Research confirms human to human transmission of avian flu
BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7485.211 (Published 27 January 2005) Cite this as: BMJ 2005;330:211All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Another spanish flu possibility should be accounted. That is the way
it starts. It is time to work very hard for an effective vaccine or
therapeutic intervention before the virus adapts to his new found host (distraught and humble men and women of this small world). This is a real
wake up call.
Competing interests:
None declared
Competing interests: No competing interests
Your article its very interesting, but I have one or two questions...
First is this kind of transmition a fact or is it only a probability?
And where can I find more information about flu transmission?
Thank you very much for your answers and congratulations for this article.
Sandra
Competing interests:
None declared
Competing interests: No competing interests
Further to Drazen Stojanovic's comments, it's worth noting that the
H5N1 highly pathogenic avian influenza (HPAI) strain of flu cannot as yet
be cultured in chicken eggs, due to its high pathogenicity to the embryos.
As such, there is no current ability to produce an H5N1 flu vaccine.
If any incentive were needed to develop improved influenza vaccine
production methods, this should be it.
Nick Bennett njb35@cantab.net
Competing interests:
None declared
Competing interests: No competing interests
In relation to the vast number of chicken farmers apparently exposed
in S.E.Asia, the proportion of severe & fatal cases seems relatively
small. Perhaps they mainly affect persons "constitutionally" (genetically)
susceptible to the virulent viruses.[1] Evidence is scanty but in one family
outbreak of H5N1 reported early in the current epidemic the Viet-Namese
man and his two sisters (sharing family genes) died; his genetically
different new wife who also helped prepare chickens for the feast
recovered from her illness, and wedding guests were unaffected.[2] I hope
investigations of incidents include genetic tests of involved humans as
well as of the viruses.
References
1 Grist NR. Bird Flu - Asian Invasion?? in Glasgow Natural History Society's Newsletter April-May 2004.
2 WHO Wkly Epid Record "Avian influenza A(H6N1) update 15 (2 Feb. 2004).
Competing interests:
None declared
Competing interests: No competing interests
More than 80 years ago the world faced a disaster that killed more
people than all wars before in human history. About 50 million deaths
during two Spanish-flu pandemic seasons occurred when international travel
took days for distances accessible in hours by modern travel by plane. I
believe that medical scientists are aware of the threat that fast travel
within incubation period of a disease is one of major threats to humans
nowadays.
None of terrorist attacks with conventional or nuclear weapons can
not cause so many deaths like spread of a disease with high mortality
rate. Sending letters with anthrax is a child game compared to
international travel of people infected with airborne deadly viral
infection. Let the numbers speak: death rate of the Spanish flu was far
less than 5/100; SARS outbreak two years ago had 8/100; avian flu in Viet
Nam since January 2004 had 77/100 (27/35 as mentioned in the article). A
quarter million tsunami victims is very low loss compared to potential
loss of maybe quarter of the entire human population from only one
disease. Governments must be aware that major threats are not only
«visible» enemies, but also «invisible» ones like natural disasters and
changes as well as emerging and new infections.
What we can do? For sure we know what we can not do: we can not cease
air travel; we can not close boundaries; we can not vaccinate against
unknown agent. Can we produce in substantial quantity effective antiviral
drugs and distribute the drug around the world? Maybe, but only one H5N1
effective antiviral agent oseltamivir is monopolised by just one big
pharmaceutical company. I can not even imagine how many people died in the
world from hunger, diarrhoea, malaria, tuberculosis and AIDS during typing
this letter! And that are all old, known and preventable diseases. Our
race spends more money to killing devices than to feed hungry people and
to prevent diseases preventable more easily than spread of avian flu. Can
we kill all birds? We can try, but some of them will survive and natural
balance will be impaired for sure.
I know that human race can build enough scientific facilities and
drug factories as well as can feed all humans in the world. Only
comprehensive action of the Organisation of United Nations can make
progress. With one big and few smaller epidemics of flu in 20th century
and facing deadly flu pandemic in 21st century, world leaders must act.
The treat is not a big flying saucer from some distant planet but small
«invisible» enemy. And every enemy uses our weaknesses.
Competing interests:
None declared
Competing interests: No competing interests
Scott Gottlieb's article highlights what is now an actual threat to
the world's population. The Tsunami in Asia illustrated one acute natural
trauma with thousands of deaths, that catastrophe pales into
insignificance when compared with an influenza pandemic. Hundreds of
millions will die if the world does not act to prevent this developing
pandemic. Development of vaccines against H5N1 needs Governmental pump-
priming as will the stockpiling of neuraminidase inhibitors which should
be effective against Avian Flu.
General Practitioners and other prescribing practitioners must learn
the practicalities of treating epidemic or pandemic influenza and be
prepared to prescribe appropriately in all cases of true influenza in
order to gain experience with the available drugs as well as encouraging
increased pharmaceutical company capacity.
It is many years since a pandemic struck.... we have become
complacent in that time. Burying governmental heads under the sand may
have some benefits in many political areas but will be disastrous in terms
of pandemic planning.
Competing interests:
None declared
Competing interests: No competing interests
Re: Avian 'flu - genetic susceptibility?
It would be interesting to know the genetic susceptability to avian
flu virus.Other point that should also be considered is the seroprevalance
survey among people of countries affected by H5N1 virus.
A report by Dr. Arnold Bosman and colleagues appeared in Eurosurveillance
weekly suggested that during Dutch 2003 outbreak of H7N7, atleast half of
those exposed to infected poultry had H7 antibodies.They also suggested
that H7N7 avian infection possibly occured in 1000-2000 people and
population at risk for avain influenza was not limited to those in direct
contact with infected poultry but rather person-to-person transmission may
have occured on a larger scale.
It may also be the case with H5N1 infection, there may be many infected
people who are either asymptomatic or have mild symtoms but may be
unknowingly transfering it to others.
The good news though is that two companies have developed prototype
vaccine for H5N1 and is in the clinical trial stage.
Competing interests:
None declared
Competing interests: No competing interests