Recombinomics Commentary

fiddlerdave2 wrote: Absolutely it is about money.    It is completely disgusting that research and information paid for with taxpayer money goes to a few well-connected companies for their sole benefit at the cost of untold money and lives to all of us.

Quit beating up on the pharmaceutical companies.  I am immensely grateful they are working their bottoms off to create vaccines or innovative therapies.

Let's see I signed up here in December, it's May so it's taken 5 months to get wind of sustained H2H transmission with a change in the virus not seen in birds.  Took a little longer than my guess but with this many people infected in India if you have any last minute preps, time to get hopping.  News here by tomorrow AM will hopefully give us a little clearer picture if it's Pandemic time. 

"Quit beating up on the pharmaceutical companies.  I am immensely grateful they are working their bottoms off to create vaccines or innovative therapies. "

My question is WHY does the World Health Organization feel the need for a private database when this information could be used by many scientists to find a vaccine that actually works (as opposed to the anti-virals).  So this must be on an international level - the secrecy?  According to this ariticle, one billion $'s worth of 5 year contracts went to:

The five-year contracts were given to Britain's GlaxoSmithKline PLC, MedImmune Inc., Swiss firm Novartis Vaccines and Diagnostics, DynPort Vaccine Co. and Solvay Pharmaceuticals of Belgium.

http://news.yahoo.com/s/afp/20060504/hl_afp/ushealthflucompany_060504173915

 

 

And when they make that pill cost $100 a day?  $1000 a day? 

http://www.recombinomics.com/News/05180602/H5N1_Karo_Symptoms.html

Commentary

Three Additional Family Members in Karo With Bird Flu Symptoms

Recombinomics Commentary
May 18, 2006

"It is certainly alarming,'' said Dick Thompson, a WHO spokesman in Geneva. ``This is the largest H5N1 cluster we have seen. There are obviously important questions that we need answered. But right now it is too early in the investigation to say anything definitive.''

Yesterday, three members of the family said they were feeling sick, with symptoms including headache and cough.

H5N1 bird flu symptoms in three additional family members are cause for concern. As of yesterday these symptoms were mild, but should these relatives deteriorate, their illness would be alarming. Six family members have already died and the index case developed symptoms about a week prior to symptoms in family members. The symptoms in the index case were April 27 and all infected family members were at an April 29 barbeque strongly implicating human-to-human transmission. H5N1 infection in three more family members would implicate human-to-human-to- human transmission in multiple family members.

Human-to-human transmission in Indonesia is also suggested by the many clusters with 5-10 day gaps between the disease onset date of the index case in additional family members. In addition, the only human sequence that has been made public has a novel cleavage site. One report has suggested that this novel sequence is found in additional human sequences, as well as a cat, and the swine in the Karo area have H5 antibodies. Since the sequence has not been reported in any poultry isolates, a non-poultry source is implicated However, testing of patients in Indonesia is predicated on exposure to dead or dying poultry, which would underestimate H5N1 from sources other than poultry.

Since there are over 30 confirmed H5N1 cases in Indonesia, it is likely that sequences from many or most of these cases is at a private WHO database. Those sequences should be released immediately.


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I have to agree with fiddlerdave on the large pharmacutical companies.  My mom has a neurological disorder and when BF came up we asked her dr. for a 1 year script for meds that keep her functioning - without them she would most likely commit suicide - she has an exposed nerve in her brain.  Ever had an exposed nerve, say in a tooth???  Long story short, her insurance wouldn't cover it except month-to-month, and to pay out of pocket for these pills was ROBBERY.  We went to on-line Canada pharmacy.  The pills were sent from INDIA - in packaging that was all in English...and was no different than what we would have received here in the states but with a HUGE mark-up.  Yes, big co's have the right to make money...but when it comes at the price of life and death?  Where are the priorities?  Why are children in 3rd world countries still dying from disease that has been eradicated here in the states???  NO EXCUSE!!!!  Take care of our people without draining them of money that would feed them.  Many elderly make the choice of their meds or a meal.  Not right!!!

Nikita wrote: 3 more family members today???  Sounds H2H to me.  Joe, you checking in here?  What are your thoughts???  Albert?  When you locking yourselves in????   HELP!    Any word on the US restricting travel from Indonesia?

I'm here.  Holding my breath. Don't count on travel restrictions from this government.  they have screwed everything up so far, might as well continue as long as they are on a roll.

The Department on Homeland Security will make a decision within two to three months on this sensitive issue.  It is in committee right now, you know.

Emails on the side between Joe & Jhetta -- two of our top brainstormers --- now THAT makes me nervous on this thread! -k 

ReadyMom wrote: Emails on the side between Joe & Jhetta -- two of our top brainstormers --- now THAT makes me nervous on this thread! -k

Joe - thanks & please keep us posted.

http://www.recombinomics.com/News/05190601/H5N1_Indonesia_Withheld_Dates.html

Commentary

Indonesian H5N1 Cluster Onset Dates Withheld

Recombinomics Commentary
May 19, 2006

a seventh family member, a 37-year-old woman. She developed symptoms on 27 April and died of respiratory disease on 4 May. No specimens were obtained before her burial, and the cause of her death cannot be confirmed. She is, however, considered the initial case in this family cluster.

The six confirmed cases in Sumatra include the woman's two sons, aged 15 and 17 years, who died respectively on 9 May and 12 May. The 28-year-old sister of the initial case died on 10 May. This sister had an 18-month-old girl, who died on 14 May. The fifth confirmed case, who is still alive, is the 25-year-old brother of the initial case. The sixth confirmed case is the 10-year-old nephew of the initial case. He died on 13 May.

the cases in this cluster are known to have participated in a family gathering around 29 April.

The above comments are from the WHO situation update on the large familial cluster in Karo, Indonesia. WHO typically publishes an update when cases are H5N1 confirmed by a WHO affiliated lab. The updates typically give the disease onset date, the hospitalization date, and the date of death.

The dates are important in determining the source of infections, especially when familial clusters are involved. A common source typically produces disease onset date that are within a few days of each other. Human-to-human transmission typically has a 5-10 day gap between the disease onset date of the index case, and the rest of the family members. In past familial clusters, the 5-10 day gap is common.

When there was a large cluster of cases in Turkey at the beginning of the year, WHO withheld the disease onset dates as well as the relationships between the clusters, which involved three sets of cousins. In one set three siblings were H5N1 confirmed and died and one additional sibling was hospitalized. In a second set of cousins, two family members were H5N1 confirmed and eight other family members were hospitalized.. In the third set, two were H5N1 confirmed and one of the two died. Disease onset dates were consistent with human-to-human transmission within the families and between the families. Disease onset dates from the first two sets was withheld, as was the relationship between the families.

WHO began provide the information in subsequent updates but has withheld disease onset dates in the current cluster. These disease onset dates clearly have the 5-10 day gap between the index case and the other family members. The onset dates were described in Indonesian reports as well as wire service reports, yet the dates have been withheld from the WHO update.

Similarly the sequences of human H5N1 isolates from Indonesia have also been withheld. The sequence from the index cluster identified in July, 2005 has been released, but all other human sequences are sequestered at a private WHO database. Most of the human Indonesian sequences in the private database have a novel cleavage site which is not found in bird H5N1 sequences from Indonesia These sequences should be released immediately.

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Maybe it's panic control while every government gets their ducks in a row. If something is disclosed to the public scientists and it gets out, there might be panic.

The "official" reseaon given for not releasing sequences is to allow the scientists working on these squences time to publish papers on them.  It is intimated that this helps bring and keep the best people to the work. My own theory is that is additionally encouraged by Big Drug companies, who maintain financial connections with these scientists, and also have a BIG carrot for the scentists by being current and future employers, being the ones to choose them for doing drug studies etc.  This  kind of relationship has been well documented in the FDA and other regulatory agencies.

And, not to make too fine a point about, the conspiracy of ALL the people and organizations that keep these sequences secret to themselves, is very possibly amounting to the MURDER of millions of people ( the ones who will wait longer for warning or vaccines) in order to get a paper published first, or a vaccine to market first. OUR lives, the lives of our children, are second, in these people's minds, to their personal and financial advancement!

Edited by fiddlerdave2 - May 20 2006 at 12:41pm

http://www.recombinomics.com/News/05200601/H5N1_Surabaya_Clusters.html

Commentary

Suspect H5N1 Clusters in Surabaya Indonesia Cluster

Recombinomics Commentary
May 20, 2006

A suspected 20-year male bird flu sufferer who has been treated in Budi Mulia hospital since May 9, died here at 8.3. am on Saturday.

Two patients beforehand were a woman was the citizen's approximately 30 years old Pucang Young Ii Surabaya and AP one of the citizen's Kediri students

The patient of the citizen's woman Pucang Young Ii Surabaya had finally died, after could be treated by RKZ because his condition has been serious enough. While the patient from Kediri that is reconciled to RSUD Dr Soetomo, currently still in the intensive maintenance in this hospital.

one casualty died with the assumption of bird flu. The Lily, the Surabaya citizen, died on Friday last week.

the child the Lily is currently treated in the hospital with the sign similar to bird flu.

The above translations define a new cluster of confirmed or suspect H5N1 bird flu cases in Surabaya. The confirmed case (38F) was describe in the WHO update. She developed symptoms on May 2, was hospitalized on May 7, and died May 11. The above report indicates her child is now hospitalized with bird flu symptoms, consistent with human-to-human transmission within a family.

Another suspect case (20M) died today, but the same hospital has admitted two additional suspect cases, a teacher (30F) who died earlier, and her student (18M) who is in critical condition and on a respirator.

The geographical cluster in Surabaya thus has one confirmed and four suspect cases. Two of the suspect cases have died, and the student of one has been hospitalized. Similarly, the child of the confirmed case has also been hospitalized.

Familial clusters in Indonesia have been common. Almost all have a 5-10 day gap between the index case and family member. Recently a seven member cluster in North Sumatra was described. H5N1 has been confirmed in all but the index case, and six of the seven have died, This cluster, the largest to date, has fueled concern about increased efficiency of human-to-human transmission. This cluster may be extended because one of the family members (10M) developed symptoms later than the other family member, and now the father of that fatal case has been hospitalized.

The growth in the number and size of the clusters has focused attention on the sequences of the H5N1 isolated from the patients. However, sequences from only one of the human H5N1 isolates has been released. It has a novel cleavage site, RESRRKKR, that has not been reported in any of the publicly available bird sequences from Indonesia or elsewhere.

These data suggest that the majority of the reported humans cases in Indonesia have not been linked to an avian sequence. Most of the sequences human isolates have been from West Java, including various locations in Jakarta and suburbs. Some of the avian sequence also are from West Java (see below)

The lack of a connection with bird H5N1 sequences and the increasing size and number of human clusters has raised pandemic concerns.

DQ320932    A/chicken/Bantul/BBVet-I/2005                  2005    H5N1
DQ497667    A/chicken/Dairi/BPPVI/2005                      2005    H5N1
DQ497668    A/chicken/Deli Serdang/BPPVI/2005        2005    H5N1
DQ497651    A/chicken/Gunung Kidal/BBVW/2005        2005    H5N1
DQ497652    A/chicken/Kulon Progo/BBVW/2005          2005    H5N1
DQ497643    A/chicken/Magetan/BBVW/2005               2005    H5N1
DQ497648    A/chicken/Purworejo/BBVW/2005              2005    H5N1
DQ320928    A/chicken/Salatiga/BBVet-I/2005               2005    H5N1
DQ497669    A/chicken/Tarutung/BPPVI/2005                 2005    H5N1
DQ497666    A/chicken/Tebing Tinggi/BPPVI/2005        2005    H5N1
DQ320933    A/chicken/Wajo/BBVM/2005                        2005    H5N1
DQ497659    A/duck/Parepare/BBVM/2005                     2005    H5N1
DQ497655    A/chicken/Bangli Bali/BBPV6-1/2004        2004    H5N1
DQ497656    A/chicken/Bangli Bali/BPPV6-2/2004        2004    H5N1
DQ497657    A/chicken/Jembrana/BPPV6/2004              2004    H5N1
DQ320931    A/chicken/Kulon Progo/BBVet-XII-1/2004   2004    H5N1
DQ497650    A/chicken/Kulon Progo/BBVet-XII-2/2004   2004    H5N1
DQ497662    A/chicken/Kupang-1-NTT/BPPV6/2004      2004    H5N1
DQ497660    A/chicken/Kupang-2-NTT/BPPV6/2004      2004    H5N1
DQ497661    A/chicken/Kupang-3-NTT/BPPV6/2004      2004    H5N1
DQ497642    A/chicken/Malang/BBVet-IV/2004               2004    H5N1
DQ497658    A/chicken/Mangarai-NTT/BPPV6/2004       2004    H5N1
DQ497644    A/chicken/Ngawi/BPPV4/2004                     2004    H5N1
DQ497663    A/chicken/Pangkalpinang/BPPV3/2004      2004    H5N1
DQ497653    A/chicken/Purwakarta/BBVet-IV/2004        2004    H5N1
DQ320930    A/chicken/Yogjakarta/BBVet-IX/2004          2004    H5N1
DQ497647    A/quail/Boyolali/BPPV4/2004                      2004    H5N1
DQ497654    A/quail/Tasikmalaya/BPPV4/2004               2004    H5N1
DQ497645    A/chicken/Pekalongan/BPPV4/2003           2003    H5N1
DQ497646    A/chicken/Sragen/BPPV4/2003                   2003    H5N1
AY651324    A/Ck/Indonesia/4/2004                                   2004    H5N1
AY651325    A/Ck/Indonesia/5/2004                                   2004    H5N1
AY651322    A/Dk/Indonesia/MS/2004                               2004    H5N1
AY651323    A/Ck/Indonesia/2A/2003                                2003    H5N1
AY651321    A/Ck/Indonesia/BL/2003                                2003    H5N1
AY651320    A/Ck/Indonesia/PA/2003                                2003    H5N1

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http://www.recombinomics.com/News/05200602/H5N1_Surabaya_Pandemic.html

Commentary

Suspect H5N1 Clusters in Surabaya Raise Pandemic Concerns

Recombinomics Commentary
May 20, 2006

The recent reports of suspected H5N1 bird flu cases in Surabaya is cause for concern. The index case has been confirmed and died May 12. Her child is currently hospitalized with bird flu symptoms and an unrelated patient has also just died.

Although only one case has been confirmed, two additional suspect cases have raised additional concerns. One fatal infection is of a teacher, and one of her students has been hospitalized and is on a respirator. Transmission of H5N1 outside of a family has been rare. In Vietnam one confirmed transmission chain involved an index case, his sister, and a nurse, all of whom were H5N1 confirmed. A second nurse had symptoms, but was not confirmed in lab tests. However, the vast majority of clusters have been limited to family members. There was a large cluster in Turkey at the beginning of 2006, and more recently the largest Indonesian cluster, in North Sumatra. However, all members of these cluster were related to the index case.

The cluster involving teacher and student has not been reported previously. Such transmission would signal an increased efficiency and diminish the likelihood that the familial clusters were genetically linked. An earlier cluster of five in Haiphong involved a husband and wife and three daughter. All five family members were H5N1 confirmed and the infection of both husband and wife diminishes the genetic link. The results of tests on neighbors with symnptoms has been withheld.

Concerns that transmission is from a source other than avian has been raised since almost all sequenced human cases in West Java have a novel cleavage site not found in poultry isolates. This novel sequence has also been found in a cat, raising the possibility that the sequence is closely linked to mammalian infections.

Since most suspect cases in Indonesia are not tested in the absence of a poultry link, many infections from a mammalian source many not be diagnosed. The frequent detection of the novel cleavage site highlights the need for more aggressive testing of avian and swine H5N1 infections.

Similarly, the H5N1 human and animal sequences sequestered at the WHO private data base should be released immediately.

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http://www.recombinomics.com/News/05210601/H5N1_Surabaya_Student.html

Commentary

H5N1 Confirmed in Student Teacher Cluster in Surabaya

Recombinomics Commentary
May 21, 2006

An 18-year-old East Java shuttlecock maker has been diagnosed with bird flu, according to local test results announced on Sunday.

The confirmation of H5N1 bird flu in the student in the teacher/student cluster in Surabaya is cause for concern. The teacher died earlier and the circumstances surrounding here hospitalization and death have not been described. However, the confirmation of her student raises the number of confirmed cases to two, and increases the likelihood at the other three members of the cluster have been infected with H5N1.

This cluster is in East Java and distinct from the larger cluster in North Sumatra. These clusters in addition to the clusters in and around Jakarta raise additional concerns and highlight the need for the release of the human and animal sequences sequestered at the private WHO database. Most of the human Indonesian sequences have a novel cleavage site not found in the avian isolates suggesting the human cases are not linked to poultry, increasing pandemic concerns.

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CORRECTION - PLEASE NOTE:

Commentary

H5N1 Confirmed in Student Teacher Cluster in Surabaya

Recombinomics Commentary
May 21, 2006

An 18-year-old East Java shuttlecock maker has been diagnosed with bird flu, according to local test results announced on Sunday.

The confirmation of H5N1 bird flu in the student in the teacher/student cluster in Surabaya is cause for concern. The teacher died earlier and the circumstances surrounding here hospitalization and death have not been described.

Correction:

The teacher decribed earlier appears to be another media description of the confirmed fatality (38M) and therefore there is no infected teacher and no relationship between a fatally infected teacher and the H5N1 confirmed student.



However, the confirmation of her student raises the number of confirmed cases to two, and increases the likelihood at the other three members of the cluster have been infected with H5N1.

This cluster is in East Java and distinct from the larger cluster in North Sumatra. These clusters in addition to the clusters in and around Jakarta raise additional concerns and highlight the need for the release of the human and animal sequences sequestered at the private WHO database. Most of the human Indonesian sequences have a novel cleavage site not found in the avian isolates suggesting the human cases are not linked to poultry, increasing pandemic concerns.

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