Some Central Texas hospitals required employees to get flu vaccinations this year or wear masks while working with patients as the H1N1 swine flu virus spread and seasonal flu loomed. One nurse at the Seton Family of Hospitals was fired for refusing to do either.
What do you guys think? She seems a bit out of it, in my opinion. Just unwilling to comply with perfectly reasonable requests.
tested positive or think that you already had the flu? the majority of cases have not been tested so you don't really know. and, even positive confirmed cases can be reinfected as well. https://allnurses.com/pandemic-flu-fo...et-437207.html
if the disease itself doesn't profer protection, why in heaven's name should we think the vacine will?!!!
well, this may well open another can of worms, but my opinion is that so far, se's of the vaccine seem to be mild; so, my statement would be "it probably can't hurt."
tested positive or think that you already had the flu? the majority of cases have not been tested so you don't really know. and, even positive confirmed cases can be reinfected as well. https://allnurses.com/pandemic-flu-fo...et-437207.html
if the disease itself doesn't profer protection, why in heaven's name should we think the vacine will?!!!
no vaccine is 100% effective especially if you are exposed to the disease too soon before your body has had the chance to develop its peak antibodies (3 to 4 weeks), or if you are immuno-compromised in which case you may never be protected. for most of us however, it should be enough protection to avoid a fatality because the real goal is to prevent death even if you do get sick. your chances of having a severe case would be far less with at least some antibodies. i have not yet come across any instances of fatalities in any lab confirmed reinfections either although they were likely to be plenty miserable as flu can make you very sick indeed which would seem to indicate that having some antibody is better than none at all.
contrary to all of the pre-vaccine hysteria, this vaccine has been thus far, a very safe vax. i would rather get the vax, and go for all the antibody that i can generate to try to avoid getting sick, and risk infecting other people who may not have been vaxed or can't be.
for pregnant women, the chance of a fatality is far higher than for the rest of the population as is always the case in pandemics. definitely all pregnant women should receive the vaccine to avoid the severe outcomes that are continuing to occur across the globe from being infected with this flu virus.
Wearing a mask is not a reasonable request. I personally am in that Texas nurses position, I refused the shot, and I am not exactly compliant wrt the mask. It is uncomfortable, but worse, after an extended period begins to make it a little difficult to breathe.
This is nothing but singling out employees who don't bend at the knee readily enough. Besides, anyone who compares this flu "epidemic" to historic flu epidemics can see this one is all hype.
No vaccine is 100% effective especially if you are exposed to the disease too soon before your body has had the chance to develop its peak antibodies (3 to 4 weeks), or if you are immuno-compromised in which case you may never be protected. For most of us however, it should be enough protection to avoid a fatality because the real goal is to prevent death even if you do get sick. Your chances of having a severe case would be far less with at least some antibodies. I have not yet come across any instances of fatalities in any lab confirmed reinfections either although they were likely to be plenty miserable as flu can make you very sick indeed which would seem to indicate that having some antibody is better than none at all.
Contrary to all of the pre-vaccine hysteria, this vaccine has been thus far, a very safe vax. I would rather get the vax, and go for all the antibody that I can generate to try to avoid getting sick, and risk infecting other people who may not have been vaxed or can't be.
For pregnant women, the chance of a fatality is far higher than for the rest of the population as is always the case in pandemics. Definitely all pregnant women should receive the vaccine to avoid the severe outcomes that are continuing to occur across the globe from being infected with this flu virus.
but are persons dying of the flu or secondary illness? the lung issues would seem to be the cytokine cascade issue...that would seem to be a risk factor for getting the vac as well as the disease...less though.....i still want to know if any one is checking for low IgG levels.....esp preg women....
Besides, anyone who compares this flu "epidemic" to historic flu epidemics can see this one is all hype.
These hugh outbreaks are called pandemics, not epidemics. It does not have to be as virulent as the worst to have a big impact.
It sure makes a believer out of a person when you have lost a loved one to influenza. Personally, I cannot read of these cases without feeling empathy for these families that are struggling to cope afer losing their children or pregnant wives or the bread winner of the family dies. They are left with hugh medical bills as well, and in case after case, the communities are holding fund raisers to help these families. It is real personal to these people, because they are having to deal with something that they never expected to happen in their lifetimes, and it isn't even the worst case scenario like 1918 was. Five times as many children have died since this started than in any seasonal influenza outbreak as per the CDC. I find that hard to overlook.
No one is comparing this to the very virulent virus of 1918. Each pandemic is different. This one is mild to moderate. It is still killing people even now in eastern Europe and Asia, about 40% of them with no prior existing conditions, and continues to kill pregnant women as well. That is fact, not hype.
It is still ongoing in eastern Europe and Asia. As of yesterday, the Ukraine officially registered more than 1,000 deaths from influenza. The novel H1N1 reached this number of fatalities in just 80 days in Ukraine. In the United States, a country
with 6 times the population count, it took 175 days to do this. That is rather
impressive, and sobering as well. There is some concern about mutations that
may be causing the higher death rates, and this is being watched closely. Influenza always mutates rapidly but we don't know if these changes are going to be real problems yet.
Meanwhile, back here the cases are slowing dramatically. Does this mean this flu is all gone? Where is our seasonal flu? There isn't any yet, and that is very strange. I think that it is way too soon to be dismissing what this novel virus might do next.
You sound like it is rather an inconvenience to you as you are forced to wear a mask or get
the shot. Maybe you should get a different job. Not every employer has the same rules, but they do get to make them.
but are persons dying of the flu or secondary illness?
It would appear to be both. The virus itself is quite capable of destroying the lungs as it is very different from seasonal flu which mostly targets the upper respiratory tract. Novel H1N1 unlike seasonal flu, we know can flourish very well in the lower tract. Look at all the cases on ECMO. We don't see this much in seasonal flu.
Something like 40% of fatalities are in otherwise healthy people so it is hard to understand what secondary illness they could have unless they developed bacterial pneumonias which does happen in a sigificant number of cases.
If we look at this study of New York autopsies in which many of these cases had health
issues, you see that 55% had bacterial pneumonia which the authors are commenting is quite different from the 1918 cases where this occurred in about 75%. That leaves 45% with no bacterial pneumonia present.
Bacterial pneumonia was observed in 55% of the fatalities described here. In comparison, postmortem cultures for bacteria were positive in more than 90% of 1918 pandemic autopsies and about 75% of 1957 autop- sies.23,25 Of the 13 decedents who died without having been hospitalized, 8 (62%) had evidence of bacterial pneumonia (Table 2), suggesting that community acquired bacterial pneumonia may play a significant role in the current pandemic. In addition, 8 of these 13 decedents also had DAD, confirming that these changes are not just secondary to prolonged mechanical respirator support but a component of the viral disease process as described in the 1918 and 1957 pandemics.
The lungs of people who have died from swine flu look more like those of the victims of H5N1 avian influenza than those of people who succumb to regular flu, the chief of infectious diseases pathology at the U.S. Centers for Disease Control says.
Study of about 70 fatal H1N1 cases so far also reveals there may be more incidences of co-infections with bacteria than was earlier thought, Dr. Sherif Zaki told The Canadian Press in an interview.
"In terms of the disease, yes, it (H1N1) is remarkably different than seasonal flu," Zaki says. "The pathology looks very similar to H5(N1)."
Zaki says about a third of the fatal cases his team has reviewed involved co-infection with a bacterium, though the culprit varies.
The swine flu patients who went on to die suffered lung damage and changes in the lungs that would have made it difficult to deliver enough oxygen into their bloodstreams, Zaki says.
That reflects the observation of intensive care doctors who've struggled to save these profoundly ill patients.
"That's what they saw in Winnipeg," Dr. Paul Hebert, an intensive care physician and editor of the Canadian Medical Association Journal, said recently of how hard it is to oxygenate swine flu patients who become gravely ill.
"They have everybody on experimental ventilators and techniques. They can barely keep them alive."
the lung issues would seem to be the cytokine cascade issue
Definitely a factor in many cases, but not all. Have you noticed the cases that have died of heart attacks, including children that had been previously healthy? I am shocked everytime I read of one of these deaths.
Wearing a mask is not a reasonable request. I personally am in that Texas nurses position, I refused the shot, and I am not exactly compliant wrt the mask. It is uncomfortable, but worse, after an extended period begins to make it a little difficult to breathe.
This is nothing but singling out employees who don't bend at the knee readily enough. Besides, anyone who compares this flu "epidemic" to historic flu epidemics can see this one is all hype.
and
My hospital made is mandatory, get the shot or get punished.
I was actually very neutral, if you wanted the shot go for it, if not, your health decisions, your call. When they came out saying you HAD to get it, I gladly encouraged everyone to refuse. Most people knuckled under, but quite a few of us said go ahead, punish us, we dare you! I still work for them, at least until something better comes along, and no, I never rolled my sleeves up, for H1N1 or the seasonal. As usual, I haven't gotten sick either.
My advice? Don't give into the hype, refuse the shot if you aren't 100% sure about it. Of those who took it, quite a few felt ill afterwards, one even says she hasn't felt good at all sicne taking it, and it has been 2 months.
Your healthcare, your call. My 2 cents says refuse it.
And indigo girl responds
You sound like it is rather an inconvenience to you as you are forced to wear a mask or get the shot. Maybe you should get a different job. Not every employer has the same rules, but they do get to make them.
Refusing a vaccination . . . .
Believing that wearing a mask is an unreasonable request . . .
You probably also think you should not be required to wash your hands either.
Indigo girl is probably right, you should look for a different job if you aren't willing to comply with your current employer's requirements.
No one is comparing this to the very virulent virus of 1918. Each pandemic is different. This one is mild to moderate. It is still killing people even now in eastern Europe and Asia, about 40% of them with no prior existing conditions, and continues to kill pregnant women as well. That is fact, not hype.
It is still ongoing in eastern Europe and Asia. As of yesterday, the Ukraine officially registered more than 1,000 deaths from influenza. The novel H1N1 reached this number of fatalities in just 80 days in Ukraine. In the United States, a country
with 6 times the population count, it took 175 days to do this. That is rather
impressive, and sobering as well. There is some concern about mutations that
may be causing the higher death rates, and this is being watched closely. Influenza always mutates rapidly but we don't know if these changes are going to be real problems yet.
Meanwhile, back here the cases are slowing dramatically. Does this mean this flu is all gone? Where is our seasonal flu? There isn't any yet, and that is very strange. I think that it is way too soon to be dismissing what this novel virus might do next.
.
As far as Ukraine registering 1000 deaths in just 80 days, the Ukraine cannot be compared to the US. The health system in the Ukraine, in many places, lacks the necessary treatment needed for sevre cases of influenza. It also lacks the equipment to differentiate(sp) between Influenza A and H1N1. Ukraine is a poverty stricken country as is India and China. We have poverty in the US, but not to the extremes that the Ukraine, China, and India has. Ukraine, China, and India has a population that is malnourished, lacks preventative healthcare, and many times are living in substandard dwellings that provide little to no protection to outside elements. These combined with any illness will increase death rates sometimes dramatically.
As far as the seasonal flu, it has been here all along. I have taken care of more patients since the fall with the seasonal flu than I have H1N1.
I'm not saying H1N1 is not deadly and precautions need to be taken, but there has been a lot of hype about it. The press had a field day with it. For awhile, every time you turned on the TV, the media was telling us we were all going to die from H1N1. If H1N1 had shown up a month or so sooner, it would have just been considered seasonal flu.
As far as the seasonal flu, it has been here all along. I have taken care of more patients since the fall with the seasonal flu than I have H1N1.
Are you talking about seeing patients with ILI? Or are you are talking lab confirmed cases of Type A seasonal flu? If it's really flu, it is likely that it is Type B. The CDC says all Type A in the US is being reported as Novel H1N1.
Could there be some significant Type A out there that is not being reported to CDC? Maybe, but this would actually be rather newsworthy (I'm not talking about the media here but, rather to those of us that are following this because we find it of interest). If it really was seasonal type A, CDC would certainly want to know about it as well, so I am guessing you must be seeing Type B or CDC would be talking about it, but they aren't.
As you can see there was also ONE case of novel H3N2, a brand new swine flu that was not swine H1N1, nor the seasonal H3N2. Another type of swine flu, isn't that interesting? Again, it's not a seasonal Type A.
One case of human infection with a novel influenza A virus was reported by the Iowa Department of Public Health. The case patient had onset of symptoms in September 2009, but did not require hospitalization and has fully recovered. The virus was identified as swine influenza A (H3N2) and investigated in November 2009. No clear exposure to swine was identified, but no evidence of sustained human-to-human transmission with this virus was found. Early identification and investigation of novel influenza A cases is critical to evaluate the extent of the outbreak and possible human-to-human transmission. Surveillance for human infections with novel influenza A viruses is conducted year-round.
All subtyped influenza A viruses reported to CDC were 2009 influenza A (H1N1) viruses.
Week 1
No. of specimens tested3,886
No. of positive specimens (%)139 (3.6%)
Positive specimens by type/subtype
Influenza A137 (98.6%)
A (2009 H1N1)78 (56.9%)
A (subtyping not performed)58 (42.3%)
A (unable to subtype)*1 (0.7%)
A (H3)0 (0.0%)
A (H1)0 (0.0%)
Influenza B2 (1.4%)
During week 1, influenza B viruses co-circulated at low levels with 2009 influenza A (H1N1) viruses. All subtyped influenza A viruses reported to CDC this week were 2009 influenza A (H1N1) viruses.
I'm not saying H1N1 is not deadly and precautions need to be taken, but there has been a lot of hype about it. The press had a field day with it. For awhile, every time you turned on the TV, the media was telling us we were all going to die from H1N1.
I actually don't know what the press has been doing as I don't read newspapers, and have not owned a TV set since the late 1990's so I am definitely not up on that, as I tend to read only in my chosen areas of interest. I would never call a pandemic
hype, though no matter what the press was saying. It really has little to do with them, and more about what the virus is doing, and it's been doing plenty. A mild to moderate pandemic still has quite an impact especially when it is largely young people that are dying.
While I was doing ongoing research on bird flu (4 year's worth), last April I became aware that something new was going on before the CDC said anything, and posts #96, 97, and 104 of the thread below demonstrate how I learned that we had a new flu. Dr. Niman of Recominombics began predicting that the novel cases were coming from Mexico before we learned about their situation down there. He was correct. Those cases were, as he called it, "the first shot over the bow."
Translators at the Flutrackers forum were on to this very early, and were reporting about the increasing numbers of flu cases that were occurring at the END of the Mexican flu season when things should have been winding down but instead were escalating. It was very mysterious, disturbing, but fascinating as well.
If H1N1 had shown up a month or so sooner, it would have just been considered seasonal flu.
Maybe at first, but once it started killing pregnant women and healthy young people, (40% are healthy), it would have been obvious that this was not seasonal flu which does not target those groups. The very first US citizen to die in the US was Judy Trunell down in Texas, whose only risk factor was pregnancy. Her death was something that the CDC was reluctant to explain especially after her husband appeared on TV saying that she was previously healthy. The CDC finally had to admit that her pregnancy was her only risk factor. Not a surprise as history teaches us that in pandemics, pregnant women are the risk group with the greatest chance of fatalities.
As far as Ukraine registering 1000 deaths in just 80 days, the Ukraine cannot be compared to the US. The health system in the Ukraine, in many places, lacks the necessary treatment needed for sevre cases of influenza. It also lacks the equipment to differentiate(sp) between Influenza A and H1N1.
I would agree with you about the state of health care there, but they do have flu test kits, and labs. There is no Type A seasonal flu being reported anywhere right now probably because novel H1N1 has replaced the seasonal Type A strains in most
locations. The only link that I did just find was this one for the UK:
The main influenza virus circulating in the UK continues to be the pandemic (H1N1) 2009 strain, with few influenza H1 (non-pandemic), H3 and B viruses detected.
(hat tip pfi/elona)
There was some H3N2 a few months ago in China but I have not heard of any since. If you can find a reference to seasonal flu
Type A occurring anywhere, please post a link. Seasonal Type A is conspicuous by its absence.
We do have a number of viral sequences from Ukraine which are of interest. They might be showing signs of increased virulence though not everyone agrees. But, given the number of fatalities in that country, it is being watched. Some are wondering if there is more to these numbers than just poverty, poor health, and a sub par healthcare system. Don't know yet.
Ukraine is a poverty stricken country as is India and China. We have poverty in the US, but not to the extremes that the Ukraine, China, and India has. Ukraine, China, and India has a population that is malnourished, lacks preventative healthcare, and many times are living in substandard dwellings that provide little to no protection to outside elements. These combined with any illness will increase death rates sometimes dramatically.
No argument with what you are saying here, except that these other countries are NOT reporting the number of deaths that Ukraine is relative to population. Of course, there is no doubt, some censorship is going on...China reports only 727
fatalities as of the last few days which is rather unbelieveable considering their population. India reports 1150.
The countries and territories shown in the table below have been affected by the virus as of Dec 20, 2009. This shows a rather significant spread since its first appearance in April of 2009.
Countries/Territories Reporting Cases of Novel H1N1 Influenza A Virus Infection
Thanks for the great info, indigo_girl! It's terrific to see the data laid out - I, like infection control professionals everywhere, am feeling a little exhaused by H1N1 data, but it really is fascinating!
Simba&NalasMom, LPN
633 Posts
well, this may well open another can of worms, but my opinion is that so far, se's of the vaccine seem to be mild; so, my statement would be "it probably can't hurt."