bbc.co.uk/health
16:22 GMT, Wednesday, 29 July 2009 17:22 UK
A suppressed immune system makes pregnant women more vulnerable
Pregnant women are four times more likely than the general population to need hospital treatment for H1N1 swine flu, data from the US suggests. The findings suggest pregnancy does increase the risk of complications without speedy anti-viral treatment.
It also underlines the need to ensure pregnant women are made a top priority when a vaccine becomes available. The study, by the US Centers for Disease Control and Prevention, appears in The Lancet medical journal. Scientists studied 34 confirmed or probable cases of swine flu infection among pregnant women. We must remember that most pregnant women who catch the disease are likely to make an uncomplicated recovery
Department of Health
They found 11 were admitted to hospital - a rate four times higher than that seen in the general population. The women covered a broad range of ages and races and were in various stages of pregnancy. Six subsequently died after developing pneumonia. None of the women who died had been given anti-viral drugs promptly, within the first 48 hours of symptoms occurring. Five of these women underwent caesarean deliveries. Four of the babies have now left hospital, and the fifth, born very prematurely, is doing well. None of the babies showed any sign of swine flu infection.
Historical echoes
The researchers accepted that doctors might be more likely to admit pregnant women to hospital than other patients - but said this was unlikely to be the only explanation for the higher rate of hospital admissions. It may be that pregnancy weakens the immune system, making complications more likely. Writing in The Lancet, the researchers, led by Dr Denise Jamieson, said: "On the basis of our investigation, pregnant women seem to be at increased risk for complications from pandemic H1N1 virus infection, with a higher estimated rate of hospital admission than in the general population. "Although the decision to admit a pregnant woman is complex and might include considerations beyond simply the severity of disease, that a high proportion of influenza-related deaths in the US have been in pregnant women is concerning."
A similar pattern was seen in the flu pandemics of 1918 and 1957, when death rates for pregnant women were higher than for non-pregnant women. A spokesman for the Department of Health said: "This study is a reminder that pregnant women can be at increased risk from swine flu, but we must remember that most pregnant women who catch the disease are likely to make an uncomplicated recovery. "Pregnant women should make early contact with their GP if they have flu-like symptoms." The spokesman said the anti-viral drug Relenza was available in an inhaled form which would not reach the foetus, and so pose no risk to it at all. Pregnant Sharon Pentleton, from Saltcoats, Ayrshire, had to be flown to Sweden for specialist care last week after developing a rare complication following infection with swine flu. Ms Pentleton, who is having her blood circulated through a machine, is described as "stable, but critical".
16:22 GMT, Wednesday, 29 July 2009 17:22 UK
A suppressed immune system makes pregnant women more vulnerable
Pregnant women are four times more likely than the general population to need hospital treatment for H1N1 swine flu, data from the US suggests. The findings suggest pregnancy does increase the risk of complications without speedy anti-viral treatment.
It also underlines the need to ensure pregnant women are made a top priority when a vaccine becomes available. The study, by the US Centers for Disease Control and Prevention, appears in The Lancet medical journal. Scientists studied 34 confirmed or probable cases of swine flu infection among pregnant women. We must remember that most pregnant women who catch the disease are likely to make an uncomplicated recovery
Department of Health
They found 11 were admitted to hospital - a rate four times higher than that seen in the general population. The women covered a broad range of ages and races and were in various stages of pregnancy. Six subsequently died after developing pneumonia. None of the women who died had been given anti-viral drugs promptly, within the first 48 hours of symptoms occurring. Five of these women underwent caesarean deliveries. Four of the babies have now left hospital, and the fifth, born very prematurely, is doing well. None of the babies showed any sign of swine flu infection.
Historical echoes
The researchers accepted that doctors might be more likely to admit pregnant women to hospital than other patients - but said this was unlikely to be the only explanation for the higher rate of hospital admissions. It may be that pregnancy weakens the immune system, making complications more likely. Writing in The Lancet, the researchers, led by Dr Denise Jamieson, said: "On the basis of our investigation, pregnant women seem to be at increased risk for complications from pandemic H1N1 virus infection, with a higher estimated rate of hospital admission than in the general population. "Although the decision to admit a pregnant woman is complex and might include considerations beyond simply the severity of disease, that a high proportion of influenza-related deaths in the US have been in pregnant women is concerning."
A similar pattern was seen in the flu pandemics of 1918 and 1957, when death rates for pregnant women were higher than for non-pregnant women. A spokesman for the Department of Health said: "This study is a reminder that pregnant women can be at increased risk from swine flu, but we must remember that most pregnant women who catch the disease are likely to make an uncomplicated recovery. "Pregnant women should make early contact with their GP if they have flu-like symptoms." The spokesman said the anti-viral drug Relenza was available in an inhaled form which would not reach the foetus, and so pose no risk to it at all. Pregnant Sharon Pentleton, from Saltcoats, Ayrshire, had to be flown to Sweden for specialist care last week after developing a rare complication following infection with swine flu. Ms Pentleton, who is having her blood circulated through a machine, is described as "stable, but critical".
Just as we share the planet's atmosphere, we share all of its infectious organisms.
Page last updated at 17:27 GMT, Monday, 27 July 2009 18:27 UK
Page last updated at 17:27 GMT, Monday, 27 July 2009 18:27 UK
Closing the door on potential pandemics
by William Karesh
Geographic and environmental boundaries that once protected us from widespread disease outbreaks
are no more, says William Karesh. In this week's Green Room, he calls for the West to adopt a "prevention is better than cure" approach to human and animal health. Animal health is tightly linked to the conditions of its surrounding environment, and humans are increasingly changing or affecting those conditions
During the 1918 Spanish Flu pandemic that killed up to 100 million people worldwide, children sang a nursery rhyme: "I had a little bird, Its name was Enza, I opened the window, and in-flu-enza." Today, the expanding human population and activity has opened the pandemic "window" even wider. A major component of any strategy to protect ourselves must involve treating disease before it gets to us.
We are reminded by the recent World Health Organization designation of a H1N1 pandemic that infectious diseases have little regard for the Darwinian divide. Humans share more than 60% of "known" infectious organisms with animals, and the majority of new or emerging diseases are linked in some way to wild animals; ebola, HIV/Aids, Sars, and Avian influenza are just a few examples. But don't blame the animals; these diseases in humans stem from how we move about the planet, interact with animals and the environment, educate our citizens, provide or don't provide health services, and deal with poverty and hunger.
Going global
Animal health is tightly linked to the conditions of its surrounding environment, and humans are increasingly changing or affecting those conditions. Boundaries that limited the spread of diseases are being broken down; The trade in wildlife for food, traditional medicine, or pets, for example, has increased in response to human demand. This flourishing trade - both legal and illegal - of domesticated animals, wildlife and wild animal parts is often marked by unsanitary conditions that can give rise to zoonotic diseases (those transmitted from animals to people).
As modern transportation is made available to more of the world, geographic boundaries that once protected us from remote disease outbreaks are nearly obsolete. Viruses and bacteria long confined to living in a single species, or in one part of the world, can now quickly be moved to new areas and thrive in environments, animals or people unprepared for their arrival. Other human-induced environmental conditions can have an effect as well, and are not predicated on human physical presence in a specific place. Disturbances, such as fluctuating precipitation levels and increasing temperatures brought about by climate change, can have far reaching consequences on ecosystems and animal health, and thus, ultimately drive changes in disease proliferation and redistribution.
Human well-being is dependent upon healthy ecosystems
Not surprisingly, predicting outbreaks of zoonotic diseases is an increasingly complex, but critically important, undertaking. It is a mistake to believe that stockpiling vaccines or drugs will be enough to ensure that we are protected from future pandemic threats. The next pandemic may not come in the form of an influenza virus. There is no guarantee that in response to a viral threat, we will have time to modify a vaccine or that current drugs will remain effective. Many of us have been actively promoting the concept of One World, One Health - a philosophy that dictates a comprehensive approach to pandemic preparedness that starts "upstream", and attacks disease at its origins. That means working with people in the poorest areas of the world who have little access to health care for themselves or their livestock, or to proper hygienic provisions for raising and handling animals.
In many of these places, the order of the day is simply survival.
To really protect those of us "downstream", in places like the US and Europe, from emerging pandemic diseases, we must focus a portion of our efforts on collaborating with those upstream populations to create a safer and healthier future. This means building capacity in the developing world to monitor wildlife, domestic animals and people for disease.
Potential pandemics needs to be tackled at source, not on our doorsteps
It also means giving those living at the frontlines of an outbreak the ability to respond. This may sound like an ominous task, but in the long run, preventing or solving a potential pandemic disease crisis at its source will prove far more cost effective than paying for the effects after its devastating impacts. The nascent beginnings of such a comprehensive, global approach to pandemic disease have been initiated by the US government and a number of UN agencies. Formal and informal networks of public health agencies, infectious disease scientists, veterinarians, conservation organisations and technology firms are sharing resources and enabling access to disease distribution data, sample analyses and outbreak information.
This is vital to predicting, identifying and responding to new emerging diseases in countries most in need of help and at the highest risk. As with climate change, we are learning that what we do locally affects our global community, and that all nations both developed and developing, will play an important role in the future condition of our shared planet. Working as partners within a One World, One Health philosophy is a critical approach to answering our environmental challenges - including minimising the impacts of a future pandemic. Just as we share the planet's atmosphere, we share all of its infectious organisms.
Dr William B Karesh is vice president of the Wildlife Conservation Society and director of its Global Health Program
The Green Room is a series of opinion articles on environmental topics running weekly on the BBC News website
by William Karesh
Geographic and environmental boundaries that once protected us from widespread disease outbreaks
are no more, says William Karesh. In this week's Green Room, he calls for the West to adopt a "prevention is better than cure" approach to human and animal health. Animal health is tightly linked to the conditions of its surrounding environment, and humans are increasingly changing or affecting those conditions
During the 1918 Spanish Flu pandemic that killed up to 100 million people worldwide, children sang a nursery rhyme: "I had a little bird, Its name was Enza, I opened the window, and in-flu-enza." Today, the expanding human population and activity has opened the pandemic "window" even wider. A major component of any strategy to protect ourselves must involve treating disease before it gets to us.
We are reminded by the recent World Health Organization designation of a H1N1 pandemic that infectious diseases have little regard for the Darwinian divide. Humans share more than 60% of "known" infectious organisms with animals, and the majority of new or emerging diseases are linked in some way to wild animals; ebola, HIV/Aids, Sars, and Avian influenza are just a few examples. But don't blame the animals; these diseases in humans stem from how we move about the planet, interact with animals and the environment, educate our citizens, provide or don't provide health services, and deal with poverty and hunger.
Going global
Animal health is tightly linked to the conditions of its surrounding environment, and humans are increasingly changing or affecting those conditions. Boundaries that limited the spread of diseases are being broken down; The trade in wildlife for food, traditional medicine, or pets, for example, has increased in response to human demand. This flourishing trade - both legal and illegal - of domesticated animals, wildlife and wild animal parts is often marked by unsanitary conditions that can give rise to zoonotic diseases (those transmitted from animals to people).
As modern transportation is made available to more of the world, geographic boundaries that once protected us from remote disease outbreaks are nearly obsolete. Viruses and bacteria long confined to living in a single species, or in one part of the world, can now quickly be moved to new areas and thrive in environments, animals or people unprepared for their arrival. Other human-induced environmental conditions can have an effect as well, and are not predicated on human physical presence in a specific place. Disturbances, such as fluctuating precipitation levels and increasing temperatures brought about by climate change, can have far reaching consequences on ecosystems and animal health, and thus, ultimately drive changes in disease proliferation and redistribution.
Human well-being is dependent upon healthy ecosystems
Not surprisingly, predicting outbreaks of zoonotic diseases is an increasingly complex, but critically important, undertaking. It is a mistake to believe that stockpiling vaccines or drugs will be enough to ensure that we are protected from future pandemic threats. The next pandemic may not come in the form of an influenza virus. There is no guarantee that in response to a viral threat, we will have time to modify a vaccine or that current drugs will remain effective. Many of us have been actively promoting the concept of One World, One Health - a philosophy that dictates a comprehensive approach to pandemic preparedness that starts "upstream", and attacks disease at its origins. That means working with people in the poorest areas of the world who have little access to health care for themselves or their livestock, or to proper hygienic provisions for raising and handling animals.
In many of these places, the order of the day is simply survival.
To really protect those of us "downstream", in places like the US and Europe, from emerging pandemic diseases, we must focus a portion of our efforts on collaborating with those upstream populations to create a safer and healthier future. This means building capacity in the developing world to monitor wildlife, domestic animals and people for disease.
Potential pandemics needs to be tackled at source, not on our doorsteps
It also means giving those living at the frontlines of an outbreak the ability to respond. This may sound like an ominous task, but in the long run, preventing or solving a potential pandemic disease crisis at its source will prove far more cost effective than paying for the effects after its devastating impacts. The nascent beginnings of such a comprehensive, global approach to pandemic disease have been initiated by the US government and a number of UN agencies. Formal and informal networks of public health agencies, infectious disease scientists, veterinarians, conservation organisations and technology firms are sharing resources and enabling access to disease distribution data, sample analyses and outbreak information.
This is vital to predicting, identifying and responding to new emerging diseases in countries most in need of help and at the highest risk. As with climate change, we are learning that what we do locally affects our global community, and that all nations both developed and developing, will play an important role in the future condition of our shared planet. Working as partners within a One World, One Health philosophy is a critical approach to answering our environmental challenges - including minimising the impacts of a future pandemic. Just as we share the planet's atmosphere, we share all of its infectious organisms.
Dr William B Karesh is vice president of the Wildlife Conservation Society and director of its Global Health Program
The Green Room is a series of opinion articles on environmental topics running weekly on the BBC News website
Australia offers swine flu test case
By Nick Bryant
BBC News, Sydney
Page last updated at 23:24 GMT, Monday, 27 July 2009 00:24 UK
Some affected schools have been shut, because Australia has realised that children are the so-called "super-spreaders" of H1N1. Therein lies a lesson for the northern hemisphere, according to Professor Raina MacIntyre, from the University of New South Wales.
"Shutting schools is probably the key non-pharmaceuticals intervention and social distancing intervention that can have an impact," he said. "We've had controversy here about things like banning sports fixtures and mass gatherings, and so on. But they have less of an impact than school closures because children are one of the key reservoirs of infection and transmission."
Global swine flu deaths top 700
Page last updated at 10:55 GMT, Tuesday, 21 July 2009 11:55 UK
The virus was first recorded in Mexico, U.S. and Canada. H1N1 swine flu has killed more than 700 people around the world since the outbreak began four months ago, says the World Health Organization (WHO). This represents a jump of at least two-thirds from the last official death toll figure of 429, published by the WHO on July 6.
Margaret Chan, WHO director-general, has warned that swine flu will become the biggest flu pandemic ever seen. However, most cases continue to produce only mild symptoms.
SWINE FLU SYMPTOMS
1. High temperature, tiredness and lowered immunity
2. Headache, runny nose and sneezing
3. Sore throat
4. Shortness of breath
5. Loss of appetite, vomiting and diarrhoea
6. Aching muscles, limb and joint pain
Source: NHS
The overwhelming majority of patients usually recover, even without medical treatment, within a week of falling ill. The WHO has said the pandemic is developing at such a high speed that it is now pointless to try to document every case. In past pandemics, flu viruses have needed more than six months to spread as widely as the new H1N1 virus has spread in less than six weeks.
But officials have stressed that there is an ongoing need for all countries to monitor unusual events, such as clusters of severe or fatal cases, or unusual clinical patterns, closely. Some 125,000 laboratory-confirmed cases have been reported worldwide - but the number of actual cases far exceeds that. WHO spokeswoman Aphaluck Bhatiasevi said a group of experts, including mathematicians, epidemiologists and a virologists, were examining various measures countries could take to slow the spread of the disease. Ms Bhatiasevi said school closures could be among the recommendations, but that it was up to each country to consider appropriate steps for their situations. Experts predict that there will be a significant surge of new cases of swine flu in the northern hemisphere when the weather begins to cool in the autumn.
"The Vice nurs'd Ingenuity
Which join'd with Time and Industry,
Had carry'd Life's Conveniencies,
It's real Pleasures, Comforts, Ease,
To such a Height, they very Poor
Liv'd better than the Rich, before
And nothing could added more"
Mandeville
Which join'd with Time and Industry,
Had carry'd Life's Conveniencies,
It's real Pleasures, Comforts, Ease,
To such a Height, they very Poor
Liv'd better than the Rich, before
And nothing could added more"
Mandeville
Can I get infected with novel H1N1 virus from eating or preparing pork?
No. Novel H1N1 viruses are not spread by food. You cannot get infected with novel HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.
Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.
Can novel H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of novel H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as novel H1N1 virus would also be similarly disinfected by chlorine.
Can novel H1N1 influenza virus be spread at recreational water venues outside of the water?
Yes, recreational water venues are no different than any other group setting. The spread of this novel H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
Prevention & Treatment
What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against novel H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.
Take these everyday steps to protect your health:
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze.
Alcohol-based hand cleaners are also effective.
Avoid touching your eyes, nose or mouth. Germs spread this way.
Try to avoid close contact with sick people.
Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.
Other important actions that you can take are:
Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and
MAMMON , a word of Aramaic origin meaning " riches." The etymology is doubtful; connexions with a word meaning " en-trusted," or with the Hebrew matmon, treasure, have been suggested . "Mammon," Gr . µaµwvas (see Professor Eb . Nestle in Ency . Bib. s.v.), occurs in the Sermon on the Mount "Ye can not serve God and mammon"(Matt . Vi . 24) and the parable of the Unjust Steward (Luke xvi . 9-13) . The Authorized Version keeps the Syriac word . Wycliffe uses " richessis." The New English Dictionary quotes Piers Plowman as containing the earliest personification of the name . Nicholaus de Lyra (commenting on the passage in Luke) says that Mammon "est nomen daemonis" . There is no trace, however, of any Syriac god of such a name, and the common identification of the name with a god of covetousness or avarice is chiefly due to Milton (Paradise Lost, i .678) . Milton's personification of the name—"Mammon, the least erected spirit that fell from heaven" ("Paradise Lost," i. 679)
Flat Earth Psychology from the Ghost in the Machine by Arthur Koestler
Flat earth psychology is a term used by Arthur Koestler to describe the school of thought known as Behaviourism. B.F. Skinner's work "The operational analysis of psychological terms "published in Behavioral and Brain Sciences (Apr. 16. 1984) describes the idea of behaviorism that he inherited from his mentor John Broadus Watson. "The learning perspective (where any physical action is a behavior) is a philosophy of psychology based on the proposition that all things which organisms do — including acting, thinking and feeling—can and should be regarded as behaviors." J.B. Watson whose work preceded Skinner by thirty years essentially believed that psychology must reject any concept of consciousness and the mind. Or as Arthur Koestler so eloquently states "Behaviorists may only study objective, measure able aspects of human behavior." The irony of the quest of knowledge that is behaviorism is that all the clinical research was performed on rats and dogs, humans, let alone chimpanzees were too complex of creatures to get to the root of the "stimulus-response theory".
The idea that all living organisms may fall under this scope of reality, necessitates that we live in a theoretical world that is solely based on stimulus and reflex (reflex would later be replaced with response). B.F. Skinner writes in his book, Science and Human Behavior (NY, 1953), "(the) mind and ideas are non-existent entities, 'invented for the soul purpose of providing spurious explanations.... Since mental or psychic events are asserted to lack the dimensions of physical science, we have an additional reason for rejecting them" Koestler notes that Skinner like Watson, "asserted that psychology could be studied with the methods and concepts of classical physics."
To say that Skinner and Watson were anti-Platonist would be an understatement. At the same time, it is hard to argue with the empirical minds hell-bent on maintaining their social status based on their shallow fields of research. C.J. Herrick offers a compelling argument based on sound "scientific and empirical" theory in his book The Evolution of Human Nature (NY, 1961). "All the information we have about the embryology and phylogenetic development of behavior shows clearly that the local reflexes are not primary units of behavior. They are secondary acquisitions." Koestler also uses a quote from Sir Charles Sherrington's work "The Integrative Action of the Nervous System" ( NY, 1906) which further emphasises the absurdity of "simple reflexes". "The simple reflex is probably a purely abstract conception, because all parts of it is probably ever capable of reaction without affecting and being affected by various other parts... the simple reflex is a convenient, if not a probable, fiction."
If any other country were to capture a ship carrying humanitarian supplies, and assault and imprison a Nobel Prize-winner and a former U.S. Member of Congress under terrible conditions, surely the U.S. media and even the U.S. government would speak out. The Spirit of Humanity was boarded and seized, and all 21 human rights workers and crew were taken prisoner, on June 30th. But the pirates in this case operate under the flag of the I.D.F., the Israeli military, and the seizure of medical supplies, toys, and olive trees intended for the suffering people of Gaza appears to have the quiet approval of the United States government. Hardly a word has appeared in any of the billionaire-owned newspapers, the case is not mentioned on television, and no statement of condemnation or concern has issued from the White House.
Sadly, as activists for peace know all too well, the U.S. mass media cannot be trusted to tell the truth, or indeed anything at all if they can avoid it, about the actions of U.S. proxies and allies in the Middle East. The prison cells, torture chambers and secret police that prop up the utterly despised regime of Mubarak in Egypt are all financed by U.S. aid. The bombs and shells and bullets and tanks that killed so many, including so very many children and non-combatants, in Gaza in January, are financed by U.S. aid that was even increased during the massacre. And now the I.D.F., using U.S. aid again, has captured a humanitarian relief ship and its crew by violence off the coast of Gaza, where the I.D.F. has no legal and legitimate authority, and the brave aid volunteers are being treated abominably - with no outcry from the U.S., and the world-wide outcry not even reported to Americans.
Around the world, it has been reported that Nobel Peace Prize-winner Mairead Maguire of Northern Ireland, and former US Congresswoman Cynthia McKinney, along with 19 others, are being held prisoner while being told they must sign confessions (in Hebrew, a language they do not understand) before being deported. They have refused, and are still in jail. Around the world, millions are concerned as vital medicine is being withheld from Mairead Maguire by her jailers. But the White House is not concerned. In Congress, no one from either corporate party, the Democrats or the Republicans, has taken to the floor to demand their release. Imagine the uproar if the ship had been captured by Iran! But because the lawlessness is committed by the Israeli allies of those Democrats and Republicans, the silence is deafening.The Peace and Freedom Party joins in the demands of hundreds of millions of people around the world: that the aid workers be released unconditionally, with all their notes, recordings and personal belongings; that the ship, the Spirit of Humanity, be released after its dismantled navigation equipment is repaired; that the I.D.F. stand away and allow the cargo (that was security-checked at the dock in Cyprus before the voyage) to be offloaded in Gaza; and above all, that the cruel embargo of humanitarian aid to the suffering people of Gaza be lifted by the Israeli government. We further ask that all aid of any kind from the United States to Israel cease until the Israeli government agrees to these conditions. While this statement is being provided to the usual media, having no confidence in the willingness of the corporate media to tell the truth about the Middle East, we are also circulating it by other means.
Adopted by the California State Officers of the Peace and Freedom Party, 6 July 2009.
Sadly, as activists for peace know all too well, the U.S. mass media cannot be trusted to tell the truth, or indeed anything at all if they can avoid it, about the actions of U.S. proxies and allies in the Middle East. The prison cells, torture chambers and secret police that prop up the utterly despised regime of Mubarak in Egypt are all financed by U.S. aid. The bombs and shells and bullets and tanks that killed so many, including so very many children and non-combatants, in Gaza in January, are financed by U.S. aid that was even increased during the massacre. And now the I.D.F., using U.S. aid again, has captured a humanitarian relief ship and its crew by violence off the coast of Gaza, where the I.D.F. has no legal and legitimate authority, and the brave aid volunteers are being treated abominably - with no outcry from the U.S., and the world-wide outcry not even reported to Americans.
Around the world, it has been reported that Nobel Peace Prize-winner Mairead Maguire of Northern Ireland, and former US Congresswoman Cynthia McKinney, along with 19 others, are being held prisoner while being told they must sign confessions (in Hebrew, a language they do not understand) before being deported. They have refused, and are still in jail. Around the world, millions are concerned as vital medicine is being withheld from Mairead Maguire by her jailers. But the White House is not concerned. In Congress, no one from either corporate party, the Democrats or the Republicans, has taken to the floor to demand their release. Imagine the uproar if the ship had been captured by Iran! But because the lawlessness is committed by the Israeli allies of those Democrats and Republicans, the silence is deafening.The Peace and Freedom Party joins in the demands of hundreds of millions of people around the world: that the aid workers be released unconditionally, with all their notes, recordings and personal belongings; that the ship, the Spirit of Humanity, be released after its dismantled navigation equipment is repaired; that the I.D.F. stand away and allow the cargo (that was security-checked at the dock in Cyprus before the voyage) to be offloaded in Gaza; and above all, that the cruel embargo of humanitarian aid to the suffering people of Gaza be lifted by the Israeli government. We further ask that all aid of any kind from the United States to Israel cease until the Israeli government agrees to these conditions. While this statement is being provided to the usual media, having no confidence in the willingness of the corporate media to tell the truth about the Middle East, we are also circulating it by other means.
Adopted by the California State Officers of the Peace and Freedom Party, 6 July 2009.
When the battle is won, let history be able to say of each one of us:
"He was a dedicated patriot: DIGNITY was his country, MANHOOD was his government, and FREEDOM was his land."
"Organization of Afro-American Unity: A Statement of Basic Aims and Objectives" New York, June 1964. quoting John Oliver Killens "Then We Heard The Thunder"
Time for a vaccine 'Manhattan Project'?
Maryn McKenna Contributing Writer
Center for Infectious Disease Research and Policy
It has been 10 years since the H5N1 strain of avian influenza first grabbed international attention by causing the death of a Hong Kong 3-year-old, the novel virus's first known human casualty (see Bibliography: CDC 1997). In the decade since, the virus has torn across the globe, causing 332 known human illnesses and 204 deaths in 12 countries, according to the World Health Organization (WHO), as well as the deaths or preventive slaughter of hundreds of millions of birds.
In that time, avian flu and the potential human pandemic it could cause have waxed and waned in public attention. Scientific attention to the H5N1 threat, though, has never wavered. Much of that attention has focused on finding a vaccine against H5N1, "the single most important public health tool for decreasing the morbidity, mortality and economic effects of pandemic influenza," according to Dr. Gregory Poland, director of the Mayo Clinic's Vaccine Research Group in Rochester, Minn. (see Bibliography: Poland 2006).
But after almost a decade of research, a safe, effective, affordable, and abundant vaccine against H5N1 flu remains disappointingly out of reach. The search for a human avian-flu vaccine that could be developed and delivered in time to short-circuit a pandemic has been dogged by multiple obstacles across many sectors. They include patchy scientific knowledge, sparse government funding, thin manufacturing and packaging capability, and restrictive regulatory structures—along with the wily immunology of the H5N1 virus itself.
Despite recent encouraging news from several clinical trials, the scientific—and financial and political—hurdles to producing a widely deployable vaccine remain dauntingly high. As the WHO admitted in its Global Pandemic Influenza Action Plan, published last year, "At the present time, if an influenza pandemic were to occur, the potential vaccine supply would fall several billion doses short of the amount needed to provide protection to the global population" (see Bibliography: WHO 2006).
Although money for pandemic influenza vaccine research has begun to flow and results have picked up speed, there is widespread frustration that it all took so long.
"If we are serious about a pandemic, we should assume it is going to be imminent and we should be prepared as if it is imminent—not 10, 15 years down the road, but imminent," said David Fedson, MD, a retired vaccine industry executive who has published analyses of pandemic vaccine planning (seeBibliography: Fedson 2007: Author interview).
A chorus of calls to action
Calls have come from across the political spectrum for a more aggressive, better-funded, tightly organized research effort. Former Senate Majority Leader William H. Frist (R-Tenn.) called in August 2005 for a "Manhattan Project for the 21st century" (see Bibliography: Frist 2005). In the same month, Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of CIDRAP News, recommended the creation of "an international project to develop the ability to produce a vaccine for the entire global population within several months of the start of a pandemic [that would be] a top priority of the Group of Seven industrialized nations plus Russia (the G-8)" (seeBibliography: Osterholm 2005).
Further, the nonprofit, nonpartisan advocacy group Trust for America's Health recommended in October 2006 that governments create a "multinational pandemic vaccine research and development master program" (see Bibliography: Trust for America's Health 2006), and the Infectious Diseases Society of America (IDSA) echoed that call in January 2007, recommending an appropriation of $2.8 billion in such a project's first year (see Bibliography: IDSA 2007).
"An effort on the scale of the Apollo space project is required," the IDSA said.
The Manhattan Project and the nuclear bombs that resulted from it are a sensitive subject to raise in a health crisis that demands international cooperation—particularly a health crisis centered in Asia, where the bombs were used.
But implicit in the invocation of that all-out effort is a hunger for the power, funding, freedom from bureaucracy, and single-minded focus that its leaders enjoyed. The Manhattan Project was founded at emergency speed: The lag time between Albert Einstein's famous letter advising President Franklin Roosevelt that nuclear fission might permit the creation of "extremely powerful bombs" and the first meeting of a newly formed federal Advisory Committee on Uranium was a mere 10 days. The project’s chief, Brigadier General Leslie Groves, was handpicked for his reputation for ruthless efficiency. Even after the United States entered World War II in December 1941, the project boasted the ability to cherry-pick any staff and claim any funding it needed; eventually it employed 130,000 people and received $2 billion in 1940s dollars (about $23 billion today).
Most notably for parallels to pandemic policy, the Manhattan Project simultaneously pursued multiple research paths into nuclear fission and weapons development, dropping entire avenues of inquiry and increasing other labs' funding and staff as results emerged. And from the time of Einstein's letter in 1939 to the dropping of two atomic bombs on Japan in 1945, less than 6 years elapsed (see Bibliography: Schwartz 1998; Gosling 1999).
"I feel as a scientist that we could make progress more rapidly if we sat down in advance and came up with a big-picture strategy and then funded it," said Dr. Gregory Poland, director of the Mayo Clinic's Vaccine Research Group in Rochester, Minn. "We have neither a process for rapidly developing new vaccines nor a track record" (see Bibliography: Poland 2007).
The National Institute of Allergy and Infectious Diseases (NIAID), the primary conduit of federal flu research funds to scientists, believes it does have a robust research agenda. Dr. Carole Heilman, director of the division of microbiology and infectious diseases, points to the flu-research recommendations issued by a blue-ribbon NIAID panel this year as evidence that the agency is guiding extramural researchers to critical questions about flu (see Bibliography: Heilman 2007, NIAID 2007). But with funding limited until recently, much of the research being conducted came into being because of private-sector interests rather than an overarching plan, said longtime flu researcher Dr. Arnold Monto of the University of Michigan (seeBibliography: Monto 2007).
Swine flu emergency in Argentina
BBC NEWS:
Published: 2009/07/01 11:30:17 GMT
Officials are being given more power and resources to tackle the epidemic, and school holidays for millions of children are being extended. Argentina has confirmed more than 1,500 cases of swine flu, which is spreading during the southern hemisphere winter. Meanwhile, an international conference on swine flu is opening in Mexico. Teams from some 40 countries are attending the three-day event in Cancun. The head of the World Health Organization, Margaret Chan, is also participating.
'Too late'
The health emergency measures in the capital and surrounding Buenos Aires province were unveiled on Tuesday. Local officials said they wanted to improve co-ordination between different state services and to put more medical staff on stand-by. They also said that school classes in the capital and three other regions would be cancelled from Monday, bringing forward winter holidays that had been due to start on 20 July. "Families shouldn't treat this as extra holidays for the kids. They should see it as a time for the children to stay at home as much as possible and avoid places where people are crowded together," said Buenos Aires Mayor Mauricio Macri.
He also appealed for calm, saying that officials were doing everything possible to control the epidemic. Officials said that restaurants, cinemas and other public buildings would remain open. Much of Argentina's population lives in the capital and the province. Many of the cases in the region have been reported in working class and poorer areas, says the BBC's Candace Piette in Buenos Aires. There has been much criticism that the government may have responded too late to stop the epidemic, our correspondent says. Argentina has had the third largest number of swine flu deaths in the world after Mexico and the United States.
Swine flu: The predictable pandemic?
29 April 2009 by Debora MacKenzie
THE swine flu virus has been a serious pandemic threat for years, New Scientist can reveal - but research into its potential has been neglected compared with other kinds of flu. As New Scientist went to press, cases were being reported far from the original outbreak in Mexico. The clusters of milder infections in the US suggest the virus is spreading readily among people. The US Centers for Disease Control and Prevention (CDC) says this strain is so different from existing human flu viruses that most people have no immunity to it. There are no existing vaccines. All this means the virus could go pandemic. Or it might not: if the virus spreads less readily than is feared, it might not be able to maintain itself in the human population and could fizzle out (see "What makes flu go global?"). We could have seen this coming, though. This type of virus emerged in the US in 1998 and has since become endemic on hog farms across North America. Equipped with a suite of pig, bird and human genes, it was also evolving rapidly. Flu infects many animals, including waterfowl, pigs and humans. Birds and people rarely catch flu viruses adapted to another host, but they can pass flu to pigs, which also have their own strains.If a pig catches two kinds of flu at once it can act as a mixing vessel, and hybrids can emerge with genes from both viruses. This is what happened in the US in 1998. Until then, American pigs had regular winter flu, much like people, caused by a mutated virus from the great human pandemic of 1918, which killed pigs as well as at least 50 million people worldwide. This virus was a member of the H1N1 family - with H and N being the virus's surface proteins haemagglutinin and neuraminidase.
Over decades, H1N1 evolved in pigs into a mild, purely swine flu, and became genetically fairly stable. In 1976, there was an outbreak of swine H1N1 in people at a military camp in New Jersey, with one death. The virus did not spread efficiently, though, and soon fizzled out. But in 1998, says Richard Webby of St Jude's Children's Research Hospital in Memphis, Tennessee, swine H1N1 hybridised with human and bird viruses, resulting in "triple reassortants" that surfaced in Minnesota, Iowa and Texas. The viruses initially had human surface proteins and swine internal proteins, with the exception of three genes that make RNA polymerase, the crucial enzyme the virus uses to replicate in its host. Two were from bird flu and one from human flu. Researchers believe that the bird polymerase allows the virus to replicate faster than those with the human or swine versions, making it more virulent. By 1999, these viruses comprised the dominant flu strain in North American pigs and, unlike the swine virus they replaced, they were actively evolving. There are many versions with different pig or human surface proteins, including one, like the Mexican flu spreading now, with H1 and N1 from the original swine virus. All these viruses still contained the same "cassette" of internal genes, including the avian and human polymerase genes, reports Amy Vincent of the US Department of Agriculture (USDA) in Ames, Iowa (Advances in Virus Research, vol 72, p 127). "They are why the swine versions of this virus easily outcompete those that don't have them," says Webby. But the viruses have been actively switching surface proteins to evade the pigs' immunity. There are now so many kinds of pig flu that it is no longer seasonal. One in five US pig producers actually makes their own vaccines, says Vincent, as the vaccine industry cannot keep up with the changes.
This rapid evolution posed the "potential for pandemic influenza emergence in North America", Vincent said last year. Webby, too, warned in 2004 that pigs in the US are "an increasingly important reservoir of viruses with human pandemic potential". One in five US pig workers has been found to have antibodies to swine flu, showing they have been infected, but most people have no immunity to these viruses. Our immune response to flu, which makes the difference between mild and potentially lethal disease, is mainly due to the H surface protein. The Mexican virus carries the swine version, so the antibodies we carry to human H1N1 viruses will not recognise it. That's why the CDC warned last year that swine H1N1 would "represent a pandemic threat" if it started circulating in humans.
The avian polymerase genes are especially worrying, as similar genes are what make H5N1 bird flu lethal in mammals and what made the 1918 human pandemic virus so lethal in people. "We can't yet tell what impact they will have on pathogenicity in humans," says Webby. It appears the threat has now resulted in the Mexican flu. "The triple reassortant in pigs seems to be the precursor," Robert Webster, also at St Jude's, told New Scientist. While researchers focused on livestock problems could see the threat developing, it is not one that medical researchers focused on human flu viruses seemed to have been aware of. "It was confusing when we looked up the gene sequences in the database," says Wendy Barclay of Imperial College London, who has been studying swine flu from the recent US cases. "The polymerase gene sequences are bird and human, yet they were reported in viruses from pigs."
So where did the Mexican virus originate? The Veratect Corporation based in Kirkland, Washington, monitors world press and government reports to provide early disease warnings for clients, including the CDC. Their first inkling of the disease was a 2 April report of a surge in respiratory disease in a town called La Gloria, east of Mexico City, which resulted in the deaths of three young children. Only on 16 April - after Easter week, when millions of Mexicans travel to visit relatives - did reports surface elsewhere in the country. Local reports in La Gloria blamed pig farms in nearby Perote owned by Granjas Carroll, a subsidiary of US hog giant Smithfield Foods. The farms produce nearly a million pigs a year. Smithfield Foods, in a statement, insists there are "no clinical signs or symptoms" of swine flu in its pigs or workers in Mexico. That is unsurprising, as the company says it "routinely administers influenza virus vaccination to swine herds and conducts monthly tests for the presence of swine influenza." The company would not tell New Scientist any more about recent tests. USDA researchers say that while vaccination keeps pigs from getting sick, it does not block infection or shedding of the virus. All the evidence suggests that swine flu was a disaster waiting to happen. But it got little research attention, perhaps because it caused mild infections in people which didn't spread. Now one swine flu virus has stopped being so well-behaved.
What makes flu go global?
A "pandemic" is an epidemic that goes global, so technically there is a flu pandemic every year. But the term is usually reserved for bad outbreaks that follow large changes in the virus. The influenza virus constantly evolves, and pandemics happen every few decades when the flu virus gets new surface proteins that people have little immunity to, generally because they come from an animal strain. The lack of immunity means the virus affects more people more severely. That's why H5N1 bird flu is so dangerous. Its H5 surface protein is totally new to humans, and the virus has killed more than half of the people it infected. It or another bird flu that can infect humans, such as a virus from the H7 or H9 families, only needs to become readily contagious to go pandemic. H1N1 has received less attention partly because an H1N1 strain already circulates in humans. The problem is the Mexican strain carries different versions of H1. Still, that alone is not enough to make this virus pandemic. It must also transmit efficiently in people. Every victim must infect more than one other person for the virus to spread. The new strain could do this, as it is packing an altogether faster engine than previous H1N1 strains. It has an avian gene that has powered it to dominance in pigs, though no one knows for certain if this will make it dangerous in people.
Animals: The world's best (and cheapest) biosensors
BY LAURA H. KAHN | 13 MARCH 2007
While policy makers fret over the obstacles in developing biosensor technology, the best and cheapest biosensors are already distributed globally but generally ignored: They're called animals. The United States has spent millions of dollars to develop biosensors that would detect bioterrorism or other deadly agents. But so far, the technology has not met expectations and questions have arisen as to whether additional spending is warranted for civilian applications. (See Steve Bunk's July 2002 Scientist article "Sensing Evil.")
The 2003 monkeypox outbreak in the Midwest was not detected until it appeared in humans. No one noticed the sick prairie dogs that shared housing with exotic African rodents. Fifteen prairie dogs became ill after a wholesale pet store sold approximately 100 of these animals. Of the 15 sick prairie dogs, 10 rapidly died. Only two were examined; the rest were destroyed. Only after 37 humans became ill was the cause of the outbreak identified. In January 2007, the University of Illinois College of Veterinary Medicine held a "One Medicine" colloquium to promote the link between human and animal health. The idea is not new. Such a concept was described and promoted in the landmark book Veterinary Medicine and Human Health in the 1980s by the late Calvin Schwabe, a veterinary epidemiologist and parasitologist. Schwabe's book proposed a unified human and veterinary approach against zoonotic diseases that built on the vision and principles initially advocated by German physician and pathologist Rudolf Virchow in the nineteenth century. What is new is that the University of Illinois College of Veterinary Medicine plans to establish a One Medicine Institute that would integrate education, research, and clinical applications involving human, veterinary, and ecological health as well as public health and epidemiology. The center would educate a new cadre of professionals trained in these disciplines in order to meet the twenty-first century challenges of emerging zoonotic diseases and potential bioterrorism agents.
Historically, human and animal diseases have been treated as largely separate entities; physicians and veterinarians rarely communicate or collaborate. The ecology of microorganisms is generally not taught in medical schools, so medical students might not see the importance of animal health on human health. But the increasing number of zoonotic agents infecting human populations illustrates the importance of this issue. Unlike most other institutions, the University of Illinois has an advantage in that its colleges of medicine and veterinary medicine share the same campus, which facilitates collaboration. Many universities have their veterinary college in a rural setting and their medical school in an urban setting. For example, Cornell University's veterinary college is in upstate New York, while its medical school is located in New York City. Under these circumstances, collaboration is difficult at best.
Another difficulty is that there are only 28 accredited schools of veterinary medicine in the United States compared to 125 accredited medical schools. The nearly 4.5-fold difference poses a further communication dilemma between the two disciplines. Globally, the discrepant ratio is about the same. According to the Foundation for the Advancement of International Medical Education and Research, there are more than 2,000 medical schools worldwide; in contrast, there are approximately 440 veterinary medical schools worldwide. The American Veterinary Medical Association Council on Education lists only 12 accredited veterinary medical schools outside of the United States. The number of well-trained veterinarians available is arguably not enough to meet the global challenges of emerging zoonotic diseases. So what should these professionals do? In her presentation at the colloquium, "Integrated Bio-Surveillance: It's Time We Stop Using Taxpayers as Sentinels," Tracey McNamara, a veterinary medical pathologist, described the challenges of utilizing animal species as sentinels for zoonotic threats. Many species (including dogs, cats, pet prairie dogs, zoo animals, and urban wildlife) fall below the radar of any federal agencies. No one is monitoring them even though they have proven to be of immense importance in the early detection of human disease outbreaks.
McNamara set up a national disease surveillance system in zoos because the exotic animals housed there have broad susceptibilities and zoos do active disease surveillance. She argued that zoo animals make good sentinels because they represent a stationary population, they are spread across the entire United States, and they are generally in close proximity to humans. Many of these animals are extremely valuable because they are often endangered species. Zoos also have veterinary medical expertise as well as diagnostic pathology and archival material of serum banks and tissue samples. According to McNamara, this national zoo surveillance network detected positive West Nile virus cases several weeks before public health departments in three out of the four years of testing. At a time when most health departments were testing only crows, the surveillance network's testing expanded the species susceptibility list dramatically. For example, the network identified the first reptile with West Nile virus, along with a novel, but different, virus in crows that mimicked West Nile virus. In addition, because it could follow known individual animals over time, the surveillance network showed that exposed but asymptomatic birds and mammals could have significant neuropathology as a result of exposure to West Nile virus. (Besides zoo animals, nonagricultural wildlife are also an extremely important sentinel group for emerging zoonotic epidemics.)
From 2001 to 2004, Duane Gubler, the head of the Centers for Disease Control and Prevention laboratory in Fort Collins, Colorado, represented the major source of support for this network, which cost just $300,000 during the four-year period. Sadly, once Gubler left his position, the funding ceased. According to McNamara, the network hasn't seen a dime since. If we use weather forecasting as an analogy to zoonotic disease forecasting, the ability to accurately forecast weather changes did not happen until weather satellites were launched in the early 1960s. For the first time in history, scientists could track and follow storms such as hurricanes and warn populations to evacuate with a higher level of accuracy. (Whether they choose to heed these warnings or not is another matter).
Just as hurricanes are a part of life on this planet, so are infectious disease epidemics. We need to develop "biological" satellites that would identify epidemics at their earliest possible stages in order to prepare and warn populations. By necessity, these biological satellites would include close surveillance of nonagricultural wildlife and require a global cadre of well-educated veterinarians and others involved in ecological monitoring. Those of us who are truly concerned about early identification of emerging infectious diseases and bioterrorism should promote and encourage the funding of programs such as the national zoo surveillance network and other programs that focus on the surveillance of nonagricultural species. Time and again, they've proven to be the best and cheapest environmental biosensors around.
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