Swine Flu in San Diego

INRM

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I heard something on TV just now about a swine-flu infection among 8 people in the Southwest USA connected to Mexico. To the best of my knowledge the people infected in San Diego.

Disturbingly I think the strain is H1N1 which is the same one to the best of my knowledge that caused the 1918 Flu outbreak.


INRM
 
It's not clear at this point that the clusters in California and Texas are connected to the cases in Mexico, although it does seem like a reasonable assumption. And I wouldn't be too disturbed just because it's an H1N1; so is the strain that dominated this year's flu season. It doesn't appear to be particularly virulent; certainly nothing like the H5N1 we've been watching for the last several years.

WSJ said:
"We are very, very concerned," WHO spokesman Thomas Abraham said. "We have what appears to be a novel virus and it has spread from human to human." If international spread is confirmed, that meets WHO's criteria for raising the pandemic alert level, he added.
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http://online.wsj.com/article/SB124058255179552887.html
 
This story is moving faster than anyone can keep up with.

There is another mild U.S. case, number 8 so far.

Mexico has reported a third possible outbreak of swine flu in Mexicali, near the U.S. border, with four suspect cases; no deaths to date.
http://www.reuters.com/article/marketsNews/idUSLO61281820090424

Looks like the Mexico virus is the same as the one in the U.S.; that's still not firmly nailed down. For some reason, cases in Mexico have been more severe; no one knows why.

We're waiting for a MMWR dispatch to be released today.
 
So that explains my urge to "If U see Kay" in the mud with some comely young sow.

So swine flu finally got here, thirty years late?
 
The "swine flu" of Jerry Ford's day was called that in hopes of preventing a panic. It was feared that the strain might be identical to the 1918 flu. I can recall the glassy gibbering of public officials simultaneously telling the public to get vaccinated! get vaccinated! and stay calm! stay calm!

By coincidence, I just finished The Great Influenza, by John M. Barry. If you can overlook his stylistic excrescences and general fear-whipping, it's an informative read.
 
"Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California."

http://www.who.int/csr/don/2009_04_24/en/index.html

It's becoming pretty clear that the conditions for raising the pandemic alert level from 3 to 4 have already been met. It will be interesting to see how long it takes the WHO to acknowledge that.
 
I remember reading back when Jimmy Carter was president that he was divorcing Rosalynn, because she had contracted swine flu and rooted up his peanut crop.
 
Do you think this will ultimately lead to a state of emergency being declared and/or a declaration of martial-law?

INRM
 
Dymanic said:
"It's becoming pretty clear that the conditions for raising the pandemic alert level from 3 to 4 have already been met.
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What do you think the "conditions" are? The WHO states that "The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans."

I see no evidence that twenty cases are "efficient" or "sustainable" -- or for that matter, anything other than "very little." Indeed, I don't even think that they've yet documented human-to-human transmission.

It will be interesting to see how long it takes the WHO to acknowledge that.
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I hope the acknowledgement doesn't happen before the event that it acknowledges, as would be the case under your proposal.
 
INRM said:
Disturbingly I think the strain is H1N1 which is the same one to the best of my knowledge that caused the 1918 Flu outbreak.
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That would actually be good. In case you hadn't noticed, the people who are particularly succeptible to the 1918 flu all died in the early 20th century. Something about a flu outbreak.....

What has the WHO's knickers in a twist isn't the resurgence of an old virus but the appearance of a new one to which we haven't already achieved large-scale resistance.
 
INRM said:
Do you think this will ultimately lead to a state of emergency being declared and/or a declaration of martial-law?
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It's too soon to speculate about a case fatality rate, but if this bug had anything like the virulence of the H5N1 virus everybody's been watching for the last several years, it seems like that would have made itself apparent already. Most of the cases have been relatively mild. So no, INRM, I'm not seeing a doomsday scenario. Quite possibly, not even a pandemic. These bugs are tough to predict; the thing could just as easily peter out.
 
drkitten said:
What do you think the "conditions" are? The WHO states that "The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans."


I see no evidence that twenty cases are "efficient" or "sustainable" -- or for that matter, anything other than "very little."
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I'm not sure which 20 cases you're talking about. The numbers keep changing so fast that it's hard to keep up. There are 943 ILI cases in Mexico, though some number of them will surely turn out not to be swine flu. (Ok, since I had last looked... on a quick pre-post recheck, it appears to have topped 1000). The WHO is now saying that the Mexican isolates are matching the U.S. strains. I realize that I'm not putting any professional reputation on the line by saying so, but that this evidences "efficient human to human transmission" looks like the most reasonable explanation at this point. (an overly cautious approach won't do the WHO's already damaged credibility much good either, by the way).

Indeed, I don't even think that they've yet documented human-to-human transmission.
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Viruses don't document their activities, so that is inferred under certain circumstances, such as multiple "clusters" of individuals with no known contact with animals -- which is what we are seeing here.
 
INRM said:
Do you think this will ultimately lead to a state of emergency being declared and/or a declaration of martial-law?
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In fact, a state of emergency and martial law has already been declared, and this "flu" (actually an above-top-secret bioweapon known as anthrax-leprosy pi) has already killed more than 98% of the human population in the northern hemisphere.

It's just that this has all been covered up.
 
PixyMisa said:
In fact, a state of emergency and martial law has already been declared, and this "flu" (actually an above-top-secret bioweapon known as anthrax-leprosy pi) has already killed more than 98% of the human population in the northern hemisphere.

It's just that this has all been covered up.
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Again! :eek:

I hope this does peter out though - flu sucks.
 
macdoc said:
This is a mild flu compared to H51 which killed 60% of those that got it despite best effort care....
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The true measure of the hazard is not the actual death rate. It is the death rate plus the prevalence. By the time the 1918 flu pandemic became worldwide, the strain had become attenuated enough so that the death rate was down below 3%. But the infectiousness meant over 30% of the world's population had become infected. The total deaths resulting were over 50 million. (Numbers are estimated as sources vary.)

This particular strain is moving through the population very quickly. And it is unlikely many in the population are going to have much immunity to infection because it is a novel strain. That is a recipe for affecting a very large proportion of the world's population. That fact alone means we can expect a high death rate compared to the seasonal influenza.

Only time will tell at this point.
 
I should point out for those of you who don't know, the H and the N numbers are only part of what identifies a strain. There are many H5N1s just as there are many H5N1 strains. LPAI H5N1 or Low Pathogenic Avian Influenza vs HPAI H5N1, or High Pathogenic Avian Influenza for example have the same Hemagglutinin and Neuraminidase proteins but differ genetically in other important ways.

The 1918 pandemic strain was an H1N1 strain, but H1N1 strains have been circulating in the human population ever since. H5 strains rarely infect humans. Some people hypothesize that the H1 strain entered the population in 1918 and that novelty (meaning humans had no prior experience thus no prior immunity) was part of the reason it was so bad. That gives credence to the hazard that H5 could do the same.

Others hypothesize that H5 is unlikely to enter the human population in a big way because it hasn't in the past and the bird flu will not be the next pandemic strain.

Genetically, there are only a couple nucleic acid substitutions that need to randomly happen for the current deadly bird flu to become well adapted to humans. It's interesting that while we had our eye on that ball, the swine H1N1 snuck in the front door no one was watching.

I was interested to hear CDC say it was too late to stop this swine flu version. WHO has a theoretical model that says they need to stop an outbreak of influenza within the first 2 weeks or it would be too late. While every serious flu case was being monitored in the third world countries bird flu had so far been seen in, influenza cases everywhere else are not so carefully tested. I'm not sure CDC or WHO thought that through. No one would be likely to know anything was wrong until the threshold for seasonal flu was exceeded. Clearly by then more than 2 weeks was going to have been passed.
 
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