OFFICIAL H1N1 flu updates for May Day thread

[uppityperson]

Since there were so many posts of it showing up here and there, and since there seemed to be 2 groups of us (those interested and those annoyed), I started "official threads". Looking at the maps, at least "probable" cases are in at least 80% of the states, as well as many places in the world.

This is becoming more personal, affecting more of us daily as schools close, as health clinics are getting more and more busy with phone calls, etc. I have not watched tv news today, so am not sure if they are still "OMG"ing this or if they've gone on to the next shiny thing. Whichever, I am very interested as a health care provider, as a mom, as a world citizen. I see no need to panic but am watching this with interest as it is a good testing of local, state, federal, world Public Health organizations, as well as the personal part.

So, if you wish to add your news items here, many of us would appreciate it as then we can more easily find, or hide, the info.

Thank you and remember, wash your hands often and rinse well. Friction and running water are what make a difference.

Last 2 days links
4/30 http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5568345&mesg_id=5568345
4/29 http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5561804&mesg_id=5561804

CDC http://www.cdc.gov/swineflu
WHO http://www.who.int/csr/don/en/

Maps
http://maps.google.com/maps/ms?ie=UTF8&hl=en&msa=0&msid=109496610648025582911.0004686892fbefe515012&ll=37.0625,-95.677068&spn=23.875,57.630033&source=embed
http://healthmap.org/swineflu

[uppityperson]

1. Warden Message - Update on Flu Outbreak (US Embassy), enhanced health checks leaving Mexico

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5573259&mesg_id=5573259

Warden Message - Update on Flu Outbreak

April 30, 2009

Warden Message - Update on Flu Outbreak in Mexico



Update on Flu Outbreak in Mexico – Enhanced Health Screening for Departing International Passengers; Mexico Closes Most Public Establishments Nationwide; U.S. Embassy and Consulates Closed until Wednesday, May 6, 2009



This Warden Message alerts U.S. citizens to the latest information regarding H1N1 Influenza A. The Mexican Secretariat for Communications and Transportation has announced enhanced health screening for all international passengers departing Mexico from the following six airports: Mexico City (Benito Juarez), Guadalajara, Monterrey, Cancun, Cabo San Lucas, and Puerto Vallarta. Any passengers displaying obvious flu-like symptoms may have their temperature taken by health officials; tests for the H1N1 virus may then be administered to those with fevers. Passengers with high temperatures or testing positive for the H1N1 virus will be denied boarding. All passengers should allow ample time for any delays the new health screening may add to the check-in process at the airport. At this time, the Embassy does not know of any plans to expand this screening to other airports or to arriving passengers, but the traveling public should be alert to this possibility. Other than the health screening, neither the U.S. government nor the government of Mexico has imposed any restrictions on travel between the U.S. and Mexico.

On April 30, 2009, the government of Mexico expanded nationwide the closure of federal government activities, and urged the closure nationwide of all establishments where large numbers of the public gather, including restaurants, bars, discos, night clubs, cinemas, movie theaters, theaters, gyms, and convention centers. The closures are expected to last until May 6.



The U.S. Embassy in Mexico, as well as all U.S. Consulates and all U.S. Consular Agencies will follow the lead of Mexican federal government offices and close on Monday, May 4, 2009. The Consulate General had already been planning to close on the Mexican holidays of Friday, May 1 and Tuesday, May 5. The U.S. Consulate General will reopen on Wednesday, May 6, 2009. Immigrant visa services are suspended through May 15. Non-immigrant services are suspended through May 8. Please check the Consulate General website: http://ciudadjuarez.usconsulate.gov for the latest information on what services are available.



Americans living or traveling in Mexico are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, https://travelregistration.state.gov/ibrs/ui / so that they can obtain updated information on travel and security within Mexico. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. All U.S. citizens in Mexico are advised to monitor the Embassy website at: http://mexico.usembassy.gov or the Consulate General website: http://ciudadjuarez.usconsulate.gov for additional warden notices and other information.

U.S. citizens may also call the Office of Overseas Citizens Services in the United States for the latest travel information. The Office of Overseas Citizens Services can be reached Monday through Friday from 8:00 a.m. until 8:00 p.m. Eastern Daylight Time by calling 1-888-407-4747 from within the U.S. and Canada, or by calling [phone] from other countries.

For further information about H1N1 flu, including steps you can take to stay healthy, please consult the Department of State information at http://travel.state.gov/travel/cis_pa_tw/pa/pa_pandemic... the United States Centers for Disease Control website at http://www.cdc.gov/swineflu, and the World Health Organization website at http://www.who.int/csr/disease/swineflu/en/index.html . For additional travel safety information, please consult the State Department's website at www.travel.state.gov .



American Citizens Services

U.S. Consulate General

Paseo de la Victoria 3650

32543 Ciudad Juarez, Chihuahua CP 32543

Tel: (011) (52) 656-227-3000

Hours: 8:00a.m. to 4:45p.m.

For after-hours emergencies only, call 044-656-327-7877 for the duty officer.

e-mail: [e-mail] ;

website: http://ciudadjuarez.usconsulate.gov /

[uppityperson]

2. Beware Swine Flu Spam (beware pdf's)

http://www.pcworld.com/businesscenter/article/164211/beware_swine_flu_spam.html

Swine flu spam is spreading like a virus of its own and recently turned malicious.

Spam campaigns often start with harmless e-mail messages and slowly build into more serious threats, according to Stephan Chenette, manager of security research at Websense Inc. "Spammers are generally very well connected with each other and see how well it's working. It always goes through the test phase," he said. They test campaigns with less threatening approaches, share feedback between each other, figure out what works and what doesn't and then launch increasingly harmful attacks, he explained. "

"By us seeing they've increased the number of e-mails that are going out surrounding the swine flu, it indicates that so far it's been a very successful campaign," he said. Websense has been tracking this latest trend, which has grown in the past week. The number of e-mail messages with subject lines related to Swine Flu is in the tens of thousands, according to Chenette.

The trend started off with traditional medical spam -- or medspam -- that didn't necessarily scam users, he said. "They were enticing the users by scaring them, but there were no malicious attachments." Then the spam evolved into money-making schemes, with spammers trying to sell pharmaceuticals, medical devices and PDFs that contain generic information on the swine flu for $20 to $30, he explained....(more including warning of infected "swine flu pdf's"0

[Debi]

3. Still no confirmed cases in Iowa - (three potential cases reported) n/t

[uppityperson]

4. Flu virus spreads faster than info on who has it (privacy concerns)

http://www.kttc.com/Global/story.asp?S=10286991

ST. PAUL, Minn. (AP) - The spread of swine flu is posing a dilemma for public health officials who must decide how much information to release on affected patients.

Minnesota has one confirmed and one probable case of the flu. The state health agency is releasing data on where the person lives, if they have a connection to a school and whether the person is hospitalized.

The amount of information has varied among states where the illness has appeared. Health officials say they are prevented from giving out identifiable information. Minnesota law and a federal medical privacy law contain exceptions for public health investigations and intervention.

Experts say releasing too much information can cause other sick people to avoid getting care. They also worry that supplying too little information can feed rumors.

[uppityperson]

5. WHO statement for May 1

nfluenza A(H1N1) - update 7
http://www.who.int/csr/don/2009_05_01/en/index.html
1 May 2009 -- The situation continues to evolve rapidly. As of 06:00 GMT, 1 May 2009, 11 countries have officially reported 331 cases of influenza A(H1N1) infection.

The United States Government has reported 109 laboratory confirmed human cases, including one death. Mexico has reported 156 confirmed human cases of infection, including nine deaths.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (34), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).

Further information on the situation will be available on the WHO website on a regular basis. WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

[uppityperson]

6. Experts warn: Answers in flu's spread will be slow in coming

http://seattletimes.nwsource.com/html/health/2009155250_fluperspective01m.html

Any attempt to put the swine-flu outbreak in perspective runs up against what our Twitter-obsessed, 24-hour news culture fears most: lack of information. There's no way around that. Experts from the World Health Organization (WHO) escalated threat levels quickly after recognizing the virus was something new. That, in turn, mobilized governments to take action and the public to take precautions — like more regular hand-washing — in hopes of slowing the spread while professionals scrambled to understand the outbreak.

But it means the rest of us are learning about swine flu in real time. And it means answers to our most pertinent questions — How contagious is it? Who is most vulnerable? How concerned should I be? — simply have to wait. "We as Americans are a little short on patience, but I'm afraid that's what it's going to take to figure out what's going on," said Gerald Callahan, a professor of immunology and pathology at Colorado State University. "There's just not very much useful information available."

Right now, experts maintain the risks of contracting the infection in Washington state are extremely low. Consider that every year, five to 20 percent of the U.S. gets a seasonal flu. And every year, about 36,000 of them die. The number of Americans nationwide who've contracted swine flu has only just surpassed 100. In addition, most influenza viruses in the northern hemisphere taper off during summer months. Most previous pandemics came in waves, with relatively minor outbreaks in spring, a severe return in fall and another minor wave the following spring. What's not clear yet is whether this virus will even follow that pattern.

(clip)
Still, there're several reasons for all the attention — and for the limited information. Virologists believe we're overdue for a worldwide flu pandemic. The Spanish flu outbreak in 1918 killed more than 40 million worldwide. The Asian flu in 1957 killed 70,000 in the United States alone. The last pandemic, the Hong Kong flu, killed an additional 34,000 Americans. That was 40 years ago.

In addition, the threat of avian flu, which has killed more than 60 percent of the 421 infected people worldwide, mostly in Vietnam and Indonesia, already had disease experts on alert, Katze said. So they reacted to swine flu with an abundance of caution — and warnings to the public. So far, while swine flu appears to spread faster and easier than avian flu, it has been dramatically less deadly....

[bluedawg12]

25. One other reason to prepare and model for pandemics: bioterrorism.

In addition to naturally occuring changes in viral infections, there has been some concern for a number of years of a dread scenario such as the intentional weaponization of known pathogens for which we have no immunity and which carry high morbidity and mortality rates.

This particular H1N1 out break, while thankfully not particularly virulent from what we are seeing ( as of today) demonstrates more about our behavior than that of the H1N1 virus. Namely how mobile we are as a world population. Thanks to fascinating map graphics I have seen the spread of this particular virus go from Mexico, to Japan and China, to Isreal and New Zealand in less than a week.

If this had been some highly virulent pathogen, then, we need to think about our global public health system, as far as alerts and ask questions when the dust settles after this outbreak, as to how effective they are and how safe the world is.

H1N1 might be a mild virus, at least it appears to be so thus far, but what if it was an intentional small pox infection? The weaponized use of a virus?

N.B. Picture of small pox sufferer circa 1912, at bottom, do not scroll if these types of images are disturbing.

http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp

Where Smallpox Comes From
Smallpox is caused by the variola virus that emerged in human populations thousands of years ago. Except for laboratory stockpiles, the variola virus has been eliminated. However, in the aftermath of the events of September and October, 2001, there is heightened concern that the variola virus might be used as an agent of bioterrorism. For this reason, the U.S. government is taking precautions for dealing with a smallpox outbreak.

http://en.wikipedia.org/wiki/Smallpox

Post-eradication (small pox)
The last cases of smallpox in the world occurred in an outbreak of two cases (one of which was fatal) in Birmingham, England in 1978. A medical photographer, Janet Parker, contracted the disease at the University of Birmingham Medical School and died on 11 September 1978,<49> after which the scientist responsible for smallpox research at the university, Professor Henry Bedson, committed suicide.<2> In light of this accident, all known stocks of smallpox were destroyed or transferred to one of two WHO reference laboratories; the Centers for Disease Control and Prevention (CDC) in the United States and the State Research Center of Virology and Biotechnology VECTOR in Koltsovo, Russia where a regiment of troops guard it.<50> In 1986, the World Health Organization recommended destruction of the virus, and later set the date of destruction to be 30 December 1993. This was postponed to 30 June 1995.<51> In 2002 the policy of the WHO changed to be against its final destruction.<52> Destroying existing stocks would reduce the risk involved with ongoing smallpox research; the stocks are not needed to respond to a smallpox outbreak.<53> However, the stocks may be useful in developing new vaccines, antiviral drugs, and diagnostic tests.<54>

In March 2004 smallpox scabs were found tucked inside an envelope in a book on Civil War medicine in Santa Fe, New Mexico.<55> The envelope was labeled as containing the scabs and listed the names of the patients they came from. Assuming the contents could be dangerous, the librarian who found them did not open the envelope. The scabs ended up with employees from the CDC who responded quickly once informed of the discovery. The discovery raised concerns that smallpox DNA could be extracted from these and other scabs and used for a biological attack.

credit: wikipedia
Smallpox sufferer: Illinois, 1912

[uppityperson]

7. Amid swine flu outbreak, racism goes viral

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5574179&mesg_id=5574179

http://www.msnbc.msn.com/id/30467300

No contact anywhere with an illegal alien!” conservative talk show host Michael Savage advised his U.S. listeners this week on how to avoid the swine flu. “And that starts in the restaurants" where he said, you “don’t know if they wipe their behinds with their hands!”

And Thursday, Boston talk radio host Jay Severin was suspended after calling Mexican immigrants "criminalians" during a discussion of swine flu and saying that emergency rooms had become "essentially condos for Mexicans."

That’s tepid compared to some of the xenophobic reactions spreading like an emerging virus across the Internet. “This disgusting blight is because MEXICANS ARE PIGS!” an anonymous poster ranted on the “prison planet” forum, part of radio host and columnist Alex Jones’ Web site.

There is even talk of conspiracy. Savage speculated that terrorists are using Mexican immigrants as walking germ warfare weapons. “It would be easy,” he said, “to bring an altered virus into Mexico, put it in the general population, and have them march across the border.”...(more if you care to read what the assholes are saying)

[Jennicut]

32. The posters on the Alex Jones website are disgusting

They are so nutso. They think it was deliberately started in a lab as a way to herd up people and control them. Certifiably crazy.
This racism against Mexicans is funny considering a pandemic like this could possibly start in any country that does not have the strict environmental laws we have here.

[ismnotwasm]

8. Hospitals, Doctors Deal With Swine Flu Jitters

LOS ANGELES (AP) -- Concerns about a possible pandemic have sent people streaming into crowded emergency rooms and walk-in clinics -- not with swine flu, but the swine flu jitters.

While the situation varies greatly around the country, hospitals and clinics in California, New York, Alabama and other states are dealing with a surge in what New York City Health Commissioner Thomas Frieden said are ''people who are worried, but not sick
http://www.nytimes.com/aponline/2009/05/01/health/AP-US-MED-Swine-Flu-Emergency-Rooms.html?_r=1

[kestrel91316]

22. I'm pretty much convinced the average Angeleno is a moron.

I have to deal with far too many clueless twits and people who obviously ruined their brain function on those 60s drug sessions.

I do my part. I tell my clients they can't give it to their kitties, or catch it from eating pork. And we are vigilant against any sick people suddenly deciding that NOW is the time to get the cat's annual well exam.

[uppityperson]

9. Questions and topic about Swine flu and factory farming

I did some research last night and found that a fair chunk of the swine part of this virus can be traced back to South Carolina farm yrs back. So, did it go from SC to Mexico and now back?

Here is link to a topic on it, if you wish to go comment:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5569987&mesg_id=5569987

[ismnotwasm]

10. Swine flu: AstraZeneca talking to US authorities about vaccine

Scientists from AstraZeneca, the British-based pharmaceutical group, are in talks with the US health authorities about the possibility of developing a vaccine for swine flu.

The staff work for the company's MedImmune subsidiary, which was bought for $15bn (£10bn) two years ago, and already produces an intra-nasal treatment for other strains of flu under the FluMist banner.

Simon Lowth, finance director of AstraZeneca, warned that even if it was decided a vaccine was needed it could be months before it was developed, given the particular strain of flu had still to be identified. "Our scientists are in close contact with the US Centre for Disease Control ... first they will need to get feedback and then they will need to deliver a vaccine," he explained.
http://www.guardian.co.uk/world/2009/apr/30/swine-flu-vacine-talks

[uppityperson]

11. Asia Reports First Case of Swine Flu in Hong Kong (I feel really sorry for places

that have already dealt with SARS, avian flu, etc. What a scary thing, again. Even if it is not proving as deadly as feared, still the fear is there
http://www.nytimes.com/2009/05/02/health/02flu.html?_r=1&hp

Swine flu spread to Asia on Friday, as Hong Kong authorities announced the continent’s first case, a 25-year-old traveler who came from Mexico via Shanghai, and immediately quarantined an entire hotel where the traveler had stayed on Thursday night.

The case re-awoke memories of SARS, the severe acute respiratory syndrome that arrived in the territory six years ago, and raised concerns that the virus may have been introduced to mainland China, although the man did not leave the airport while in Shanghai. Flu experts have warned that it would be harder to manage the disease if it becomes established in Asia’s densely populated countries.

Worldwide, the number of confirmed cases of what is now known as influenza A(H1N1) continued to climb. The Centers for Disease Control and Prevention raised its total number of confirmed cases in the United States on Friday to 141 cases in 19 states, up from 109 cases in 11 states a day earlier.

Hong Kong’s first confirmed arrived Thursday afternoon on a China Eastern flight, then checked into a local hotel and fell ill, health officials said in an evening press briefing. Hong Kong authorities responded quickly, quarantining the man at a local hospital, declaring a health emergency, and then quarantining all 200 guests at the hotel, the Metropark, for seven days — whether or not they had contact with the man. ...

[uppityperson]

12. A Sick Situation (maybe we'll get workplace policies changed?)

http://warner.blogs.nytimes.com/2009/04/30/sick-leave/

Early this week, the Centers for Disease Control and Prevention recommended that anyone with flu symptoms stay home from work or school. President Obama reiterated that advice at his press conference on Wednesday night. “If you are sick, stay home,” he said. “If your child is sick, keep them out of school.” “I know it sounds trivial,” the president said, after asking families to start taking other “very sensible precautions” like washing hands and covering up during coughs. “But it makes a huge difference.”

The president’s admonition to the sick to stay home didn’t sound trivial to Silvia Del Valle, a 42-year-old restaurant worker in Miami. It sounded impossible. When I spoke to her Thursday morning, Del Valle was sick in bed with a cough and a fever. Was she planning to go to work, I asked her, Obama’s press conference still fresh in my mind. “Yes,” she said. “I need to go. Because if I don’t go, I lose my job.”

Del Valle’s not alone. Nearly half of all private sector workers in our country – more than 59 million people – have no paid sick time at all. The problem is particularly acute among women, low-wage workers – more than three-quarters of whom have no paid sick days – and part-timers.

Food service employees are the least likely to have access to sick leave. According to the Institute for Women’s Policy Research, only 14 percent of the people serving and handling food in restaurants can stay home from work when they’re coughing and sneezing, without fear of losing their jobs. José Oliva, the policy coordinator for the advocacy group Restaurant Opportunities Centers United, told me that among the food service employees he normally counsels – many of whom, like Del Valle, speak poor English and earn well below the minimum wage for tipped employees – only about one percent can stay home sick without the fear of losing pay or even their jobs....

[Junkdrawer]

13. Two good articles on the Factory Farm/Swine Flu connections...

Chasing the Fickle Swine Flu

...

One of the first signs of trouble was a barking cough that resounded through a North Carolina farm in August 1998. Every pig in an operation of 2400 animals sickened, with symptoms similar to those caused by the human flu: high fever, poor appetite, and lethargy. Pregnant sows were hit hardest, and almost 10% aborted their litters, says veterinary virologist Gene Erickson of the Rollins Animal Disease Diagnostic Laboratory in Raleigh. Many piglets that survived in utero were later born small and weak, and some 50 sows died.

The culprit, a new strain of swine influenza to which the animals had little immunity, left veterinarians and virologists alike puzzled. Although related flu strains in birds, humans, and pigs outside North America constantly evolve, only one influenza subtype had sickened North American pigs since 1930. That spell was suddenly broken about 4 years ago, and a quick succession of new flu viruses has been sweeping through North America’s 100 million pigs ever since. This winter, for example, up to 15% of the 4- to 7-week-old piglets on a large Minnesota farm died, even though their mothers had been vaccinated against swine flu, says veterinary pathologist Kurt Rossow of the University of Minnesota, Twin Cities.

It seems that after years of stability, the North American swine flu virus has jumped onto an evolutionary fast track, churning out variants every year. Changes in animal husbandry, including increased vaccination, may be spurring this evolutionary surge. And researchers say that the resulting slew of dramatically different swine flu viruses could spell danger for humans, too. The evolving swine flu “increases the likelihood that a novel virus will arise that is transmissible among humans,” says Richard Webby, a molecular virologist at St. Jude Children’s Research Hospital in Memphis, Tennessee.

...

http://birdflubook.com/resources/WUETHRICH1502.pdf


CDC Confirms Ties to Virus First Discovered in U.S. Pig Factories

Factory farming and long-distance live animal transport apparently led to the emergence of the ancestors of the current swine flu threat.

A preliminary analysis of the H1N1 swine flu virus isolated from human cases in California and Texas reveals that six of the eight viral gene segments arose from North American swine flu strains circulating since 1998, when a new strain was first identified on a factory farm in North Carolina.

...

The worst plague in human history was triggered by an H1N1 avian flu virus, which jumped the species barrier from birds to humans and went on to kill as many as 50 to 100 million people in the 1918 flu pandemic. No disease, war or famine ever killed so many people in so short a time. We then passed the virus to pigs, where it has continued to circulate, becoming one of the most common causes of respiratory disease on North American pig farms.

In August 1998, however, a barking cough resounded throughout a North Carolina pig factory in which all the thousands of breeding sows fell ill. A new swine flu virus was discovered on that factory farm, a human-pig hybrid virus that had picked up three human flu genes. By the end of that year, the virus acquired two gene segments from bird flu viruses as well, becoming a never-before-described triple reassortment virus—a hybrid of a human virus, a pig virus, and a bird virus—that triggered outbreaks in Texas, Minnesota, and Iowa.

Within months, the virus had spread throughout the United States. Blood samples taken from 4,382 pigs across 23 states found that 20.5% tested positive for exposure to this triple hybrid swine flu virus by early 1999, including 100% of herds tested in Illinois and Iowa, and 90% in Kansas and Oklahoma. According to the current analysis, it is from this pool of viruses that the current swine flu threat derives three-quarters of its genetic material.

Tracing the Origins of Today's Virus

Since the progenitor of the swine flu virus currently threatening to trigger a human pandemic has now been identified, it is critical to explore what led to its original emergence and spread. Scientists postulate that a human flu virus may have starting circulating in U.S. pig farms as early as 1995, but "by mutation or simply by obtaining a critical density, caused disease in pigs and began to spread rapidly through swine herds in North America." It is therefore likely no coincidence that the virus emerged in North Carolina, the home of the nation’s largest pig production operation. North Carolina has the densest pig population in North America and reportedly boasts more than twice as many corporate pig mega-factories as any other state.

...

http://www.hsus.org/farm/news/ournews/swine_flu_virus_origin_1998_042909.html

[uppityperson]

16. Thanks, here's a link to DU topic on it also...

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5569987&mesg_id=5569987

[Junkdrawer]

18. Here's another one I found decrying the political clout of the Factory Farms...

From Monday's Guardian...

The swine flu crisis lays bare the meat industry's monstrous power

The Mexican swine flu, a genetic chimera probably conceived in the faecal mire of an industrial pigsty, suddenly threatens to give the whole world a fever. The initial outbreaks across North America reveal an infection already travelling at higher velocity than did the last official pandemic strain, the 1968 Hong Kong flu.

Stealing the limelight from our officially appointed assassin, H5N1, this porcine virus is a threat of unknown magnitude. It seems less lethal than Sars in 2003, but as an influenza it may be more durable than Sars. Given that domesticated seasonal type-A influenzas kill as many one million people a year, even a modest increment of virulence, especially if combined with high incidence, could produce carnage equivalent to a major war.

Meanwhile, one of its first victims has been the consoling faith, long preached by the World Health Organisation, that pandemics can be contained by the rapid responses of medical bureaucracies, independent of the quality of local public health. Since the initial H5N1 deaths in Hong Kong in 1997, the WHO, with the support of most national health services, has promoted a strategy focused on the identification and isolation of a pandemic strain within its local radius of outbreak, followed by a thorough dousing of the population with antivirals and (if available) vaccine.

...

http://www.guardian.co.uk/commentisfree/2009/apr/27/swine-flu-mexico-health

[uppityperson]

14. First Flu Death Provides Clues to Mexico Toll (delay in getting med help)

http://www.nytimes.com/2009/05/01/health/01oaxaca.html?scp=1&sq=Adela%20Maria%20Guti%C3%A9rrez%20&st=cse

Adela María Gutiérrez fell ill in the beginning of April with what she thought was a bad cold. She tried aspirin and antibiotics, bed rest and moist towels, but nothing brought down her soaring fever, reduced her aches and pains, or boosted her energy level. It would be more than a week before Mrs. Gutiérrez went to Oaxaca’s General Hospital, where she arrived listless and barely able to breathe, her extremities blue from a lack of oxygen.

That delay in getting expert help may explain why Mrs. Gutiérrez, 39, a mother of daughters ages 10, 17 and 20, became Mexico’s first death from a new, virulent strain of influenza A(H1N1). It may also suggest why this country’s death toll from the virus is higher than any other’s.

Epidemiologists are still puzzled by the virus, its origins and its modes of transmission. But they agree that prompt medical attention is crucial to treating it. That has been where Mexico, which the Health Ministry said Thursday had 312 confirmed cases and 12 deaths, lags far behind. “People wait too long to go to doctors,” said Dr. Marcelo Noguera, undersecretary of health for the state of Oaxaca. “That’s a problem here in Mexico,” he continued. “If we can treat a disease like this early, we can stay ahead.”

There may well be other factors to explain why patients like Mrs. Gutiérrez, whose medical records show a desperate, belated scramble by doctors to keep her alive, are dying in Mexico at a higher rate than flu patients elsewhere. Mexicans may have been hit by a different, deadlier strain, or the flu may have infected more people who had other health problems, researchers speculate.

But one important factor may be the eclectic approach to health care in Mexico, where large numbers of people self-prescribe antibiotics, take only homeopathic medicine, or seek out mysterious vitamin injections. For many, only when all else fails do they go to a doctor, who may or may not be well prepared....

[rainbow4321]

15. Parkland Hospital in Dallas restricts visitors under 12 yrs old

From entering hospital for inpatient visiting. For outpatient clinics the under 12 group has to stay in the waiting area only.
Meanwhile, we all continue to send patients to the ER if they show up for doctor visits with any upper respiratory symptoms. Unfortunately the warning signs that they have placed on the outside doors telling people with symptoms to NOT come in the building are useless. Patients and people still come in with the symptoms, wander around and come in to see the staff to be triaged for their visits.
If they truly want to get some kind of containment, they need to shut down the outpt clinics and restrict visitors even more. Cuz this isn't working.
We saw someone today that we have been told tested positive. He was with us before we sent him to the ER.
I assume they meant positive for flu strain A and are maybe assuming that if it is A, there is a good chancr it is swine.

[nadinbrzezinski]

17. President says that it may follow normal course

but they are still planning for the worst in the fall

MSNBC

Side comment of course folks round here took it the usual way

[bluedawg12]

19. WHO and CDC stats 5-01-09

http://www.cdc.gov/h1n1flu/

U.S. Human Cases of H1N1 Flu Infection
(As of May 1, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 4
California 13
Colorado 2
Delaware 4
Illinois 3
Indiana 3
Kansas 2
Kentucky 1
Massachusetts 2
Michigan 2
Minnesota 1
Nebraska 1
Nevada 1
New Jersey 5
New York 50
Ohio 1
South Carolina 16
Texas 28 1
Virginia 2
TOTAL COUNTS 141 cases 1 death

..............

http://www.who.int/csr/don/2009_05_01/en/index.html

Influenza A(H1N1) - update 7
1 May 2009 -- The situation continues to evolve rapidly. As of 06:00 GMT, 1 May 2009, 11 countries have officially reported 331 cases of influenza A(H1N1) infection.

The United States Government has reported 109 laboratory confirmed human cases, including one death. Mexico has reported 156 confirmed human cases of infection, including nine deaths.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (34), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).

Further information on the situation will be available on the WHO website on a regular basis. WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

[nadinbrzezinski]

20. MSNBC covering the possibility that it emerged in the US

as we saw yesterday in confirmation by CDC

On the political arena that will be interesting

For naming conventions this will be the North American flu when all is said and done

[uppityperson]

21. Winnie the Pooh and Swine Flu (thanks to Jackeens)

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5575718&mesg_id=5575718

[bluedawg12]

26. ....

:rofl:

That's cute and hilarious!

[nadinbrzezinski]

23. Plane diverted to Boston from GERMANY

woman with flu like symptoms

Critical point, is the place of origin

And germany has announced they had the first person to person not travel related

[uppityperson]

27. Here is a link and story...

http://wbztv.com/local/germany.flight.diverted.2.999173.html

A flight coming from Germany was diverted to Boston after a woman on the plane complained of flu-like symptoms.

United flight 903 from Munich to Dulles made an emergency stop in Boston because a 53-year-old woman was complaining of feeling ill.

According to airport officials, there are 245 passengers onboard the plane and 16 crew members.

Officials are not bringing the plane into a terminal, officials said. Instead, they are taxied the plane into a cargo terminal at the airport.

The passengers will be isolated on the plane until officials can figure out how to handle the situation.

[nadinbrzezinski]

28. I can tell them how to handle it

QUARANTINE

I am positive they can get a couple cargo terminals set up

Oh wait, I am over reacting, knee jerk, according to the usual crowd

[uppityperson]

29. Nadin, there is a medium road

There are other choices than over reacting and under reacting. There are other choices between being scared of "what ifs" and scoffing at those who are concerned of "what ifs".

It sounds like they are going to check this person out at a cargo terminal. Yes this pandemic could get bad, especially next fall. Yes there are dead in Mexico, as to why that is is not clear. But what is going on right now, those who are getting sick and getting medical care, they seem to be surviving without serious issues.

I am getting tired of your pre-emptive defensiveness in your posts. Seriously. Watch, let public health do what it is doing, continue to monitor, but don't give yourself an ulcer about this now. Perhaps an asteroid will hit the earth next week. Perhaps I will be killed in a car accident later today. You can drive yourself crazy preparing for all the "what ifs" and getting angry and snide at others who don't share your viewpoint.

There are other choices.

[nadinbrzezinski]

30. Tired, ok whatever have a good one

damn it that is actually standard practice, you do check, you get them off the plane, not the best place to keep them

And you check them and observe for a few hours...TEST Her, the initial differential takes a couple hours, this is standard practice

Essentially it is a quarantine

This is what is happening all over the place by the way from planes coming in with suspected patients

[uppityperson]

31. Of course and this is what they are doing. eom

[nadinbrzezinski]

24. An observation the people who are bothered by this

are now scoffing at anything and running the place ...

Methinks we need to partially leave our partial quarantine, no pun

[bluedawg12]

33. Some prespective: Human transmission seems higher than actual viral infectivity.

What 5 days of CDC data “suggests.”

I post this to gain some perspective. I still see this as a moderately infectious, low- to -moderate morbidity and morality pathogen, which appears to be spreading by human travel more than due to it being that infectious.

This is purely speculative on my part and brought up for discussion.

I have followed the CDC numbers for the US for the last 5 days.

What I noticed is that two States with early reporting of cases, NY and Calif., have remained stable in terms of confirmed cases, while it is the addition of news States to the roster that has increased the total number of cases confirmed in the US.

Two thoughts come to mind.

If NY had 45 cases on the 28th and is at 50 today, it suggests that either there is good containment and low exposure, or low infection rates with high exposure, or both.

California reported 7 cases on 4-25-09 and is now at 13 today.

This seems to suggest more about the mobility of people within the US, than it does infectiousness within a region with known infection from the virus.


That’s good news.

In another words, are the national rates of infection climbing more because people are traveling between States and spreading sporadic cases, rather than, seeing a highly infectious virus spread once it has a foothold?

NY and Calif. Seems to suggest the former.

Likewise with the world Stats, the dissemination of the virus is high– reflecting our mobility as humans- but the number of infections per region, or nation is low.

The bad news is, if this were a particularly nasty pathogen, with high morbidity and mortality rates, then, even with global alerts, we still manage to travel all over the world spreading infectious diseases.

That’s not such good news.

In short, my question is, are we the ones spreading the disease faster than the disease actually spreads itself?

...........

http://www.cdc.gov/h1n1flu/

U.S. Human Cases of H1N1 Flu Infection
(As of May 1, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 4
California 13
Colorado 2
Delaware 4
Illinois 3
Indiana 3
Kansas 2
Kentucky 1
Massachusetts 2
Michigan 2
Minnesota 1
Nebraska 1
Nevada 1
New Jersey 5
New York 50
Ohio 1
South Carolina 16
Texas 28 1
Virginia 2
TOTAL COUNTS 141 cases 1 death
..............
U.S. Human Cases of Swine Flu Infection
(As of April 29, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 1
California 14
Indiana 1
Kansas 2
Massachusetts 2
Michigan 2
Nevada 1
New York City 51
Ohio 1
Texas 16 1
TOTAL COUNTS 91 cases 1 death
..............
http://www.cdc.gov/swineflu /
U.S. Human Cases of Swine Flu Infection
(As of April 28, 2009 11:00 AM ET)
State # of laboratory
confirmed cases
California 10 cases
Kansas 2 cases
New York City 45 cases
Ohio 1 case
Texas 6 cases
TOTAL COUNT 64 cases
..........

http://www.cdc.gov/swineflu /
April 27, 2009
State # of laboratory
confirmed cases
California 7 cases
Kansas 2 cases
New York City 28 cases
Ohio 1 case
Texas 2 cases
TOTAL COUNT 40 cases
.................

http://www.cdc.gov/swineflu/investigation.htm
April 25, 2009 19:30 EDT
U.S. Human Cases of Swine Flu Infection
As of April 25th, 2009 7:30 p.m. EDT
State # of laboratory
confirmed cases
California 7 cases
Texas 2 cases
Kansas 2 cases
TOTAL COUNT 11 cases

...............

[uppityperson]

34. It also suggests, to me, that they are now testing for this

If you don't test, or only test a couple people, the confirmed numbers will be low. Now that they are testing more people, more will show up positive.

I wonder how far it was spread before testing began, how many people have had it, gotten over it, without ever being tested.

It is good that this is a relatively innocuous virus as yes, humans travel around a lot and things can get all over really fast.

[bluedawg12]

36. They have been testing in NY and California from early on.

Those numbers are not going up a lot.

I would think, that with increased awareness of this virus, more people than ever would have by now presented for treatment and testing in NY and California and of that cohort there should have been more confirmed cases.

My point is that this is a relatively little change by State, for days now and only national spread seems to be showing up.

Now Texas is different, they went from #2 confirmed cases on 4-25 to #28 on 5-01. That may reflect high initial contact and increased testing or new cases. :shrug: Who knows, thre is little actual data.

[L. Coyote]

35. AP: Now more than 140 swine flu cases in US ... in 19 states, up from 11 ...

http://news.yahoo.com/s/ap/20090501/ap_on_go_pr_wh/us_med_swine_flu_us

the Centers for Disease Control and Prevention reported the virus has been confirmed in eight more states.

Confirmed cases have risen from 109 to 141, the CDC said, and it said the flu now is in 19 states, up from 11. Separately a few states reported slightly higher numbers.

[bluedawg12]

37. CDC: 11 on 4-25, and 91 on 4-29 and 141 today.

Mostly due to new States reporting cases.


http://www.cdc.gov/h1n1flu/

U.S. Human Cases of H1N1 Flu Infection
(As of May 1, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 4
California 13
Colorado 2
Delaware 4
Illinois 3
Indiana 3
Kansas 2
Kentucky 1
Massachusetts 2
Michigan 2
Minnesota 1
Nebraska 1
Nevada 1
New Jersey 5
New York 50
Ohio 1
South Carolina 16
Texas 28 1
Virginia 2
TOTAL COUNTS 141 cases 1 death
..............
U.S. Human Cases of Swine Flu Infection
(As of April 29, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 1
California 14
Indiana 1
Kansas 2
Massachusetts 2
Michigan 2
Nevada 1
New York City 51
Ohio 1
Texas 16 1
TOTAL COUNTS 91 cases 1 death

[L. Coyote]

39. I've traveled six states in the last week, another yet today.

I drove thru Denver w/o stopping. Otherwise, no state on the list.
Moab, UT, was to be a week of fun, but too many travelers there!
Moved up my schedule to get to my destination a week earlier.

[Yo_Mama]

42. They forgot GA

It was actually confirmed yesterday. 1 case, a woman who had been in Mexico. She has been hospitalized in LaGrange since 4/26, I believe. So 20 states.

[bluedawg12]

52. it will likely spread across US, in small numbers, few very sick.

Perhaps not Alaska, "you betcha." :P

Not much in Canada, so far 29 confirmed cases. Russia seems to be reporting no cases. Looking like further north = less cases??

[bluedawg12]

38. Interesting story about science, scientists and the hunt for 1918 killer flu.

Science is funny like that. It's studied by human beings with human flaws and foibles. Yet, something interesting may appear just when one door seems closed, another one opens.

Anyway, I just ran across this and it was pretty interesting reading. :P

New England Journal of Medicine
Volume 350:523-524 January 29, 2004 Number 5
Book Review

Hunting the 1918 Flu: One Scientist's Search for a Killer Virus

By Kirsty Duncan. 297 pp., illustrated. Toronto, University of Toronto Press, 2003. $35. ISBN 0-8020-8748-5.

The copyright page of this book proclaims that the paper on which it is printed is acid-free. The same cannot be said of the contents. Hunting the 1918 Flu describes the sometimes acrimonious relationship between the initiator of the hunt (the author) and some of the people she recruited to carry it out.

The story is fairly widely known. In 1918–1919, in one of the worst epidemics in recorded history, an influenza virus dubbed the "Spanish flu" killed about 20 million to 40 million people worldwide. The virus was extraordinarily virulent. Historical accounts tell of people who were well in the morning, sick and in bed by midday, and choking to death by evening, their lungs swamped with blood, foam, and pus. Projectile nosebleeds were common, and cyanosis meant almost certain death.

The 1918 influenza virus was never isolated (the human influenza virus was first isolated in 1933), but antibodies in the serum of survivors showed that it was related to a virus later found to infect swine in the United States. Why was the 1918 influenza virus so powerful? For some researchers, finding the answer would be the crowning achievement of their lives. In 1951, the bodies of several persons who had died of the flu in 1918 in Alaska and which had been buried and preserved in the permafrost were exhumed. Samples were taken from them in an attempt to isolate the virus, but no live virus was obtained. This was, perhaps, just as well, because the sophisticated containment facilities now considered necessary to house dangerous human pathogens did not exist in 1951.

In 1992, Kirsty Duncan, a geographer then at the University of Windsor in Canada, began to search for other victims of the 1918 flu whose bodies had been buried and preserved in permafrost. Eventually she located the bodies of seven young coal miners who had died in 1918 and were buried in the cemetery of the little village of Longyearbyen in Spitsbergen, Norway. Duncan's book describes her efforts to exhume these bodies and obtain tissue samples for analysis — not to isolate the live virus but to find bits of the virus's RNA that could be sequenced with the use of techniques that had not been available in 1951. To conduct this work, Duncan had to gain the permission of the Norwegian authorities and recruit a team of virologists and other technical experts. She found that the former task was much less difficult than the latter.

It is clear that many of the scientists she invited to join what she referred to as "my team" regarded this young Canadian geographer with a mixture of contempt and respect. On the one hand, she was perhaps her own worst enemy, coming across as a vain, self-centered person full of her own importance and sanctimonious to a degree. It is also clear why some of the scientists she invited to join her team found some of her behavior irritating. One was heard to say, "Young lady, I have spent all my life working on influenza. You are a neophyte in this area."

The virologists, on the other hand, had their own faults — they were ruthless, egotistical, deceitful, arrogant, and uncontrollable. At one stage of the work at the exhumation site, Duncan ordered that no one should talk to the media except herself. Imagine, then, her feelings when one of the scientists was caught near the buried bodies, hiding in a ditch, making a tape recording for the press.

Some of the unpleasantness between Duncan and the virologists seems to have been unnecessary and should never have occurred. For example, after the expedition was over, a meeting was held in London to discuss the results. Duncan was not invited to this meeting, and when she turned up and forced her way in, she was more or less told by the organizer to "get lost." It is sad to learn that the person who started the whole project, no matter how irritating she may have been, was treated so disrespectfully.

Despite all this, after six years of work, everything came together. The graves of the seven miners and the apparent depth at which their bodies were buried were located by ground-penetrating radar. Containment facilities were set up, the bodies were exhumed, and tissue samples were obtained for analysis. One thing was wrong, however. The ground-penetrating radar had suggested that the bodies were buried deep in the permafrost. Alas, they were not. They were in the upper, active layer, which had repeatedly thawed and then frozen again over the years. The tissue samples were pretty well ruined, and, as far as I am aware, no sequencing results of any RNA fragments of the 1918 influenza virus taken from the samples from Spitsbergen have been reported.

But there is more to the story. At the same time that all this was going on, in the United States Ann Reid and Jeffrey Taubenberger (who was, at one point, a member of Duncan's team but had dropped out to do his own work) had been sequencing bits of RNA from the virus in samples of lung tissue obtained from military personnel who had died from the flu in 1918. The lung tissue had been preserved in paraffin blocks, and in a series of incredibly painstaking experiments some sequences of RNA of the 1918 flu virus were obtained.

This work came to the attention of Johan Hultin, who had been a member of the 1951 expedition to Alaska. Hultin called Taubenberger and offered to return to Alaska to take more samples from the frozen bodies. Taubenberger asked Hultin when he could go, thinking it might be in a year or so. The answer was, "Not this week, but I could go next week." Hultin did go and was able to obtain some well-preserved lung-tissue samples, which have now made possible the determination of much of the RNA sequence of the 1918 influenza virus.

Hultin's success was enormously distressing to Kirsty Duncan. She referred to him as "the Boy Scout" and when they later met refused to talk to him. Her ungracious behavior is understandable. Duncan's bloated, over-funded, overpublicized expedition, which had taken six years to organize, had failed, whereas someone else, working on his own, quietly and with no publicity and little in the way of funds, had succeeded. I should mention that, so far, the sequencing of the RNA of the 1918 influenza virus has not given any answers as to why the virus was so lethal.

What about the book itself? Is it worth reading? Duncan describes in some detail almost every communication between herself and the scientists on her team. I have never met Duncan, but I have known some of the flu virologists for a long time, and I found her descriptions of their individual characters accurate and fascinating. Whether the average reader would feel the same, I have no way of knowing.


William Graeme Laver, Ph.D.
Murrumbateman 2582, NSW, Australia

[kimmerspixelated]

41. Interesting.

No link to share, but I have read several places that the 1918 flu was only really dangerous after it mutated from soldiers that were vaxed and then put into mustard, etc. gas trials. It was a bioweapon experiment.

[bluedawg12]

48. Lessons Learned From SARS- "Reads Like A Crichton Thriller."

It's posted right here on DU. You might find that interesting too.

Sometimes the back story behind science is as interesting as the actual work. :)

Her's the link:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5561804&mesg_id=5563052

[The Velveteen Ocelot]

40. CDC now thinks it's not like the 1918 virus.

http://www.google.com/hostednews/canadianpress/article/ALeqM5hnQli1AF50u0Cw0p4hAE4RN0AJgw

[rainbow4321]

43. Another Dallas area school district to shut down: Lewisville ISD

One of the bigger districts in the area, not as big as Ft Worth..district info page has student population around 50,000 (Ft Worth is 80,000).

3 probable case, 1 confirmed.

http://breakingnewsblog.dallasnews.com/archives/2009/05/lewisville-isd-to-close-denton.html

From Denton County health officials:

"We now have 3 probable cases and 1 confirmed case. The probable case, reported this afternoon, is still being investigated and there are no other details available at this time. In response to the added probable case and current H1N1 activity, Lewisville ISD has made the decision to close their school district for the next 7 days."

"Ponder ISD has made the decision to close their school district. This closure is in response to several positive Influenza A tests. There are no probable or confirmed cases linked to the Ponder ISD closure; however, the school district and the Denton County Health Department agreed that school closures were necessary because of the small size and number of positive flu A tests."

[rainbow4321]

44. CDC has sent states their own batches of swine flu testing kits

A very good thing..now states won't have to wait THREE days to find out if the case is really swine flu or "just" Flu A.
I imagine we will start seeing more diagnosed cases over the next week or so since they will get the results faster.
Per the article, the CDC was only able to run 100 tests per night, so that also delayed the results, given how inundated they were with samples being mailed to them.


http://apnews.myway.com/article/20090430/D97T2ALO1.html


On Friday, the Centers for Disease Control and Prevention will start shipping kits so states can do their own swine flu tests. Until now, state labs could only rule out previously known flu strains and send suspicious samples to CDC

With the new kits from CDC, states will be able to declare presumed swine flu cases, allowing doctors to start treatment. Medicines to fight the virus, such as Tamiflu and Relenza, must be taken within 48 hours of first symptoms to do any good.

Until now, many busy labs have been so overrun that they could do preliminary tests only on samples that meet a strict case definition or that involve people who traveled to Mexico.

"The capacity of the state laboratories to test all the swabs is being exceeded," said Dr. Paul Jarris, executive director of the Association of State and Territorial Health Officials.

[uppityperson]

45. Really good website with info on all sorts of influenza

http://www.pandemicflu.gov/

[uppityperson]

46. 53 pediatric deaths 200-2009 season from "regular" influenza in USA

http://www.cdc.gov/flu/weekly/weeklyarchives2008-2009/weekly14.htm
Meaning "regular flu"

[uppityperson]

47. 6 of the 8 genetic segments of today's swine flu ..can be traced to NC triple hybrid

http://www.guardian.co.uk/world/2009/may/02/swine-flu-pandemic-mexico-pig-farming
(clip)
But then in 1998 there was an explosive new outbreak of swine flu in a factory farm in North Carolina that made thousands of pigs ill. The virus had evolved into a triple hybrid that had never been seen before, containing gene segments from bird, human and swine flu. It had found the ideal breeding ground. Pigs, whose immune systems were suppressed by the stress of crowding and fast feeding, and kept confined indoors, were perfect disease incubators for flu whose preferred method of transmission is virus-infected aerosol droplets, expelled by the million in the hog's famous barking cough. Thanks to the modern practice of transporting live animals, the new virus spread rapidly through pig herds around the country.

Six of the eight genetic segments of today's swine flu outbreak isolated by CDC experts can be traced back to the triple hybrid from North Carolina.

Factory animal farming has developed as a giant ecological credit bubble. It has delivered enormous growth in global meat production over the last three decades. Consumers have happily bought its cheap products just as they gobbled up the freely-offered loans of the financial boom without asking too closely how such consumption could be sustained or what the eventual consequences might be. Swine flu should make us question that complacency.
(more clipping)

[bluedawg12]

53. Estimated human population 2015: 7 +billion. n/t

[nadinbrzezinski]

49. Things one learns readying El Universal

in an effort to educate the population they had an article on the two phases historically, for pandemics

Who knew? A paper went there? Oh wait, that's not the American press

I will see if I can find that

Second piece of trivia... not that it will come as too much of a surprise... most of the infected are coming from the very much less well to do areas of town

What is called marginal zones, the correct term is ciudad perdida or favela for Brazil

That is actually relevant

Lesser nutritional status and elevated respiratory problems like oh Asthma will do that to a population any day of the week and twice on sunday

http://www.eluniversal.com.mx/nacion/167705.html

For the geeks following this

<----------- proud member of the geek squad, well this is a critical piece of information

Note also that I do not need to post this second phase could be much worst... since we know... but at least they are trying to educate their population

[bluedawg12]

50. H1N1 East to West Spread Evokes Guns, Germs and Steel.

Looking at the world map of the spread of H1N1 tonight, reminded me of Dr. Jared Diamond’s book and his notions on the predominant east - west flow of some aspects of global civilization: i.e. “Guns, germs and steel.”

Without getting into the controversy about the Eurocentric POV of his book, rather sticking to "germs" or how infections might have spread and seems to be spread today, what struck me was how much it echoed his idea that germs traveled east to west as travel was dictated by large continuous land masses. That’s what came to mind when I looked at the idemc.org map (link below) today. The current H1N1 virus has predominantly spread where peole travel, across the US, and then across Europe. Obviuosly it's not identical due to air travel, which could explain Japan and New Zealand and Australia. But absent airplanes, it sure looks predominantly like Dr. iamopnd described. Perhaps he was predicting a model for infectious disease spread in modern times?


http://www.idemc.org/index.php?area=

http://en.wikipedia.org/wiki/Guns,_Germs,_and_Steel#The_theory_outlined

>>Guns, Germs, and Steel
From Wikipedia,

{i]Guns, Germs, and Steel: The Fates of Human Societies is a 1997 book by Jared Diamond, professor of geography and physiology at UCLA. In 1998 it won a Pulitzer Prize and the Aventis Prize for Best Science Book

<snip>

Eurasia's large landmass and long east-west distance increased these advantages. Its large area provided it with more plant and animal species suitable for domestication and allowed its people to exchange both innovations and diseases. Its East-West orientation allowed breeds domesticated in one part of the continent to be used elsewhere through similarities in climate and the cycle of seasons.

<snip>
Europe was the ultimate beneficiary of Eurasia's East-West orientation: in the first millennium BC the Mediterranean areas of Europe adopted the Middle East's animals, plants, and agricultural techniques; in the first millennium AD the rest of Europe followed suit.<1><2>

<snip>

Eurasia's dense populations, high levels of trade, and living in close proximity to livestock also made the transmission of diseases easy, so natural selection forced Eurasians to develop immunity to a wide range of pathogens. When Europeans made contact with America, European diseases ravaged the indigenous American population, rather than the other way around (the "trade" in diseases was a little more balanced in Africa and southern Asia: malaria and yellow fever made these regions notorious as the "white man's grave";<3>; and syphilis may have spread in the opposite direction<4>). The European diseases - the "Germs" of the book's title - decimated indigenous populations so that relatively small numbers of Europeans could maintain their dominance.<1><2><<

[bluedawg12]

51. Comments from Pres. Obama + CDC: spread no faster than ordinary flu.

http://www.idemc.org/read/index.php?pageid=news_read&news_id=49

USA, 02.05.2009 04:46:07
President Barack Obama voiced hope Friday that the swine flu virus will run its course "like ordinary flus" as officials reported more than two dozen new cases and scores more schools shut down. The government issued new guidance for schools with confirmed cases, saying they should close for at least 14 days because children can be contagious for seven to 10 days from when they get sick. That means parents can expect to have children at home for longer than previously thought.
The Education Department said that more than 400 schools had closed, affecting about 245,000 children in 18 states. That was about 100 more schools reported closed than reported on Thursday. Major U.S. airlines, meanwhile, announced plans to curtail flights into flu-ravaged Mexico. "I'm optimistic that we're going to be able to manage this effectively," Obama told reporters as he received an update from his Cabinet on the federal response to the health emergency. At the same time, he emphasized that the federal government is preparing as if the worst is still to come so that it won't be caught flat-footed. Obama's fresh take on the flu scare - more intense in neighboring Mexico than in the United States but also present in some measure around the globe - came as the Centers for Disease Control and Prevention reported the virus has been confirmed in eight more U.S. states and seems to be spreading. Confirmed cases have risen from 109 Thursday to 141 Friday, the CDC said, with the flu now reported in 19 states, up from 11. Separately, a few states reported slightly higher numbers, and the District of Columbia announced its first two probable cases. The U.S. death toll remained at one - the Mexican toddler who visited Texas with his family and died there.

The most recent onset of illness was Tuesday, CDC said, indicating a continuing spread, though no faster than the rate of the regular winter flu. "We think the cases do continue to occur," said CDC's Dr. Anne Schuchat. But CDC also said the new swine flu virus lacks genes that made the 1918 pandemic strain so deadly. Obama said it wasn't clear whether the flu would be more severe than others before it, and he said the swine flu is a cause for special concern because it is a new strain and people have not developed an immunity to it. Government agencies are preparing in case the flu comes back in a more virulent form during the traditional flu season, the president said, talking of an overarching effort to help schools and businesses while also responding to pleas for help from other countries. While emphasizing at a press conference that the closures to date represent a tiny fraction of the almost 100,000 schools in the country, Education Secretary Arne Duncan instructed teachers, parents and students to be prepared if their school does close. To teachers, Duncan said: "Think about reworking upcoming lesson plans so students can do their schoolwork at home if necessary." To parents: "Learn about what they're learning at school. Keep them on task." And to students: "Don't fall behind your peers at other schools that are still in session. Keep working hard."

Many travelers have become increasingly concerned about going to Mexico, though authorities there said new cases were leveling off. The Mexico City mayor said Friday that no new flu deaths were reported overnight for the first time since the emergency was declared a week ago. Mexico has confirmed more than 300 swine flu cases and has 16 confirmed deaths, although reports have indicated that roughly 120 may have died from it. U.S. travelers have been advised to avoid nonessential travel to Mexico. Continental Airlines Inc., the biggest U.S. carrier to Mexico, said Friday it would halve the number of seats it sells to fly there. Delta Air Lines Inc. and UAL Corp.'s United Airlines also announced plans for reduced flights to Mexico, while smaller carriers were following suit. Mormon church officials canceled church services in Mexico City until further notice and said they were delaying sending new missionaries to that country. The energy secretary aide who apparently got sick helping arrange Obama's recent trip to Mexico told The Associated Press when reached at his office Friday that he was feeling better.

The aide, Marc Griswold, a former Secret Service agent who was doing advance work for Energy Secretary Steven Chu, declined to elaborate beyond comments in The Washington Post. "We're not the Typhoid Mary family, for goodness sake," he told the Post in a story published Friday. "We've been told that we're not contagious. We're already past the seven-day mark for that." The White House has said Griswold did not fly on Air Force One and never posed a risk to the president. Though most U.S. cases have been relatively mild and have not required a doctor's visit, U.S. precautions include shipping millions of doses of anti-flu drugs to states in case they're needed, replenishing the U.S. strategic stockpile with millions more treatment courses, and shipping 400,000 treatment courses to Mexico. The CDC added the following states to its list of those with confirmed cases: New Jersey with five cases, Delaware with four, Illinois with three, Colorado and Virginia with two, and Minnesota, Nebraska and Kentucky each with one. CDC previously had confirmed cases in New York, Texas, California, South Carolina, Kansas, Massachusetts, Indiana, Ohio, Arizona, Michigan and Nevada.

[nadinbrzezinski]

54. By the way why it is deadlier in Mexico

piece of trivia was published in the press today (mexican)

I posted it above

The positives are coming from the real poor areas

This means poor nutrition ( I am being generous here, really), and exacerbated and poorly treated (best case) respiratory conditions such as Asthma

[bluedawg12]

55. Yup, poverty, diet, air quality, even access to care.

Plus it seems to be ground zero. I agree many reasons.

[nadinbrzezinski]

56. By the way two local schools closed today

and more and more are closing

Now that this crap is not so theoretical, the OMG we are gonna die is going down

[uppityperson]

57. It'll turn into OMG what are we going to do with the kids

Looking at some closing in my rural area also. My kid works in public market in Seattle, lots of tourists and is trying to stay calm. Was VERY sick a couple wks ago, so says will be fine

[nadinbrzezinski]

58. It already is...

and they are ordering home quarantine

The schools cannot enforce it, they are right, but cops can

And that will come... if cops can spare the time

Why am I seeing NG or Pubic Health or both in our future if they go there with the plans?

[bluedawg12]

59. CDC: Information for Concerned Parents and Caregivers

http://www.cdc.gov/h1n1flu/parents.htm

H1N1 Flu (Swine Flu):
Information for Concerned Parents and Caregivers
May 1, 2009, 7:15 PM ET

What is H1N1 Flu?
H1N1 is a type of influenza (flu) virus that causes respiratory disease that can spread between people. Most people infected with this virus in the United States have had mild disease, but some have had more severe illness, and there has been at least one death. Young children, pregnant women, and people with chronic diseases like asthma, diabetes, or heart disease may be at higher risk for complications from this infection. More information about who may be at higher risk will be available when more is known about the disease. There are steps you can take to protect your family and to know when to seek medical care.

What are the symptoms?
In most children, the symptoms of H1N1 flu are similar to the symptoms of regular flu. They include:

Fever
Cough
Sore throat
Body aches
Headache
Chills and fatigue
Occasionally, vomiting and diarrhea

Young children may not have typical symptoms, but may have difficulty breathing and low activity. Little is known about how H1N1 may affect children. However, we think the infection may be similar to other flu infections. Typically, flu infections cause mild disease in children, but children under 5 years old are more likely to have serious illness than older children. Although rare, severe respiratory illness (pneumonia) and deaths have been reported with flu infections in children. Flu infections tend to be more severe in children with chronic medical conditions.

How to keep from getting it:
Flu viruses spread from person to person mainly through the coughing or sneezing of a sick person. Flu virus may also be spread when a person touches something that is contaminated with the virus and then touches his or her eyes, nose, or mouth. We think H1N1 flu spreads the same way as other flu viruses. Right now, there is no vaccine to protect against H1N1 flu, but there are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like H1N1 flu:


Teach your children to wash their hands frequently with soap and water for 20 seconds. Be sure to set a good example by doing this yourself.
Teach your children to cough and sneeze into a tissue or into the inside of their elbow. Be sure to set a good example by doing this yourself.
Teach your children to stay at least six feet away from people who are sick.
Children who are sick should stay home from school and daycare and stay away from other people until they are better.
In communities where H1N1 flu has occurred, stay away from shopping malls, movie theaters, or other places where there are large groups of people.

What to do if your child is sick:


Unless they need medical attention, keep children who are sick at home. Don’t send them to school or daycare.
Have them drink a lot of liquid (juice, water, Pedialyte ®).
Keep the sick child comfortable. Rest is important.
For fever, sore throat, and muscle aches, you can use fever-reducing medicines that your doctor recommends based on your child’s age. Do not use aspirin with children or teenagers; it can cause Reye’s syndrome, a life-threatening illness.
If someone in your home is sick, keep him or her away from those who are not sick.
Keep tissues close to the sick person and have a trash bag within reach for disposing used tissues.
If your child comes in contact with someone with H1N1 flu, ask your doctor if he or she should receive antiviral medicines to prevent getting sick from H1N1 Flu.

If your child experiences any of the following warning signs, seek emergency medical care:
Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that he or she does not want to be held
Not urinating or no tears when crying
Their symptoms improve but then return with fever and worse cough

[BlooInBloo]

60. Mexico revises number of infected DOWN by 56%...

This follows on Mexico revising the number of dead DOWN by a similar amount a few days ago.

I know that doesn't comport well with the omgwe'reallgonnadie thing, but whatever.

http://www.nytimes.com/2009/05/02/health/02flu.html?_r=1&hp

[bluedawg12]

62. Confirmed cases smaller than suspected cases is expected, that's why they test.

[uppityperson]

71. Texas lab swamped with swine flu samples (181 of 2,492 done)

http://www.chron.com/disp/story.mpl/ap/tx/6404592.html

Only a fraction of the nearly 2,500 nasal swabs sent to the state health department lab have been tested. The Austin lab had tested 181 of the 2,492 nasal swabs received from counties around the state by Friday, Department of State Health Services spokesman Doug McBride told the Austin American-Statesman for Saturday's editions.

The lab's single testing machine became overwhelmed Wednesday when samples began flooding in from around the state. Three more machines are being added, more staff is being trained to run on two more shifts and the lab will work seven days a week to catch up, McBride said. The lack of test results does not change how doctors treat patients, but makes an accurate count of cases impossible.

"I'd like to know how many (cases) there are," said Dr. Pat Crocker, medical director of Dell Children's Medical Center in Austin. "We have heard disappointingly little from the state."That hospital's emergency room received twice as many patients Thursday as usual. On Friday, the hospital set up three air-conditioned tents with cots to treat overflow patients in a covered parking area.

After state labs test samples from counties, they forward possible swine flu samples to the U.S. Center for Disease Control and Prevention lab in Atlanta for final confirmation. The CDC also is sending supplies to state labs so they will be able to start making their own confirmations. "Part of what we're trying to do is speed up the confirmation time," said CDC spokesman Scott Bryan. With the additional machines and personnel, the state lab should be able to handle 200 cases per day, whereas now it can do 70, McBride said.

[bluedawg12]

61. "when public health works, nothing happens" and that's what we want.

http://scienceblogs.com/effectmeasure/2009/05/swine_flu_case_definitions_and.php
Swine flu: case definitions and tough decisions
Category: CDC • Infectious disease • Influenza treatment • Pandemic preparedness • Public health preparedness • Surveillance • Swine flu
Posted on: May 1, 2009 2:41 PM, by revere

Just a brief note to remind everyone about the case definitions CDC is using for reporting on swine flu (or whatever name we collectively settle on). In order to make sure numbers are comparable from day to day and place to place we have to decide on criteria for knowing we have something to count. Is someone with flu-like symptoms to be counted as a case? Or do we confine it to someone with laboratory proved infection with the virus? Should there be different categories of diagnostic certainty?

For the moment, CDC is using the following definitions for suspected, probable and confirmed cases of swine flu.

To be considered under any of these categories, the person must first have an acute febrile respiratory illness. The fever has to be at least 100 degrees F. (that's the febrile part) and accompanied by recent onset (the acute part) of at last one of these respiratory tract symptoms: rhinorrhea (runny nose) or nasal congestion, sore throat, cough (these, obviously, are the respiratory illness components of the definition).

Having an acute febrile illness at this juncture is not enough to put you into the biggest category, "suspect case." You also have to have been in close contact with a confirmed cases within the last 7 days (the upper range of the incubation period) or have traveled in the last 7 days (in the US or internationally) someplace where there have been confirmed cases, or now, live in a US community that has cases. These are people who might be infected with this virus or could have another reason for their symptoms. Suspect cases vastly outnumber true cases at the beginning of any outbreak, and that's true this time as well.

The index of suspicion gets ratcheted up when a suspect case is shown to be shedding influenza A virus through one of the rapid antigen tests available in a doctor's office. These tests don't detect all flu A, however. They are said to be about 50% sensitive, meaning they miss about half of true flu A infections. Their main use was as a way to detect the presence of flu A (or flu B) in the community. Using it as a test for an individual, as here, is not the best way to make a diagnosis, but the number of errors that will be made will be a function of the prevalence of flu A among those with acute febrile respiratory illnesses at any point in time. If they are positive by this test, the swab is supposed to be sent to a state-level public health laboratory for subtyping. If it cannot be subtyped at this level, it is sent to CDC for a specific test for the current swine flu virus involved in the outbreak. From the moment a person is flu A positive to the final disposition either at the state lab or CDC, the person is a probable case (probable pending laboratory confirmation).

Specimens that are shown to contain the genetic material of the current swine flu virus (by RT-PCR) or that yield the virus when cultured in cell culture are the tip of the diagnostic pyramid, the confirmed cases.

Probable cases are popping up all over and I wouldn't be surprised if CDC's lab started to back up. That will mean that decisions about closing schools or businesses will be waiting for final confirmation. The decision makers are in a difficult position, because shutting schools at the end of a school year, with proms, SAT and final exams and who knows what else creates extremely difficult and painful problems. If this (so far) mild influenza peters out they will be accused of panicking and over reacting. But if this outbreak builds up a real head of steam, the consequences could be a great deal of illness, discomfort and some deaths and almost certainly medical facilities will be overwhelmed.

There is an old adage: when public health works, nothing happens. In this case, the purpose of closing schools and canceling events is to prevent further transmission of disease. Experience indicates that the earlier social distancing and other similar interventions are applied, the more likely there will be a good effect. In this case, success will mean "nothing happens," which is what we want.

Unfortunately it is more than likely that the decision makers who helped bring it about will be blamed for doing what needs to be done.

[crispini]

63. Virus has been isolated and work on vaccine has begun.

Via CDC twitter feed about an hour ago.

[L. Coyote]

64. Now 615 world-wide cases confirmed. n/t

[L. Coyote]

65. Mexico: no new swine flu deaths, cases up to 443

Mexico: no new swine flu deaths, cases up to 443
Paul Haven, Associated Press – 36 mins ago - http://news.yahoo.com/s/ap/20090502/ap_on_he_me/med_swine_flu

MEXICO CITY – Mexican officials were cautiously optimistic Saturday that the worst of the swine flu epidemic is over for Mexico, with no new flu deaths reported overnight. But the virus keeps spreading around the world, with new cases confirmed in Europe and Asia, and some governments banning flights and preparing quarantines for travelers from Mexico.

"What we thought is that we would have an exponential growth in the number of persons with symptoms. But the information we have is that hasn't occurred, and we now have a stabilized curve with no important growth" of confirmed cases, Mexico City's mayor Marcelo Ebrard said declared Saturday.

Mexico said it had no confirmed deaths from swine flu overnight, even as its confirmed caseload grew to 443. The U.S. count rose to 155 and worldwide, there were 653 confirmed swine flu cases, although the real number is believed to be much higher. The virus also has been detected in Canada, New Zealand, China, South Korea, Israel and eight European nations.

It should soon become clear whether the epidemic is really stabilizing in Mexico, but many questions remain about how the disease kills, ..............

[bluedawg12]

67. "Suspected cases" versus "confirmed cases."

The first cohort of people reported are those who meet clinical criteria for a disease, these are suspected cases.

Then, as people are subjected to testing, the number going from "suspected cases," to "confirmed cases"
is expected to be lower.

In the meantime, the number of confirmed cases is expected to rise, while the number of suspected cases should fall.

So, it makes sense, Mexico reports a high number of suspected cases, which then drops to a lower number of "confirmed cases"when testing rules out non-infected people.

As the WHO receives data, the number of "confirmed cases," does go up world wide.

The markers to watch are regarding spread:
a rise in suspected cases
a rise in new cases
a rise in confirmed cases

Then, to evaluate virulence, monitor:
Deaths
Hospitalizations for confirmed cases
The number of people on critical care units
The number of people requiring ventilators


Defintions: suspected, probable and confirmed:



>>http://scienceblogs.com/effectmeasure/2009/05/swine_flu_case_definitions_and.php

Probable

"To be considered under any of these categories, the person must first have an acute febrile respiratory illness. The fever has to be at least 100 degrees F. (that's the febrile part) and accompanied by recent onset (the acute part) of at last one of these respiratory tract symptoms: rhinorrhea (runny nose) or nasal congestion, sore throat, cough (these, obviously, are the respiratory illness components of the definition).

Suspected:
Having an acute febrile illness at this juncture is not enough to put you into the biggest category, "suspect case." You also have to have been in close contact with a confirmed cases within the last 7 days (the upper range of the incubation period) or have traveled in the last 7 days (in the US or internationally) someplace where there have been confirmed cases, or now, live in a US community that has cases. These are people who might be infected with this virus or could have another reason for their symptoms. Suspect cases vastly outnumber true cases at the beginning of any outbreak, and that's true this time as well.

Confirmed:
The index of suspicion gets ratcheted up when a suspect case is shown to be shedding influenza A virus through one of the rapid antigen tests available in a doctor's office. These tests don't detect all flu A, however. They are said to be about 50% sensitive, meaning they miss about half of true flu A infections. Their main use was as a way to detect the presence of flu A (or flu B) in the community. Using it as a test for an individual, as here, is not the best way to make a diagnosis, but the number of errors that will be made will be a function of the prevalence of flu A among those with acute febrile respiratory illnesses at any point in time. If they are positive by this test, the swab is supposed to be sent to a state-level public health laboratory for subtyping. If it cannot be subtyped at this level, it is sent to CDC for a specific test for the current swine flu virus involved in the outbreak."<<

[bluedawg12]

66. The Overreaction Overreaction

http://scienceblogs.com/effectmeasure/2009/05/swine_flu_the_overreaction_ove.php
Swine flu: the overreaction overreaction

Posted on: May 2, 2009 10:38 AM, by revere

Laurie Garrett of the Council on Foreign Relations and a well-known authority on emerging infectious diseases was on PBS's Newshour last night and she made a very important but little appreciated point. Mexico has made a major national sacrifice for global public health by shutting down its country and interrupting transmission of disease. The cost to Mexico has already been enormous it will continue to pay in other ways. The reputation of the government has suffered because of the way it handled this -- the lack of transparency, the initial slow footedness (which of course it denies), its lack of credibility in the eyes of its citizens. There will continue to be a halo of risk and danger for an indeterminate time. And there will be the inevitable backlash against the government's actions, which went from cold to scalding hot in a week. We are starting to see this in the US as well: the "overreaction" backlash. So it's important to sort all of this out. What is the Big Picture at this point?

It's now been a little over a week since swine flu (rebranded H1N1/2009) popped its head above water in southern California. From two cases discovered in mid-April in San Diego, the virus is now confirmed to have spread, mostly from Mexico, to 15 countries in North America, Europe and Asia. Confirming a case takes time so there are significant differences between reports of suspected, probable and confirmed cases, but as of this moment WHO acknowledges 17 deaths (16 in Mexico, 1 in the US) and confirmed 615 cases. The confirmed cases are new, not previously existing but unrecognized cases and there is clear and convincing evidence of person to person transmission. It appears the age distribution continues to be shifted toward younger age groups as compared to endemic seasonal influenza, probably a reflection of the fact that most people are immunologically naive to this flu virus. There remains an open question as to whether people who were born before 1957, the date that H2N2 replaced a previous H1N1 as the predominant subtype, may have some cross-reactivity to the current H1N1 strain. In any event, a novel influenza virus has spread quickly worldwide and is transmitting efficiently, pretty much the dictionary definition of a pandemic.

The extent and speed of spread is one factor of concern. The other is the clinical severity of the disease. The good news is that so far, clinically this influenza virus looks much like a mild seasonal influenza. "Mild" is a relative term. Any influenza infection is a potentially serious disease, and while we have no hard figures, good estimates of the excess mortality caused by influenza yearly in the US is around 35,000 to 40,000. These deaths and the significant but non-fatal illnesses that require hospitalization each flu season are the upper tails, the tip of the iceberg, of flu infections. Most people have milder cases. Some of these "milder" cases are still miserable affairs, with severe headache, joint and muscle aches and hacking coughs that can to on for weeks and malaise and tiredness lasting much longer. Some people are infected and have no symptoms at all. But the more people infected the more people who are in the upper tail of the distribution. You don't have to shift the distribution much to double or triple the number of people in the tip of the iceberg (think of the tip as a pyramid, and as you raise the iceberg up slightly the new people are in its base, which is much wider). These are the people that will stress our already over stressed medical care system. US emergency departments are already overcapacity. They would break during a bad flu season.

So that's where we are at this moment. There is some evidence from 1918 that cities that acted immediately to interrupt transmission by reducing opportunities for contact ("social distancing") did better than those that didn't. We would of course expect this on common sense grounds as well. That's what Mexico has done -- and I echo Laurie Garrett's point, they have done so at great cost to everyone's benefit. That is what is behind CDC's recommendations that a school be closed as soon as a case is confirmed. There is a cost to that, too. Proms are canceled, to the deep disappointment of the prom go-ers and the economic loss of the venues and ancillary businesses. Exams are delayed. Child care needs for younger students produce a ripple effect throughout the community. And as in Mexico, these costs can produce a backlash if the public doesn't understand why they have been incurred.

The irony is that the overreaction backlash will be more severe the more successful the public health measures are. If, for example, the virus peters out this spring because transmission was interrupted long enough for environmental conditions (whatever they are) to tip the balance against viral spread, CDC and local health officials will be accused of over reacting. It's another example of the adage, "When public health works, nothing happens." On the other hand, if local officials do nothing and things get worse, they will be accused of being slow.

It's not just the current reputation of local officials that concern me, however. If this virus does wane with the summer months (something we expect to happen), it's current mildness and its disappearance may lead citizens and decision makers back into the kind of reckless disregard of public health facts that has produced our current weak and brittle health infrastructure. But flu season will come again next fall, and it would be no scientific surprise if this strain is part of flu's repertoire. Most of the world would still be unprotected unless we spend the interim preparing for the possibility it will reappear in a more serious clinical form (flu viruses are notorious for that kind of change). When I say prepare, I am not just talking about a vaccine, although that will be an important, but difficult< part. We will also need to invest urgently in a health care, public health and social infrastructure to absorb the consequences of potentially large scale absenteeism. We will also need to work out policies that will allow social distancing measures to work (child care, sick leave policy and other issues).

It's an urgent task that must be started immediately. If there is an overreaction to perceived overreaction, the job of rationally preparing for a plausible near future event will be made much more difficult.

[marshall]

68. You risk your health when you eat at ANY restaurant

Not to be too Bidenean, but the health risk of public restaurants didn't start with the swine flu. It's really just a crap shoot as to whether the food was prepared properly and the utensils cleaned well enough.

[bluedawg12]

69. CDC Report for US 5-02-09.

http://www.cdc.gov/h1n1flu/
U.S. Human Cases of H1N1 Flu Infection
(As of May 2, 2009, 11:00 AM ET) States # of
laboratory
confirmed
cases Deaths
Arizona 4
California 24
Colorado 2
Connecticut 1
Delaware 4
Florida 2
Illinois 3
Indiana 3
Kansas 2
Kentucky* 1
Massachusetts 8
Michigan 2
Minnesota 1
Missouri 1
Nevada 1
New Jersey 7
New York 50
Ohio 1
South Carolina 13
Texas 28 1
Virginia 2
TOTAL (21) 160 cases 1 death

http://www.cdc.gov/h1n1flu/

U.S. Human Cases of H1N1 Flu Infection
(As of May 1, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 4
California 13
Colorado 2
Delaware 4
Illinois 3
Indiana 3
Kansas 2
Kentucky 1
Massachusetts 2
Michigan 2
Minnesota 1
Nebraska 1
Nevada 1
New Jersey 5
New York 50
Ohio 1
South Carolina 16
Texas 28 1
Virginia 2
TOTAL COUNTS 141 cases 1 death


U.S. Human Cases of Swine Flu Infection
(As of April 29, 2009, 11:00 AM ET) States # of laboratory confirmed cases Deaths
Arizona 1
California 14
Indiana 1
Kansas 2
Massachusetts 2
Michigan 2
Nevada 1
New York City 51
Ohio 1
Texas 16 1
TOTAL COUNTS 91 cases 1 death
..............
http://www.cdc.gov/swineflu /
U.S. Human Cases of Swine Flu Infection
(As of April 28, 2009 11:00 AM ET)
State # of laboratory
confirmed cases
California 10 cases
Kansas 2 cases
New York City 45 cases
Ohio 1 case
Texas 6 cases
TOTAL COUNT 64 cases
..........

http://www.cdc.gov/swineflu /
April 27, 2009
State # of laboratory
confirmed cases
California 7 cases
Kansas 2 cases
New York City 28 cases
Ohio 1 case
Texas 2 cases
TOTAL COUNT 40 cases
.................

http://www.cdc.gov/swineflu/investigation.htm
April 25, 2009 19:30 EDT
U.S. Human Cases of Swine Flu Infection
As of April 25th, 2009 7:30 p.m. EDT
State # of laboratory
confirmed cases
California 7 cases
Texas 2 cases
Kansas 2 cases
TOTAL COUNT 11 cases

...............

[bluedawg12]

70. WHO Update 9, for 5-02-09.

WHO Update 5-02-09. Older WHO updates below for comparison.

Also note, there is some information lag, as the CDC posted TOTAL 160 confirmed cases in the US today, not 141.

.....

http://www.who.int/csr/don/2009_05_02/en/index.html
Influenza A(H1N1) - update 9
2 May 2009 -- The situation continues to evolve. As of 06:00 GMT, 2 May 2009, 15 countries have officially reported 615 cases of influenza A(H1N1) infection.

Mexico has reported 397 confirmed human cases of infection, including 16 deaths. The 241 rise in cases from Mexico compared to 23:30GMT of 1 May reflects ongoing testing of previously collected specimens. The United States Government has reported 141 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (34), China, Hong Kong Special Administrative Region (1), Denmark (1), France (1), Germany (4), Israel (2), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (13).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.


.........
http://www.who.int/csr/don/2009_04_27/en/index.html

27 April 2009 -- The current situation regarding the outbreak of swine influenza A(H1N1) is evolving rapidly.

As of 27 April 2009, the United States Government has reported 40 laboratory confirmed human cases of swine influenza A(H1N1), with no deaths.

Mexico has reported 26 confirmed human cases of infection with the same virus, including seven deaths.

Canada has reported six cases, with no deaths, while Spain has reported one case, with no deaths.
.................

http://www.who.int/csr/don/2009_04_28/en/index.html

Swine influenza - update 4
28 April 2009--The situation continues to evolve rapidly. As of 19:15 GMT, 28 April 2009, seven countries have officially reported cases of swine influenza A/H1N1 infection.
The United States Government has reported 64 laboratory confirmed human cases, with no deaths.
Mexico has reported 26 confirmed human cases of infection including seven deaths.

The following countries have reported laboratory confirmed cases with no deaths - Canada (6), New Zealand (3), the United Kingdom (2), Israel (2) and Spain (2).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.
................

http://www.who.int/csr/don/2009_04_29/en/index.html

Swine influenza - update 5
29 April 2009 -- The situation continues to evolve rapidly. As of 18:00 GMT, 29 April 2009, nine countries have officially reported 148 cases of swine influenza A/H1N1 infection. The United States Government has reported 91 laboratory confirmed human cases, with one death. Mexico has reported 26 confirmed human cases of infection including seven deaths.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (13), Germany (3), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.
.................

[we the tweeple]

72. For the love of God, stop doing the Illuminati's work for them!

This is yet another scare tactic, ala 9/11 and our germaphobe society has bought it hook, line, and sinker! Enjoy the Kool-Aid!:rofl:

[uppityperson]

73. Says the TS'd poster. Yup, passing on real info to counter rumors is a bad thing

I can see why you are no longer with us.

[bluedawg12]

75. No kidding uppity- well, that one calls for a LOL cat! heh heh

[Aloha Spirit]

74. Canada set to report a pig has been infected with H1N1, first known case

Canadian officials are set to announce the swine flu virus is believed to have infected pigs in Alberta.

http://www.thestar.com/News/Canada/article/628138

"A government source says the animals were thought to be infected by a farm worker who had recently been to Mexico and fell ill upon his return.
This may be the first time this particular swine flu virus has been found in pigs....
Genetic testing shows the pigs in Alberta were infected with the same virus responsible for cases in California, Mexico and other countries around the world."

[L. Coyote]

76. Spain leads Europe in swine flu cases with 40

Margie Mason, AP Medical Writer – 1 hr 30 mins ago
http://news.yahoo.com/s/ap/20090503/ap_on_re_la_am_ca/med_swine_flu


MEXICO CITY – Swine flu extended its reach through Europe and Latin America, with at least five countries reporting new cases on Sunday. Health experts were investigating a case of the virus jumping from a person to pigs, trying to determine if the disease was reaching a new stage.

Hong Kong kept 350 people under quarantine in a hotel as a precaution even though no new swine flu infections appeared in Asia, and Egypt's attempt to kill all pigs as a precaution against the disease prompted pig owners to clash with police who were helping to seize their animals for slaughter.

So far the swine flu epidemic has killed 19 in people in Mexico and one toddler in the U.S. and has spread to 18 countries worldwide — but experts believe the actual spread is much wider.

Mexico's health secretary said 11 people were suspected to have died from the virus in the previous 24 hours. ................

[bluedawg12]

77. CDC Update 5-03-09; Total 226 confirmed cases.

U.S. Human Cases of H1N1 Flu Infection
(As of May 3, 2009, 11:00 AM ET) States # of
laboratory
confirmed
cases Deaths
Alabama 1
Arizona 18
California 26
Colorado 4
Connecticut 2
Delaware 10
Florida 3
Illinois 3
Indiana 3
Iowa 1
Kansas 2
Kentucky* 1
Massachusetts 7
Michigan 2
Minnesota 1
Missouri 1
Nebraska 1
Nevada 1
New Hampshire 1
New Jersey 7
New Mexico 1
New York 63
Ohio 3
Rhode Island 1
South Carolina 15
Tennessee 1
Texas 40 1
Utah 1
Virginia 3
Wisconsin 3
TOTAL (30) 226 cases 1 death

[bluedawg12]

78. WHO Update 11 May 3, 2009

http://www.who.int/csr/don/2009_05_02/en/index.html

Influenza A(H1N1) - update 11
3 May 2009 -- As of 0600 GMT, 3 May 2009, 17 countries have officially reported 787 cases of influenza A(H1N1) infection.

Mexico has reported 506 confirmed human cases of infection, including 19 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens. The United States Government has reported 160 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (70), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Denmark (1), France (2), Germany (6), Ireland (1), Israel (3), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (15).

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

Canada on 2 May reported the identification of the A(H1N1) virus in a swine herd in Alberta. It is highly probable that the pigs were exposed to the virus from a Canadian farm worker recently returned from Mexico, who had exhibited flu-like symptoms and had contact with the pigs. There is no indication of virus adaptation through transfer from human to pigs at this time.

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.