Surge of Flu Cases in Argentina and Chile

indigo girl · Jul 16, 2009

Swine Flu Bites Southern Hemisphere

http://www.globalpost.com/dispatch/argentina/090714/swine-flu-deaths

Argentina's health minister claims his country is currently the most affected on earth. Visiting infectious disease specialist Alejandro Macias, who helped coordinate the response to the H1N1 epidemic in Mexico, calls it “the epicenter of the world.”
This is where most of the swine flu deaths are now happening, according to World Health Organization numbers. With 137 official H1N1 deaths, the outbreak in Argentina has been the second deadliest of the pandemic, second only to the United States.
All of those deaths were registered in the past month, almost a third of them just this past weekend. With the flu up north slowed by the summer but just moving into full swing down here, Argentina may very soon have lost more people to the disease than any country on earth.
"The countries of the Northern Hemisphere are looking at Argentina as a mirror," Macias said in an interview with the second largest Argentine newspaper last week. "The same scenario will be reflected next winter in the north, and we've come here to learn."
Canada, Australia and neighbor Chile have all reported several times as many cases of the infection. But the death toll and the mortality rate have been drastically worse in Argentina than in any almost any other country, raising questions about this government's handling of the outbreak.

(hat tip PFI/monotreme)

indigo girl · Jul 28, 2009

This is a strange translated article coming out of Ecuador, not Argentina or Chile but another South American country experiencing the winter flu season in this pandemic.

The article acknowledges that these deaths are in young people that were not diagnosed and treated early enough to save them.

What I would question however, is that this is reporting no prior health issues in 80% of the cases. Now if this it true, than it is very unusual, and someone needs to be looking at those viral sequences.

http://www.flutrackers.com/forum/showpost.php?p=273015&postcount=2

Source: http://www.cre.com.ec/Desktop.aspx?Id=143&e=130513
Quito (CRE) .-
Three more deaths were recorded in the country by the influenza virus AH1N1 bringing to 17 the number of deaths in Ecuador.
Two people died in Loja, the other in New York, as announced Marcelo Aguilar, Deputy Minister of Health, who did not rule out an increased number of deaths in the coming days.
80 percent of those killed are young people between 20 and 45 years of age who have no history of other diseases and have not been diagnosed in a timely manner.
"The majority of cases came to public bodies to take care of and handled (the disease) in private," said the national director for Health, John Cuenca.
According to statistics, men are much more vulnerable to the contagion of the disease and death, as reported 60 percent of total deaths.
Meanwhile, health authorities Carchi investigating the death of a citizen, 53 years old, who reportedly died of virus AH1N1.
We proceeded to take the sample to check whether the swine flu, but the results will be ready in 72 hours.

indigo girl · Jul 30, 2009

Mayo Clinic expert looks south for answers

http://www.kare11.com/life/community/health/healthfair_article.aspx?storyid=820237

What struck me about this interview with Dr. Gregory Poland of the Mayo clinic was that he is saying that in Argentina, the current Case Fatality Ratio is 2 to 3%. This is truly astonishing! Could this really be accurate? As he says, this is the oft reported CFR for the 1918 pandemic.

This is only one country, mind you. Maybe there is something different going on there? I know that Dr Niman over at flutrackers has been watching for changes in the swine flu virus, and has noted something new in the Sao Paulo sequences released from Brazilian cases near the Buenos Aires border. And, the Argentian scientists are also reporting something different. Dr. Poland, himself is a well known and respected virologist. That he is reporting this unusual CFR at all is unsettling.

From his office at the Mayo Clinic in southern Minnesota, flu pandemic expert, Dr. Greg Poland is keeping a close eye on the southern hemisphere and how H1N1 virus is spreading. Because while we're in the midst of a sunny summer, it's winter flu season there. Poland says, "We're talking tens of thousands of cases and close to 1,000 deaths by now."
He continues, saying, "One thing of concern early on in Argentina in part is they were seeing case fatality rates that were somewhere in the 2 to 2 1/2% range. Now in the U.S. our case fatality rate has been under, well under, 1%. About .4 to .5%. But 2 to 3% is the same case fatality rate that historians think happened in 1918.
The 1918 flu pandemic killed more than 600,000 in the U.S. So the question is, could H1N1 become as deadly?
Poland, who is a liaison on the Advisory Committee on Vaccination Practices and who is chair of the Pandemic Preparedness Panel for the Secretary of Defense, says there are concerns.
One is that in the southern hemisphere, H1N1 has completely replaced seasonal flu.
Poland says, "What's happening down there is mimicking what was seen in 1918 and again in 1968. This pandemic virus is fitter and is outpacing, outcompeting, replacing all the seasonal virus."

(hat tip P4P/happycamper)

indigo girl · Aug 5, 2009

http://www.bangkokpost.com/breakingnews/151238/argentina-flu-deaths-double-to-337

Swine flu deaths in Argentina have more than doubled in the past two weeks and now total 337, officials said Wednesday.
The figure, up from the previous count of 165, confirmed Argentina as the country with the second-highest swine flu fatality count in the world after the United States, which has 353 dead.
Argentina's deputy health minister Maximo Diosque said swine flu had almost totally replaced the normal seasonal flu in the country, which was in the southern hemisphere's winter.
More than 700,000 of the 763,000 flu cases detected in the country were of the A(H1N1) swine flu type, he said.
"We have confirmed 337 deaths by A(H1N1) flu,'' he said.

"We have a similar number, of around 400 cases, that are in the process of being confirmed.''
Although Argentina has reported almost as many deaths as the United States, its population is just a fraction of the latter, estimated at 40 million to the United States' 300 million.

(hat tip flutrackers/niman)

oramar · Aug 5, 2009

I am really waiting and wondering what is going on with the discrepancy with death rates in the two countries. Could it be that people in US are seeking help sooner? Just don't know.

indigo girl · Aug 8, 2009

Is Argentina in First Place Now?

http://www.scottmcpherson.net/journal/2009/8/6/latin-america-continues-to-suffer-under-weight-of-swine-flu.html

Scott McPherson is the Chief Information Officer of the Florida House of Representatives. Here is a pared down version of commentary from his blog.

The latest information coming from the CDC indicates a confirmed total of 353 deaths from swine flu. But Argentina just released new, two-week numbers which raise their death toll to 337.
But wait, there's more. According to the Guardian UK newspaper story, the Argentine government is waiting for positive pathology on another 400 deaths. If even a third of these are confirmed H1N1v, that will catapult Argentina to the top of the world's death list. Hat-tip to Cindy of Nerstrand, MN.
So what, you might ask. Well, two things should leap out at you. First, Argentina has just under 41 million people, according to the CIA. That means Argentina has just over one-seventh the population of the United States, yet it now effectively leads the world in deaths. If the United States had, say, 2,600 deaths from swine flu, that would be a comparable ratio relative to population.
Second, recall that this is Argentina's flu season. The Guardian article discusses that 750,000 confirmed cases of swine H1. I am sure that is just an estimate and not actual swabs. But the number of deaths could be double what is being officially reported, if the 400 unknown results become positive.
This strains further an Argentine government that was the textbook example of how NOT to handle risk communication.
When H1N1v broke out, they acted as if the virus never existed. No, not here. Move along. When it became painfully apparent the virus was in Argentina and people were dying from it, only then did the government do an about-face and started engaging their pandemic plan.
...there seems to be quite the debate raging as to whether or not the virus has indeed mutated in South America...the Brazilian research facility Instituto Adolfo Lutz...
...has typed the first known mutation of the virus' hemagglutinin (the "H" in "H1N1"). Hemagglutinin is what sticks the virus to the cell wall in your respiratory tract (think of those velcro ping-pong balls that stuck to felt dartboards from back in the day). An antigenic change in hemagglutinin could make the virus much easier to catch (search umbrellas and coneson this blogsite for a full description of this phenomenon).
The isolation of the virus provided the sequence of the genetic material of the Brazilian strain, experiments being performed by Dr. Cecília Luiza Simões dos Santos of the Instituto Adolfo Lutz.
The complete sequences of the genes HA and HB, the first determined for strains isolated in Brazil, are available in GenBank, a database that U.S. shared sequences obtained worldwide...Molecular analysis indicated that while the virus segment 7 of A / Paulo/1454/H1N1 are shown to be completely conserved when compared to the reference strain A/Califórnia/04/H1N1, segment 4 showed a discrete number of nucleotide changes and of amino acids, with similar rates of around 99, 7% and 99.5% respectively. Detection of amantadine-resistance marker, comprising the amino acid asparagine (N) located at position 31 (N31) of the M2 protein in strain A / San Paulo/1454/H1N1, corroborates the literature that point be the new virus resistant to this class of antiviral compounds.
The debate started just after the sequencing of this new substrain of H1N1v was announced, and it continues to rage on flu sites such as Flutrackers to this very hour. The issue is this: Do these changes have a lot in common with the hemagglutinin from 1918? At first glance, the answer is yes. There was a lot of swine involvement in the 1918 virus, and so it would not be surprising to see this unique virus sort of "run home to Momma" when it comes to picking up mutations. Swine flu is a much closer antigenic descendant to the 1918 pandemic strain than is our seasonal H1N1! The fact that some of these mutations were first typed in the "Brevig Mission, Alaska" trip of Johan Hultin, circa 1997-98, and came conclusively from the 1918 virus, are somewhat unsettling.
It remains to be seen if this Brazilian mutation is responsible for the larger numbers of infected and dead in Latin America relative to population. Sao Paulo is Brazil's southernmost metropolis. It is about 800 miles from Buenos Aires, the capital of Argentina. The area also borders the capitals of Uruguay and Paraguay.
Let us shift to Mexico, which is reporting a new spike in human H1 cases. Are these cases the vanguard, the herald of the Second Wave? Or are these outbreaks simply vestiges of the first wave of the virus? Nobody knows yet, but there are more reports coming from the border region with Texas which indicates more Tamiflu resistance than originally thought.