Swine Flu outbreak

We don't even have any cases here yet and I'm swamped. Which is not good since I've been procrastinating all day looking at the latest info.

But I did manage to get a respirator fit test kit on short notice, a variety of masks for testing, a new contract to fit test some docs with an unusual practice, and more than enough data on the benefit (or not) of using a fit tested N95 over just a face shield and good handwashing that I think they'll be impressed with my knowledge of the subject. :D
We have 3 confirmed and 10 high probable cases. Busy busy busy
 
Certainly the Kiwi kids who have had it seem to report less-serious symtoms than any old flu.

Spreading pretty fast, though - I'd say we're only days away from widespread community infection.


I'm not so sure about that. The number of people in isolation has fluctuated (at one point it was over 170) and Health Authorities have stated today that they're treating anyone with Influenza A as infected with Swine Flu. I think our government are being a little over cautious, calm, non-panicky, and direct about the situation. Exactly what I'd want them to be.

Personally I think John Key might have it right - what's going to be most harmed by all of this is our tourism earnings.
 
Personally I think John Key might have it right - what's going to be most harmed by all of this is our tourism earnings.

That seems unusual, from reports here in Canada people are still heading to Mexico on vacation, but they've stopped eating pork (go figure).

As an out of towner I certainly wouldn't put off going to Australia or NZ because of this. I can't speak for everyone obviously.
 
That seems unusual, from reports here in Canada people are still heading to Mexico on vacation, but they've stopped eating pork (go figure).

As an out of towner I certainly wouldn't put off going to Australia or NZ because of this. I can't speak for everyone obviously.


A big chunk of our tourism dollars come from Asia, and they tend to overreact about these things. India has officially issued a travel warning against going to any of the countries with an outbreak, including NZ.
 
A big chunk of our tourism dollars come from Asia, and they tend to overreact about these things. India has officially issued a travel warning against going to any of the countries with an outbreak, including NZ.


Ahh, OK. I still haven't heard any official travel advisories out of Canada or the US (not that there aren't any).

Do you know what officially counts as an outbreak?
 
I haven't read this entire thread, but I'm curious if anyone here thinks they may have already got this virus? I got very sick in early February, probably the sickest I have ever been. I felt fine on the Tuesday, Wednesday I was sluggish and knew I probably had something. By Thursday I was full on sick, achy, coughing, sore throat, the works. Friday was no better and by that point it hurt to breathe, sore from the dry coughing. Normally I would have felt better by the Saturday, that's usually how it works. This time though was different, by the Saturday night I was so sick I was almost hallucinating, my chest felt like there was a Mack Truck parked on it and I had the worst headache ever. I didn't get off the couch all day except to get more water, which I probably drank close to 10 L of (nothing to eat). I could barely sleep due to the headache, the pain in my chest and sweating. When I did get to sleep I had a very vivid dream I went out to the bar that night. It was so vivid it took me a while to realize I hadn't actually gone out. It wasn't until Sunday night that I started to feel a little better. I didn't shake it until the Wednesday or Thursday.

I recall thinking to myself that had I been older I probably would have died from this flu. This was the worst and the longest I have ever been sick, by about 3 days. My entire class was sick with this at some point in January or February. Many for longer than a week.

I'm just curious if anyone else had a similar experience with a virus in the last month or so? I seriously think it many have been the same virus.

About a month ago a whole lot of my 5th graders got sick. My classroom sounded like an infirmary ward. I got what felt like a mild cold out of it. I thought it was odd because I usually don't see that many sick kids after winter.

Oh, and on Monday, a Hispanic student of mine who speaks no English was very sick. My administrator had a lot of questions about that one. I teach in Southern California and about 65% of my school's population is Hispanic.
 
I don't buy into any of this. It's a panic.
Experts in immunology should be stating this.
Panic in Detroit.
 
About a month ago a whole lot of my 5th graders got sick. My classroom sounded like an infirmary ward. I got what felt like a mild cold out of it. I thought it was odd because I usually don't see that many sick kids after winter.

There was a dry cough going around the class we referred to as "SARS", pretty much anyone hacking was going to be absent in the following days. It wasn't until recently this died off. It was a very virulent strain of whatever it was, I just found it unusual that the swine flu came under scrutiny so soon afterwards. Like The Atheist says, the probability it was this swine flu is remote, still it makes you wonder.
 
reuters.com/article/domesticNews/idUSTRE53R5OF20090428

"LOS ANGELES (Reuters) - California Governor Arnold Schwarzenegger on
Tuesday declared a "state of emergency" for the state over an outbreak
of the swine flu that has killed 149 people in Mexico.

Schwarzenegger's proclamation allows the state to deploy additional
resources to the Department of Public Health and more quickly and easily
purchase equipment and materials."


My first post, hehe.

A few questions:

Is state of emergency the same as Martial Law? (according to wiki & some danish newspapers it is)

Is the Governor overreacting when he declares a state of emergency over this?

Why is California the only place a state of emergency has been declared?

Are the other states not preparing?

1. As Gumboot explained, SoE and Martial Law are not the same. SoE is basically taking it to alert level if you want to put it on a scale of awareness. The state(s) can do various things and pull in extraordinary resources more easily under State of Emergency. But it's just fancy footwork, since the Governor(s) can declare SoE unilaterally at any time, it's really just a good excuses for a press conference. (Are you familiar with the expression "bully pulpit"?)

2. Overreacting? Probably not. He's not required to do anything under SoE, he's merely capable of doing it, and he got himself a press conference and helped spread the word about a contagious disease that has their state worried.

3. Why California? Because they move faster than Texans.
(First state to declare could've been any of the ones that share a large border with Mexico. That's the real reason California is early. Texas, Arizona, and New Mexico should follow suit.)

4. Other states, including countries, are preparing. Gordon Brown announced that he's ordered the purchase of gauze masks for the entire NHS staff yesterday.
 
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Antivirals may or may not be effective in mitigating a pandemic and it's seriousness. We can hope.

Antibiotics don't affect flu (a virus).

And pandemics occur when the flu mutates into a new strain, making existing vaccines useless. And by the time you get a new vaccine made and distributed you may have already have lost millions of lives.

Also, medicine may have come a long way but the world hasn't the hospital bed space to deal with the numbers we might be talking about here.

And you also forget that the modern era has brought greater mobility that may allow a pandemic to spread much faster than it did in 1918, overwhelming your medical establishment and making the delay in getting a vaccine that works far more serious.

Plus, the world is far more vulnerable to disruption than it was a century ago when many people lived on the farm and didn't depend on production and distribution systems being intact ... which might not be the case during a pandemic.

So like I said, not necessarily.

You're not the first, but would folks stop using the word "pandemic" as a synonym for virulent or deadly. Epidemic refers to the ease/speed with which a disease or infection spreads. Pandemic merely means that it's spread to larger geographic areas (or multiple geographic areas, which I believe the WHO uses). You could have a pandemic of an interesting strain of the common cold, and count zero fatalities.

ETA: Crud! I did that old "don't read the last page" trick again, and didn't see that Gumboot addressed this at about Post 241 or so. So sorry.....

Oh, and other than that, BaC, most of your post is wrong. The mobility factor of modern society is more than offset by the available treatments that they didn't have in 1918.
 
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Ahh, OK. I still haven't heard any official travel advisories out of Canada or the US (not that there aren't any).

Do you know what officially counts as an outbreak?

Well when I sat outbreak, I mean anywhere that the virus is suspected. India issued a rather blanket advisory.
 
According to http://www.recombinomics.com/founder.html

Recombinomics, Inc. Founder and President, Henry L Niman earned a PhD at the University of Southern California in 1978. His dissertation focused on feline retroviral expression in tumors in domestic cats.

He took a postdoctoral position at Scripps Clinic and Research Foundation where he developed monoclonal antibody technology. He fused monoclonal antibody and synthetic peptide technologies and accepted a staff position at Scripps.

In 1982, he developed the flu monoclonal antibody, which is widely used throughout the pharmaceutical, biotech, and research industries in epitope tagging techniques. He also produced a broad panel of monoclonal antibodies against synthetic peptides of oncogenes and growth factors. These monoclonal antibodies were distributed worldwide to researchers by the National Cancer Institute. The antibodies identified novel related proteins which correlated with clinical parameters.

This technology was used to form ProgenX, a cancer diagnostic company that became Ligand Pharmaceuticals. Dr Niman subsequently identified protein expression patterns at the University of Pittsburgh. More recently, he became interested in infectious diseases while at Harvard Medical School. He then founded Recombinomics and discovered how viruses rapidly evolve. These latest findings are the subject of recent patent filings.

Here is a half hour interview with him discussing the flu and what it is all about.

http://www.wpxi.com/video/19313969/index.html

I'm personally more worried about what is going to come this fall when the virus mutates with the new flu season. It could fizzle out, but it doesn't appear to be headed in that direction.

I listened to him on Jeff Rense tonight. It was fairly interesting.%aihe said that both the bird and human flu have been in pigs for the last several decades. The other 6 pig flu's are already well known. So this is a natural flu, but it is also extremely familiar to the 1918 Spanish flu, and it could very easily head in the same direction as it is following the same pattern.

I almost hope I get it now, so I have some possible immunity to a mutated strain this fall, if it does become worse.
 
It's hard to know quite what to make of Henry Niman. He does have the credentials, but has chosen to operate mostly outside of established scientific circles. The larger virology/epidemiology community is reluctant to accept some of his ideas, largely because he holds critical details of his theories close to his chest. Hasn't published anything in years (unless you count his prolific efforts to reach a lay internet audience). His recent work is really more bioinformatics than virology. He seems to take sort of a shotgun approach; makes a lot of predictions, some of which are more than a bit alarmist in nature, but so far he hasn't hit enough targets to impress much of anyone beyond his flublogia loyalists ("Nimanites" I believe they're called). On the other hand, nobody seems very eager to simply brush his ideas aside altogether, either.

I almost hope I get it now, so I have some possible immunity to a mutated strain this fall, if it does become worse.
I've been leaning slightly toward that idea myself. Sort of a twist on the live vaccine concept. But it's a risky strategy. I certainly wouldn't want to try it without a supply of Tamiflu already on hand. I think what you'd be betting on is that this will turn out to be a repeat of 1918, with what we're seeing now being the "herald" wave, to be followed by a killer wave in the fall. I DO think this thing could still fizzle as days in the Northern Hemisphere get warmer (and, perhaps more importantly, longer). The case numbers are growing, but so are the number of people who have recovered, and because the tallies are not lowered to reflect that, things may not be quite as grim as they appear to be. It seems to me that what counts the most is the total number of people infected -- and contagious -- at any given time.

What troubles me is that every approach to this thing is risky. The vaccine could fail (several ways), and if it does perk up in the fall, there could be a lot of opportunities for it to aquire resistance to the antivirals, since the recent seasonal strains (the H1N1 and the H3N2) have all exhibited resistance to either the neuraminidase inhibitors or the M2 inhibitors -- and it could also aquire greater virulence, or shift its antigens (meaning that whether the price you paid was a poke in the arm or the risk of serious illness, you'd get less protection in return).

In other words, we could be in the same boat we're in now, except worse, because we'd be facing it essentially empty-handed. PLUS, public perception of the degree of risk would be dulled, and the credibility of the epidemiological community would suffer. Everyone would be laughing about all the fuss that was made over the pandemic that never happened. Boy that cried wolf and all that.
 
It's hard to know quite what to make of Henry Niman. He does have the credentials, but has chosen to operate mostly outside of established scientific circles. The larger virology/epidemiology community is reluctant to accept some of his ideas, largely because he holds critical details of his theories close to his chest. Hasn't published anything in years (unless you count his prolific efforts to reach a lay internet audience). His recent work is really more bioinformatics than virology. He seems to take sort of a shotgun approach; makes a lot of predictions, some of which are more than a bit alarmist in nature, but so far he hasn't hit enough targets to impress much of anyone beyond his flublogia loyalists ("Nimanites" I believe they're called). On the other hand, nobody seems very eager to simply brush his ideas aside altogether, either.
I don't know much about him beyond his website, and that he set up that first google map with the flu cases. Seems like he isn't a nut because he doesn't believe it is some government created virus.

I don't have any issues with people operating outside of established anything. I think I sometimes prefer it as many discoveries were made by doing such things.

I've been leaning slightly toward that idea myself. Sort of a twist on the live vaccine concept. But it's a risky strategy. I certainly wouldn't want to try it without a supply of Tamiflu already on hand. I think what you'd be betting on is that this will turn out to be a repeat of 1918, with what we're seeing now being the "herald" wave, to be followed by a killer wave in the fall. I DO think this thing could still fizzle as days in the Northern Hemisphere get warmer (and, perhaps more importantly, longer). The case numbers are growing, but so are the number of people who have recovered, and because the tallies are not lowered to reflect that, things may not be quite as grim as they appear to be. It seems to me that what counts the most is the total number of people infected -- and contagious -- at any given time.

What troubles me is that every approach to this thing is risky. The vaccine could fail (several ways), and if it does perk up in the fall, there could be a lot of opportunities for it to aquire resistance to the antivirals, since the recent seasonal strains (the H1N1 and the H3N2) have all exhibited resistance to either the neuraminidase inhibitors or the M2 inhibitors -- and it could also aquire greater virulence, or shift its antigens (meaning that whether the price you paid was a poke in the arm or the risk of serious illness, you'd get less protection in return).

In other words, we could be in the same boat we're in now, except worse, because we'd be facing it essentially empty-handed. PLUS, public perception of the degree of risk would be dulled, and the credibility of the epidemiological community would suffer. Everyone would be laughing about all the fuss that was made over the pandemic that never happened. Boy that cried wolf and all that.

It may be that our flu season is ending, but it's starting in the southern hemisphere so we will see what happens this fall.

As for taking any vaccines, I have problems with taking something that hasn't been tested before for a flu that we just discovered. Considering the last swine flu vaccine killed more people than the flu itself, I'll take my chances without it.

Also, when the flu mutates the vaccine will not be very useful, so it's really a waste of money beyond the profit taking of the drug companies who will sell it to every school and health care institution they can.
 
I hear you. I'm not sure you're hearing me. I'm not so much talking about fatalities as the severity of the infection. We do have some data for that (both internationally and in Mexico) and it's heartening - the majority of people are recovering quickly.
Funny you think I don't hear what you are saying when I thought I addressed it a number of different ways. And you haven't responded indicating you understand my point.

Here's the summary as I see it:

I say there is so little data on the severity outside of Mexico one cannot use the data to draw any conclusion.

You think there is enough to draw a conclusion, even if tentative.


CDC on rate of complications with seasonal flu
During 1990--1999, estimated average rates of influenza-associated pulmonary and circulatory deaths per 100,000 persons were 0.4--0.6 among persons aged 0--49 years, 7.5 among persons aged 50--64 years, ...
I don't know the exact average of the population expected to get flu but I believe it is 10-30% per season.

Roughly estimating 1-8 deaths per 200,000 people times a 20% attack rate means you need to see 4,000 cases of flu before you could expect to see 1-8 deaths in the age range in question.

Clearly we have not seen enough cases outside of Mexico to estimate anything yet.

Using the figures to roughly estimate the other direction, if there are 150 deaths in the age range in question in Mexico, and the strain is about average lethality, using 5 deaths per 4,000 cases for simplicity that translates to 150/5 times 4,000 or roughly 120,000 actual cases of influenza in Mexico. I think that number better explains the number of cases all over the world with exposure histories of travel to Mexico but otherwise unrelated to a single source of exposure within Mexico.

Those of us familiar with influenza and with epidemiology have no problem understanding the significance of the numbers of reported and confirmed cases. Just as an oceanographer can tell you with certainty what % of an iceberg is visible out of the water, the principles of the science of epidemiology can tell you what numbers of cases you need to have to see the tip of the pandemic that is visible.
 
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No, no, you've got it all wrong. You should be jumping to conclusions, panicking, and assuming anyone who doesn't do the same is either uninformed or just plain stupid.
Apparently you have no clue that while I am arguing on cannot yet draw a conclusion there is little to no risk, I am not arguing one should draw the opposite conclusion instead as your comment suggests you falsely believe.
 
That seems unusual, from reports here in Canada people are still heading to Mexico on vacation, but they've stopped eating pork (go figure).

As an out of towner I certainly wouldn't put off going to Australia or NZ because of this. I can't speak for everyone obviously.
I've had one call for advice from a client who said he refused to put his trip to Mexico off.
 

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