Is H5N1 still a threat? What to do when your pandemic preparedness work is challenged

first_img(CIDRAP Source Osterholm Briefing) – How are you explaining the current risk of an H5N1-related influenza pandemic to your boss, the emergency preparedness committee, or the executive suite today? Is the task daunting? Are you being waved off with the comment that all this attention to pandemic preparedness is just public health’s version of Y2K?If so, you are not alone. After all, while sporadic human cases and bird-related outbreaks continue, the last worrisome cluster of human cases emerged more than a year ago. And the much-anticipated trigger that would launch many pandemic plans—sustained human-to-human transmission of the deadly H5N1 strain of influenza—has yet to occur. Maybe you are even questioning whether this current level of bird and human virus activity is the “new normal.” Perhaps you’re wondering if you can relax your preparedness efforts a bit.The answer is absolutely not. The risk of H5N1 causing a pandemic remains very real. Yet no one with a credible understanding of influenza virology can put odds on that risk. Given that quandary, what are responsible planners supposed to say and do? Let me see if I can offer help.Companies built to last take the long viewWe routinely plan for disasters that we can anticipate but for which we are unable to predict the exact time or place. Ten pandemics have been documented in the last 300 years, and we know more will happen in the future. So why has the much-watched H5N1 virus suddenly fallen off the radar screen?Ten years ago in May, H5N1 claimed its first human victim in Hong Kong. Public health authorities documented what they considered an apparent isolated case of human H5N1 infection. Later that year, an outbreak of H5N1 in domestic waterfowl sold in Hong Kong markets resulted in another human outbreak. By November 1997, 18 human cases of H5N1 infection, with six deaths, were documented. Sustained person-to-person transmission did not occur, and the outbreak stopped when all birds in the Hong Kong commercial poultry industry (about 1.4 million) were slaughtered.With a backdrop of international news coverage, some public health and animal health officials claimed that the prompt and unprecedented avian control efforts likely averted the next influenza pandemic. This event and such statements likely “set up” an expectation that H5N1 could cause the next pandemic. The public felt that if we didn’t control the threat at that moment, a pandemic would begin. Then everyone felt relief, which led to the sense that we could quash the threat.But H5N1 resurged in Asia in the fall of 2003 and spread in domestic poultry farms at an historically unprecedented rate. Human cases with bird contact followed. Obviously, the success claimed in eradicating the virus as a future pandemic risk was premature. The 2003 outbreak tapered off in spring 2004, but in summer it reemerged in several Asian countries (including Cambodia, China, Laos, Thailand, and Vietnam), where the virus continues to infect and kill people.But because sustained human-to-human transmission has yet to happen, we see much of the public and many preparedness officials confused about the risk. Unfortunately, many seem to believe that, like a severe weather warning that ends without incident, the risk of H5N1 causing another pandemic will pass with time. Companies built to last won’t be fooled by such short-sightedness.Why you should keep watching H5N1The H5N1 strains currently causing outbreaks across Asia and elsewhere are genetically distinct from the strain isolated from humans in Hong Kong in 1997. The virus continues to produce a virtual kaleidoscope of new strains. And that’s dangerous.Leading influenza experts who gathered in Toronto last week at the International Conference on Options for the Control of Influenza offered some sobering observations:Southeast Asia, the area from which the virus began spreading in late 2003, has seen multiple H5N1 bird outbreaks just in the past month, along with Vietnam’s first human death in 2 years, noted Dr. Watanee Kalpravidh of the United Nations’ Food and Agriculture Organization. “Freedom from infection has not been sustained in the region,” she said. “There has been a recurrence of cases in most of the affected countries, with some countries having continuing outbreaks. The virus may be endemic in some countries.”Dr. Ian Brown of the British government’s Veterinary Laboratory Agency noted that in Europe and the Russian Federation, “the reemergence of the virus in a number of countries does suggest we are moving toward endemicity,” even though some countries have deployed vaccinations against the disease.The apparent endemic threat means that every day this virus is replicating, and with each reproduction of itself, such viral activity leads to another chance for a critical pandemic-related genetic mutation.Remember H3N8I would also remind every pandemic preparedness planner never to forget our experience with the H3N8 influenza virus. What the heck is H3N8, you may ask?This strain of avian influenza virus emerged as an important cause of illness in horses in the early 1960s. No one understands from either a genetic or transmission standpoint why it jumped from birds to horses. Then, after more than 40 years of ongoing transmission in horses, this virus was suddenly able to infect dogs. Initially the infection only occurred in racing greyhounds, a breed of dogs that has close contact with race horses.Since 2004 when the first isolated cases of greyhound infections were documented, H3N8 has become widespread in pet dogs throughout the United States. No one can provide a clear explanation why this new disease problem has occurred except to say some unexplained changes along the bird-to-horse, horse-to-dog transmission road took place.Such a phenomenon very well could be a model of bird-to-human transmission of H5N1. A critical genetic change that results in a human pandemic strain might occur today, tomorrow, or even 10 years from now. Maybe it will never occur. But we can never rule out that one day an unexpected genetic change will take place in the widely circulating H5N1 virus that will suddenly change the potential for H5N1 to be transmitted by and between humans.The bottom line for businessAnother influenza pandemic will occur one day in the future—we just don’t know when. As one of my colleagues has said: “The pandemic clock is ticking; we just don’t know what time it is.” So, no, of course we don’t have a public health Y2K. How could we? We don’t have a clue when the next pandemic’s “Jan 1, 2000” will be. And I sure wouldn’t want to bet my family’s life on H5N1 not becoming the next pandemic strain—the unknowns are too many, while the knowns are abundant enough to raise alarms. When you find yourself challenged by myopic colleagues about the waning risk of an H5N1 pandemic, cite the H3N8 example.I don’t know if H5N1 will cause the next pandemic. It might. It might not. What I do know is that some strain of influenza will cause a pandemic. If you expect the unexpected—just as you would with any disaster—you and your company will be far better off.—Michael T. Osterholm, PhD, MPH, Director of the Center for Infectious Disease Research & Policy (CIDRAP), Editor-in-Chief of the CIDRAP Business Source, Professor in the School of Public Health, and Adjunct Professor in the Medical School, University of Minnesota.last_img read more

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Ex-IAAF boss, Diack faces four-year jail term

first_imgFrench prosecutors on Wednesday requested a four-year jail term and a fine of 500,000 euros ($562,000) for Lamine Diack, the former IAAF president standing trial for corruption, money laundering and breach of trust.Prosecutors said that Diack, an 87-year-old Senegalese who led track and field’s governing body for nearly 16 years, directly or indirectly solicited 3.45 million euros ($3.9 million) from athletes suspected by the IAAF of doping. The athletes allegedly paid to have their names cleared in order to continue competing.“The IAAF tripped on the hurdle of corruption,” prosecutor Arnaud de Laguiche said Wednesday on the hearing’s penultimate day. “(People like) Diack live like little emperors, they have their little courts and people court them.”The Paris court has considered allegations that top athletes paid millions of dollars in illicit payoffs to corrupt administrators led by Diack – once among the most influential leaders in Olympic sports.About two dozen Russian athletes were reportedly involved, with Russian marathon runner Liliya Shobukhova testifying that she paid 450,000 euros ($506,000).“The main issue here is: how could doped athletes take part in competitions? The first layer is institutionalized doping in Russia. The second layer of the (cake) is the slowing down of suspensions,” de Laguiche said. “The IAAF is the paradise of conflict of interests. … Diack tied the slowing down of suspensions of Russian athletes to his (election) interests in Senegal.”A lawyer representing the World Anti-Doping Agency, a civil party to the case, also took a swipe.“Between 2011 and 15, Mr. Diack chose money, dishonesty and corruption – that´s a reality,” Emmanuel Daoud said Wednesday. “Can Mr. Diack look in the mirror with pride?”The IAAF at the time under Diack’s guidance provided “a system of total protection (for Russian doping) … (whereby) the cheats are never punished,” Daoud added.Wearing a light blue robe on Wednesday, Diack sometimes looked forlorn as he sat slumped in a chair with his head bowed. But at other times he was sprightly, cheerful and smiling as he grabbed one person by the arm and led him away for a quick talk during a break in proceedings.Prosecutor Francois-Xavier Dulin expanded on Diack´s links with Russia, alluding to the apparent benefit gained by slowing suspensions.“In 2011 Lamine Diack went to Moscow, where he was received by Vladimir Putin,” Dulin said, later adding: “Diack built houses in Dakar for his IAAF employees.”Diack signed an agreement to pay his son Papa Massata Diack $1,200 per day and expenses for consultancy work, negotiating tens of millions of dollars in sponsorship deals for the IAAF.RelatedPosts Ex-IAAF boss bags two-year jail term We’ve perfected measures to stop money laundering, terrorism financing — Lottery DG Malabu Oil deal violated money laundering laws – Witness tells court The Diacks both deny corruption.Tags: CorruptionIAAFJAILLamine DiackMoney launderinglast_img read more

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USC attempts to bounce back against No. 8 UCSB

first_imgThe USC men’s volleyball team looks to recover from a tough loss against BYU as they host UCSB tonight at the Galen Center in an Mountain Pacific Sports Federation conference game. The Trojans (5-3, 4-3 MPSF) fell to the Cougars in five sets, 16-25, 25-22, 15-25, 25-20, 15-10. USC dropped to the fifth spot in the AVCA top 15 as the Gauchos (5-2, 4-2) climbed to No. 8 after sweeping a double-header against Hawai’i.Killing it · Outside hitter Lucas Yoder was named the Off The Block National Freshman of the Week on Feb. 3 for the third time this season. – Tucker McWhirter | Daily TrojanDespite the loss, freshman outside hitter Lucas Yoder had a match-high 23 kills for the Trojans. Yoder was named the Off The Block National Freshman of the Week for the third time in five weeks for his performance. Junior outside hitter Cristian Rivera had 12 kills of his own, along with three aces. Sophomore outside hitter Alex Slaught had 11 kills and freshman middle blocker Andy Benesh had six blocks.USC also outhit the Cougars .261 to .233, but could not stop BYU’s rally late in the game. After handily winning the first set thanks to hitting .600 and serving three aces, the Trojans fell behind early in the second set and never recovered. USC again jumped to an early lead in the third set and converted the lead to a win. The Trojans had an early lead in the fourth set, but lost the lead and eventually the set. The Cougars went on a 5-0 lead early in the final set and pulled away to win the match.“We need to limit the number of errors we make,” said USC head coach Bill Ferguson. “We make errors at bad times and it hurts us in the end and it kills our momentum.”The Gauchos are led on the offensive end by outside hitter Austin Kingi, who has amassed 84 kills in seven games. On the defensive side of the ball, setter Jonah Seif leads the team with 48 digs. The squad’s only losses this year have come at the hands of two of the country’s top teams, No. 1 UCLA and No. 9 UC Irvine.The Trojans average 14.2 kills per set while the Gauchos average only 11.71. What the Gauchos lack in offensive firepower, they make up for by minimizing errors. USC has 181 errors this year to UCSB’s 143.Tonight’s game against the Gauchos is the first of two home games this week for the Trojans, leading up to Sunday’s match against UCLA at 6 p.m.“We need to come together and play as a team and not as individuals,” Ferguson said. “If we do that, we’ll be in good shape.”The match begins tonight at 7 p.m. in the Galen Center.last_img read more

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FLOW Journey To Champs excites Hydel

first_imgHydel High School was presented with $200,000 towards the school’s sports programme, during FLOW’s Journey to Champs stop, at the Ferry-based institution on Monday.The second stop on the Flow Journey to Champs route was well received as the students enjoyed the show provided by the telecommunications and media company.Corey Bennett, Vice Principal and head coach of the track and field team, said they were thankful for the assistance from FLOW as they continue preparation for the ISSA/GraceKennedy Boys and Girls’ Athletics Championships, which will run from March 15-19 at the National Stadium.”We are very pleased; we would have been doing something special to attract support for three years. Any assistance we get is good. This is the third year that they (FLOW) are coming here and it was a good vibes,” Bennett told The Gleaner.Hydel High finished second behind champions Edwin Allen High in the girls’ section last year and they are hopeful of doing better by getting more points.”I thought we were quite prepared for Champs, but did not perform to expectations at Western Relays last Saturday. We still have some work to do in order to achieve our objective this year at Champs,” he disclosed.Stephen Miller, FLOW’s sponsorship manager, said this year’s ‘Journey’ that started at Jamaica College two weeks ago provided a big buzz.”It is good, Champs fever is in the air, the atmosphere is electric. The students and athletes are eagerly anticipating the big event. We are pleased to continue to contribute to the schools,” he added.The entertainment saw the students having a good time as popular deejay Chi Ching Ching gave a good performance.Champs title sponsors, GraceKennedy, were also on hand and provided products for the students.The next stop on the FLOW Journey to Champs route will be at Kingston College this Friday, starting at 1 p.m.last_img read more

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