30. mai 2006

Austraalia vaatenurk

Austraaliast siis järgnev jutt
Indonesia's approach to bird flu concerns Abbott
The Federal Health Minister Tony Abbott says he is concerned about Indonesia's efforts to manage and control the spread of bird flu.

There have been several recent bird flu deaths in Indonesia.
After releasing a revised plan to handle an influenza pandemic, Mr Abbott revealed his concern about Indonesia's approach to bird flu. "There is still not effective surveillance of poultry stocks, there could be improvements in reporting," Mr Abbott said.

But Australia's chief health officer John Horvath is playing down the concern. He says if there was a pandemic outbreak, the nation's proximity to Indonesia would not make much difference. "Where it breaks out it would be a worldwide event within 24 hours," he said.

Continue reading "Austraalia vaatenurk" »

29. mai 2006

kellel on suurem õigus elule?

Who lives? Flu crisis may make us pick
Experts are divided on who gets the limited vaccine in case of a pandemic.
By LISA GREENE, Times Staff Writer
Published May 29, 2006

Imagine the worst: A deadly new strain of flu speeds across the globe, and as it approaches the United States, the reality is grim.

There isn't enough vaccine to prevent people from getting the virus. Not enough medicine, hospital beds or even ventilators to treat the sick.

Whom do you save?

What was once an abstract philosophical dilemma has become an urgent health policy question. The most immediate danger, Asia's killer bird flu, hasn't turned into a worldwide epidemic because it hasn't yet developed the ability to spread easily from person to person.

But public health officials must prepare for the threat of a disease that could spread with explosive speed. A global epidemic could kill nearly 2-million people and hospitalize nearly 10-million just in the United States. If a pandemic hits any time soon, scientists estimate that there may be only enough vaccine for about 10 percent of the population during the first year of the illness.

Continue reading "kellel on suurem õigus elule?" »

26. mai 2006

karmid valikud ja eetika

see oli üks huvitav artikkel :)

Pandemic planning puts ethics in spotlight
Amy L. Becker Staff Writer

May 25, 2006 (CIDRAP News) – When vaccine supplies are limited, should children, young adults, or seniors move to the front of the line for shots? Is it appropriate to remove one person from a ventilator to put somebody else on the machine?

Those are samples of the thorny ethical questions pandemic planning raises. People rely on ethical frameworks to answer them. Some experts are encouraging Americans to think aloud about rationing and other problems expected during a flu pandemic, to enhance public awareness and cooperation.

Having a public discussion about values is a crucial step in preparedness, said Arthur Caplan, PhD, Emmanuel and Robert Hart Professor of Bioethics, chairman of the Department of Medical Ethics, and director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.

Continue reading "karmid valikud ja eetika" »

25. mai 2006

finantsturud mäletavad sars-i

Pandemic fears as bird flu kills seven of this man's close family
By Mark Henderson, Lewis Smith and Leo Lewis

enamus juttu siis sumatra klastrist, sh pilt ainsast ellujäänust haiglavoodis, aga üks huvitav lõik finantsturgude kohta

Reports and rumours of the outbreak caused chaos in financial markets and prompted a bout of panic-selling of currencies and stocks.

In a volatile day of trading on the Tokyo exchanges, the currencies of Indonesia, Thailand, the Philippines and Singapore all sustained big losses as traders fled towards the perceived “safe haven” status of the US dollar.

“There is no way to look at this WHO inquiry and not be worried,” one Tokyo-based currency trader said. “These are markets that have lived through Sars and know very well the economic impact of potential pandemics. Even if the disease itself is contained, you get people cancelling important business trips, and tourism drops off a cliff.”

Indoneesia kontekstist

Poverty, forgotten diseases weigh heavily on Indonesia
Thu May 25, 2006 1:35 PM BST

By Tan Ee Lyn

JAKARTA (Reuters) - In a squatter settlement at the heart of central Jakarta, half a dozen Indonesian children play as a few scrawny chickens flit amongst them.

The H5N1 bird flu virus has killed 33 people in Indonesia -- and as many as seven in a single family in north Sumatra this month -- but Suhadi, 71, could not be less concerned.

"I have reared chickens for the last 40 years and never been sick. We have traditional medicine and herbs," said Suhadi, who brought up his 11 children selling drinks from his ramshackle hut. He also supplements his income selling eggs and chickens.

Continue reading "Indoneesia kontekstist" »

22. mai 2006

äärelinna kogukonna pandeemiaplaanid

jutt siis Ohio ajalehest
If bird flu strikes, neighborhood will be ready
Block party part of Clintonville effort to unite against crisis
Monday, May 22, 2006
Barbara Carmen

Clintonville’s newest neighborhood block watch is planning a big summer street party as a key part of its plan to fight bird flu.

Eight neighbors gathered Thursday at a corner cafe to sip coffee and start planning how they might unite to prepare for a deadly flu outbreak or any other disaster.

"Should it happen, the recommendation will be social distancing, do the elbow bump and stay 3 feet away — and that’s not practical always," said Betsy Hubbard, one of the meeting’s leaders.

The neighbors agreed they have a lot going for them. Their wide Clintonville front porches would allow them to both stay apart and stay connected.

They can buy the recommended three months’ worth of food stocks, which might pinch their wallets but isn’t impossible, as in some poor neighborhoods.

Continue reading "äärelinna kogukonna pandeemiaplaanid" »

WHO raport H5N1 viiruse levikust vee ja kanalisatsiooni kaudu

WHO: Review of latest available evidence on risks to human health through potential transmission of avian influenza
(H5N1) through water and sewage
Last updated 24/03/2006

kommentaar IFlu'st allpool

Open water such as reservoirs, lakes or rivers which have been contaminated by infected migratory birds might be able to spread the H5N1 bird flu virus to humans who drink or swim in the water, but there is insufficient data to be sure concludes a recent World Health Organization report.

Continue reading "WHO raport H5N1 viiruse levikust vee ja kanalisatsiooni kaudu" »

21. mai 2006

WHO: ravisoovitused ja riskigrupid

WHO Rapid Advice Guidelines on pharmacological management of humans infected with avian influenza A (H5N1) virus
May 2006


Human cases of avian influenza A(H5N1) infection have remained rare and sporadic, but the disease is very severe and the case fatality is high. With the H5N1 virus now confirmed in birds in more than 50 countries, additional sporadic human cases should be anticipated. Using innovative guideline development methods based on the best available evidence, the WHO assembled an international panel of experts in March 2006 to develop rapid advice for the pharmacological management of patients with H5N1 infection. The recommendations are classified as strong or weak and cover several specific patient and exposure groups for the treatment and chemoprophylaxis of H5N1 virus infection. All recommendations are specific to the current pre-pandemic situation and are based on careful consideration of the current evidence about benefits, harms, burdens and cost of interventions. As there are currently no clinical trials in patients with avian influenza H5N1 disease, the overall quality of evidence on which to base judgments is very low.

Recommendations for treatment of patients with confirmed or strongly suspected human infection with the H5N1 virus

Continue reading "WHO: ravisoovitused ja riskigrupid" »

19. mai 2006

soovitused religioossetele ühendustele


Prepare the Host in advance with priests blessing both water/wine. Hand out wafers prior to local cases.

Hold all services outdoors, in sunlight, with several feet between church members. This will necessitate a mic set up in advance. It will also mean church-goers will have to bring their own chairs from home.

Pass on the coffee hour, and hand-shaking.

Set up a phone tree based on how close families are to one another. If one family does not answer the phone a close neighbor can check up on them. This should be done from a safe distance in case someone is sick.

A pantry needs to be set up immediately. Ask only for items that can be stored. Urge all members to have at least a three month food supply on hand. Give guidance as to what should be stored. Remember that many will have to use only the cheapest of foods in order to comply.

Have the womans auxiliary start a program teaching basic cooking skills, and using stored foods. Contact your local Mormon church for help with the fundamentals.

All members should have a basic course in first aid and a minimum knowledge in how to care for the sick.

If your denomination requires last rights, then either the priest needs to have several sets of personal protective clothing. Also lots of masks and gloves. Or, a formal service which does not require the priest to be physically present.

The most important ways a church or faith-based group can be of immense value is to help members know they will not be going alone through this valley of death. Teamwork, vigilance, compassion, and guidance prior to the outbreak, will go a long way in alleviating suffering and death.

18. mai 2006

linnugripifilm torrentis

et siis seesamune ABC telefilm nüüd torrentboxis üleval
mitte et ma piraatlust propageeriks :D
aga selle vaatamiseks paraku muid variante ei ole

sikutasin alla, vaatasin läbi - suht kõhe oli jah, eriti arvestades ametlikke kommentaare et "eks see umbes nii võib välja näha jah" (vt allpool kuskil on kommentaarid toodud)
reaalsed õudukad on alati kõhedamad kui täielikult ebareaalsed

11. mai 2006

USA valitsuse ametlik juhend kodanikele

Pandemic Influenza Planning: A Guide for Individuals and Families
Get Informed. Be Prepared.

U.S. Department of Health and Human Services May 2006

U.S. Department of Health and Human Services
May 2006

"While the Federal Government will use all resources at its disposal to prepare for and respond to an influenza pandemic, it cannot do the job alone. This effort requires the full participation of and coordination by all levels of government and all segments of society... perhaps most important, addressing the challenge will require active participation by individual citizens in each community across our Nation."

George W. Bush, President
United States of America

"Pandemics are global in nature, but their impact is local. When the next pandemic strikes, as it surely will, it is likely to touch the lives of every individual, family, and community. Our task is to make sure that when this happens, we will be a Nation prepared."

Michael O. Leavitt, Secretary
U.S. Department of Health and Human Services

Pandemic Influenza - Get Informed. Be Prepared.
This guide is designed to help you understand the threat of a pandemic influenza outbreak in our country and your community. It describes commonsense actions you can take now in preparing for a pandemic. We cannot predict how severe the next pandemic will be or when it will occur, but being prepared may help lower the impact of an influenza pandemic on you and your family. Additional information including a planning checklist for individuals and families can be found at

Continue reading "USA valitsuse ametlik juhend kodanikele" »

USA pandeemiategevuskava

National Strategy for pandemic influenza implementation plan
233 lk pdf

28. aprill 2006

Nature artikkel pandeemia-piiramise võimalustest

Strategies for mitigating an influenza pandemic
Neil M. Ferguson1, Derek A. T. Cummings2, Christophe Fraser1, James C. Cajka3, Philip C. Cooley3
& Donald S. Burke2

Development of strategies for mitigating the severity of a new influenza pandemic is now a top global public health priority.

Influenza prevention and containment strategies can be considered under the broad categories of antiviral, vaccine and nonpharmaceutical (case isolation, household quarantine, school or workplace closure, restrictions on travel) measures. Mathematical models are powerful tools for exploring this complex landscape of intervention strategies and quantifying the potential costs and benefits of different options. Here we use a large-scale epidemic
simulation6 to examine intervention options should initial containment of a novel influenza outbreak fail, using Great Britain and the United States as examples.

We find that border restrictions and/or internal travel restrictions are unlikely to delay spread by more than 2–3 weeks unless more than 99% effective.

School closure during the peak of a pandemic can reduce peak attack rates by up to 40%, but has little impact on overall attack rates, whereas case isolation or household quarantine could have a significant impact, if feasible.

Treatment of clinical cases can reduce transmission, but only if antivirals are given within a day of symptoms starting. Given enough drugs for 50% of the population, household-based prophylaxis coupled with reactive
school closure could reduce clinical attack rates by 40–50%.
More widespread prophylaxis would be even more logistically challenging but might reduce attack rates by over 75%.

Vaccine stockpiled in advance of a pandemic could significantly reduce attack rates even if of low efficacy.
vt ka graafikuid artiklist endast (pdf)
Estimates of policy effectiveness will change if the characteristics of a future pandemic strain differ
substantially from those seen in past pandemics.

UK: haiguse levikuks piisab mustadest jalanõudest

A 'dirty boot' was enough to breach bird flu defences
By Valerie Elliott, Countryside Editor

INFECTED faeces from a wild bird carried into a chicken shed on a workman’s boot are thought to be the most likely source of a bird flu outbreak on a farm in Norfolk.

Continue reading "UK: haiguse levikuks piisab mustadest jalanõudest" »

26. aprill 2006

Euroopa riikide pandeemiaplaanide analüüs

ahhaa, üles leidsin :))

How prepared is Europe for Pandemic Influenza?
An Analysis of National Plans

koostajaks siis London School of Hygiene and Tropical Medicine

kahjuks ei ole iga konkreetse riigi kohta eraldi kokkuvõtet tehtud :S
igas valdkonnas on riigid jagatud kolme gruppi, ma eesti kohta püüan mingi kokkuvõtte teha :p

ühe valdkonna tooks esile:

* Completeness of essential services planning in country preparedness plans.
Eesti kuulus sellesse gruppi, kel plaan PUUDUS
, koos 6 teise maaga (Austria, Leedu, Poola, Rumeenia, Hispaania, Shveits)
ehk - siseministeeriumi tegemata töö

Essential services
* National contingency plans should be developed and clearly incorporated into plans
* The roles and responsibilities of different government departments should be made obvious

A substantial number of plans (7) do not address the need to prepare for the maintenance of essential services during a pandemic. Only 8 plans note that a contingency plan has been developed for the maintenance of essential services. This lack of clarity may reflect the leading role that the Ministry of Health takes in the process of planning for a pandemic in many countries.

In countries that mention the existence of a contingency plan, the Ministry of Interior or local authorities are generally documented partners in the planning process. In 2 cases, the pandemic response is actually led by the Ministry of Interior or the Emergency Services (France, the Netherlands). A basic (though often incomplete) list of essential personnel is described in 11 of the plans and in 7, replacement personnel are identified to supplement essential workers. These include military and NGO personnel who will support or replace regular personnel in providing essential services or support for confined persons.

Continue reading "Euroopa riikide pandeemiaplaanide analüüs" »

New Orleansi kogemused

väga huvitav lugemine inimpsühholoogia valdkonnast ..
kuidas käituvad inimesed kriisiolukorras :)
rohutirtsud vs sipelgad :D

Thoughts On Disaster Survival

Continue reading "New Orleansi kogemused" »


väga hea vaatenurk muide :)
ja kindlustustegelasi tasub riskide osas kuulata küll

Think the worst - then prepare for it
(Filed: 17/04/2006)

The chief of the world's largest insurance broker tells Andrew Cave about his fears of an infodemic

The world feels increasingly risky to Michael Cherkasky. The chief executive of the world's largest insurance broker, Marsh & McLennan, is convinced that it will be afflicted by a global pandemic within the next decade.

"I have been told by a series of virologists at some of the world's great institutions that a pandemic is something that's likely to occur, just because of the nature of our transportation and communications," he declares. "That's what we have to make sure we prepare for."

Continue reading "info(pan)deemia" »

dieetõe soovitused 2 ndl toiduvarudeks

tähendab, muidu, nojah, aga mind häiris lõpus olnud väide et "see toit jääb söömata"
miks siis? osta tuleb sääraseid asju, mida niikuinii tarbid - ja neid siis regulaarselt ära süüa/uuematega asendada ..
või kasutada võimalust heategevuseks - iga 3a tagant konservid koerte varjupaigale annetada ja uued osta :D
ära ei pea nüüd küll midagi viskama, see on otsene rumalus :(

Government Recommends Shopping For Bird Flu
4/25/2006 8:03:23 AM

The U.S. government says we all should be well prepared personally in the event of a bird flu outbreak among humans. In fact, it says to have at least a two week stockpile in our homes of food and water.

But what does that mean?

Continue reading "dieetõe soovitused 2 ndl toiduvarudeks" »

20. aprill 2006

EL riikide pandeemiaplaanide analüüs

hahaaa, see on küll hea lugu :)
kannatamatusega ootan raporti avaldamist ja luban eesti osa ära tõlkida :DDD

"ühel EL liikmesriigil oli antiviraalide tagavara nii pisike nagu 2%" .. see saab ainult eesti olla :D
kuigi 3000 karpi on 0,2%, mitte 2% :DDD

Wall Street Journal: Study Finds Europe Bird-Flu Defenses Vary Widely
April 13, 2006

A study slated to be published in a prominent medical journal has found wide variations in the plans European countries have drawn up for a possible bird-flu pandemic among humans, raising politically sensitive questions for some governments.

Continue reading "EL riikide pandeemiaplaanide analüüs" »

18. aprill 2006

linnugripifilm :D

haha, ameeriklased :))


April 18, 2006 -- ABC announced its May Sweeps' bird-flu movie yesterday - which came as a complete surprise in a business nearly devoid of surprises. But that's just what the producers of "Fatal Contact: Bird Flu in America" intended. "We did that because of its topicality," co-producer Diana Kerew said.

"The world changes very quickly, and we wanted to make sure at the point we were ready to unveil [the movie] that we were accurate and up-to-date."

"Fatal Contact," airing May 9, stars Stacy Keach, Joely Richardson, Ann Cusack and Justine Machado in a tale of a worst-case scenario, if the bird-flu virus was transmitted to humans in America.

Continue reading "linnugripifilm :D" »

Cidrap ülevaade arengutest

Avian flu outbreaks wax, wane

Apr 17, 2006 (CIDRAP News) – Poultry deaths due to the H5N1 avian influenza virus are spreading in some parts of the world as cases decline elsewhere.

Continue reading "Cidrap ülevaade arengutest" »

10. aprill 2006

Maaleht: Eesti kodulinnukaart

Maaleht: Eesti kodulinnukaart 06.04.2006 Heino Laiapea

Veterinaar- ja toiduameti andmetel on Eestis üle 2,5 miljoni linnu, kelle eest inimesed hoolitsevad ja neid omaks peavad.


7. aprill 2006

Barry: 1918a õppetunnid

Kanada CBC telejaama intervjuu John Barry'ga, intervjuu tehtud 2005a lõpus ja oli eetris 11.01.06

esimest osa ei hakanud siia panema, üldine jutt viirustest kui säärastest
järgnev osa siis 1918a ja praegu ..

väga asjalik jutt igatahes :)

Continue reading "Barry: 1918a õppetunnid" »

31. märts 2006

pandeemia korral iga Euroopa riik enda eest väljas

jahah, kas tõesti keegi arvas vastupidist ka või :D
kui on ikka tõsine jama, siis kaotavad igasugused lepingud jõu ja enda eest hoolitsetakse esmajoones
tegelikult võiks selle originaalraporti välja kaevata ju .. siin too ongi :) link
Every man for himself’ in Europe’s bird flu simulation
By Andrew Jack in London
Published: March 31 2006 19:22 | Last updated: March 31 2006 19:22

Plans by Switzerland to seal itself off in the event of a flu pandemic triggered “serious concern” by other countries during Common Ground, a recent simulation exercise, because of its strategic location as home to many drug and vaccine manufacturers.

Continue reading "pandeemia korral iga Euroopa riik enda eest väljas" »

matusekorraldus pandeemia ajal

'Mass grave' a possibility for victims if flu pandemic strikes civic workers
Mar 31 2006

VICTIMS of a flu pandemic in Croydon could be buried in a mass grave if the illness hits council workers.

A report into how the town would deal with a flu pandemic on the scale of the one that struck after the First World War has put the number of potential fatalities at 8,000 - with a quarter of the town's 330,000 population becoming infected.

Continue reading "matusekorraldus pandeemia ajal" »

USA pandeemiaplaani analüüs

TFAH Evaluation of HHS Pandemic Planning
analüüsitud siis USA pandeemiaplaani ja selle täitmist kümnes valdkonnas
1. Leadership; 2. Disease surveillance; 3. Vaccine production capacity and supplies; 4. Antiviral supplies;
5. Medical supplies and equipment; 6. Surge capacity and working with states and localities; 7. Quarantines and other public health measures; 8. Communications; 9. Working with businesses and other sectors; 10. Funding and resources

kriitika on päris karm
aga kui keegi vaevuks tegema sarnase analüüsi Eesti pandeemiaplaanile ja selle täitmisele, siis oleks tulemused ilmselt väga haledad :(

Continue reading "USA pandeemiaplaani analüüs" »

30. märts 2006

EL pandeemiasimulatsioonist

et siis seesama, mis sügisel toimus

Simulation shows Europe prepared for flu
Thu Mar 30, 2006 4:29 PM GMT
By Jeremy Smith

BRUSSELS (Reuters) - A European exercise to simulate an influenza pandemic showed the countries involved were reasonably prepared but exposed flaws in the system used to report national health crises, officials said on Thursday.

Continue reading "EL pandeemiasimulatsioonist" »

Eesti vs Soome: valikud ja tegevused oma inimeste kaitseks

võrdluseks eelnevale jutule siis Soome valikud ja tegevused oma kodanike kaitseks

1) tegi lepingu 20.12.05 täpse vaktsiini ostmiseks hollandi firmaga Solvay Pharmaceuticals, kes kohustub toimetama Soome 5,5 miljonit annust vaktsiini
Soome on järjekorras neljas, ja maksab ainuüksi järjekorrakoha eest(!) 550 000 eurot aastas, vaktsiini eest siis makstakse veel eraldi

2) 23.03.06 sõlmis lepingu esialgse prototüüp-vaktsiini ostmiseks, 5,2 miljonit doosi, maksumusega 21 miljonit eurot.

3) Tamiflud on ostetud 1,2 miljonit karpi

riigi hinnang pandeemiaohule: suur risk

Ministeeriumide ja maakondade riskianalüüsi kokkuvõte 2005Viimati uuendatud: 20. märts 2006

Järgnevalt nimetatud hädaolukordade toimumise tõenäosust tuleb hinnata suureks, st üks kord 1-10 a jooksul ning tagajärgi rasketeks või väga rasketeks, mis on tingitud ennekõike tagajärgedest inimeste elule ja tervisele otseselt või läbi keskkonna ja/või elutähtsa valdkonna toimimise.
* loomataud (linnugripp, suu- ja sõrataud);
* epideemia, pandeemia (gripipandeemia);
* ulatuslik reostus merel, rannikul;
* loodusõnnetusega seotud hädaolukord (torm, üleujutus);
* suure tulekahju/plahvatusega seotud hädaolukord (metsatulekahju);
* transpordiõnnetusega seotud hädaolukord (paljude kannatanutega lennuõnnetus, paljude kannatanutega õnnetus raudteel);
* ulatuslik elektrikatkestus;
* massiline mürgistus.

Continue reading "riigi hinnang pandeemiaohule: suur risk" »

Toronto: SARS'i õppetunnid

hea lugu Toronto kogemustest SARSi ajast ..
kuidas see vanasõna oligi, et tark õpib teiste vigadest ja loll enda omadest ..
et kasutaks juhust ja õpiks nende vigadest? :p

FEATURE-SARS prepares Toronto for bird flu
29 Mar 2006 13:01:05 GMT
Source: Reuters
By Jonathan Spicer

TORONTO, March 29 (Reuters) - Toronto's deadly brush with the SARS virus three years ago has uniquely prepared the city for the possibility of a bird flu pandemic, health officials say.

Continue reading "Toronto: SARS'i õppetunnid" »

26. märts 2006

riigijuhtide ränk vastutus tegematajätmiste eest

The Pandemic Prophecy
He doesn’t know when it’s coming, or how bad it will be. But Dr. Michael Osterholm, one of the world’s foremost infectious disease experts, believes a flu pandemic is inevitable. And to hear him tell it, we’re nowhere near ready.
By Tim Gihring
Published April 2006

pikk hästikirjutatud artikkel Osterholmist, aga eriti rõhutaks üht lõiku poliitikute isiklikust vastutusest

Last November, Osterholm spoke at a pandemic flu preparedness seminar sponsored by the Minnesota Chamber of Commerce and aimed at local businesses. Osterholm was asked his opinion of the federal government’s commitment to preparedness. He mulled the question so long it seemed he might not answer. Finally, he did. “I don’t give a damn about not being liked anymore—this is too important an issue,” he said. And then he laid into politicians who’ve paid lip service to pandemic preparedness but done nothing. “I’m afraid we’re going to have a commission like [the one convened after] 9/11,” he said. In other words, a sweeping, klieg-lighted investigation into everything that went wrong during the Great Influenza Pandemic of 200–. “And this time,” he says, “we’re all going to be held accountable.”
veel üks hea tsitaat:
When discussing pandemic flu, Osterholm frequently quotes Ben Franklin’s observation, “If we don’t hang together, we’ll all hang separately.
paar lõiku veel:

Continue reading "riigijuhtide ränk vastutus tegematajätmiste eest" »

miks epideemia on juhtidele väga raske aeg?

Why to bioattacks present special challenges and high-stakes decisions for leaders?

A deliberate epidemic poses compounded, unfamiliar dangers in today's setting. Most elected U.S. officials, health authorities, and the public have no direct experience with large outbreaks, nor do they know the best ways to control them. Even less familiar is the premeditated use of disease as a weapon.

Epidemics are complicated events due to their biology, but also because they provoke fear, contradictory impulses, and competing social aims:
* An epidemic's outcomes -- suffering, death, lost livelihood and commerce -- are troubling to consider. Leaders and the public may deny that a problem exists, or intervene too quickly without regard to the negative effects of their actions.

Continue reading "miks epideemia on juhtidele väga raske aeg?" »

juhtimisest ja usaldusest kriisiolukorras

täiesti võrreldav situatsioon pandeemiaga ju :D
How to Lead during Bioattacks with the Public's Trust and Help

What situations splinter the social trust necessary to cope with health crises, and how might they be defused? Breaches of social trust are a common predicament for leaders during outbreaks and are likely to arise during a bioattack. Social and economic fault lines as well as preconceived notions about "the government," "the public," and "the media" can alienate leaders and the public, and community members from one another.

Continue reading "juhtimisest ja usaldusest kriisiolukorras" »

25. märts 2006

Nabarro: enamus peaks valmistuma peitupugemiseks

United States Helping Lead War on Bird Flu, says U.N. Envoy
24 March 2006

International officials are issuing warnings about preparedness because the avian influenza epidemic among animals could evolve into a human influenza pandemic. With an eye toward that potential crisis, Nabarro also discussed the need for governments to develop contingency plans for maintaining continuity of government as well as the rule of law. "In the event of a pandemic, public services are going to be stretched to their limits and certain regions in the world will be vulnerable to a breakdown in law and order," he said. (See related article.) According to Nabarro, avian influenza has spread to 20 countries during the last six weeks alone and has recently moved into the Gaza Strip as well as settlements in the West Bank. "We are very vulnerable," he warned. "Most of us, I think, feel that it's best to be preparing to hunker down."

Continue reading "Nabarro: enamus peaks valmistuma peitupugemiseks" »

24. märts 2006

lindude gripi laialdase leviku korral kuulutatakse Eestis välja eriolukord

Avalikkuse teavitamine lindude gripi leviku korral Eestis
sellise ppt leidsin siis - tuleb meeles pidada, et jutt käib ainult lindudest

Eesmärk: Kommunikatsiooni korraldamine, avalikkuse/elanikkonna teavitamine (olukorra pidev jälgimine, koostöö teiste asutustega)
Prioriteet – isikute elu ja tervise kaitse, läbi taudi laialdase leviku tõkestamise ning vajaliku informatsiooni jagamise

Continue reading "lindude gripi laialdase leviku korral kuulutatakse Eestis välja eriolukord" »

23. märts 2006

haiglad: ideaalsed vahendid vs hädapärast piisavad

Experts struggle with issue of what medical masks to stockpile for a pandemic
Helen Branswell, Canadian Press
March 21, 2006

ATLANTA (CP) - The issue of medical masks - who should use them, and what types should be stockpiled - is one of the vexing and potentially explosive questions facing public health experts working to prepare for a possible flu pandemic.

paar lõiku pikemast artiklist:

Continue reading "haiglad: ideaalsed vahendid vs hädapärast piisavad" »

22. märts 2006

eesti riskantsemad piirkonnad

vt ka kaarti, mis artikli juures on

Postimees: Gripihirm pöördub linnukasvatuste vastu
22.03.2006 00:01
Andrus Karnau, reporter

Ornitoloogid leiavad, et surmavat linnugrippi levitab pigem kodulindude ja nende kasvatamise eri saaduste transport üle riigipiiride kui vabas looduses elavate lindude ränne.

Continue reading "eesti riskantsemad piirkonnad" »

20. märts 2006

eesti ravimivarudest

Meditsiiniuudised: Linnugripi ja pandeemia puhuks tuleb olla valmis

Viimase poole aasta jooksul on sotsiaalministeerium kaks korda täiendanud linnugripiks ja pandeemiliseks gripiks valmisoleku kava, õnneks pole linnugripp seni Eestisse jõudnud.

Continue reading "eesti ravimivarudest" »

19. märts 2006

1918 vs 2006

FluWIki koostas väga laheda sisukorra oma foorumi teemadest :)

ja sealt leidsin ühe teema, mida polnud juhtunud lugema ja mis oli tõsiselt huvitav:
1918 Shortages
võrdlus 1918a ja praeguse aja vahel, väga .. õõnes lugemine oli :S

paar lõiku allapoole ka

Continue reading "1918 vs 2006" »

17. märts 2006

linnugripivõitluse rahastamine USA vs Eesti

Eesti eraldas raha - 6 miljonit krooni
USA - 3,3 miljardit dollarit, sellest üle poole vaktsiinide väljatöötamisele

Eestis on 0,43% elanikke USAga võrreldes
võtame 0,43% USA eraldatud rahast, arvame maha vaktsiinide väljatöötamise osa (milleks eesti niikuinii võimeline ei ole) - saame võrreldavaks rahasummaks 86 miljonit krooni, mitte 6 miljonit ..

Continue reading "linnugripivõitluse rahastamine USA vs Eesti" »

sõltumatud communityd

suurepärane artikkel!

Spectrum - Wednesday, March 15, 2006
Guest Opinion: The urgent need to 'build resilient communities'
by Peter Carpenter

Our current disaster-preparedness system is built on the basis of mutual aid. When one community has an extraordinary event then mutual aid is the perfect solution because it allows nearby communities to contribute resources.

But when there is an areawide, nationwide or worldwide disaster (a "Pandisaster" like human transmissible avian flu or a 7+ earthquake) mutual aid will no longer be a viable solution — there will be no available resources from neighboring communities. We must therefore develop truly Resilient Communities — communities that have planned, prepared and tested the capacity to help themselves in the event of a Pandisaster. Designing and implementing a Resilient Community will not be easy. It will require 'civilianizing' our current disaster-preparedness-and-response model — our current emergency responders must become teachers rather than doers. We must build resilience into each neighborhood and every family.

Continue reading "sõltumatud communityd" »

sõltumatud communityd

suurepärane artikkel!

Spectrum - Wednesday, March 15, 2006
Guest Opinion: The urgent need to 'build resilient communities'
by Peter Carpenter

Our current disaster-preparedness system is built on the basis of mutual aid. When one community has an extraordinary event then mutual aid is the perfect solution because it allows nearby communities to contribute resources.

But when there is an areawide, nationwide or worldwide disaster (a "Pandisaster" like human transmissible avian flu or a 7+ earthquake) mutual aid will no longer be a viable solution — there will be no available resources from neighboring communities. We must therefore develop truly Resilient Communities — communities that have planned, prepared and tested the capacity to help themselves in the event of a Pandisaster. Designing and implementing a Resilient Community will not be easy. It will require 'civilianizing' our current disaster-preparedness-and-response model — our current emergency responders must become teachers rather than doers. We must build resilience into each neighborhood and every family.

Continue reading "sõltumatud communityd" »

USA armee ellujäämiskäsiraamat

U.S. Army Survival Manual FM 21-76
vt eeskätt psühholoogia-osa

15. märts 2006

mida peab tegema?

How to prepare if bird flu comes
Posted March 15 2006

State and federal health officials have compiled a list of precautions residents can take to prepare in ways that mirror hurricane preparations.

>Buy extra canned goods each time you shop, along with other nonperishable foods such as dried beans, rice, peanut butter, crackers, canned juices, granola bars, powdered milk and bottled water. Widespread flu infections could require grocery stores to close or to limit deliveries if employees are too sick to work. Such stocks can also be used in other types of emergencies.

>Have nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins. If you have young children, stock up on baby food and diapers.

>Stock up on batteries and candles, and be prepared for rolling brownouts or blackouts, and the possibility of no phone service.
SourceS: U.S. Department of Health and Human Services, Florida Department of Health

14. märts 2006

eesti tamifluvarudest

Rahvaliidu fraktsioon soovitab sotsiaalministeeriumil paremini teavitada avalikkust linnugripiga toimetuleku abinõudest

Riigikogu Rahvaliidu fraktsioon kohtus sotsiaalministeeriumi asekantsleri Ivi Normetiga, et saada täpne ülevaade Eesti valmisolekust võimalikuks linnugripi levikuks inimeste seas ning viia end kurssi nende meetmetega, mida ministeerium on rakendanud seoses Eestitki ohustava võimaliku haigusega.

Continue reading "eesti tamifluvarudest" »

13. märts 2006


eile oli siis hispaania gripi alguse 88.aastapäev :D
Tõnis Erilaid kirjutab SL Õhtulehes
1918: Ameerika Ühendriikides pääses valla kogu maailma laastanud linnugripp ehk Hispaania tõbi

11.märts 1918 algas USA sõjaväebaasis Kansase osariigis Fort Rileys (sinna olid majutatud I maailmasõja tandritelt koju ravile või puhkusele saabunud sõdurid) rahulikult.

Continue reading "11.03.1918" »

12. märts 2006

tsitaadikogumik - mida arvavad eksperdid?

fluwikiest Quotes from Officials and Experts about BF Pandemic Possibility (Taken from news articles between February and March 2006):

I found that this list of quotes (updated from my earlier one) has a big impact on some people who are in denial that there is a significant proabability of a pandemic in the near future. Some people just read news headlines and not the entire article, thus missing the entire message. Hopefully this will get the point across. Pass it on to those in the hopes that it will get them to prep!

Quotes from Officials and Experts about BF Pandemic Possibility (Taken from news articles between February and March 2006):

Continue reading "tsitaadikogumik - mida arvavad eksperdid?" »

peamine eesmärk - vee ja elektri tagamine

Maintaining water, power may be job one in pandemic

Jan 30, 2006 (CIDRAP News) – Keeping the taps flowing, the lights glowing, and food on the shelves may be a higher priority than caring for the ill during an influenza pandemic, the United Nations' coordinator for avian and pandemic flu has said.

Continue reading "peamine eesmärk - vee ja elektri tagamine" »

10. märts 2006

ülemuste ülesanne on planeerida

It pays to expect the worst
By Carly Chynoweth

Terrorist attacks, “mad cow” disease or bird flu epidemics are not everyday events, thankfully. But should they occur the best way to deal with them is to be prepared ARE you bored with bird flu yet? Yeah, me too. While senior executives are all resilience planning this, training day at a plush conference centre that, the rest of us are left to get on with our everyday tasks. But come the revolution (or the radiation attack on the City/alien landing on your building/blooming bird flu), junior and middle managers will have to act. You’d better hope that someone has a plan . . .

Continue reading "ülemuste ülesanne on planeerida" »

8. märts 2006

kolm peamist pandeemia-fakti linna/valla jaoks

suurepärane jutt Reverelt
Three points about bird flu to tell others

Continue reading "kolm peamist pandeemia-fakti linna/valla jaoks" »

6. märts 2006

perearsti tegevusjuhis gripipandeemia ajal

Perearsti tegevusjuhis gripipandeemia ajal.
Koostanud Madis Tiik ja Ruth Kalda, aluseks on võetud Tervisekaiste inspektsiooni ja infektsionistide juhised

Continue reading "perearsti tegevusjuhis gripipandeemia ajal" »

5. märts 2006


jutt siis sellest, et kuidas peaks inimesi teavitama pandeemiast ja selle ajal
ja pärineb ameerika psühholoogide assotsiatsioonilt

Life-saving communication

If a flu pandemic strikes, psychologists' expertise could help keep society running and ensure that the people who need treatment get it. By Christopher Munsey

Continue reading "kriisikommunikatsioon" »

3. märts 2006

infra sõltub inimestest

Bird flu spreading rapidly; U.S. government warns population
Posted Thursday, March 02, 2006 by Mike Adams

A recent poll conducted in the U.S. by the Harvard School of Public Health reveals that if a bird flu outbreak hits the U.S. population, an astounding 68% of the population will stay home and skip their jobs. (Similar behavior is expected across Europe, although the number might not be exactly the same.)

Continue reading "infra sõltub inimestest" »

õpime klassikast - Naksitrallid

aiteh Kitile :)
kes luges Naksitralle ja leidis, et sealne linnavõimude ja kodanike tegevus rotihirmus oli kiiduväärselt kiire ja põhjalik :)))

et oleks siis tulevikus linnavõimude ja kodanike tegevus gripihirmus sama kiire ja põhjalik ;)

Continue reading "õpime klassikast - Naksitrallid" »

2. märts 2006

ettevalmistused kui kindlustuse vorm

Why I'm not gambling with my life

I am not a gambler. I don't play the slots at Vegas, I don't buy lottery tickets, and I don't gamble with the safety of my readers when it comes to telling the truth about the bird flu virus. The truth is that this virus is one mutation away from becoming a global pandemic that could kill tens of millions of people around the globe. And yet most people do nothing to prepare.

Continue reading "ettevalmistused kui kindlustuse vorm" »

eriolukorra seadus

eriolukorra seadus

seda seadust saab vajadusel rakendada
1) loodusõnnetuse või
2) katastroofi korral või
3) nakkushaiguse leviku tõkestamiseks

Continue reading "eriolukorra seadus" »

1. märts 2006

Eesti infomaterjalid

yahoo uudistest :DDD
võib lugeda, et märtsis plaanib põllumajandusministeerium üllitada teabelehe linnugripist, mida levitatakse kõigi peamiste ajalehtede lisana

eelmise nädala maalehe vahel ilmus ka üks vihik: Infovoldik Maaelu Heaks linnugripist

veel üks voldik: Veterinaar- ja Toiduameti koostatud lindude gripi infovoldik

26. veebruar 2006

miks on vaja koonduda

FluWiki väga kurb kirjeldus, kuidas üksi ja väga haigena hakkama saada :S
hea selgitus, et miks on kriisiolukorras väga mõistlik mitmekesi kokku kolida
ainuüksi mõte sellest, et oled voodis vägaväga haige ja mitte keegi ei too sulle klaasi vett ega tuleta meelde, et nüüd oleks vaja kraadida või rohtu võtta, tekitab minus õudusjudinaid :S

Home Alone link
by Lisa the GP, who is real author of this story

Years ago I had (human) influenza, and developed a secondary bacterial pneumonia. I live alone, and these are a few of the things that I wish I had done to make my stay in bed easier. When you start getting symptoms, before you go to bed,

Continue reading "miks on vaja koonduda" »

25. veebruar 2006

Virumaa Teataja: Dekameroniaeg

Juhtkiri: Dekameroniaeg link

Ühel kaunil suvepäeval aastal 1343 said Firenzes kokku kümme noort ilusat inimest - kolm noormeest ja seitse neidu – ning otsustasid linnamüüride vahel (ja kogu tuntud maailmas) võimutseva musta surma eest maale ühte linnalähedasse villasse pakku minna.

Continue reading "Virumaa Teataja: Dekameroniaeg" »

21. veebruar 2006

oled sa valmis pandeemiaks?

If a Pandemic Strikes, ARE YOU READY? link
By Anita Manning

If you had to be on your own, in your home, for two weeks or more, what would you need to have on hand to survive? That's the question Americans should consider now, before the next flu pandemic strikes, health experts say. "If we have a pandemic, stores are going to run out of food," says Arnold Monto, an epidemiology professor at the University of Michigan. "It would be a good idea to have things available."

Continue reading "oled sa valmis pandeemiaks?" »

Kanada mõttekoja raport

Facing the Risks
Global Security Trends and Canada link
värske raport, koostatud veebruaris 2006, nõuab registreerimist lugejaks, aga tasuta ja aega kulub ehk 1 min

mõned pandeemiat puudutavad lõigud kopin allapoole

Continue reading "Kanada mõttekoja raport" »

19. veebruar 2006

pandeemia: minna tööle või jääda koju?

natuke mõtlemiseks :)
cureventsi foorumis kirjutab üks meedik järgmist:
(tegelikult väärib terve see arutelu lugemist: link)

Continue reading "pandeemia: minna tööle või jääda koju?" »

18. veebruar 2006

Sandman: ei ole vaja karta paanikat!

Peter Sandman on kõrgelt tunnustatud riskikommunikatsiooniekspert

ta kinnitas CIDRAPi äriliidritele korraldatul konverentsil, et riigijuhtidel ei ole mõtet karta paanikat, inimestele tõese info jagamine on vajalik, kuna ainult hirm on see, mis paneb inimesed tegema ettevalmistusi.

ma pean siinkohal tunnistama, et seda juttu oli väga hea lugeda :)
ma sain kinnitust sellele, et see infojagamine - ja ka mõõdukas hirmutamine :D -, millega ma olen viimased kuud tegelenud - on õige tegevus :)
eriti viimastel päevadel, kui selle blogi külastatavus on kasvanud, olen mõned korrad mõelnud, et järsku ma teen valesti .. järsku on see ikkagi vaid mõttetu hirmu külvamine .. aga tundub siiski, et ei ole :)

Fear can play role in pandemic readiness, speaker says link
Robert Roos News Editor

Feb 17, 2006 (CIDRAP News) – One expert's advice to leaders trying to prepare the world for an influenza pandemic: Don't be scared of scaring people.

Peter M. Sandman, PhD, a risk communication expert from Princeton, N.J., told those attending a Minneapolis conference on business planning for pandemic flu that fear is what motivates people to take sensible precautions in the face of a real threat.

Continue reading "Sandman: ei ole vaja karta paanikat!" »

Leavitt: gripipandeemia on vältimatu

Leavitt on siis USA kõrgeim tervishoiuboss

USA prognoos (1918a alusel): 300 miljonit elanikku, neist 90 miljonit (30%) haigestuvad, neist omakorda 45 miljonit (15%) vajavad arstiabi

eesti numbritesse üle viidud: 1,3 miljonit elanikku, neist 390 000 haigestuvad, ja neist omakorda 195 000 vajavad arstiabi
ülejäänud siis saavad kodus põetatud, eks selleks avaldatakse mingid juhised loodetavasti, mida teha ja mida mitte teha ..

surevuse kohta ei taha keegi eriti prognoose teha, neid on seinast seina, ja reaalselt selgub see siis kui pandeemia kohale jõuab, mitte enne

karm on see, et paljudel puudub tänapäeval üldse raske haiguse koduspõetamise kogemus ju, rääkimata sellest, et tänapäeval ei sure keegi praktiliselt enam kodudes
psühholoogiliselt saab see päris räige olema kindlasti :(

Flu pandemic deemed inevitable link
Communities will be on their own in crisis, top federal official says
Saturday, February 18, 2006

COLUMBUS - An influenza pandemic is inevitable and local communities will be on their own when it hits because federal and state governments will have their hands full, U.S. Health and Human Services Secretary Mike Leavitt warned yesterday.

Continue reading "Leavitt: gripipandeemia on vältimatu" »

lindude gripi infovoldik, eestikeelne

veterinaaramet on andnud välja infovoldiku linnugripi kohta (kiitus!)

asub aadressil: link

pdf kujul, sikuta oma arvutisse ja trüki välja :)

17. veebruar 2006

Soome ostis endale koha vaktsiinijärjekorras

Suomi varautuu influenssapandemiaan link

Kansanterveyslaitos on 20.12.2005 allekirjoittanut täsmärokotetta koskevan viisivuotisen ennakkovaraussopimuksen hollantilaisen influenssarokotevalmistajan Solvay Pharmaceuticals B.V:n kanssa. Sopimuksella hollantilainen valmistaja sitoutuu toimittamaan Suomeen 5,5 miljoonaa annosta pandemiavirusta vastaan suunnattua täsmärokotetta sopimusjärjestyksessä sitä mukaa kuin rokotetuotanto etenee. Suomi on neljäntenä jonossa. Varausmaksu on 550 000 euroa vuodessa.

Barry: mida võiks õppida ajaloost?

Barry on siis raamatu The great influenza autor.
kui keegi vajab veenmist, et linnugripp on reaalne oht ja on võimeline inglise keeles raamatuid lugema, siis kinkige talle see raamat :D

mis puutub lainetesse, siis kuigi Barry arvab, et ka uus pandeemia võib tulla lainetena - siis selles osas on nii mõnigi erineval arvamusel, kuna tänapäeval toimub inimeste liikumine märkimisväärse kiirusega üle maailma

oluline on artikli lõpp, kus rõhutatakse, et inimestele õigeaegse ja õige info andmine väldib paanikat ja võimaldab inimestel teha vajalikke ettevalmistusi ..

Author Barry says pandemic planners should expect waves link
Robert Roos News Editor

Feb 16, 2006 (CIDRAP News) – If the next influenza pandemic imitates past ones and plays out in waves, the first wave might serve as a warning that gives the world a little time to prepare for the worst, a leading expert on the pandemic of 1918 told business leaders at a Minneapolis meeting this week.

Continue reading "Barry: mida võiks õppida ajaloost?" »

15. veebruar 2006

kuhu matta oma surnud?

Preparing for pandemic: know how to bury your dead link
Wed Feb 15, 2006 3:39 PM ET
By Andrew Stern

MINNEAPOLIS, Feb 15 (Reuters) - When burying a body in the backyard, don't put it too close to the septic system. That was one piece of advice offered on Wednesday to a business conference on preparing for a potentially lethal bird flu andemic.

Continue reading "kuhu matta oma surnud?" »

inimestele tõe ütlemine väldib hiljem rahutusi

Public not ready for grim realities of health-care in a flu pandemic: experts

MINNEAPOLIS (CP) - Health-care delivery during a flu pandemic won't be remotely like current standards of care - and the public isn't prepared for that fact, leaders from the health-care sector warned Wednesday at a conference on business continuity planning for a pandemic.

Continue reading "inimestele tõe ütlemine väldib hiljem rahutusi" »

14. veebruar 2006

vastutus oma pere ees

üks osa pikemast artiklist

News of avian flu may be buried in the back of newspapers, but prepare for the possibility that it will become front-page news link

Meanwhile, one wonders how many Canadians will actually prepare themselves an emergency survival kit. Allison Stuart, director of the Emergency Management Unit of the ministry of health, thinks you should. "We know, based on history, going back centuries, things can happen. We owe it to ourselves to be ready. We have got to be ready." The province of Ontario is ready -- at least as ready as you can be. In the past our government has done a great job of responding to things like the ice storm, massive floods, the Walkerton nightmare, the giant power outage and, of course, the SARS situation. "It's about making plans," said Michael Morton, assistant chief of training and education for Emergency Management Ontario. "In reality, an emergency could happen a minute from now, a year from now or never."

But when it comes to a pandemic, he says, it's only wise to be prepared.

"Ontario is the safest place in the world to live and yet we have seen we can be affected." He and his wife have an emergency kit in both their home and in their car. Morton suggests you do the same. "I think it's so important for every member of the public to prepare a personal emergency kit," he said.


This would include water, food, money, medical supplies, batteries, a flashlight, a battery-less radio and other items.

Morton says if there ever is a pandemic people will be glad they did it because in such a situation it could be difficult to go outside, go to the bank or get supplies. If you are fully stocked, a person could get their family in their homes and be able to sustain themselves until the situation is stabilized. "Having a kit at the minimum will make life more pleasant," Morton said, adding it also puts less strain on the system, which would be taxed in such a reality.

UK haigla pandeemiaplaanid

Bird flu warning link

A QUARTER of doctors and nurses in Barnsley are expected to fall ill, throwing Barnsley's health service into chaos, if a bird flu pandemic sweeps the borough, health chiefs have warned. At the same time more than 11,000 extra patients would be likely to call on GPs for an appointment - most of them home visits - during the expected eight-week course of any outbreak.

Continue reading "UK haigla pandeemiaplaanid" »

üheskoos on kergem

suurepärane jutt!

"It's no news" is bad news link

It's not news any longer that there is bird flu all over the place: asia, southeast asia, Russia, Turkey, Iraq, Saudi Arabia, Azerbaijan, Bulgaria, Croatia, Slovenia, Greece, Italy, Nigeria -- where did I miss? Nevermind. Mainly in birds, of course, but enough humans to give us pause. This virus is still experimenting and looking for new hosts to use for its only purpose in life -- make copies of itself. Maybe it will find humans or cats or dogs or all of the above good factories. Maybe not. But pretty much we are now at the mercy of the virus's biology as to what it will do. There is little at the moment we can do to affect that.

This is not true for managing the consequences of what it might or will do, however. There we still have a chance to affect the course of events. We don't have to fatalistically submit to whatever the virus has in store. Since on any given day about half our readers are first time visitors, we'll repeat here what we have been saying for the last year or more. We can get ready for this and we can do it despite the yawning public health and governmental leadership void. In a pandemic every community will have to depend on its own resources anyway, as the need will be so huge that no outside source will be able to satisfy it.

Our interests here and at The Flu Wiki are what can be done as a community, not as individuals. There is no shortage of sites with individually-oriented survivalist strategies and we wouldn't discourage anyone who felt the need to do whatever they feel is necessary for themselves and their families. But if we are going to get through this with minimum pain we will, above all, need to help each other. The more prepared we are as communities the more likely we will see neighbor helping neighbor instead of neighbor fleeing neighbor. In essence this is a task at community mobilization and the closer a pandemic seems, the easier it will be to mobilize the community. So we should be thinking about it and doing it, even if in the past it was hard to get attention. Perceptions change and with them, willingness to take action.

We are not just talking about public health measures. In a way, they will more likely take care of themselves because that seems to be the only thing state and local governments are thinking about. The big issues will be those loosely called social services:
* how to care for the many people who will need care despite no money, family or social support;
* how to ration scarce resources of all kinds;
* how to cope with a prolonged 30% to 40% absenteeism that can cripple essential services like food supply, pharmacies, water, power;
* how to provide for the dead and comfort their survivors.

All of these things can be done by schools, businesses and agencies thinking ahead and putting in place some rudimentary planning.
Who are the key people in your business and what would you do if they were out sick?
What if power was off for a week or ten days?
When do you close your school and what do you do about childcare if school is closed?

These are hard questions but it won't do any good waiting for someone else to give you the answer. No one knows what to do. But you can start thinking about it. There is an impressive amount of raw brain power in our communities and we have no doubt some innovative solutions will be found -- sooner or later.

kui tuttavad hakkavad surema

Northcom branches out to fight flu link

Peterson Air Force Base - Military commanders called together government emergency-response officials recently for a brainstorming session at this Cold War base turned headquarters for homeland defense. But rather than dirty bombs or suicide attacks, they wanted to talk flu.

Convinced that pandemic influenza inevitably will strike inside the United States, military leaders contend the failure of civilian agencies after Hurricane Katrina could happen again. It's an example of how U.S. Northern Command military forces charged with homeland defense quietly are assuming broader, non-traditional roles.

Continue reading "kui tuttavad hakkavad surema" »

13. veebruar 2006


Linnugripp A(H5N1) inimesel – mis on teada senisest kogemusest link
Autor: Mari Järvelaid
Ilmunud: © Moodne Meditsiin, detsember 2005.
Väljaandja: Eesti Ekspressi Kirjastuse AS

Maailma Terviseorganisatsiooni selle aasta mais Hanois peetud kohtumisel tõdeti, et enneolematu loomataud – linnugripp A (H5N1), mis on väga patogeenne, on ületanud liikidevahelise barjääri Aasias, põhjustanud inimeste hulgas fataalseid juhte ja suurendanud ohutunnet, et läheneda võib pandeemia.

Continue reading "linnugripikogemused" »

Soome uuendab oma valmisolekuplaane

Finland fears aquatic birds may bring bird flu link
13.2.2006 at 13:40

Finland's Ministry of Agriculture and Forestry said Monday that the risk of avian influenza spreading to Finland would increase with the spring migration of aquatic birds.

However, most of Finland's aquatic birds winter in Denmark and Britain, countries where bird flu has not yet been found.

"Small groups of birds come from other parts of the world, but it is not known whether these birds are susceptible to carrying the bird flu virus, nor if they could make it to Finland with the virus," said Matti Aho, a director general at the ministry.

The ministry has updated its readiness plan to take into account the bird flu risk.

tapvad tervitused

eilne new york times
Greetings Kill: Primer for a Pandemic linkin

Published: February 12, 2006

TO the pantheon of social arbiters who came up with the firm handshake, the formal bow and the air kiss, get ready to add a new fashion god: the World Health Organization, chief advocate of the "elbow bump."

If the avian flu goes pandemic while Tamiflu and vaccines are still in short supply, experts say, the only protection most Americans will have is "social distancing," which is the new politically correct way of saying "quarantine."

But distancing also encompasses less drastic measures, like wearing face masks, staying out of elevators — and the bump. Such stratagems, those experts say, will rewrite the ways we interact, at least during the weeks when the waves of influenza are washing over us.

Continue reading "tapvad tervitused" »

12. veebruar 2006

Tervishoiuteenuste osutajate valmisolekust nakkushaiguste raviks

MATRA projekt MAT03/ES/9/1 - Nakkushaiguste tõrje suutlikkuse tõstmine Eestis, konverents 15.12.05
Tervishoiusüsteemi valmisolekust, Dr. Mihkel Tamme, Tervishoiuamet link

Raviasutuste nakkussuutlikkus:
Voodeid kokku 6798

Nakkusosakonnad :
AS LTKH –85+15
SA Pärnu Haigla-18(20)
AS Ida-Viru Keskhaigla-12
Narva Haigla SA-20

Infektsioniste – 43
Anestesiolooge – 275
Erakorralise meditsiini arste - 118

Intensiivravi voodid:
Kokku: 619; I-II aste – 496 ;III aste – 123
SA PERH - 174 (127+47)
AS ITKH - 82 (72+10)
AS LTKH - 46 (44+2)
SA TLH - 48 (36+12)
SA TÜK - 152 (98+54)
SA Pärnu Haigla - 36 (32+4)
SA Ida-Viru Keskhaigla - 21 (18+3)
SA Narva Haigla -10 (7+3)
Nakkusosakondades intensiivravi voodeid ei ole, välja arvatud SA Pärnu Haigla-2)

pandeemiarisk kasvab linnugripi levides

Pandemic risk rises as bird flu spreads link
By Elisabeth Rosenthal and Donald G. McNeil Jr. The New York Times

paar lõiku:

The arrival of bird flu in Italy, and in the European Union, had been predicted for some months, as the virus has marched steadily from eastern Asia, to Russia, to the Balkans and, in the last week, to West Africa. Experts say the virus is being carried by migrating birds, so all countries on their flight paths are vulnerable.

World health officials say they have not had the cooperation they need from many poor countries, even those on the flight paths of migrating birds known to carry flu. Because of poor surveillance and rudimentary laboratory capabilities, they often received lab samples for testing weeks or months after problems begin - and for that reason, they worry that the disease is already much more widespread than they can prove.
"We are fighting the good fight, but to win it we'll need a lot more proactive surveillance and prevention," said Juan Lubroth, a senior veterinarian at the UN Food and Agriculture Organization, in Rome. There was strong evidence that bird flu took root in Nigeria "a few months ago," Lubroth said, even though it was only confirmed last week, after Nigerian veterinary officials had said last Monday that bird flu was not in the country.

There may be more unreported outbreaks in Africa and the Caucasus region, he said. "We've been repeating over and over to countries that they have to be vigilant, but in most countries, it's business as usual. They say, 'Avian influenza isn't here now. We'll deal with it when it arrives.' But then it's too late." Maria Cheng, a spokeswoman for the World Health Organization, said the agency suspected there might be human cases of bird flu in Africa, but had no way to confirm that yet. "We're getting a team ready to go," she said, "but we're waiting to get the invitation from Nigeria."
But Africa also has the worst AIDS epidemic in the world; in some countries nearly a third of the adult population is infected. In the initial stages, having a depressed immune system could have a protective effect, said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, because virulent flus set off a powerful immune reaction that can drown the lungs in fluid. However, he added, it would probably hurt patients trying to fight off secondary immune reactions. But HIV-infected people who managed to fight off bird flu would become ideal crucibles in which the H5N1 virus could exchange genes with other viruses, dramatically increasing the likelihood of a bird flu strain that could readily infect humans. "If H5N1 gets into people with AIDS it would likely persist and throw off mutants left, right and center," Oxford said. If bird flu takes root in Africa - or if has already done so, undetected - it could prove disastrous not just for that continent, but for Europe as well, experts say, since the northern migration of birds begins next month. "The prospects are not good," said Oxford. "Soon they'll be coming back over Europe and why wouldn't it cause a great danger?" As a virologist, Oxford said that he could only assume that Nigeria was just the "red light we could see," but that there were similar bird flu problems in many other places.

11. veebruar 2006

WHO nõuab EU-lt aktiivset võitlust linnugripiga

WHO urges stronger response as bird flu hits EU link

ZURICH, Feb 11 (Reuters) - The World Health Organisation (WHO) called on Saturday for stronger surveillance and response after the first reported outbreak of the H5N1 bird flu virus in the European Union.

However, the Geneva-based U.N. health agency said it saw no reason to escalate its pandemic alert level.
"Surveillance and response of H5N1 in both animals and humans needs to be strengthened in all regions bordering countries where outbreaks have been identified," said WHO spokesman Dick Thompson.

Earlier on Saturday, Greece and Italy said they had found dead swans with the H5N1 bird flu virus, the first known cases in the European Union of wild birds with the deadly strain of the disease.

Intensified surveillance meant alerting hospitals to be on the lookout for patients arriving with flu symptoms and to ask whether they had any contact with sick birds. It also meant speeding up official reporting to health and veterinary officials of sudden deaths among birds, Thompson said.

"At this point it is still an animal disease and does not transmit very easily to humans," he told Reuters by telephone. "Even more rare is that it would transmit from one human to another."

However, he urged caution when dealing with sick or dead animals.

"It is important that people understand that they do not handle sick animals," he said. "We believe it has the potential to evolve into a pandemic virus."

Italy said wild swans found in the island of Sicily and the mainland regions of Puglia and Calabria had tested positive for the highly pathogenic version of the H5N1 strain.

Nigeria started testing people who had fallen ill close to where the virus was found in birds, in Africa's first outbreak of the disease.

"When the virus shows up in a new country, it doesn't mean that the pandemic has started, it means that the animal disease has spread," Thompson said.

"The animal disease is spreading and if we get the alert out now to humans we can lower the risk," he said.

The virus has killed at least 84 people in Asia since early 2003 and forced affected nations to cull millions of domestic fowl. Indonesia reported on Saturday that a 27-year-old woman had died of the disease, the second in two days.

8. veebruar 2006

kuidas öelda EI soovimatutele öömajaotsijatele

cureventsis käis arutelu, et kuidas selgeks teha ämmale vm kaugematele sugulastele, et sa ei taha neid oma koju kui pandeemia peaks käivituma

Jonesie kirjutas järgmist:

I have had friends want to come to my place after 9/11 in case of a terrorist attack.
I told them, fine. "But all my kids and their friends will be staying with me also. And my 3 cousins and an old aunt...and 3 babies. I just don't have the heart to turn anyone away for any reason.
So please bring all the food in your freezer, your canned goods and money, your bedding and mattress. The couch will be used by my 90 year old auntie. She is incontinent, so there will always be her undies hanging in the bathroom drying out. Baby diapers too. Hope you don't mind sleeping on the floor. It will be wall to wall sleeping arrangements. Probably will be upwards to 35 people on any given weekend. 15 or 20 during the week. Bring a carboard box to keep all your toiletries and other things in. Write your name on it. We will stack boxes along one wall.
There will be a 5 minute limit in the shower. And everyone draws numbers for the toilet."
Funny thing, every one of my friends said they always had another place to go to. And nobdy came to visit after that either.


ühelt poolt on mõistlik muidugi grupeeruda, teiselt poolt tuleb ka see enda jaoks läbi mõelda, keda sa oleksid nõus oma katuse alla võtma ja kellega oma varusid jagada

6. veebruar 2006

viieastmeline aktsepteerimistee

oli cureventsis arutelu teemal, et kuidas inimesed psühholoogiliselt suudavad aktsepteerida võimalust, et pandeemia on reaalne oht
üks kommentaar:

I think once I realized that a flu pandemic is a real possibility, I experienced the loss of a certain type of innocence. With that loss began a process of grieving, not unlike when someone dies.
I think we're all in various stages of grief.
As I understand it, the five typical stages are
1) Denial (most people we know are still here)
2) Anger (I'm guessing some soldiers in Iraq may be here soon)
3) Bargaining (PREPPING, busy, busy, busy... pretend control!!!!)
4) Depression
5) Acceptance

5. veebruar 2006

US: Tamiflu prioriteedid

Antiviral Drug Priority Group Recommendations
Info extracted from U. S. HHS Pandemic Influenza Plan
Page D-21 thru D-29

For each priority group, the plan provides a definition, a rationale for why this group is considered a priority and a medication strategy or how much antiviral a member of a group will be given. Info is also included re:estimated number for each group, as well as any "unresolved issues" pertaining to that group.

Listed strategies for Tamiflu use: Treatment (T) requires a total of 10 capsules and is defined as 1 course. Post-exposure prophylaxis (PEP) also requires a single course. Prophylaxis (P) is assumed to require 40 capsules (4 courses) though more may be needed if community outbreaks last for a longer period.

Selected Comments:
"Based on this guidance, state, local, and tribal implementation plans should be developed to 1) include more specific definitions of the priority groups (e.g., which functions are indeed critical to maintaining continuity) and their size; 2) define how persons in these groups will be identified; and 3) establish strategies for effectively and equitably delivering vaccines and antiviral drugs to these populations. The committees acknowledged that further work is needed, in particular, to identify the functions that must be preserved to maintain effective services and critical infrastructures and to identify the groups that should be protected to achieve this goal. The committees also acknowledge that the specific composition of some priority groups may differ between states or localities based on their needs and that priority groups should be reconsidered when a pandemic occurs and information is obtained on its epidemiology and impacts."

“The committee considered the primary goal of a pandemic response to decrease health impacts including severe morbidity and death. Minimizing societal and economic impacts were considered secondary and tertiary goals.”

Antiviral Drug Priority Group Recommendations
1. Persons admitted to hospital with influenza infection
2. Healthcare workers and emergency medical service providers who have direct patient contact
3. Outpatients at highest risk for severe morbidity or mortality from influenza infection
4. Pandemic health responders, public safety workers, and key government decision-makers
5. Outpatients at increased risk of severe morbidity or mortality from influenza
6. Outbreak control
7. Healthcare workers in ER, ICU, EMS, and dialysis settings
8. Pandemic societal responders and healthcare workers who have no direct patient contact
9. Other outpatients

In addition to recommendations for priority groups, NVAC unanimously adopted the following recommendations:
Sufficient drugs should be stockpiled to address top priorities. NVAC recommends that the minimum stockpile size be about 40 million courses, allowing coverage of the top 7 priority groups.

Continue reading "US: Tamiflu prioriteedid" »

kahte sorti ettevalmistujad

cureventsi foorumist üks hea kommentaar, mida ma ei raatsi jätta siia kopeerimata :D
kirjutab Frankilee link

It's becoming increasingly obvious that there are two very distinct camps here at CE. There are many similarities between the two, but one HUGE divide as well.

Group 1 has prepared and plans on riding it out with as much limited exposure as possible. Private transportation, social distancing etc. Proper hygiene. Group 1 believes that after 3 months or so, (see poll) life will pretty much return to normal. "Wow, that pandemic was bad! Nasty stuff that flu! Almost lost an uncle. Who do you think will win the world series?"

Group 2 is prepared and has also put into place measures for telecommuting. Group 2 will not under any circumstances, or very limited ones, risk exposure to the populace. Group 2 understands that this may well lead to a significant breakdown of services and even the collapse of society. Group 1 snickers like children in church when these assertions are made. Group 2 has prepared as best as one can for total chaos, if preparing for such is truly possible.

Continue reading "kahte sorti ettevalmistujad" »

4. veebruar 2006

toiduvarud USA-s

Food: U.S. Achilles’ heel? link
Publishing date: 02.02.2006 22:20

The U.S. has been giving away a lot of food in recent years. So much food, in fact, has American given away that its own emergency food reserves are shockingly low.

There was a time, not too long ago, that by law the U.S. government was forced to maintain emergency food provisions for every man, woman and child in the country for three years.
That was considered good stewardship through much of the 1960s. It was a program put together by men who read the Bible and recalled the idea Joseph gave the Pharoah to avoid famine in the seven lean years.

But then the political winds of change began to blow through America. There were calls in Congress to bail out starving nations throughout the world. There were even actions to bail out America’s enemies – like the Soviet Union.

Within 20 years, the grain elevators were virtually empty – yet the amount of food given away as direct aid to foreign nations continued to increase.

By 1996, the U.S. Department of Agriculture claimed – and it was something of a hollow boast — that there was enough emergency food in storage to provide for every American in the cities for three days. The total was five days, the USDA said, for those in rural areas in the event of a national emergency.

Then came Sept. 11, 2001. There was talk of nuclear terrorism, biological and chemical weapons threats. America had seen that it was not invulnerable to massive, unforeseen attacks. Rogue nations such as North Korea and Iran were developing nuclear weapons and the missiles to fire them.

The Department of Homeland Security was formed and hundreds of billions were spent to make Americans feel safe.

But the food supply continued to dwindle.

By 2003, the USDA stopped counting in terms of “days” for emergency food supplies, because there was less than one day for every American. The new calculations were made not in terms of time, but in terms of pounds. They were made not in terms of how much food was actually stored and awaiting delivery, but rather how much was in the economy – including what was currently being harvested, what was on store shelves, what was en route in the transportation system.
The federal government claimed, under this new formulation, that there were 77 pounds of food per person in the U.S. at any given moment. Yet the number has continued to plummet more rapidly than ever before.

By September 2005, there were only 15.7 pounds of food for every American. That represented an 80 percent decrease in just two years.

According to USDA figures analyzed by Alan Guebert of the Farm & Food Report, the decrease gets worse every day. Of the 15.7 pounds of emergency food per person, 11 pounds consists of unprocessed wheat – of questionable value in times of emergency. The rest consists of non-fat dry milk, cheese, corn, peanuts and lentils.
Even after the Katrina disaster, almost no one is talking about food supplies in America.


lk 107-130
otsene jutt levikust, lindudest, ravimitest - aga puudutab ehk rohkem planeerijaid kui lihtinimesi :D
seega, ei viitsi kopeerida, kel vaja või huvi loeb ise :)

lisatud: foorumis keegi noppis olulisemad faktid välja
* says it was in 15 countries in the first of Dec.
* Virologist in Hong Kong states, "Avian flu virus can be found in most poultry markets in China".
* DOD purchased 24 million capsules of Tamiflu 15 million of which were to be delivered Dec. 15. 5mill to be delivered 28, Fed.
* They (DOD or Department of Defense) have also bought 10% of all known Relenza supplies.
* Ms. Embry (unknown person who evidently works for the Bush admin.) says their first priority is protecting our forces and the second is keeping business between countries alive. She also states that they are walking a tightrope re: what their position should be in protecting the public and their international partners happy. And balancing the other priorities. Fairly straightforward speech in my estimation. The American public wasn't as high on the list as I would like to have seen.
* 20% of pediatric patients develop a resistance to Tamiflu

3. veebruar 2006

just-in-time ruulib

Stockpiles should include more than vaccines and anti-virals, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
"Today we have a just-in-time delivery system for masks, syringes, for IV bags," he says. "Most people don't realize that 80% of the drugs we use in this country come from offshore. Right now, the two manufacturers of N95 masks in this country are operating on 100% capacity. They have no surge capacity. We will run out quickly of all these things. And at that time, we'll be dealing with the equivalent of a 1918 health care system." link

2. veebruar 2006

veidi otseütlemist pandeemia teemal :D

Some Hard Truths About Bird Flu link
Miller Op-Ed in the Taipei Times
by Henry I. Miller
January 14, 2006

Intensive animal husbandry procedures that place billions of poultry and swine in close proximity to humans, combined with unsanitary conditions, poverty and grossly inadequate public health infrastructure of all kinds, make it unlikely that a pandemic can be prevented or contained at the source. It is noteworthy that China's chaotic effort to vaccinate 14 billion chickens has been compromised by counterfeit vaccines and the absence of protective gear for vaccination teams, which might actually spread disease by carrying fecal material on their shoes from one farm to another.

In theory, it is possible to contain a flu pandemic in its early stages by performing "ring prophylaxis"—using anti-flu drugs and quarantine aggressively to isolate relatively small outbreaks of a human-to-human transmissible strain of H5N1.According to Johns Hopkins University virologist Donald Burke, "it may be possible to identify a human outbreak at the earliest stage, while there are fewer than 100 cases, and deploy international resources—such as a WHO stockpile of antiviral drugs—to rapidly quench it. This tipping point strategy is highly cost-effective."

However, a strategy can be "cost-effective" only if it is feasible. Although ring prophylaxis might work in Minneapolis, Toronto, or Zurich, in the parts of the world where flu pandemics begin, the probability of success approaches zero. In places like Vietnam, Indonesia and China—where the pandemic strain will likely originate—expertise, coordination, discipline, and infrastructure are lacking.

The response in Turkey—where as many as 50 possible cases have appeared in the eastern part of the country—is instructive. Officials in that region warned the government on Dec. 16 of a surge in bird deaths, but it took 12 days for an investigation to begin. When a 14-year-old boy became Turkey's first avian flu mortality last week (soon followed by two siblings), a government spokesman criticized doctors for mentioning the disease because they were "damaging Turkey's reputation." This is ominously reminiscent of China's initial response to SARS in 2003.

For now, it seems that all of the human H5N1 infections have been contracted from contact with infected poultry. But the situation in Turkey is what the outbreak of a human to human pandemic could look like at its earliest stages: the rapid spread of confirmed cases (and deaths) from an initial site to nearby villages and cities. We would expect to see a large number of illnesses among both employees and patients in hospitals where the victims are treated, and soon someone [perhaps even a carrier who is not ill] would spread it to Ankara, Istanbul, Tbilisi, Damascus, Baghdad and beyond.

The anti-flu drugs Tamiflu and Relenza are extremely expensive and in short supply. History suggests that if we were to make these drugs available to poor countries for ring prophylaxis, they would often be administered improperly—such as in sub-optimal doses—in a way that would promote viral resistance and only intensify a pandemic. Or perhaps they would be sold on the black market to enrich corrupt government officials.

If the pandemic were to begin relatively soon—say, within a year or two—there would be little that could be done to attenuate significantly the first wave of infections. But, if we're ready to rush the pandemic strain into an emergency program to manufacture vaccine, we could possibly blunt the second wave.

A flu pandemic will require triage on many levels, including not only decisions about which patients are likely to benefit from scarce commodities such as drugs, vaccines and ventilators, but also broader public policy choices about how best—among, literally, a world of possibilities—to expend resources.

inimesed ei kipu alluma riiklikele plaanidele

tehti USAs uuring ja küsitleti inimesi, kuidas nad käituksid kui terroristid levitaks rõugenakkust või dirty bomb rünnaku korral,
siit võiks ehk natuke tõmmata paralleele inimeste võimaliku käitumisega gripipandeemia korral ..

ja ei maksa eeldada, et eestlased paremini käituksid, pigem veel enam tõrksalt :D

Redefining Readiness link

Far fewer people than needed would follow protective instructions in these two terrorist attack situations.
Only two-fifths of the American people would go to the vaccination site in the smallpox outbreak.
Only three-fifths of the American people would shelter in place for as long as told in the dirty bomb explosion.

Continue reading "inimesed ei kipu alluma riiklikele plaanidele" »

WHO: me teame linnugripist liiga vähe

WHO chief says bird flu still little understood link
osa jutust:

ANKARA, Feb 2 (Reuters) - The World Health Organisation (WHO) said on Thursday the death of an Iraqi girl believed to have had bird flu showed how little was known about the disease.
Tests carried out by a British laboratory on the Iraqi teenager have confirmed she died of bird flu, the New Scientist magazine said on its Web site on Thursday.
WHO officials have declined to confirm the report but say they are working on the assumption that the H5N1 strain of bird flu was indeed the cause of her death.

"(The death) has highlighted how little is still known about the spread of the avian flu virus among poultry. Before her death, the presence of H5N1 in poultry in Iraq was not known," WHO director-general Lee Jong-Wook told a news conference during a visit to the Turkish capital Ankara. "Similarly here there was almost no prior warning of infection in poultry in the eastern part of Turkey," he added.

1. veebruar 2006

marketite ettevalmistused

jahah, optimistlik kutt see intervjueeritav :)
pandeemia erinevus nt maavärinast on just see, et ei kuskilt abi kutsuda .. kõik riigid ja piirkonnad on korraga hädas ja omade probleemidega maadlemas

Key concern for grocers will be fresh shipments link

Grocers should expect a spike in demand during a pandemic, said Tim Hammonds, president and CEO of the Food Marketing Institute, which represents food retailers and wholesalers.

The institute hasn't devised a plan for a pandemic, Hammonds said, but he expects a health care emergency plan to be incorporated into the industry's overall disaster preparation. Supermarkets including H-E-B, Albertsons, Randall's and Whole Foods declined to comment on their emergency plans.

Stores would have time to stockpile key supplies, including water, face masks, canned goods, frozen foods, batteries, vitamins, cold remedies and other items, Hammonds said. But fresh food supplies might be tight, he said.

In general, stores get several deliveries a week, but if many truckers were out sick, he said, regions not being hit by the pandemic could help those under siege.

"There is a lot of excess capacity and flexibility built in there," he said. Pharmacy chains can reroute supplies immediately when demand increases, said Karen Reagan, vice president of the Texas Retailers Association, which represents groceries and pharmacies. After Hurricane Katrina brought evacuees to Texas, CVS, Wal-Mart, Walgreens and H-E-B cooperated to set up pharmacies in evacuation centers, she said.

Vaccinating truck drivers would be crucial for maintaining supplies of many essential goods, said Bill Webb, president and chief executive officer of the Texas Motor Transportation Association. Food, water and fuel shipments would be top priorities, he said. Given the fragmented nature of the trucking industry, with 40,000 companies and 300,000 commercial drivers, "it would be difficult" to come up with a comprehensive and binding emergency plan, he said.

The association has worked with state emergency preparedness officials on tabletop exercises focusing on bioterrorism, and that planning could be applied to a pandemic, Webb said.

31. jaanuar 2006


The Battle to Stop Bird Flu link
pikk jutt, mõned väljavõtted ainult

tehti arvutisimulatsioon rõugetega - levik, valitsuse tegevus jne

The first: "The superspreader hypothesis isn't necessarily true," Smith says. This rule holds that in any population, the more social individuals - the hubs - are the principal conduits for spreading disease. Shatter the network by inoculating or removing these hubs, the theory goes, and you'll stand a better chance of knocking out the disease. But EpiSims has shown that we're all more popular than we might think. Even the most reclusive of us runs to Walgreens for toothpaste or drops by Boston Chicken for takeout. For a highly communicable disease like smallpox or influenza, these incidental interactions spread disease just as well as extended encounters. So chasing after the hubs can mean chasing after 80 percent of the population - a huge waste of time and energy. Better simply to inoculate the entire city.

A second revelation: With a lethal pathogen like smallpox, response time is all. As the delay stretches from 4 to 7 to 10 days before officials move into action, EpiSims found that the outbreak becomes increasingly lethal. It turns out that, in the ticking moments after an epidemic strikes, when health officials act is more important than what they actually do. Start with inoculation. Or quarantine. Or school closings. It doesn't matter. What does matter is reducing the time between first outbreak and first response.

tehti nüüd linnugripipandeemia simulatsioon:

EpiSims has begun assessing the threat of avian influenza. They're modeling the health care system down to the hospital bed, to see what happens if flu victims flood hospitals, fill the beds, and then spill back into their homes. They're taking into account slight behavior changes, so if people start wearing surgical masks, SARS-style, disease transmissions in the sim will fall off according to the masks' particulates-per-million filtration rate.

EpiCast reveals that, in contrast with flu epidemics of decades past, an outbreak today won't progress "like a wave across the country," spreading from town to town and state to state. Instead, no matter where it erupts - Seattle, Chicago, Miami - it will swiftly blanket the nation. "It starts in Chicago one day," Germann says, "and a couple of weeks later it's everywhere at once." Thank the airlines. Even though disease has piggybacked on air travel for decades, we generally had only isolated outbreaks of low-transmission viruses - like when SARS leapt from Hong Kong to Canada in 2003 but failed to spread beyond Toronto. In an epidemic of a highly communicable disease, the airlines' hub network would effectively seed every metropolitan area in the country within a month or two - and then reseed them, repeatedly.

EpiCast showed that local intervention measures can have some impact: Close the schools, enforce a quarantine, and the disease will slow down. That buys the federal government time to develop and mass-produce a vaccine. But Germann quickly adds a caveat: Acting locally may not be enough. In a worst-case outbreak, without a viable vaccine, "the disease will climb, and eventually go exponential. And once it's on the exponential curve, it's very difficult to contain." Cue Richard Preston.

In November, the Department of Health and Human Services released its pandemic influenza plan. The report offers a thorough and frank assessment of the havoc a full-fledged pandemic would wreak. The nation, the report says, "will be severely taxed, if not overwhelmed." Disease will break out repeatedly, for as long as a year. Hospitals will run out of beds and vaccines. Doctors and nurses will be overworked to the point of exhaustion. Mass fatalities will overwhelm mortuaries and morgues with bodies.

Rather than an all-out response focused on one particular region, a flu epidemic would force the government to ration its resources to serve the entire nation.

29. jaanuar 2006

1918a jutt

seekord siis medõe jutustus link

Since so many nurses had enlisted for the Red Cross, often there was no more than one nurse to fifty patients. Even though we were probationers and not given very much responsibility, and there were ward maids and orderlies to take care of many of the disagreeable details, we had a great deal of physical labor. It was a city hospital and patients had to be very sick before they were admitted. We had to change each bed every day, bathe all our patients, rub them down with alcohol, dress bed sores, give out the medicines, attend demonstrations, and generally assist in the irrigations and injections, tappings for spinal and lung fluid, and all the other treatments for patients in the medical and receiving wards. …

That was the year of the influenza epidemic, and we worked so hard that we fell unconscious into our beds at night and had to drag ourselves out of sleep in the morning. I had to take cold baths when I got up because if I got into warm water I fell asleep. Most of the nurses were keen and zealous over the work. We were all so busy we did not have time to suffer over the human misery we saw, although it was heart-breaking to see young people dying all around us of the flu. Often we had to prepare for the morgue as many as eight corpses a day.

Every morning we were expected to have our wards in order by ten o'clock, and it used to give me pleasure to see everyone cleaned and washed and neatly tucked under white counterpanes in the long rows. They were good patients because they were poor and did not expect too much. They were uncomplaining, and they accepted their suffering with stoicism. They did get good food and clean bedding. In the middle of the morning we gave everyone eggnogs, and in the male wards most of the men who were in the habit of drinking got a good stiff drink of whiskey in the eggnog. …

One got into the habit, in the hospital, of consistent, sustained effort and of disregarding fatigue, both physical and mental.

pilt haiglast

pilt 1918a pandeemia aegsest erakorralisest haiglast link

infrastruktuuri hoidmine olulisem kui haigete eest hoolitsemine

ÜRO viis läbi pandeemiasimulatsiooni, olulisim järeldus oli see, et infrastruktuuri (vesi, toit, energia) säilitamine on pandeemia korral olulisem kui haigestunute eest hoolitsemine.

UN may use 'flu-casters' if pandemic hits link

DAVOS, Switzerland (Reuters) - The United Nations is considering using "flu-casters," modeled on television weather forecasters, to publicize vital information if a global flu pandemic strikes. They could broadcast latest developments from emergency-response facilities at the U.N.'s World Health Organization in Geneva, according to David Nabarro, the U.N.'s top influenza coordinator.

"The flu-casters would draw out the maps and keep people engaged at regular intervals ... beaming it from the WHO bunker," Nabarro told Reuters in an interview at the World Economic Forum in Davos. The WHO's Geneva bunker, a $5 million facility built in a former cinema, is the world's nerve-center for tracking bird flu and other deadly diseases.

The room will become a global command center if the H5N1 bird flu virus, which has killed at least 83 people in Asia since 2003, mutates into a form which spreads easily among humans and sparks a flu pandemic which could kill millions.The screen-filled bunker could link the "flu-casters" with TV networks via satellite feeds.

Nabarro was speaking as the United Nations analyzed results from a top-level catastrophe simulation to set policies that envisage governments, companies and the media working together to fight a global flu pandemic. The exercise has produced surprising conclusions that could prove key should the disease start to spread quickly among humans.

One of the most important conclusions was that maintaining infrastructure -- water, power and the provision of food -- could take a higher priority than providing care to the sick, Nabarro told Reuters.
"It is maybe even more important to concentrate on the essentials of life for those who are living than it is to focus on the treatment of those who are sick," he said. "We learned a lot."

A pandemic could see travel and trade halted, workers forced to stay home, schools closed and a number of other dramatic measures designed to limit the spread.
The U.N. aims to forge fixed partnerships with key actors who would be involved in any pandemic response effort, which would include community groups, aid groups like the Red Cross, businesses and the media, Nabarro said.

"The focus on business is important. They have skills and can do things that governments cannot," he said. Clear communications would also be crucial.

The simulation assumed that the world was 40 days into the outbreak of a deadly pandemic.
"What became clear to us was, if we don't work together effectively and get prepared, we will be badly hit by that pandemic," he said.

The pandemic preparations will call for novel approaches if officials are to limit the potential catastrophic damage -- such as the use of mobile phone technology to distribute questionnaires and information, Nabarro said.

Nabarro also warned there was still a lot of work to be done in the event of an outbreak.
"Governments are starting to realize that they are nowhere near prepared for the damage that it could cause," he said at a panel discussion.

28. jaanuar 2006

WHO juhendist ja inimestest

WHO avaldas eile uue juhendi mustandi:
WHO pandemic influenza draft protocol for rapid response and containment

no et kuidas võiks käituda pandeemia alguses, piirata levikut jne

kaks huvitavad asja jäi silma
1) WHO on väga ettevaatlik oma faaside muutuse väljakuulutamisega
praegu on pikemat aega juba faas 3, kuigi olukord ja tegutsemine vastab 4.faasile
ja sellest on nüüd juttu (esimest korda kui ma seda näen WHO kirjatükkides):

A WHO decision to change the phase of pandemic alert will be made separately from the decision to initiate a rapid response or rapid containment effort. Since a change in phase is expected to trigger a number of potentially cascading actions by countries, possibly including travel restrictions and border closures, such a decision will be highly visible and is expected to have significant political, social and economic implications.

2) PPE (isiklikud kaitsevahendid) loetelu, mille võiks enamvähem enda varude koostamisel ka aluseks võtta (erandiks siis Tamiflu, mida enam võimalik reaalselt hankida ei ole, küll aga peaks veel olema piisavalt nii maske kui kaitseprille)

Personal protective equipment (PPE) kits consisting of:
Surgical and N-95 masks
Surgical gloves
Disposable boot covers
Disinfectant wipes for equipment
Biohazard bag for proper disposal of contaminated items
Pictograph directions
Hand-washing soap or hand disinfectants (alcohol-based hand rubs)
Disinfectant for cleaning surfaces in health care settings
Instructions written so they are easily understandable in multiple cultures
Antiviral drugs (oseltamivir in 75mg tablets)
Antibiotics to cover the most common secondary pneumonias

3) hingamisaparaatidest, millest ka Eestil puudus on

Consideration should be given to stockpiling a small number of ventilators (for example, 10 to 20) regionally. However, if ventilators are stockpiled, then the groups maintaining the stockpiles must also plan for having respiratory staff and technicians available to use and maintain these machines plus all associated supplies needed to use these machines.

aspekt, mida ei tohi unustada - et masinad võivad sul ju olla, aga neid ei ole võimalik kasutada, kui puuduvad vastavalt väljaõppinud inimesed .. sh võivad nad olla pandeemia ajal surnud/haiged/paranemas/hooldamas oma haigeid/valvamas oma lapsi/kardavad tööle tulla -mis tähendab siis, et neid tuleb välja õpetada 2-3x rohkem kui normaaloludes

selle nädala ekspressis oli mh juttu hingamisaparaatide võimalikust puudusest link

1000 voodikoha vabastamine gripihaigetele ei ole väga keeruline, sest sisuliselt lõpetatakse ära plaaniline haiglaravi, kuid intensiivravi voodikohtade arv, eriti hingamisaparaatide arv on väga tõsine probleem. Praeguse prognoosi kohaselt on minimaalselt vaja juurde 50–60 hingamisaparaati.

27. jaanuar 2006

Guardian: linnugripp kui 21.sajandi must katk

Bird flu 'could be 21st-century Black Death'
Larry Elliott in Davos
Friday January 27, 2006
The Guardian link

Avian flu has the potential to develop into a global pandemic that would be as devastating as the Black Death of the 14th century, the World Economic Forum warned yesterday in its assessment of the risks threatening stability and prosperity.

In a worst-case outcome, experts charged with weighing up systemic dangers said there might be riots to gain access to supplies of vaccines, a collapse of public order, a partial flight from the cities and large-scale migration.

hm, huvitav, esimest korda vist kui ma näen võrdlust musta katkuga .. siiani on ikka võrreldud 1918.a. pandeemiaga
mustast katkust kirjutab wikipedia siin
soovitan lugeda, päris põnev :)
paar lõiku:
The Black Death was a devastating pandemic that first struck Europe in the mid-14th century (1347–50), killing about a third of Europe's population, an estimated 34 million people. A series of contemporaneous plague epidemics also occurred across large portions of Asia and the Middle East, indicating that the European outbreak was actually part of a worldwide pandemic.

In addition to its drastic effect on Europe's population, the plague irrevocably changed Europe's social structure, was a disastrous blow to Europe's predominant religious institution, the Roman Catholic Church, resulted in widespread persecutions of minorities such as Jews and lepers, and created a general mood of morbidity that influenced people who were uncertain of their daily survival to live for the moment.

It is estimated that between one-third and one-half of the European population died from the outbreak between 1348 and 1350. As many as 25% of all villages were depopulated, mostly the smaller communities, as the few survivors fled to larger towns and cities. The Black Death hit the culture of towns and cities disproportionately hard. Some rural areas, for example, Eastern Poland and Lithuania, had such low populations and were so isolated that the plague made little progress. Larger cities were the worst off, as population densities and close living quarters made disease transmission easier.

kommentaar samale artiklile linnugripifoorumist:

There were two epidemics in 15th century Iceland that killed 50%+ of the population- neither of which could have been Bubonic Plague. There were no rats in Iceland!!!

Plague without rats: The case of fifteenth-century Iceland
Journal of Medieval History
Volume 22, Issue 3 , September 1996, Pages 263-284
Gunnar Karlsson*

University of Iceland, Faculty of Arts, Sudurgata, 101, Reykjavik, Iceland

In the fifteenth century Iceland was ravaged by two epidemics which usually have been identified as plague. It is shown here that these epidemics were no less lethal than the Black Death in Europe. The first one probably killed half the population or more and persisted in the country for at least a year and a half. Since, for several reasons, it can safely be assumed that Iceland was not populated by rats at this time, this may offer the strongest available proof that an epidemic like the Black Death was not dependent on rats for its dissemination.

* GUNNAR KARLSSON is professor of history at the University of Iceland at Reykjavik. He has published on aspects of the history of Iceland in both the medieval and the modern periods.

26. jaanuar 2006

Tamifluvarud erinevatel riikidel

linnugripifoorumis (Curevents) tehtud kokkuvõte:

TAMIFLU ON HAND (in descending % of population);

Kuwait - 5M doses/2.4M citizens = 208% coverage (104% w/ full dose)
Canada - 35M/32.8M = 107% coverage (53% w/ full dose)
New Zealand - 835,000/4M = 21% coverage (10% full dose)
Australia - 3.5M/20M = 17.5% coverage (8.7% full dose)
Singapore - 500,000/4.4M = 11.4% coverage (5.7% full dose)
UK - 2.4M/60M = 5% coverage (2.5% full dose)
Jordan - 60,000/5.8M = 1% coverage (0.5% full dose)
USA - 2M/296M = 0.67% coverage (0.33% full dose)
California - 70,000/33M = 0.2% coverage (0.1% full dose)
Turkey - 100,000/70M = 0.1% coverage (0.07% full dose)

STATED GOALS (in descending % of population);

UK - goal 25% of population (~15M doses) by August (12.5% full dose)
Algeria - goal 7M/32.7M = 22% coverage (11% full dose)
Japan - goal 25M/127M = 19.6% (9.8% full dose)
USA - goal 20M/296M = 6.7% (3.3% full dose)
Spain - goal 2M (on order)/40M = 5% planned coverage (2.5% full dose)
UAE - goal 1M (on order)/2.5M = 4% planned coverage (2% full dose)


Virgin Air - 10,000 doses/ ? # of employees

hirmujutud :D

nõrganärvilistel mitte lugeda - ja noh, autor ei pidanud ka väga usaldusväärne olema :)
a kui närvid korras, siis võib ikka lugeda :D

Continue reading "hirmujutud :D" »

25. jaanuar 2006

Nature - fiktsioon

26.05.04 Natures ilmunud lühike jutustus, kuidas võiks pandeemia areneda :D link

jutt lõppes sõnadega: Were we ready? Ready, my ass!

veel Oprahist ja Osterholmist

nobedad inimesed teevad märkmeid saate ajal ..
(he=Osterholm, she=Oprah)

paar huvitavamat lõiku

If the bird flu is anything like the 1918 pandemic, the highest death rates could actually be "those between the ages of 20 and 40." "In the months of September and October of 1918, 7 percent of the residents of Boston between 20 and 40 years of age died," he says.

How could individuals in the prime of their health be so susceptible to a disease? "It turns out that this virus multiplies very quickly in your body," Dr. Osterholm explains. "The people who have the healthiest immune systems are the ones that succumb to the virus because the immune system goes into overdrive."

The demographic least likely to survive the 1918 pandemic were pregnant women, Dr. Osterholm says. "Fifty-five percent of all pregnant women died from having this flu virus. There is no more precarious time in a healthy person's immune system, than [when they are] pregnant. Part of you says, 'Get rid of that [baby]. It's not all me.' And part of you says, 'This is the most precious cargo I'll ever carry. Protect it.'" This confusion makes bird flu extremely dangerous for pregnant women.
(ja ta jättis mainimata, et kuigi 45% haigestunud rasedadest jäi ise elama, siis loodetest ei jäänud praktiliselt keegi ellu)

Pandemics can last for up to two years, and since many of our medical supplies are shipped from overseas sources, Dr. Osterholm predicts that America will run out of masks, prescription drugs and other necessities before the threat is over.

Like the people of New Orleans learned, this is not the time to panic and feel hopelessness. It's the time to be prepared.
"What we have to do for pandemic flu preparedness is better prepare our world to get the living through it, the sick through it, and then come out the other end as well as we possibly can," Dr. Osterholm says. "That's the difference between being hopeless and hopeful. We're going to come out the other end…it's how well we can come out the other end."

arutlus rahvamälust

kommentaarid 1918a pandeemia kohta ja miks sellest eriti ei räägita

"Then, after it was over, no one wanted to talk about it, so it became lost in history."
It was so painful, they didn't want to speak of losing loved ones, or the bodies in the streets, doctors making housecalls and finding all had died,
(or, the people who hadn't lost anyone, or were born later, didn't want to hear about it; so depressing?)
so, between the war dead, the PTSD soldiers and the PTSD populace, wonder why people thought outlawing alcohol would solve some societal problems? Maybe they confused the symptom for the problem?
Very interesting:
does not even *mention* the Spanish flu pandemic!
Only keeps referring to "the end of WWI"

- history is written by who, taught by who, remembered by who, of interest to who?
Humans don't pass things along as carefully as perhaps they should.

24. jaanuar 2006

Nabarro: tegutseda tuleb nii nagu pandeemia algaks homme

jälle üks homne artikkel ;)

World must act as if flu pandemic imminent: UN official link


Many people appeared to be under the impression that they would have time to prepare for the widely feared pandemic but that was wrongheaded, Dr David Nabarro says.

"It's very hard to get people prepared for something that is as uncertain and unclear as this problem," Dr Nabarro said. "So many people, when I talk to them about getting prepared, seem to imply that we've got months in which to get prepared but I say to them: It may not be months. "It could be that we're going to get human-to-human transmission tomorrow so please act as though it's going to start tomorrow. Don't keep putting off the difficult issues."

The H5N1 bird flu virus has affected poultry flocks in the far east and Turkey, and has claimed some 80 human lives after spreading from birds to people. But experts fear the virus could mutate almost overnight and unobserved into a new form that would spread easily between humans and spark a repeat of the global influenza pandemics that killed tens of millions of people in the past century.

"There is a sensation for all of us who are working on this of standing on the edge of a really deep precipice and not knowing how far we're going to fall," Dr Nabarro said. "The moment the pandemic starts it's too late to get prepared."


oh, samast pressikonverentsist? teine artikkel veel: link

Senior UN System Coordinator for Avian and Human Influenza Dr. David Nabarro noted to reporters tUESDAY that he worries every day from receiving the news of a human to human transmission of the Avian Flu.
Nabarro said that "we are all standing on a deep edge and not knowing how far we are going to fall" when it happens. "Not only I am 'freaking out', to use the correspondents expression, and not mine, not only is that worry or anxiety because of the impact of a possible pandemic, but there is also that worry and anxiety because so many people when I talk to them about getting prepared seem to imply that we have months ahead to get prepared," he said. However he added that "I say to them it might not be months, it could be that we get human to human transmission tomorrow, so please act as though it is going to start tomorrow, don't keep putting off the difficult issues"."I am scared of the possible arrival of human influenza pandemic, everybody is scared of it," he said.

linnugripisurmad vanuste kaupa

1918a graafik vt alumist graafikut: link
enamus siis 15-25a

praegused andmed aga veidi erinevad:link

70% on alla 25a, üle poole alla 20a ..
vat see on üks ütlemata kurb statistika :(

see tuletab meelde paari veidrat asja ..

üks suvalise listi e-mail eelmisest suvest, kus muude segaste loodusnähtuste kõrval mainiti, et põlisrahvastel sünnib viimasel ajal väga vähe lapsi

Did you know that all over North America, migratory birds have stopped returning to their nesting grounds? And that salmon are no longer returning to their spawning grounds? And indigenous tribes throughout the world have stopped having children?”
Why would tribes stop having children? Maybe it’s because of their low survival rate during any process of change? Maybe because of the extra resources they take? Why would these things suddenly change?

ja siis teisest kohast kuuldud märkus, et üks eesti ennustaja, kes joonistab inimestele elukõveraid või midagi sellist :)
keeldub neid tegemast peale 2000.a sündinud lastele, kuna liiga paljudel neist pidi lühike kõver olema ..

linnugripisurmad vanuste kaupa

1918a graafik vt alumist graafikut: link
enamus siis 15-25a

praegused andmed aga veidi erinevad:link

70% on alla 25a, üle poole alla 20a ..
vat see on üks ütlemata kurb statistika :(

see tuletab meelde paari veidrat asja ..

üks suvalise listi e-mail eelmisest suvest, kus muude segaste loodusnähtuste kõrval mainiti, et põlisrahvastel sünnib viimasel ajal väga vähe lapsi

Did you know that all over North America, migratory birds have stopped returning to their nesting grounds? And that salmon are no longer returning to their spawning grounds? And indigenous tribes throughout the world have stopped having children?”
Why would tribes stop having children? Maybe it’s because of their low survival rate during any process of change? Maybe because of the extra resources they take? Why would these things suddenly change?

ja siis teisest kohast kuuldud märkus, et üks eesti ennustaja, kes joonistab inimestele elukõveraid või midagi sellist :)
keeldub neid tegemast peale 2000.a sündinud lastele, kuna liiga paljudel neist pidi lühike kõver olema ..

23. jaanuar 2006

ettevalmistatuse kasust

Planning for a disaster on our doorstep

üks päris mõistlik artikkel

paar lõiku:

.. we're overdue a serious flu epidemic, and when it arrive we're all going to know about it.

.. flu already kills 3,000 people across the UK each year and if it mutates into a superstrain scientists predict it will take them at least six months to come up with an effective vaccine.

.. We can't close our doors on it, either. It's been estimated that even if we were able to lock and bolt 99 per cent of the entry points to the county and pull up the drawbridge, it would only delay the arrival of the sneaky virus by a maximum of 10 days.

.. He's keen to increase public awareness of what risks we face, and what they can do if the worst comes to the worst. "If more people are able to help themselves, the emergency services will be able to concentrate on the vulnerable people who cannot," he said.

22. jaanuar 2006

ettevalmistused pandeemiaks

Planning for bird flu pandemic a community obligation

Arizona Daily Sun

Nobody likes to contemplate a disease that modern science seems powerless to cure.
Throw in a mortality rate of 50 percent, and there is good reason to plan early against panic.

That's what local health officials are doing as the avian flu advances westward from Southeast Asia into central Europe. Faced with life or death decisions, individuals tend to look out for their own interests and those of their immediate families first. But it's as a community that Flagstaff is likely to pull through such a crisis best.

The challenge is to recognize early that some tough decisions will have to be made, then make them.

* If there isn't enough vaccine to go around, who should get it first?
* Will all health and public safety workers be expected to remain on the job or be allowed to tend to their families?
* At what point will the sick and dying be told to stay home rather than come to the hospital and risk infecting others?
* How long will schools and businesses have to remain closed and will a citywide quarantine mean shutting off access by outsiders?

Those are all difficult ethical issues to ponder, but we should be thankful that we have the time and knowledge to address them in advance. From the bubonic plague of the Middle Ages to the Spanish Influenza of 1918 and even the polio outbreak in the early 20th century, most pandemics have struck without much warning and with little scientific understanding of their cause or cure.
loe edasi

20. jaanuar 2006

Cheney - pandeemia võib põhjustada olulisi probleeme majandusele

WASHINGTON, Jan 20 (Reuters) - Vice President Dick Cheney said that if avian flu were to arrive in the United States, it could deal a blow to the U.S. economy because of disruptions to businesses, schools and transportation systems.
"It's the kind of thing I think that probably would have a major impact," Cheney said in an interview with radio talk show host Hugh Hewitt.

"I think also when you start to think about a pandemic, some of the early measures basically are to shut down transportation systems, close schools and public meeting places and so forth in order to minimize the possibility of transmission," Cheney said.

H5N1 avian influenza now mostly affects birds but it has occasionally jumped to people, killing just around 80 in six countries. The fear is that the virus could mutate into a human influenza, spread quickly and kill millions globally.
"There are things clearly that would have significant economic consequences were there to be such a pandemic," he

pandeemia korral probleeme toiduainetega

The Science and Technology Committee said a pandemic is likely to cause shortages of food and other essential supplies because of workers being off the job sick.

While the peers said Britain is better prepared than most countries, more needs to be done. "It is going to affect everybody in all walks of life," Labor peer, Lord Mitchell, said. "Distribution networks in this country -- as we saw through the petrol crisis -- are very finely balanced and any interruption can affect it quite dramatically. link

19. jaanuar 2006

1918.a. gripipandeemia mälestused Torontost

ühtlasi palve - küsige, kas teie vanemad sugulased mäletavad midagi 1918a gripipandeemiast Eestis ja kirjutage siia kommentaaridesse :)

lugu 1.
In the fall of 1918, Clara was a young woman and lived with her mother in a small apartment near the Danforth and Jones Ave. When her mother became sick, the doctor was summoned. "It's the flu," he said after a brief examination. "She's in God's hands."

Coughing and shaking from fever and chills, her mother grew weaker with every passing hour. Nothing Clara did seemed to help. Worried and frightened, she kept glancing out the bedroom window of their second-floor apartment, watching the endless line of hearses and carts that wheeled up the puddles and ruts of Danforth, then a dirt road. As far as you could see, nothing but mourners and their sad processions.

It had been days and days of families bringing their dead to the cemeteries on the outskirts of Toronto. It seemed to Clara that the flu was killing everyone it touched. As she sat there worrying and listening to her mother's raspy breaths, she noticed a big barrel of oranges in front of the corner grocery across the street. She didn't know whether it would help or not, but she just had to get some oranges.

Pocketing a few coins, Clara threaded her way through the endless line of mourners jamming the street, and marched up to the grocer's store. She had enough money for nearly a dozen oranges, and she spent every cent. One by one, the grocer dropped them into a paper bag.

Clara raced back across the street and up the stairs to her mother. She sliced open each orange, and squeezed all the juice into a cup. Teaspoon by teaspoon, she held them to her mother's lips. It took hours to finish all the juice.
By morning, her mother's fever had all but disappeared, and in a few days, was gone. And the Spanish flu that only days before had been taking the lives of young and old seemed to just fade away. Fewer and fewer mourners trudged along the Danforth. Soon enough, they stopped.

lugu 2
In 1918 my grandfather Dr. Charles W. L. Clark was a doctor in Toronto. He was one of the few ear, nose and throat specialists in this city but during the flu epidemic everybody with any kind of medical background was pressed into service. He was seeing patients day and night in their homes. He often spoke of how terrible it was to answer those house calls only to find that his patients had died.

He described one particularly tragic incident when he arrived at a patient's home late in the evening, his last call of the day. No one answered the front door, but it was open, so he went in. He found two children dead in the living room, then went upstairs and found the mother dead in the bedroom with her baby dead in the bassinette beside her.
link artiklile

huvitavad kommentaarid Hiina majanduse kohta

võibolla ei tähenda eriti midagi, võibolla tähendavad - huvitavad faktid nii või naa :)

foorumikommentaarid siis, linki ei ole

China has far more cash reserves than it needs compared to short term debt (one standard measure). In fact, China's total reserves to GDP ratio are approximately 50%. Cash reserves of 1% would be considered generous. 2 International Monetary Fund economists (Aizenmann and Lee) concluded that China is building its reserves "as a precaution against a crisis".

China has purchased a very, very, very large amount of strategic resources, fuel, wood, metals, grains, and they pay for it via their exports to western countries.

haiglatel soovitatakse pandeemia korral kasutada triaazhi abivajajate hindamiseks

Hospitals will have to use triage procedures devised for battlefield casualties to cope in the event of a bird flu pandemic, a Canadian critical care expert has warned.

.. Military-style battlefield triage may be needed at peak times when patient numbers outpace the number of beds, ventilators, the supplies and drugs and the number of people needed to tend to them, Dr Hawryluck told the seminar

"The military had used triage systems for many years," she said. Her system has already adopted the military color codes for patients, she said.

"The red people would be the highest priority for ICU care," she said. "Yellow - those are the people you know they might do well with ICU care, they might do well without, it would be nice if the resources were available," she added. People deemed "blue" or "black" would receive only palliative care - to reduce pain and suffering while they died, while people given a "green" rating would not require immediate attention. link

ülevaade pandeemiaohust -powerpoint

päris huvitav ppt ettekanne: link
ja sealt alla laadida siis PowerPoint Presentations - Overview of the Pandemic
mh küsitleti hulka eksperte ja tehti kokkuvõte nende arvamustest

Continue reading "ülevaade pandeemiaohust -powerpoint" »

ülevaade pandeemiaohust -powerpoint

päris huvitav ppt ettekanne: link
ja sealt alla laadida siis PowerPoint Presentations - Overview of the Pandemic
mh küsitleti hulka eksperte ja tehti kokkuvõte nende arvamustest

Continue reading "ülevaade pandeemiaohust -powerpoint" »

miks Türgis ainult lapsed surevad?

sellele ei tea vastust keegi :(

arvatakse, et vastus võib olla mingi kombinatsioon järgmistest põhjustest:
- ida-Türgis on 80%! elanikest alla 18a vanad, 8-10 last peres on tavaline,
- kodulindude eest hoolitsemine on laste töö,
- kuna lindude grippe on olnud ennegi, siis täiskasvanutel võib olla veidi immuunsust (üks suhteliselt suvaline arvamus),
- lapsed on väiksemat kasvu ja seega linnusitale lähemal,
- laste hügieenikombed on täiskasvanute omast viletsamad (mustade kätega puudutab nägu, ei pese käsi enne sööki jne),
- lapsed mängivad kanadega ja peavad neid lemmikloomadeks

nakatumisest lindude väljaheite kaudu

tervisekaitseinspektsiooni kodulehelt: link

Küsimus: Kas linnugrippi võib nakatuda ka nii, et astud jalanõuga haige linnu väljaheitesse ning siis puutud kokku selle jalanõuga või vaibaga, kuhu oled astunudd?

Haige linnu väljaheitest nakatumine on võimalik – vaibale sattunud väljaheide kuivab kiiresti ja tolmuga võib viirusi sisse hingata. Samal põhjusel ei soovitatagi (eriti lastel) viibida linnutoitmise kohtades, kus on nii väljaheiteid kui ka tolmu – väike laps on ninaga ohule vähemalt 1 meeter lähemal kui temast pikem täiskasvanu.

Kui tuppa tulles on jalanõud saastunud, siis tuleb need (ja ka vaip) vee-seebiga puhastada ja pärast seda käed hoolega puhtaks pesta. Käte pesemine on päästva toimega ka paljudest teistest haigustekitajatest lahti saamiseks ja enda kaitsmiseks. Seda teadmist peaks lastele varakult sisendama hakkama.

linnuliha tarbimisest

raadiost just öeldi, et Venemaa keelas Ukrainast lihaimpordi, kuna võib olla ohtlik inimeste tervisele

tervisekaitseinspektsiooni kodulehelt soovitused linnuliha käsitlemiseks:link

* Töödelge toorest ja keedetud/küpsetatud linnuliha ning muid toiduaineid eraldi (eraldi laud, nuga, nõud).

* Peske käsi toore ja keedetud/küpsetatud linnuliha ning muude toiduainete töötlemise vahel.

* Ärge sööge ega kasutage toiduvalmistamisel tooreid ja poolvedelaid mune.

* Peske käsi pärast toore, külmutatud ja ülessulatatud linnuliha ja kanamunade käitlemist.

* Kuumtöödelge (keetke, küpsetage) linnuliha ja kanamune: liha sisemuses peab temperatuur tõusma vähemalt +70°
C-ni (soovitatavalt +74°C); muna ei tohi olla vedel või poolvedel.

* Ärge sööge toorest linnuliha ja tooreid mune.

kui kiiresti inimene sureb linnugrippi?

vastus siis ühte foorumisse, kopeerin siia ka ..

veidi otsisin, parim allikas, mis leidsin: link

räägib ajast siis järgmist:
peiteaeg: keskmiselt 2-5 päeva, maksimum 8-17 päeva

surm saabus keskmiselt 9-10 päeva jooksul peale haigestumist, enamus patsiente suri "progressive respiratory failure" - ma ei oska seda tõlkida, aga põhimõtteliselt kopsud lihtsalt hävivad ..

siiani on kinnitatud H5N1+ surnud umbes pooled,
Türgis on kinnitatud juhtumeid 21, surnud siiani 4
21 haigestunust 18 on olnud lapsed, surnutest olid kõik lapsed ..

18. jaanuar 2006

gripiviiruse mutatsioonid tekitavad muret

Scientists studying virus samples from the human outbreak of avian flu in Turkey have identified three mutations in the virus's sequence. They say that at least two of these look likely to make the virus better adapted to humans.

The Turkey outbreak is unusual, because of the large family clusters of cases; the fact that many of those infected have only mild symptoms; and the speed with which infections have arisen — twenty cases, including four deaths, in less than two weeks. So scientists are urgently trying to establish whether the virus is behaving differently in this outbreak from previous ones in Asia. In particular, international teams are investigating the possibility that the virus is moving between people.

"With such a large number of cases within such a short period of time, human-to-human transmission is something that we've had to consider," says Maria Cheng, a spokeswoman at World Health Organization (WHO) headquarters in Geneva.

jutt läheb edasi sealt

17. jaanuar 2006

erinevad kalkulatsioonid

erinevad tõenäosused ja siis tulemused - eks too üks numbritega mängimine muidugi ole .. reaalseid numbreid ei tea keegi

erinevad nakatumise määrad ja nakatunute surevusmäärad ja nende erinevad kombinatsioonid

Influenza Pandemic Level Analysis

US Population 297,702,697
World Population 6,480,130,950
Low infection 25%
Med infection 50%
High infection 75%
Low mortality 4%
Med mortality 8%
High mortality 12%
Very high mortality 50% - (praegune reaalne väikese arvu nakatunute juures, jätkuks pandud siia)

Level Infect % - Kill % - Tot % - US deaths - World Deaths - Comments
I Low (25%) - Low (4%) - 1% - 2,977,027 - 64,801,310 - WHO's worst case
II Low (25%) - Med (8%) - 2% - 5,954,054 - 129,602,619
III Low (25%) - High (12%) - 3% - 8,931,081 - 194,403,929
IV Med (50%) - Low (4%) - 2% - 5,954,054 - 129,602,619 - 1918 infection rate
V Med (50%) - Med (8%) - 4% - 11,908,108 - 259,205,238
VI Med (50%) - High (12%) - 6% - 17,862,162 - 388,807,857
VII High (75%) - Low (4%) - 3% - 8,931,081 - 194,403,929
VIII High (75%) - Med (8%) - 6% - 17,862,162 - 388,807,857
IX High (75%) - High (12%) - 9% - 26,793,243 - 583,211,786

X .Low (25%) - VHigh (50%) - 12.5% - 37,212,837 - 810,016,369
XI Med (50%) - VHigh (50%) - 25.0% - 74,425,674 - 1,620,032,737
XII High (75%) - VHigh (50%) - 37.5% - 111,638,511 - 2,430,049,106

progressiivne Uus-Meremaa planeerib juba orbude paigutamist ..

Uus-Meremaa on ikka teistest riikidest mitu penikoormat ees oma ettevalmistustega :D
alles oli uudis, et massihaudade asukohad on välja valitud, täna on siis uudis, et orbude majutust planeeritakse..

Hundreds of children left parentless in a flu pandemic would be housed in makeshift orphanages in community halls or maraes, Child, Youth and Family (CYF) says.
Details of CYF's plan for coping with extra orphans comes as New Zealand health chiefs confirmed a bird flu pandemic was inevitable. link


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uuring potentsiaalsest pandeemiaohvrite arvust

Tegi miski säärane asutus nagu Insurance Information Institute uuringu, et kui palju siis võiks potentsiaalse pandeemia korral inimesi Ameerikas otsa saada - ja mis see kindlustustele maksma võiks minna. link

Although many variables could affect the number of people who could catch and die from the H5N1 flu, the U.S. Department of Health and Human Services (HHS) projects that in a severe influenza pandemic 1.9 million people in the United States could die. That figure was reached working largely from the experience of the 1918 pandemic—to date, the deadliest and most infectious known influenza strain. Laurie Garrett, extrapolating from the recent H5N1 outbreaks, calculates an “extreme… worst case scenario,” based on an assumption of 80 million Americans infected and a mortality rate of 20 percent, namely 16 million deaths.

Huvitav oli võrdlus 1918.a. pandeemiaga, et mis on selle ajaga võrreldes parem ja mis halvem.

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16. jaanuar 2006

iga pere vajab oma pandeemiaplaani ..

Friday was the Rhode Island State Summit.
If a flu pandemic develops around the world, each community will have to cope on its own, Michael O. Leavitt, U.S. secretary of health and human services, warned Rhode Island officials yesterday.

The entire nation will be affected, so the federal government will not be able to marshal help from other areas. "Every community will have to rely on its own resources," Leavitt told an overflow crowd of hundreds of Rhode Islanders at the Crowne Plaza hotel.

"Every state needs a plan. Every tribe needs a plan. Every school, every business, every church, every family needs a plan," Leavitt said.

Leavitt's visit to Rhode Island was his fifth stop in a tour he plans to take to every state to push for action on pandemic-flu planning. He spoke unflinchingly of what would happen if there were a worldwide pandemic like the Spanish flu of 1918, which killed 40 million people.

"Pandemics are world-changing events," he said. A flu virus of similar strength to the 1918 flu would sicken 90 million Americans and kill 2 million. Even the healthy would be affected, because there would be fewer people able to stock grocery shelves, deliver fuel oil, care for the sick or provide other services.

If a pandemic arrives, Leavitt said, "We're not going to be able to stop it. Our preparation is to try to limit its impact.

"We may be the first generation in human history . . . that has had the opportunity to do something about it in advance." link

15. jaanuar 2006

soome saun kui gripiravi

linnugripifoorumis arutavad soome sauna kasulikkuse üle

teemat alustas soomlane järgmiste soovitustega:

Heat your Sauna to 120 C at the level of your to rest.
1. Lay down, give no water to the stove, lift your feet to the roof and relax, take in 10-15 minutes of heat.
2. Sit up frow some water on the stove, breath freely, inhale the steam. Repeat 5 times.
3. Go out relax end enjoy the cool
4. Go back try to have the heat at roof top at around 100c and top bench at 87-95 and start steaming it.
5. Try to keep your body temperature hot, remember your lungs can take it but the virus cant.
6. Enjoy and have a lemonade, beer or some clean water.

ameeriklaste kommentaarid sellele:

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h5n1 mutatsioonidest

väga segane värk igatahes :S

niipalju ma sain aru, et Vietnamis toimus muundus no 1, mis võimaldab viirusel ellu jääda 34 kraadi juures - mis olevat siis nina sisetemperatuur

ja Türgis on nüüd toimunud veel üks muundus, mis võimaldab efektiivsemat edasikanduvust, nii b2h kui h2h (linnult inimesele ja inimeselt inimesele)

siiani ongi vist üheks "probleemiks" tollel linnugripiviirusel olnud aeglane edasikandumisvõime, mis nüüd on lahendatud? ueh, oleks ainult veidi rohkem mõistust ja saaks sellest keemiast paremini aru ..

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tehnotrendide-ennustajad linnugripist

Microsoft and Oracle are humbled, phone calls become free, and product design trumps functionality.

There's much to get excited about in 2006, according to five of Silicon Valley's leading venture capitalists -- as long as we don't all die first from a global outbreak of bird flu.

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püha müristus .. nüüd nad arutavad linnugripifoorumis, et HIV võib kombineeruda linnugripiga (H5N1), see oleks küll üks jõhker viirus, mis sealt välja tuleks
ja nakatunud linnud on nüüd suundumas Aafrikasse, kus kohati on valdav enamus inimesi HIV-positiivsed

mitte, et ma midagi jagaks viiruste toimemehhanismist .. aga kõlab igatahes halvasti ausaltöelda :(

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linnugripi leviku graafiline esitus

rootsikeelne ta ju on, aga see-eest hästi ilmekas

esiteks vajuta lingile, mis on väikese maakaardi pildi all
Se rörlig grafik
ja siis Fortsätt on "edasi"

Maailma riikide pandeemiariski analüüs

Euroopa kõrgeima riskiga piirkonnaks on märgitud UK. Eesti on märgitud sarnaselt skandinaaviamaadega madala riskiga piirkonnaks, tulenevalt siis tõenäoliselt madalast asustustihedusest ja põllumajanduse vähesest osatähtsusest .. Erinevalt skandinaaviamaadest on Eesti võimekust pandeemia piiramise osas hinnatud vaid keskpäraseks.

mõningaid väljarebitud tsitaate :D

mõningad linnugripifoorumis kogutud tsitaadid "juhtivate ekspertide" kõnedest ja raportitest

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pandeemia piiramiseks võib olla vajalik kasutada armeed
The World Health Organisation yesterday predicted authorities might need to use the army and police to quarantine about 120,000 people to contain aninitial pandemic flu outbreak of just 19 cases.

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