Swine Flu Updates and Issues

indigo girl · May 21, 2009

duplicate post of the one below.

indigo girl · May 21, 2009

You have to wonder how many people have had swine flu and were never tested. If the test is only 70% right, would we have more deaths attributed to swine flu.
So if your not testing for it then your not going to find it.

http://afludiary.blogspot.com/2009/05/h1n1-in-europe-hiding-in-plain-sight.html

Exactly. Let's pretend it is not happening. Don't test because it is too much trouble or too expensive. In the EU, make it hard to test then they won't have to acknowledge the community transmission into yet another region of the globe.

One of the mysteries surrounding the H1N1 `swine flu' outbreak is why 90% of all known cases are documented in North America, and so few have been detected in Europe.
As unpolitic as it may sound, many people (including this blog) have suggested that some European nations are simply turning a blind eye to suspect cases, failing to test them, so as not to force the WHO into moving to a Phase 6 Pandemic declaration.

http://www.newscientist.com/article/mg20227094.400-europe-may-be-blind-to-swine-flu-cases.html

... European countries are using a case definition from the European Centre for Disease Prevention and Control (ECDC) in Stockholm, Sweden, that virtually precludes discovering such cases. It recommends testing people with symptoms only if they have been to affected countries or had contact with a known or suspected case in the past seven days.
"We can't test every mild case of flu symptoms," says Johan Giesecke, chief scientist at ECDC. "But it's true, we might not be seeing community spread because we aren't looking."
Tests may simply be unavailable. "I was given only two swabs [for H1N1] initially," says Laurence Buckman, head of the GP committee of the British Medical Association. More are available now, "but if you can't do many tests you save them for people who meet the case definition".
Any others, says Buckman, will be picked up by "sentinel" clinics that compile weekly statistics. The ECDC claims this system "would detect circulation of the new H1N1 virus before any major outbreaks occur".
However, such sentinel systems are designed to track ordinary flu, not to detect a new infection that is initially highly localised. "It may take weeks before the numbers indicate an epidemic," warns Dick Wenzel of Virginia Commonwealth University in Richmond, past president of the International Society for Infectious Diseases. He advises testing clusters of flu and all severe cases.
Hong Kong is testing all hospitalised cases of flu and pneumonia. Belgium, departing from ECDC advice, is testing flu-like clusters and deaths. But without more tests, Europe may be missing an epidemic.

Girl Scout · May 21, 2009

When I've read about the world's preparations for a global H5N1 pandemic in the past, I always wondered this: how in the world do you get everything, and everyone, on the whole planet, working and communicating smoothly and effectively? And take out all the things that divide us and obfuscate our true priorities, like politics and business? You just don't. That, in itself, creates the disaster.

indigo girl · May 21, 2009

When is a pandemic not a pandemic?

http://www.nature.com/news/2009/090521/full/news.2009.501.html?s=news_rss

Africa has poor surveillance systems and many health challenges. We already know that swine flu hits those with co-existing conditions the hardest. What will happen if there is large scale transmission in the countries with large numbers of HIV and TB cases? There are already some reports coming out of Africa, but not much news yet.

...Margaret Chan, director-general of the WHO, came under pressure from member states-including the United Kingdom and Japan-to move the goalposts to delay or prevent a move to phase 6, by redefining it to include an assessment of the severity of the disease, and not only its geographical spread.
Adding that requirement of severity may sound like common sense. But it is not, because the severity of a pandemic is unpredictable. The flu might fizzle out; or it could go away for months only to come back with a vengeance, creating as much devastation as the 1918 flu outbreak, which caused an estimated 50 to 100 million deaths worldwide.
Moreover, the WHO has pointed out that adding that criterion at a global level would be largely meaningless-what might be deemed a mild disease in a rich country with many doctors, drugs and intensive-care units might be more severe and cause considerable mortality in a poor country with little health infrastructure, and where underlying diseases may worsen outcomes of a flu infection.
So what's the big hang-up with calling a pandemic a pandemic? Those fretting over the term include news pundits in denial about the scale of the threat, along with politicians and scientists who fear that using the word may induce public panic.
The importance of the phase 6 designation is overrated. It is not some alert threshold that, when passed, triggers an automatic and unstoppable series of draconian measures. As Chan says, "Level 6 does not mean that we are facing the end of the world."
The WHO revised its pandemic preparation guidelines in April to make it clear that the organization's role is limited to the following: defining the extent of the virus's spread; coordinating the international public-health response; selecting the pandemic vaccine strains and recommending when large-scale vaccine production should start; and coordinating the gathering of scientific data on the outbreak.
Individual nations then take responsibility for deciding an appropriate course of action.
Indeed, the WHO's expectations of national response are the same for phases 5 and 6. Both call for "each country to implement actions as called for in their national plans", and to be ready for an "imminent response".
...the move to phase 5 had already activated several preparedness measures, and had helped to put public-health services, labs and industry on alert. She reiterated the definition of a pandemic: "A defining characteristic of a pandemic is the almost-universal vulnerability of the world's population to infection. Not all people become infected, but nearly all people are at risk."
Heavy surveillance teamed with rapid isolation and treatment of individual cases only makes sense at the very earliest stage of an outbreak in a region, when there is a possibility of slowing the initial spread. It becomes irrelevant once the virus is spreading widely within the community, as it is in the United States.
As Chan implied in her address, there are more pressing issues at hand than quibbling over phase definitions, such as helping poorer countries to prepare for the pandemic.
"This virus may have given us a grace period, but we do not know how long this will last," says Chan. "I strongly urge the international community to use this grace period wisely. I strongly urge you to look closely at anything and everything we can do, collectively, to protect developing countries from, once again, bearing the brunt of a global contagion."

Amen to that.

indigo girl · May 21, 2009

Suspected cases of Swine Flu in Africa

http://www.hararetribune.com/health/22-news/709-suspected-cases-of-swine-flu-in-africa.html

"The WHO in Africa has so far 12 suspected cases in the region. Five of them are waiting now for results and are currently under investigation," Luis Sambo said at a meeting of the continent's health ministers in Addis Ababa.
"We've been discussing with pharmaceutical companies to make Tamiflu, the only effective medicine we have, available. For Africa, we have already dispatched thousands of doses to the countries," Sambo said.
"If the epidemic hits Africa, the impact would be more serious than in other parts of the world as the surveillance systems are weaker, and the resources insufficient," the WHO chief said.
"That is why we are now making the assessment of the needs to be sure we can respond to any outbreak," he added.
Sambo nevertheless pointed out that the continent was grappling with graver epidemics -- such as AIDS, malaria and tuberculosis -- and noted that swine flu's mortality rate was low.
The African Union Commissioner for Social Affairs Bience Gawanas said it was critical for the continent to initiate concerted action in the face of an H1N1 pandemic threat.
"Africa needs to take immediate and concrete actions to meet the emerging threat of H1N1 and related epidemics, the cost which will be too huge for individual member states to bear," he said.

indigo girl · May 21, 2009

http://www.nytimes.com/2009/05/21/nyregion/21kids.html?_r=2&partner=rssnyt&emc=rss

What a surprise! Kids being kids are not going to stay home unsupervised so now they will bringing swine flu to the mall.

Marlene Telalyan, 14, spent an afternoon swanning around the Queens Center Mall with a pack of her girlfriends.
"My mom told me not to go out," she proclaimed, giggling. "Too bad she's at work and can't see me."
With swine flu still shuttering schools and more than 15,000 students granted an unexpected week off, they are scattering across Queens this week like new visitors to a planet called Weekday, somewhere between a snow day and a full summer vacation. Students have popped up among adults in stores, parks and libraries, places they are often forbidden to visit unsupervised.

Girl Scout · May 21, 2009

http://www.nytimes.com/2009/05/21/nyregion/21kids.html?_r=2&partner=rssnyt&emc=rss
What a surprise! Kids being kids are not going to stay home unsupervised so now they will bringing swine flu to the mall.

The kids out from school in Japan are taking the same approach: shopping, going out to parties, clubbing. If any are carrying the virus (and I suppose many are), closing the schools didn't really actually serve its purpose. But what are you going to do, keep the schools open?

Besides... they're teenagers! Teenagers rarely follow instructions or have good rationale even on the best of days. Telling them not to do something is almost the same as daring them not to do it, and with a pack of 10 of their buddies!

indigo girl · May 23, 2009

W.H.O. Plans to Rewrite Its Rules for Declaring a Pandemic

http://www.nytimes.com/2009/05/23/health/policy/23who.html?_r=1&ref=world

There are some interesting things of note in this article. First, that the WHO has bowed to pressure to redefine what a pandemic is or is not. But, btw, this is not the first time that they have done so.

The other, at least to me, startling point is that 300 people in the US have been hospitalized. I had no idea that 300 people were sick enough to be in the hospital This is reportedly a mild flu. And, we are only a month into this "epidemic" or whatever we are now calling it.

Bowing to pressure, the World Health Organization announced Friday that it would rewrite its rules for alerting the world to new diseases, meaning the swine flu circling the globe will probably never be declared a full-fledged pandemic.
Dr. Keiji Fukuda, the deputy director general making the W.H.O. announcement, said that he could not predict exactly what the new rules would be but that criteria would include a “substantial risk of harm to people,” not just the geographic spread of a relatively benign virus.
The six-point system was created in 2005 when the threat was H5N1 avian flu, which has a fatality rate of about 60 percent. But the system does not take into account a virus’s lethality, and in the current outbreak, some countries have complained that the warning system created panic and pressure for border closings, even though the strain was less deadly.
Asked if the W.H.O. could damage its credibility by changing the rules in mid-outbreak, Dr. Fukuda said: “There’s nothing like reality for telling you whether something is working or not. Rigidly adhering to something that is not working would not be very helpful.”
Separately, federal health officials said a study of flu genes released Friday showed that the virus could have been circulating undetected in pigs for years, and called for better surveillance.
The study, published online by Science magazine, was a collaboration between virologists from the Centers for Disease Control and Prevention and the W.H.O., along with others from Mexico, Britain, the Netherlands and the health departments of several American states and New York City.
The closest match, surprisingly, was found in Thailand in 2005 — a pig with both North American and Eurasian flu genes.
Now that the mixed genes have been found in Asia, it is possible that they came from a North American pig that was taken there. There is little flu surveillance of pigs in much of the world, and even in the United States it is “not very systematic,” Dr. Cox said.
Henry L. Niman, who runs a Web site tracking flu mutations, complained that many swine sequences are posted by American universities and in Mexico only on private databases. “Those sequences would be very useful for figuring out how the H1N1 emerged,” he said.
The flu could also be in an intermediate host, said Dr. Cox, as the 2002 SARS virus passed from bats to humans through palm civets. But she said scientists “don’t have a hypothesis for alternative hosts.” Not enough is known about how many species carry flu, Dr. Cox said. For example, virologists were surprised to learn in 2004 that bird flu could kill zoo tigers and house cats.
Dr. Fukuda also said the new virus has been confirmed in 42 countries and had killed 86 people. About half of those hospitalized are young and healthy with no underlying conditions, he said. In the United States, such conditions are more common among the 300 now hospitalized.

Right, but what they don't say are that these underlying conditions are not necessarily so terrible that they would interfere with anyone most of the time. You know conditions such as mild asthma, or gout, or even sleep apnea not requiring CPAP. And, let us not forget obesity is also being noted as a co-exising condition.

It is not a surprise that pregnancy always puts women at risk as this is true even with seasonal influenza.

Health Department: 56 hospitalized with swine flu in city

http://www.nydailynews.com/ny_local/2009/05/21/2009-05-21_health_dept_56_hospitalized_with_swine_flu_in_city.html

A health department spokeswoman says 56 people are hospitalized with confirmed cases of swine flu around New York City.
Spokeswoman Jessica Scaperotti had no information Thursday on the patients’ conditions or ages, or how the number of hospitalizations compares with recent days or weeks.

indigo girl · May 23, 2009

US directs $1 billion for new swine flu vaccine

http://www.reuters.com/article/governmentFilingsNews/idUSWBT01127820090522

If needed.

The U.S. government said on Friday that it was setting aside $1 billion to help companies develop a vaccine against the new strain of H1N1 influenza that is sweeping the world.
Health and Human Services Secretary Kathleen Sebelius said the money would be used for clinical studies over the summer and for commercial-scale production of two potential vaccine ingredients for the pre-pandemic influenza stockpile.

RedWeasel, RN · May 23, 2009

One man came in (21) with a fever and was vomiting blood, with multiple organ failure. That happened in 1918. See the info at Stanford.edu I think. Also look up on Wikipedia. This is getting scary. We aren't being told the final symptoms....pneumonia vs vomiting blood is a big difference.

RedWeasel, RN · May 23, 2009

Also the pregnant woman who died, her husband said she had no real underlying medical problems....so who is trying to calm us by upping the chronic health conditions of the victims. I want the truth, if it is hitting, and killing healthy people, I want to know....we have a right to know...not personal details, but I would like to be well informed, not 'calmed'

RedWeasel, RN · May 23, 2009

I will have to find the actual email, but the cdc just changed the criteria for testing, didn't it? Well, our hospital still says...anyone in contact with someone from Mexico, or travelled there. Are they idiots? Or they say, if anyone has a sore throat AND cough with fever, in absence of other possible causes, well, then you can test them. I think our actual numbers in the country and state are way below what they actually are....