The question seemed straight forward.
“In human medicine, most people would agree that a person gets sick with a cold or with the flu when their immune system is suppressed. Has anyone considered what is suppressing the immune system of the people and chickens in Vietnam, making them more susceptible to deadly effects of H5N1? Has anyone investigated what is suppressing the immune system of migratory birds?” The question was posed to Dr. Alex Thiermann, President of the OIE, the World Organization for Animal Health at the First Bird Flu Summit held in Washington, DC, February 27-28, 2006. His response, “No one is looking at this, in fact, no one has even thought about it” was echoed by the reporters and scientists during the ensuing coffee break.
An investigation into the immunosuppressive effects of environmental chemicals–with a particular focus on dioxin–may shed light into the seemingly scattered and disconnected outbreaks of bird flu around globe. The association between dioxin and influenza may even explain the increased number of deaths in China, Vietnam, and in particular, Indonesia.
Dioxin: The most toxic chemical on earth
Dioxin is a general term that describes a complex family of more than 400 chemicals. An unintentional waste product, dioxin is formed during industrial processes which combine chlorine with an organic substance, such as wood, pulp or paper, in the presence of heat. Production facilities that manufacture pesticides smelt copper and bleach paper all release of dioxins as by-products. Additionally, dioxin can enter the environment through the incineration of plastics, particularly those that burn municipal and medical waste.
A highly persistent chemical, dioxin can take more than 15 years to degrade to half its original concentration. If released into the local water supplies–for example, ponds and rivers–it can accumulate in fish. If not immediately absorbed by aquatic life, the remaining dioxin is rapidly deposited into the sediment. It will remain there, virtually forever, unless it moves up the food chain through grasses and frogs, becoming particularly toxic to humans and waterfowl.
Dioxin has been shown to disrupt the immune system at exposures as low as 1.0 ppt. This is the equivalent of a single drop of liquid placed in the center car a ten-kilometer (6.2 miles) long cargo train.(1) Because chemicals are usually a mixture of toxic and non-toxic compounds, a score for each chemical is developed called its Toxic Equivalency (TEQ). The TEQ of any chemical is established by comparing it to TCDD, the most toxic form dioxin in the world.
Dioxin combined with influenza viruses: Serious consequences
A definite link exists between dioxin exposure and the effect of influenza viruses on the immune system, a connection that has been studied using laboratory mice.
Research has clearly demonstrated that two types of white blood cells, Natural Killer (NK) and CD8+ cells, are exquisitely sensitive to extremely small concentrations of TCDD. Studies have shown that if mice are subjected to 100-1,000 ppt of TCDD prior to being exposed to common influenza A viruses, the number of mice that died was significantly higher than the number of control mice that were not pre-exposed to this dioxin.(2) In another study, when mice were subjected to a mere 10 ppt of TCDD one week before they were exposed to influenza A viruses, the mortality rate among the mice doubled. Researchers noted that this was the “smallest toxic dose of dioxin ever demonstrated” to inhibit the ability of the immune system to ward off the flu.(3)
In a third study, fluid extracted directly from the lungs of deceased mice demonstrated that the increased mortality seen in TCDD-exposed mice was due to the intense inflammatory action of dioxin. Death was not due to viral infection alone.(4) In other words, the combination of influenza viruses and dioxin caused so much inflammation in the lungs–due to a massive cytokine storm–that normal lung tissue was destroyed, leading to death of most of the mice.
Dioxin in Vietnam
The volume of herbicides sprayed during the U.S. conflict in Vietnam between 1961 and 1971 has been estimated that more than 19 million liters. The highest concentrations were deposited over the Mekong Delta in what is now southern Vietnam. The containers with dioxin were known as Agent Orange, identified by orange striped barrels. More than 30 years later, this persistent chemical remains in the soil and food of local residents, continuing to cause serious health problems.
Absent ongoing aerial spraying, dioxin’s primary route for entering the body is through food grown on toxic soils. Canadian researchers found that dioxin levels in soil samples throughout different regions of southern Vietnam to be as high as 898 ppt. The most extreme levels of contamination-in the area of Bien Hung Lake-were measured to be greater than 1.1 million ppt.(5)
In 2002, levels of dioxin were measured in 16 different food samples were collected from local markets around the Bien Hung Lake in southern Vietnam. The preliminary results were startling. Three of the specimens contained dioxin levels that were so extraordinarily high they were sent to a second, independent laboratory for additional analysis. The second lab confirmed the disturbing results. In the final report, chemical contaminants and large concentrations dioxin, up to 536 ppt, were detected in all 16 food samples. To put these elevated levels in perspective, the usual dioxin level found in food is less than 0.1 ppt.(6)
Dioxin, influenza and humans: a connection?
In May 2006, Indonesia reported a cluster of human bird flu cases that involved eight family members, seven of whom died. All but one person in the family appeared to have contracted the virus from another family member. This became the first reported incidence of H5N1 spreading from one person to another, and then another. Alarmed officials feared that the bird flu virus had acquired characteristics that would soon allow easy passage from human-to-human.
The members of the deceased family lived in a small village in Karo district located in the Indonesian province of North Sumatra. The Karo highland borders on Lake Toba, the world’s largest volcanic lake. The largest lake in Southeast Asia, Toba has been deteriorating since 1998, defenseless against Indorayon, a paper, pulp and rayon manufacturer owned by multinational companies and funded by the World Bank. Untill it was shut down, Indorayon was the largest polluter of Lake Toba in the past decade, dumping tons of chlorine and dioxin into the waters.
Interestingly, hundreds, perhaps thousands, of individuals with H5N1 influenza have not been sick enough to require medical care, as confirmed by Dick Thompson, spokesperson for the WHO in March, 2005.(7) However, between 2003 and April, 11, 2007, there have been 291 cases and 171 deaths, with 61% of the deaths in Vietnam and Indonesia. An investigation, perhaps including a fat biopsy, should be undertaken to determine if those who died had significantly higher concentrations of dioxin in their body than those who have been exposed to H5N1 and remained well or fully recovered.
What can be done?
A global pandemic is brewing, but not because a virus may “jump species” and rapidly circumnavigate the globe, wiping out everyone in its wake. It appears that only those most at risk will be affected. But critically important information is missing: What is each person’s individual level of risk? Beyond spending billions on global bureaucratic preparedness, true prevention is in order through developing tests and detoxification methods for humans.
Instead of funding the development a vaccine that as a marginal chance of being effective, billions of dollars would be better spent funding international environmental clean up programs. Legislative initiatives that put enforcement teeth into international treaties that are already on the books may be the best way of aborting disaster.
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(1) Quynh, Hoang Trong, MD, et al. “Long-term consequences of Vietnam War,” Nordic News Network, Report to the Environmental Conference on Cambodia, Laos and Vietnam.
(2) Burleson, G. R., et al. “Effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on influenza virus host resistance in mice,” Toxicological Sciences, 29 (1996): 40-47
(3) Burleson, G. R., et al. “Effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on influenza virus host resistance in mice,” Toxicological Sciences, 29 (1996): 40-47.
(4) Luebke, R. W, et al. “Mortality in dioxin-exposed mice infected with influenza: mitochondrial toxicity (Reye’s-like syndrome) versus enhanced inflammation as the mode of action,” Toxicological Sciences 69 (2002): 109-116.
(5) Schecter, A., Quynh, H. T., Pavuk, M., Papke, O., Malisch, R., Constable, J. D. “Food as a source of dioxin exposure in the residents of Bien Hoa City, Vietnam,” Journal of Occupational and Environmental Medicine 45 (2003): 781-788. PMID: 12915779.
(6) Schecter A., et al. “Food as a source of dioxin exposure in the residents of Bien Hoa City, Vietnam,” Journal of Occupational and Environmental Medicine 45 (2003): 781-788. PMID: 12915779.
(7) 23 Roos, Robert. “Relatives of avian flu patients have asymptomatic cases,” CIDRAP News, 9 March 2005.
The World Health Organization (WHO) makes reports and updates regarding new human cases of infection with bird flu. The only subtype that can cause severe illness to people is Influenza A /H5N1 virus, initially it affects chickens, ducks and other birds by the process of mutation they can become highly pathogenic. Because highly pathogenic viruses can survive for long periods in tissue, water and in the environment, especially when temperatures are low is transmitted very easily in chickens and other birds through direct contact with feces and secretions from infected birds, eggs, feed, water, cages equipment, vehicles and clothing. Public health authorities monitor human illnesses associated with avian influenza. In Hong-Kong occured for the first time infection both in humans and poultry and were killed about 1.5 million chickens.
In China and Hong-Kong avian influenza A (H9N2) virus infection affected two children who recovered. The source was unknown, but suspected the poultry.
In Virginia, 2002 an outbreak of H7N2 among poultry was descovered but,with no human victims. Canada, 2004: human infections among poultry workers with H7N3.
Thailand and Vietnam human infections with H5N1. Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, 2006: Human infections with H5N1 occurred as a result of contact with infected poultry and with infected death swangs. Cambodia, China, Indonesia, Thailand and Vietnam, 2005 two persons have been infected with H5N1 as result of consuming uncooked duck blood. China two cases of patogenic infections with avian influenza A (H5N1) have been confirmed in a family travelling through China. Netherlands, 2003 were reported outbreaks of influenza A (H7N7) in several farms, after which in pigs and people, 90 people were confrmed with bird flu virus H7N7 in association with cases of eye conjunctivitis, one death occured at a veterinarian with acute respiratory distress syndrome and other complications after having direct contact with infected poultry. In New York, 2003 there has been registered one case a patient with respiratory symptoms which recovered in few weeks and tests confirmed it had been avian influenza A (H7N2) virus. Signs and symptoms of bird flu in humans are similar to other influenza viruses: sore throat and cough, fever, muscle weakness and/or pain, eye infections, with life-threatening complications such as: severe viral pneumonia, respiratory distress syndrome, multi- organ failure.
U.S. Food and Drug Administration suggests the following antiviral agents supposed to prevent and treat avian influenza: amantadine, rimantadine, oseltamivir, and zanamivir. They may be not always effective it has been demonstrated that viruses are resistent to amantadine and rimantadine. In the United States they are not in use any more for the treatment or prevention (prophylaxis) of influenza A. Specialists are monitoring the resistence of avian influenza A viruses to influenza antiviral medications.
Sixty-eight thousand birds were recently culled in a Suffolk farm in England. This is part of the UK’s Department of Environment, Food, and Agriculture’s control measures on the most recent bird flu case in the area.
Among the culled birds were 56,000 ducks, 9,000 turkeys and 3,000 geese.
Earlier, DEFRA has culled 28,600 birds in the same area. But new information about other farms being exposed to the bird flu virus led to the latest culling. DEFRA confirmed that the farm involved is owned by the same company which operates Redgrave Park Farm, where the virus was first detected in early November.
Farmers and poultry keepers are enjoined to be vigilant in observing safety measures, and to immediately report any signs of bird flu.
From BBC News
Image Source
Bulletin on Bird Flu (Avian Influenza)
Bill Gates announced that he would add an additional $250 million to the $4 billion he has already given to tackle the world’s most deadly diseases. What are these deadly diseases and how might they affect you?
One that is on the rise and has infections disease experts concerned and fearing a worldwide pandemic with potentially disastrous results is the “bird flu.” Unlike an epidemic—which is localized and affects a defined geographic area—pandemics are worldwide epidemics and as such, are far more serious and difficult to contain, especially in today’s modern age, with literally millions of individuals traveling internationally each year.
What is the Bird Flu?
According to the Centers for Disease Control (CDC), “bird flu” is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. While wild birds usually do not get sick from them, it is very contagious among birds and can make some domesticated birds—including chickens, ducks, and turkeys—very sick and kill them.
History of similar flu strains
The bird flu is related to the Spanish flu, which broke out as a worldwide pandemic in 1918. While estimates of the death toll and number of individuals stricken vary, most experts estimate that more than 20 million Americans became sick and of these, about 500,000 died—about ten times more than were killed in battle during World War I. Experts place the worldwide death toll from the Spanish flu at between 30 and 50 million. Many people died within the first few days after infection, and others died later of other complications. Nearly half of those who died were young, healthy adults—something that is a-typical for most common virus strains today, which tend to affect the most vulnerable among us—the young, the old, and the infirmed.
Potential to infect humans
Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997. As of July 5, 2005, there have been 116 confirmed human cases of avian influenza A (H5N1) in Vietnam, Thailand, and Cambodia, resulting in 54 deaths, and at least two have died in the Netherlands. Most cases occurred among poultry workers and are believed to have been transmitted through human contact with infected poultry or contaminated surfaces. However, there is at least one documented human-to-human transmission, and there may be others.
Risks to humans today
The potential risk of a pandemic breaking out today could be significant for the following reasons:
Potential for mutation. Influenza viruses are constantly changing, and while person-to-person transmission of the bird flu is rare, experts fear that strains will adapt over time to infect and spread among humans.
No vaccines. There is no vaccine and while efforts are underway, developing one will be difficult and take many years, since this modern strain has been so rare among humans.
No immunity. There is little preexisting natural immunity to infection in the human population.
Mortality (death) rate. While the Spanish flu had an estimated 5% mortality rate, the early outbreaks of the bird flu had an estimated 70% mortality rate. However, according to recent information from officials, mortality rates have declined to about 30%. This should be good news but it is not, because if that trend continues, it is more likely that greater longevity of infected humans will make them more difficult to identify early on. This lack of early detection could result in more people contracting the bird flu as it silently spreads—thus increasing the chances it will become a global pandemic.
Symptoms of bird flu
Symptoms of bird flu in humans have ranged from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases and distress, and other serious and life-threatening complications. The symptoms of bird flu may depend on which strain of the virus caused the infection.
Medications for combating symptoms if you become infected
Several medications have been in common use for combating viral symptoms for a number of years, and while it is unknown just how effective they will be to help with bird flu, it seems appropriate to have something to do if it gets started in you or your family. As with all medications, be sure to read the package inserts for possible warnings regarding contraindications, drug interactions, and possible side effects prior to taking them.
Singular. This medication was developed years ago as an anti-cytokine agent for asthma, sinusitis, inflammatory lung disease or allergies. Cytokines are released when viruses enter cells to call for white blood cells and immunologic proteins to come to fight off the virus. Sometimes cytokines become present in excess and cause a “cytokine storm” that kills its victims within hours.
Tamiflu. This antiviral agent has been on the market for several years and has been singled out by the World Health Organization as the drug of choice against the bird flu, due to is proven effectiveness in treating those infected with H5N1, the strain most likely to be involved in the event of a worldwide outbreak. Tamiflu must be used as soon as possible (within1 – 3 days within the onset of symptoms) to be useful. All major governments are currently stockpiling it, to protect their employees in the case of a pandemic and allow them to continue to provide necessary services to their citizens.
Physicians and other prescribers should be aware that patients with severe influenza-like illness—especially those with chronic medical conditions or complicated manifestations of acute illness—might have significant bacterial infections instead of, or in addition to, viral illness and should be evaluated accordingly.
What to do if you decide to buy the prescriptions
We suggest the following as a reasonable approach, given all available information to date:
Don’t take the medications until the flu has spread to humans in your town.
Realize that Tamiflu may be on backorder at some pharmacies. In this case, put your name on the list at your local pharmacy and ask them to notify you when it comes in.
Store them both in the refrigerator or freezer. Doing so will make them last years after the expiration date. Be sure to remember where you put them, as you may not be able to remember if you are feeling sick. Also inform family members.
Suggested regimen
When the media alerts you to the presence of bird flu in your community consider beginning the regimen shown below:
Start taking Singulair once a day to ward off the first of the cytokine problems.
When you think you may have contracted the flu, increase the Singulair to twice a day and begin taking the Tamiflu twice a day.
Begin all the usual supportive measures you have found useful for the flu in the past, and be sure to stay well hydrated by drinking lots of liquid.
Call your physician to alert them and consider making an appointment for an evaluation to prevent unnecessary and potentially serious complications from secondary infections.
Current predictions
Experts believe that the bird flu pandemic will hit the human population and that it is only a matter of time. No one knows for sure, but most agree it will be in the next 50 years, and many expect that the outbreak will occur in next few months. An estimated 350 million or more people could die in the bird flu pandemic. For now, the medications noted above are not scheduled to go into increased production and thus severe shortages could result—with a large gap between those who need them and those who are able to get them.
If you would like to be prepared, get your prescriptions soon.
Dr. Joe
Other sources for information
About the bird flu and to obtain the latest CDC updates:
http://www.cdc.gov/flu/avian/
About Singular:
http://www.singulair.com/montelukast_sodium/singulair/consumer/index.jsp
About Tamiflu:
[http://www.fda.gov/cder/consumerinfo/druginfo/tamiflu.htm]
Avian bird flu, often referred to as Avian influenza, is an infectious disease found usually in birds which is caused by A strains of the influenza virus. This influenza virus occurs naturally in the intestines of wild birds and usually does not cause them sickness.
Avian influenza, or influenza A, is chiefly found in animals, but a virus infection of this type could occur in humans. Although cases of human infection have been on the rise since 1997, risk from this virus to humans is considered mild. In most cases, humans have caught this disease by coming in contact with contaminated surfaces like water bowls and cages, and with infected birds.
Cases of transmission of this virus from an infected human to another human have not been recorded officially. Some human influenza viruses are known to be subtypes of the avian bird flu influenza. Influenza A is continuously changing and it is possible that subtypes may adapt over time to infect and spread among humans.
Migratory waterfowl, most notably wild ducks, are the natural reservoir of avian influenza viruses, which is very contagious among them. When passed on to domestic birds like chicken, ducks and turkeys, the virus can make them very sick and even result in their death.
Infected birds transmit the influenza virus through their saliva, nasal secretion and feces. Domestic birds can contract the sickness when they come in contact with food containers, cage bars, water bowls, floors or with material such as feed and water that has become contaminated with this virus.
There is an extensive number of influenza viruses potentially circulating in bird populations, due to the fact that there are over a dozen subtypes of the influenza virus that infect birds. To date, all outbreaks of avian influenza have been caused by influenza A viruses of subtypes H5 and H7.
The sickness caused by this virus often take two stages. The first is a mild stage which often goes undetected. Symptoms for this stage are ruffled feathers and a drop in egg production. The second stage is where the internal organs of infected birds stop functioning and ultimately results in the death of the bird within 48 hours.
Humans who become infected with influenza A show symptoms similar to human influenza virus, and they may suffer from fever, muscle aches, sore throat, cough and eye infections.
In severe cases, they may have pneumonia and other life-threatening diseases. Death is a possible outcome of the infection.
What can we do to try to prevent a world-wide pandemic? While the efficacy of vaccines is no sure protection, many are trying to get their hands on these, since there is a chance that vaccines might help. The Australian government, not unlike many other governments, have stockpiled vaccines such as Tamiflu to prepare themselves for a possible outbreak of avian influenza, even though the exact virus that causes influenza A in humans has not yet been identified.
Another point to remember is that these viruses often become resistant to vaccines so by the time they are used, the particular influenza strain might not react to the present vaccines.
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