Tuesday, May 23, 2006

Bird Flu : 1st Human to Human cases reported

There is now growing concern over several cases of the H5N1 flu in Indonesia (Sumatra)in which it appears that the virus may have adapted to human to human transmission (reported in Bloomberg.com) .
"In one case, a 10-year- old boy who caught the virus from his aunt may have passed it to his father, the first time officials have seen evidence of a three-person chain of infection, an agency spokeswoman said. Six of the seven people have died."
At this point no one knows if any mutations have occured.

"So far, studies of the Sumatran outbreak and genetic analyses of the virus don't indicate the virus has undergone major changes, Cheng said. Scientists at WHO-affiliated labs in the U.S. and Hong Kong found no evidence that the Indonesian strain of H5N1 has gained genes from pigs or humans that might change its power or spreading ability, WHO said."

"Almost all of the 218 cases of H5N1 infections confirmed by the WHO since late 2003 can be traced to direct contact with sick or dead birds. Strong evidence of human-to-human transmission may prompt the global health agency to convene a panel of experts and consider raising the pandemic alert level, said Maria Cheng, an agency spokeswoman.

``Considering the evidence and the size of the cluster, it's a possibility,'' Cheng said in a telephone interview. ``It depends on what we're dealing with in Indonesia. It's an evolving situation.''

"Health officials earlier found strong evidence of direct human-to-human spread of H5N1 in Thailand in 2004. Scientists reported in the Jan. 27, 2005, issue of the New England Journal of Medicine that the H5N1 virus probably spread from an 11-year- old girl in Thailand to her aunt and mother, killing the mother and daughter. People who had more casual contact with the girl didn't become infected.

In the Sumatran cluster, close, direct contact with a severely ill person was also needed for spread, Cheng said. Preliminary findings from the investigation indicate that the woman who died, considered to be the initial case, was coughing frequently while the three others spent the night in the same room. One of the three, a second brother, is the sole survivor. The other two, her sons, died."

``It looks like the same behavior pattern'' of close contact and caretaking during illness with the bird flu virus, Cheng said. To raise the level of pandemic alert ``i

t would have to be transmissible from more casual contact.''

Indonesia is the worlds 2nd largest country and like China, the worlds largest, there is an abundant bird population in close association with people. If this is the start of human to human transmission then look for cases to turn up in it's neighbors ( Australia and Asia). I would guess that those countries with more 3rd world medical facilities would show up first, since ICU protocols would isolate prolonged close human contact. Something that at least for now, seems necessary.

Saturday, May 20, 2006

Is Amahdinejad the next Hitler?

For those who are not keeping up with the news about this guy...here it is. This guy is certifiable. Amir Taheri has a good article about this.
He is the current Iranian President and a member of a sect of Islam called the "Twelver's" who believe that the hidden Imam will return after a worldwide catacylism......one that can be brought about by the actions of man. More here.
Now that the Iranian economy is headed for the dumper ( even with record high oil prices) he seems to be on the same track as Adolph Hitler. The Iranian Islamic Majlis (parliament) passed a law that will require religous minorities to wear strips of colored cloth just as the Germans did prior to World War II.

"The law mandates the government to make sure that all Iranians wear "standard Islamic garments" designed to remove ethnic and class distinctions reflected in clothing, and to eliminate "the influence of the infidel" on the way Iranians, especially the young, dress.

It also envisages separate dress codes for religious minorities, Christians, Jews and Zoroastrians, who will have to adopt distinct color schemes to make them identifiable in public. The new codes would enable Muslims to instantly recognize non-Muslims so that they can avoid shaking hands with them by mistake, and thus becoming najis" (unclean)."

I can't help but see the parallels with pre-Nazi Germany. The one difference I do see is that Amahdinejad primarily goes off against the west at the same time he ranks on the Jews. You can clearly see that he works the world oil markets by talking about nuking Israel and waiting for the price per barrel to go up. I'm not sure how you deal with a threat like this. There is a very young population in Iran that doesn't like the Mullahs and with the right amount of support they may be able to effect change like so many eastern European countries.

Barbaro- Disaster at the Preakness

For those that watched the Preakness this afternoon it brought back memories of Ruffian. Heres what we know now according to Dr Larry Bramlage. Barbaro suffered two fractures in the right hind fetlock and is most likely being transported to New Bolton Center, the equine hospital at The University of Pennsylvanian. New Bolton is one of the only Hospitals that can recover horses from surgery in a pool and decrease the risk of wrecking the surgical repair during recovery.Unfortuneatly, this is a very significant injury since the fetlock is now very unstable and will most likely have to be plated . Additionally, if the blood supply or nerves are stretched or damaged then the picture gets worse. It was a great thing Prado did such a masterful job of bringing Barbaro to a quick stop without doing any further damage. We will find out more in a few days if the information is released, if all goes well.....sooner than later.

Barbaro underwent surgery and at this point it is looking pretty good. It the repair holds and there are no complications such as compromised blood supply
it could turn out well. Here is a look at the radiograph after the repair. You can see a stainless steel bone plate bridging the fetlock joint and numerous bone fragments. This repair is called an arthrodesis where the fetlock joint is fused.
There is still alot of weight on the leg and he could still bend the plate or have some of the bone screws loosen.