panasonic-br.html

OK, so now you are as caught up as anyone in the CIA.

So in the immortal words of Slim Pickens: What in the wide-wide-world of sports is-a-goin-on-here?

What does Panasonic know? When did they know it? And are they just slightly ahead of their time, as the old-school ad campaign suggested?  Or is its corporate risk assessment flawed and in need of a good shaking-up, as Dr. Osterholm speculates?  Or does the spirit of Nostradamus live in the Panasonic corporate mainframe?

First, we know Panasonic made the corporate decision in December. That meant they had some reason in December, if not earlier, to believe (not suspect, but believe) that H5N1 was on the march in a decidedly bad way.

Looking back at the November/December 2008 timeframe, there is nothing untoward to signify that bird flu was marching anywhere except into oblivion. There were no human cases to speak of; the world was preoccupied with the results of the US presidential election and the economic meltdown; and bird flu was strictly a problem of the Asians, Indonesians and Indians.

Or so we thought. 

For Panasonic to have come to this conclusion in December, sending the word out to its executives to get their dependents out of faraway places where travel is problematic, strongly foreshadows the events of January and February.  Regarding that explosion of cases: Were they tipped, were they right, or were they just lucky?  And have they overreacted?

It is certainly possible that Panasonic was tipped off about this new "living chickens" bird flu problem, this possible change of vectors to infect humans, and knew that new human cases would come in rapid-fire succession. It is possible that they knew, or at least strongly suspected, that the first six weeks of 2009 would bring a flurry of human cases not seen in the past three years. And it is possible that this prompted the Panasonic leadership, as pragmatic and as deeply rooted in seriousness as any company on the planet, to take this solo step of placing itself out there for ridicule and scorn.

But to make this decision in December still brings us back to this: What did they know? What did they learn?

Panasonic has huge financial interests in China. It is safe to say that China would not condone such a public move by one of its manufacturing partners, especially if that move cast aspersions on China itself. Look no further than the SARS epidemic's origins and initial government behavior for confirmation of that fact.

But it is also safe to say that because of its presence, Panasonic has eyes and ears in many, many places. And with its acquisition of Sanyo, those eyes and ears are multiplied. Is it possible that Panasonic has its hooks into the Chinese medical establishment? Into rural hospitals and farm areas? Is Panasonic's surveillance, unfettered and probably free(er) of Chinese government censorship, better than the WHO, the OIE or the FAO?

Or is it a real case of Panasonic preparing to cease manufacturing and distribution operations at these many locations, and they wanted a better cover than "We can't sell these damn plasmas and we will never admit that, so we will use bird flu as the cover story so our stock does not tank?"

That, of course, constitutes corporate lying, and stock regulators all over the planet would have a very hard time not jailing senior Panasonic executives for such a contrived and deliberate cover-up. Especially not now, with the global economy in peril.

Nor would Panasonic risk triggering a panic, alluded to in the excellent CIDRAP story. that is absolutely counterproductive and would wind up hurting Panasonic badly, and perhaps permanently.

So we must conclude that Panasonic has tossed all this about in its corporate boardrooms and acted based on that information.  It knows something, or suspects something, that we apparently do not.  Just what "something" is, is unknown at this time. But the inference is crystal--clear: Panasonic believes strongly that an influenza pandemic will start over the summer, and is staking its corporate reputation on pulling its dependents out of harm's way before the event starts.

Recall there have been accusations, sometimes made public and later recanted, that Chinese bird flu deaths are woefully underreported. Perhaps the announcement from the Japanese military that they will fly home citizens living overseas if/when a pandemic starts and the Panasonic admission stemmed from the same data. Miss that story? Here it is:

SDF planes to fly home Japanese stranded in event of flu pandemic

The Yomiuri Shimbun

The Defense Ministry has drafted an action plan that will allow government aircraft to bring home stranded Japanese following the overseas outbreak of a new type of pandemic influenza, it has been learned.

The plan calls for the dispatch of Self-Defense Force's aircraft, including chartered government jets, if an outbreak of influenza leads to the suspension of commercial airline and passenger-ship services, preventing Japanese from returning home. It also refers to treating these people at SDF hospitals after they return.

The plan is expected to be announced as early as March, according to sources.

The draft also states that SDF medical officers will be deployed at airports and ports if there are insufficient quarantine officers to cope with a flood of Japanese returning from an affected country, the sources said.

(Feb. 4, 2009)

In my opinion, there is virtually zero possibility that the Panasonic senior leadership misinterpreted the Defense Ministry statement.  These guys all know each other; they play golf together; and they have each other in their Rolodexes.  The Japanese are nothing if not meticulous. 

I also find zero coincidence between this statement and the Panasonic action.  The concept -- Fly stranded Japanese home when the excrement hits the fan -- is just too similar to be coincidental.

Is there also a coincidence between this and the Federal Stimulus package?  Both chambers included hundreds of millions of dollars for pandemic preparedness, which alert budget-reading maniacs have alertly pointed out to us, may God bless them. 

So let's stay tuned.  And stay very, very watchful in case any other Asian conglomerates do the same thing.

DANGER!!!!  LONG BLOG AHEAD.

I was going to call this particular blog "We don't need a pandemic to show us the economic consequences of one." In it, I was going to talk about how the current recession -- and a possibly worse description lurks in the wings -- is mimicing how the global economy would recoil during a pandemic of any severity.

One look at the economic numbers draws a striking parallel. GDP in the US is down by about half the Congressional Budget Office's estimates for a severe, 1918-style pandemic. The CBO estimated (along with the World Bank, the IMF and just about every other financial entity) that a 1918-severity pandemic would reduce global GDP by 5% to 6%, and most of that would come in a huge shockwave with a 20-week duration.

Well, it's the first quarter of 2009, and the US GDP has declined by an estimated 3.8%, adjusted annually. And again, most of it happened in a very condensed timeframe.

The key difference? This recession will be with us for a long time. Comparatively rosy estimates of a 2010 or even a 2011 recovery are going by the boards. In the government sector, no one can seem to get the declining revenue numbers right.  (My advice to them is to take their most pessimistic estimates and reduce them another 20% and budget from there.)

Now imagine what would happen if the Next Pandemic were to occur just as the global economy attempts to restart its engine; say, in 2011. And imagine if this pandemic were as severe as 1918's. Imagine a 5% to 6% drop in global GDP on top of an annual 3% to 4% decline in 2009, 2010 and 2011.

This is enough to cause even the most optimistic among us start to head for the proverbial hills.

Making matters worse is the lack of funding to prepare for the first pandemic of the 21st Century.  Any pretense -- any possibility -- that the private and public sectors can adequately stockplie and purchase items for that event is now out the window.

But not for all. In Britain, even though its government is also dutifully doling out billions of pounds Sterling to banks and other institutions, its government has declared it is doubling its stockplie of antivirals -- and (wisely) increasing its reliance on the inhalant Relenza/zanamivir for prophylactic use by first responders and law enforcement/military.

What do the Brits know that we don't know?

I read the federal government's recent assessment of the fifty states' preparedness for a flu pandemic, and I am sorry, but I don't believe a word of it. It's not that I think anyone is lying, but I refuse to believe any state is truly, look-in-the-mirror-prepared for a killer pandemic with a mortality rate close to 1918's.

Why? I do not see any state moving beyond the 25% antiviral purchase goal. I see many states meeting their share of that 25% goal, but none really exceeding it.

Why? I see no state embracing innovative solutions, such as the co-administration of probenecid to effectively double the supply of Tamiflu.

Why?  I don't think the feds can plan their way out of a wet paper bag.

Why? There is no emphasis on information technology data center and network professionals as among the first to need antivirals, particularly those in the public sector's own front lines of defense -- namely social services, law enforcement and unemployment assistance. Nowhere, in any federal pandemic document, do I see anything other than a cursory reference to "critical infrastructure" as even acknowledging the essential role that government data center and application developer and system engineer and network engineer and cybersecurity professional employees will play in a pandemic.

Why does this matter? NOTHING is done on paper anymore. Further, try to move back to paper! You will fail, and fail miserably. You want to see civil unrest and civil disturbances? You want to see blood in the streets? Watch the computers fail and watch people already bone-weary from years of a severe recession lose their subsistence lifelines because a pandemic hit and the mainframes shut down. The quickest route to civil discord is if/when the mainframes fail during a severe pandemic.

Why does this matter? Computers will route the information that is needed for people to make decisions and move resources. Computers will tell us who is sick and where (look at the Google plan to match search expressions with geography and, in their plan, be able to predict where a pandemic has broken out). Computers will tell us how much of something is left and how much to ration. If data center people get sick (and because they work in enclosed spaces, they work in very close physical proximity to one another and they WILL get sick in disproportionate numbers to the general population), you will have staffing problems and you will have maintenance postponements and database reorgs gone undone and then you will have system failures. Big system failures.

Recently, I wrote a blog saying Nature has a way of hitting humankind when it is down.  Look at 1918 for confirmation of that fact.  War builds stresses within the system.  So does famine.  So does pestilence.  So does economic uncertainty and calamity.  Everything is interconnected.  The 1957 pandemic was facilitated by American servicemen returning home from tours of duty in Korea and elsewhere in the Pacific theatre. 

We all know that we are long overdue for an influenza pandemic. We also know that pandemic fatigue is now itself a pandemic. And we know that there are stresses upon the world's ecomonic system that are impacting virtually every person on the planet in one way or another. 

Governments in this country no longer have the money to buy adequate stockpiles of masks, gloves, and antivirals.  That time has come and gone.  The only things we can do now to prepare are to plan and to educate.  Fortunately, these things cost little money.  They do require time and leadership. 

If governments (and for that matter, the private sector) have no money to stockpile, manufacturers will have no incentive to produce items that are not wanted.  So you will see reductions in the production of masks and other items intended to brunt the effects of a flu pandemic.  This means that if/when a pandemic does occur, the supply chain will be absolutely empty at the first sign of trouble.  We knew that would be the case anyway, but we also figured the manufacturing capabilities of the world's producers would eventually catch up.

We are in worse shape now than we were in 2005, in my opinion. We are no closer to deciding if schools close in unison or not than we were three years ago. We are no closer to making final decisions about quarantine and isolation than we were three years ago.  And while we have made great strides in preparedness and contingency planning, I cannot help but feel we are overconfident and arrogant in our belief that we have done everything we can do to adequately prepare.

And now we have lost our opportunity to further our stockpiles.  We put off those difficult bioethical decisions for another day.  And now, we lack the capacity to buy our way into enforcement of bioethics and pandemic policy.  It's gone, and won't be back for at least two to three years.  Pity, since recent studies point to successes in mask usage, and of course the recent stories of Tamiflu resistance in H1N1 in this country point to a huge need for Relenza that now no one can afford to buy.  This bird flu blogger has been championing the increased acquisition of Relenza and the purchase and use of Probenecid for years. 

Every day that passes brings us closer to pandemic.  Every day that H5N1, or H9N2, or H2N3 human cases are found brings us closer to pandemic.  And we have learned that despite our best international efforts, H5N1 continues to evolve and claim human lives -- and now, apparently, without the deaths of "sentinel chickens" that have warned us of trouble.

While the world's governments have indeed made strides, we are far short of the goal.  So let us take the opportunity to do whatever we can do in this current economic climate to prepare.  That means we educate people like we have never educated them before on this topic.  And also, we must plan, plan and then plan some more.  As Ike said:  The plan's useless, it's the planning that's important.  We should be taking our pandemic plans and stressing them in tabletop after tabletop exercise.  We need to be reaching out and running these plans past citizens and the media.  And we must ask everyone, What have we not thought of yet?

Because one day the worst will happen, and believe me, we will get bitten on the rear end by the stuff no one took the time to find. 

The proMED email I just received is startling. Apparently the Ebola-Reston substrain, which has been recently documented to have crossed the species barrier to infect pigs, has now had its first known pig-to-human transmission.

This is not small news. Ebola-Reston, which was first discovered in primates in the Philippines, was the topic of the best-selling book The Hot Zone. That seminal work, which started many of us on our infectious disease journeys, documented a fierce substrain of the dreaded Ebola virus that was first subtyped in a group of primates imported from the Philippines to Reston, Virginia. Hence the name Ebola-Reston.

Recently, at two farms in the Philippines, Ebola-reston was found to have jumped from apes to swine.  Now, the jump has taken the virus from swine to humans.

While Ebola-Reston is not as bad a strain today as, say, Ebola-Zaire, it is never a good thing to have yet another species jump. Quoting from the proMED email:

Experts said the jump was a concern even if the Ebola-Reston strain of the virus is not as deadly as other strains of the [virus], which can cause incurable haemmorrhagic fever and have a mortality rate of 25 to 90 percent. "Viruses jumping across species is always worrying," said Lo Wing-lok, an infectious diseases expert in Hong Kong. "If it continues to do so, the virus will adapt to the human body or may mutate to become more transmissible among humans."

Although human cases of Ebola Reston in the past have been mild, Lo warned against any complacency. "We can't say for sure that it is not dangerous to man, we have to follow developments very closely," Lo said. "In the past, the infections happened to a very small number of people. But this virus may get magnified in swine and we could get a higher-density virus in the environment and more cases of human infection can occur," he said.

The ink is flowing fast and furious regarding Chinese apprehension in the run-up to the Lunar New Year.  The latest warning is from Shu Yuelong, from the National Centre for Disease Control in Beijing. The BBC story is below.

Fresh warning on China bird flu

A Chinese health expert has said that the country is likely to experience an upsurge in the number of human bird flu cases in the next month or two.

Shu Yuelong, from the National Centre for Disease Control and Prevention, said China needed to work harder at preventing bird flu outbreaks.

The warning came after the health ministry said a 16-year-old boy had died in central Hunan province.

The human form of bird flu has now claimed three lives this year.

An earlier BBC report said Mr Shu had suggested that China risked an epidemic in the next few months, but it later became clear that he was referring to an increased risk of an epidemic occurring.

New Year exodus

The BBC's Beijing correspondent Quentin Sommerville reports that winter and spring are prime bird flu seasons, when more than 70% of cases occur.

Millions of Chinese people are heading home for Chinese New Year, increasing the chances of infection, he says, and in spring, migratory birds carry the virus over great distances.

On Monday, the authorities announced that a woman in eastern Shandong province had died from bird flu.

And two weeks ago, a 19-year-old woman died in Beijing after handling ducks.

Meanwhile, a two-year-old toddler reported to have been in critical condition with the H5N1 virus has now recovered and is described as "stable".

Chinese and Hong Kong media have been reporting that the toddler's mother had died this month after exhibiting symptoms similar to bird flu, but her death has not been officially blamed on bird flu.

Neighbourly concern

The upsurge in bird flu deaths on the mainland is causing concern in Hong Kong, where consumers have been told not to eat poultry brought in from the Chinese mainland.

China's ministry of agriculture said on Sunday that no bird flu epidemics were detected in Shanxi and Henan provinces after the two-year-old's infection was confirmed.

Hong Kong's secretary for food and health, Dr York Chow, said this was a cause for concern.

"There are two main areas we are concerned about: one is that if there is no avian flu outbreak in poultry and yet there are human cases, does this mean the virus has changed?

"Secondly, we are worried about whether there are more so-called 'slightly infected' chickens that actually might be carrying the virus and transmitting the disease, and yet do not show any symptoms or die from those illnesses," Dr Chow said.

The ministry said China now faces "a grim situation" in bird flu prevention, threatened by frequent outbreaks in neighbouring countries, the Chinese state news agency Xinhua reported.

China has the world's biggest poultry population and is seen as critical in the fight to contain the H5N1 strain of the virus, which resurfaced in Asia in 2003, killing at least 247 people.

H5N1 does not transmit easily to humans but experts fear it could mutate and cause a worldwide pandemic.