Swine Flu, Mexico Lung Illness Heighten Pandemic Risk
- Thread starter Panameno718
- Start date
<font size="5"><center>
Scientists trace ancestry of swine
flu virus to 1998 outbreak</font size></center>
McClatchy Newspapers
By Barbara Barrett
May 1, 2009
WASHINGTON — <SPAN style="BACKGROUND-COLOR: #ffff00">The new H1N1 influenza virus</span> that continues to spread through the U.S. <SPAN style="BACKGROUND-COLOR: #ffff00">has ancestry in a swine flu outbreak that first struck a North Carolina hog farm more than 10 years ago</span>, according to scientists studying the strain's genetic makeup.
The current strain hasn't shown up in surveillance of U.S. pigs, and it can't be caught by eating pork.
The finding about its genetic background illustrates how viruses mutate over time and in some cases jump among species.
"Until you look at that, you can't understand the epidemiology of it," said Peter Cowen, the animal disease moderator for ProMed, an online emerging disease early-warning system. "It's key to understanding what our challenges may be in the future and how the virus is acting in the population."
<SPAN style="BACKGROUND-COLOR: #ffff00">The current strain's eight genetic segments are all associated with swine flu</span>, said Raul Rabadan, a Columbia University scientist studying the new H1N1 genetic sequence that was made public this week by the Centers for Disease Control and Prevention.
<SPAN style="BACKGROUND-COLOR: #ffff00">Two of the segments, Rabadan said, appear to come from Eurasia and are somewhat mysterious in origin. The other six can be traced to the North American pig outbreak, which turned out to include a combination of avian, swine and human flu.</span>
<font size="3">The 1998 Outbreak -- Pigs but not Humans</font size>
"This virus was found in pigs here in the United States," Rabadan said in an interview. "They were getting sick in 1998. It became a swine virus."
It spread among pregnant sows in Newton Grove, N.C., causing them to abort their litters, and then to swine in Texas, Iowa and Minnesota — putting epidemiologists on alert about the new viral strain and the potential for a human outbreak.
That didn't happen, but public health officials became more aware of the farm-by-farm monitoring system and its importance to public health.
"We cannot protect human health unless we're working with what's going on in the environment and animal species," said Barrett Slenning, who leads the Animal Health Biosecurity Risk Management Population Health and Pathobiology Department at North Carolina State University.
Scientists don't yet know when or where the current H1N1 strain first developed. They know only that it was first identified after people in Mexico began falling ill with the fevers and aches associated with flu.
The current virus hasn't been found in swine, and the country's pork industry is scrambling to reassure consumers about the safety both of pork and the U.S. farm system.
<font size="3">'Humane Nuts' Say U.S. Factory Farms a Danger</font size>
Still, this week's findings about the new H1N1 virus' ancestry also has reignited concerns about the health impacts of factory farms, where thousands of hogs are housed closely together and shipped among sites as they grow.
The Humane Society of the United States highlighted factory farms in its analysis of the new H1N1 virus' history. The animal-rights organization People for the Ethical Treatment of Animals on Friday called on North Carolina Gov. Bev Perdue to close the state's factory farms. And a report last year funded by the Pew Charitable Trusts emphasized that viruses can spread quickly among pigs in the close quarters of such farms. North Carolina has about 10 million pigs being raised on such farms.
"Pigs are amazing mixing bowls for creating new viruses," said Bob Martin, senior officer at the Pew Environmental Group. Martin was executive director of the study.
<SPAN style="BACKGROUND-COLOR: #ffff00">"It's a matter of when, not if,"</span> Martin said of <SPAN style="BACKGROUND-COLOR: #ffff00">the creation of new viruses on factory hog farms. "The structure of the system is the problem."</span>
Cowen, who also is an epidemiologist at North Carolina State University's College of Veterinary Medicine, said factory farms have shown their ability to contain disease in their animals.
However, he said the current H1N1 outbreak shows the need to improve surveillance of healthy swine as well as pigs that show signs of illness.
"The key to being prepared in terms of responding to this threat from influenza, wherever its coming from — humans, swine or birds — is to know as much as we can about the viruses that are circulating," Cowen said.
This week's discovery is, in part, just another piece of the scientific puzzle in trying to understand the new H1N1 flu's history.
<font size="3">Scientist Disagree with 'Humane Nuts'</font size>
Scientists working around the world this week began tracing the virus' origins days after the CDC published its eight-chromosome genetic sequence.
Steven Salzberg, a computational biologist at the University of Maryland, was among the scientists who found that the new H1N1 virus contains strains from past swine viruses, including the one that swept through pig farms in 1998.
Salzberg said he doesn't blame factory farms for the current outbreak, because swine flu is common among pigs. He wants to know more about the H1N1 virus' ancestry.
That would require that scientists have more genetic sequences of swine flu taken from sick pigs over the past decade. Salzberg hopes the CDC will ask animal labs to send their existing samples in for coding.
"We really need many more," Salzberg said. "This outbreak is going to induce us to do that."
He may not have to wait long. Nancy Cox, the director of the influenza division at the CDC, said talks have already begun with the U.S. Department of Agriculture to begin collecting genetic sequences of swine flu found on farms in the future.
"If the samples haven't been collected from pigs, you won't have data to fill in the gaps," she said. "Going forward, it's going to be very important to have."
http://www.mcclatchydc.com/256/story/67371.html
Scientists trace ancestry of swine
flu virus to 1998 outbreak</font size></center>
McClatchy Newspapers
By Barbara Barrett
May 1, 2009
WASHINGTON — <SPAN style="BACKGROUND-COLOR: #ffff00">The new H1N1 influenza virus</span> that continues to spread through the U.S. <SPAN style="BACKGROUND-COLOR: #ffff00">has ancestry in a swine flu outbreak that first struck a North Carolina hog farm more than 10 years ago</span>, according to scientists studying the strain's genetic makeup.
The current strain hasn't shown up in surveillance of U.S. pigs, and it can't be caught by eating pork.
The finding about its genetic background illustrates how viruses mutate over time and in some cases jump among species.
"Until you look at that, you can't understand the epidemiology of it," said Peter Cowen, the animal disease moderator for ProMed, an online emerging disease early-warning system. "It's key to understanding what our challenges may be in the future and how the virus is acting in the population."
<SPAN style="BACKGROUND-COLOR: #ffff00">The current strain's eight genetic segments are all associated with swine flu</span>, said Raul Rabadan, a Columbia University scientist studying the new H1N1 genetic sequence that was made public this week by the Centers for Disease Control and Prevention.
<SPAN style="BACKGROUND-COLOR: #ffff00">Two of the segments, Rabadan said, appear to come from Eurasia and are somewhat mysterious in origin. The other six can be traced to the North American pig outbreak, which turned out to include a combination of avian, swine and human flu.</span>
<font size="3">The 1998 Outbreak -- Pigs but not Humans</font size>
"This virus was found in pigs here in the United States," Rabadan said in an interview. "They were getting sick in 1998. It became a swine virus."
It spread among pregnant sows in Newton Grove, N.C., causing them to abort their litters, and then to swine in Texas, Iowa and Minnesota — putting epidemiologists on alert about the new viral strain and the potential for a human outbreak.
That didn't happen, but public health officials became more aware of the farm-by-farm monitoring system and its importance to public health.
"We cannot protect human health unless we're working with what's going on in the environment and animal species," said Barrett Slenning, who leads the Animal Health Biosecurity Risk Management Population Health and Pathobiology Department at North Carolina State University.
Scientists don't yet know when or where the current H1N1 strain first developed. They know only that it was first identified after people in Mexico began falling ill with the fevers and aches associated with flu.
The current virus hasn't been found in swine, and the country's pork industry is scrambling to reassure consumers about the safety both of pork and the U.S. farm system.
<font size="3">'Humane Nuts' Say U.S. Factory Farms a Danger</font size>
Still, this week's findings about the new H1N1 virus' ancestry also has reignited concerns about the health impacts of factory farms, where thousands of hogs are housed closely together and shipped among sites as they grow.
The Humane Society of the United States highlighted factory farms in its analysis of the new H1N1 virus' history. The animal-rights organization People for the Ethical Treatment of Animals on Friday called on North Carolina Gov. Bev Perdue to close the state's factory farms. And a report last year funded by the Pew Charitable Trusts emphasized that viruses can spread quickly among pigs in the close quarters of such farms. North Carolina has about 10 million pigs being raised on such farms.
"Pigs are amazing mixing bowls for creating new viruses," said Bob Martin, senior officer at the Pew Environmental Group. Martin was executive director of the study.
<SPAN style="BACKGROUND-COLOR: #ffff00">"It's a matter of when, not if,"</span> Martin said of <SPAN style="BACKGROUND-COLOR: #ffff00">the creation of new viruses on factory hog farms. "The structure of the system is the problem."</span>
Cowen, who also is an epidemiologist at North Carolina State University's College of Veterinary Medicine, said factory farms have shown their ability to contain disease in their animals.
However, he said the current H1N1 outbreak shows the need to improve surveillance of healthy swine as well as pigs that show signs of illness.
"The key to being prepared in terms of responding to this threat from influenza, wherever its coming from — humans, swine or birds — is to know as much as we can about the viruses that are circulating," Cowen said.
This week's discovery is, in part, just another piece of the scientific puzzle in trying to understand the new H1N1 flu's history.
<font size="3">Scientist Disagree with 'Humane Nuts'</font size>
Scientists working around the world this week began tracing the virus' origins days after the CDC published its eight-chromosome genetic sequence.
Steven Salzberg, a computational biologist at the University of Maryland, was among the scientists who found that the new H1N1 virus contains strains from past swine viruses, including the one that swept through pig farms in 1998.
Salzberg said he doesn't blame factory farms for the current outbreak, because swine flu is common among pigs. He wants to know more about the H1N1 virus' ancestry.
That would require that scientists have more genetic sequences of swine flu taken from sick pigs over the past decade. Salzberg hopes the CDC will ask animal labs to send their existing samples in for coding.
"We really need many more," Salzberg said. "This outbreak is going to induce us to do that."
He may not have to wait long. Nancy Cox, the director of the influenza division at the CDC, said talks have already begun with the U.S. Department of Agriculture to begin collecting genetic sequences of swine flu found on farms in the future.
"If the samples haven't been collected from pigs, you won't have data to fill in the gaps," she said. "Going forward, it's going to be very important to have."
http://www.mcclatchydc.com/256/story/67371.html
For those interested the CDC has posted pictures of the H1N1/2009
influenza virus. Would appreciate it if someone could embed one or two.
http://www.cdc.gov/h1n1flu/images.htm?s_cid=tw_epr_105
This is a quick analysis from an epidemiologist.
This looks like it is grown in tissue culture (probably dog kidney cancer cells). It presents the ideal picture of a spherical virus studded with HA and NA protein spikes on its surface and enveloped with capsular material derived from the host cell. When flu virus infects actual organ tissue in an intact host it is pleomorphic, i.e., it has a variety of shapes, including a long threadlike one. However this is its ideal shape, often rendered in cartoon or diagram form in textbooks.
influenza virus. Would appreciate it if someone could embed one or two.
http://www.cdc.gov/h1n1flu/images.htm?s_cid=tw_epr_105
This is a quick analysis from an epidemiologist.
This looks like it is grown in tissue culture (probably dog kidney cancer cells). It presents the ideal picture of a spherical virus studded with HA and NA protein spikes on its surface and enveloped with capsular material derived from the host cell. When flu virus infects actual organ tissue in an intact host it is pleomorphic, i.e., it has a variety of shapes, including a long threadlike one. However this is its ideal shape, often rendered in cartoon or diagram form in textbooks.
China Quarantines Mexicans
<font size="5"><center>
China Quarantines Mexicans </font size><font size="4">
Beijing, Fearing Flu, Locks Down Dozens of Travelers;
Offers Little Information or Medical Help</font size></center>
WSJ
By ANDREW BROWNE
May 4, 2009
BEIJING -- The A/H1N1 flu outbreak is leading to a potential diplomatic row between China and Mexico, as Chinese health authorities round up and quarantine scores of Mexicans -- <SPAN style="BACKGROUND-COLOR: #ffff00">only one of whom is thus far reported to be sick</span> -- as they fly in on business and holiday trips.
Mexico's foreign minister said <SPAN style="BACKGROUND-COLOR: #ffff00">Mexican citizens with no signs of infection had been isolated in "unacceptable conditions" in China</span>. Patricia Espinosa told a news conference Saturday that such measures were "discriminatory and ungrounded" and that the government is advising Mexicans to stay away from China.
She also criticized four Latin American countries -- Argentina, Peru, Ecuador and Cuba -- for suspending flights coming from Mexico against the recommendations of the World Health Organization.
More than 70 Mexicans are in isolation around China, according to Mexican officials, and that number is rising as Mexican travelers call in to their embassy to report their plight.
<SPAN style="BACKGROUND-COLOR: #ffff00">China has been rounding up all travelers aboard an AeroMexico flight from Mexico that arrived on Thursday in Shanghai with a 25-year-old Mexican man now ill with human swine flu in Hong Kong.</span>
That man is the only known Mexican sufferer in China to date. However, Mexicans on other flights say they have been singled out for harsh treatment.
<SPAN style="BACKGROUND-COLOR: #ffff00">Gustavo Carrillo, a 36-year-old general manager of a Mexican technology company in China who lives in Beijing with his wife and three sons, was taken off his Continental Airlines plane on Saturday and rushed into quarantine at a Beijing hotel. He had traveled to the U.S. from China on a business trip and hadn't visited Mexico.</span>
Mr. Carrillo said health officials took the temperatures of other passengers after the plane landed, but didn't check his after they saw his Mexican passport. Instead, they led him down the aisle past gawking passengers. "It was embarrassing and humiliating," he said. "It's just pure discrimination."
Mexicans who were on the flight to Shanghai with the 25-year-old flu victim complain about how China has enforced its quarantine, offering little information and only the most basic medical testing. Among them is a family of five, including three young children, who transited to Beijing. They were then roused from their hotel room in the Chinese capital in the early hours of Saturday and whisked to an infectious diseases hospital. There, according to the father, Carlos Doormann, AeroMéxico's finance director, they were <SPAN style="BACKGROUND-COLOR: #ffff00">isolated in a room with bloodstained sheets and what appeared to be mucus smeared on the walls.</span>
"I'm frustrated and sad," said Mr. Doormann, whose family has since been moved to the nearby Guo Men Hotel on the outskirts of the Chinese capital, where they are in quarantine along with five other Mexican nationals, including Mr. Carrillo.
<SPAN style="BACKGROUND-COLOR: #ffff00">According to accounts from Mexicans in the hotel, Mexican travelers arriving on various flights from Mexico and the U.S. were singled out by health officials who boarded their aircraft wearing white protective suits, masks and rubber gloves. They led away Mexican passport holders, while non-Mexicans watched from their seats.</span>
Several said that Chinese television camera crews and photographers surprised them at the doors of their aircraft as they emerged. They said the filming continued through the windows of an isolation ward at the Beijing Ditan infectious diseases hospital.
"We felt like we were in a zoo," said Angel Yamil Silum, a 27-year-old business student, who arrived in Beijing with his girlfriend on Saturday as transit passengers en route to Bangkok for a holiday and ended up at Ditan and then the Guo Men Hotel.
<SPAN style="BACKGROUND-COLOR: #ffff00">Chinese authorities allowed Mexico's ambassador to China, Jorge Guajardo, to enter the hotel on Sunday but refused him permission to see the quarantined Mexicans or to call up to their rooms</span>, Mexican officials said. The embassy is shuttling soft drinks, pizzas, chips and other Western food into the hotel along with CDs, toys for the children and other entertainment.
Chinese officials deny that Mexicans are being unfairly targeted. "There is no discrimination at all," said Zhang Jianshu, head of the news office at the Beijing Health Bureau. "We treat all people the same," he said, adding that there are many Chinese passengers in isolation. He said the measures are in line with the requirements of the World Health Organization.
The spokesman for China's ministry of health, Mao Qun'an, said he sympathized with the Mexicans. "We totally understand their feelings," he said. He added: "The isolation is not only good for their health, but is also good for the public. It's not discrimination at all."
China's government was widely blamed for a slow and ineffective initial response to Severe Acute Respiratory Syndrome in 2003 and appears eager to demonstrate to the Chinese public that it is taking the threat more seriously this time.
The Doormann family's ordeal began at 2:00 a.m. on Saturday when a Spanish-speaking woman, who identified herself as a Chinese health official, called their hotel room and instructed the family to "pack immediately and go to the hospital," Mr. Doormann said.
"I said, 'can't we wait? I have three little kids'," Mr. Doormann recalled. The children are ages 8, 6 and 5. But at 4:30 a.m. they were whisked through the dark streets of Beijing to Ditan, a recently opened showcase medical facility. Apart from the dirty sheets and walls of their room, Mr. Doormann said the bathroom had no soap or toilet paper.
After the personal intervention of Ambassador Guajardo, the family was moved to the Guo Men Hotel. Like their fellow Mexican guests, they have had no contact with Chinese government officials, except health workers, and have no idea how long they will have to stay. "We're held hostage here," said Mr. Doormann.
The Guo Men Hotel is a sprawling complex of aging buildings with green-tiled roofs surrounded by lawns and trees. Police and uniformed guards patrol the grounds. <SPAN style="BACKGROUND-COLOR: #ffff00">Twice each day, nurses leave thermometers outside the Mexicans' rooms. No other medical testing is carried out. The quarantined guests are allowed into the hotel grounds, although the hotel has "recommended" they stay in their rooms.</span>
Myrna Elisa Berlanga Morales, a 31-year-old administrative assistant from Mexico City, arrived in Beijing on the Continental flight on Saturday with two American friends. She asked why Chinese consular officials in Mexico issued her and other Mexicans visas when they were heading straight into quarantine in China. "They could have warned me," she said.
Her two friends had told her that her holiday in China "would be the most unforgettable 15 days of my life". She added: "Now I believe them."
—Kersten Zhang contributed to this article.
Write to Andrew Browne at andrew.browne@wsj.com
http://online.wsj.com/article/SB124137876507580987.html
<font size="5"><center>
China Quarantines Mexicans </font size><font size="4">
Beijing, Fearing Flu, Locks Down Dozens of Travelers;
Offers Little Information or Medical Help</font size></center>
WSJ
By ANDREW BROWNE
May 4, 2009
BEIJING -- The A/H1N1 flu outbreak is leading to a potential diplomatic row between China and Mexico, as Chinese health authorities round up and quarantine scores of Mexicans -- <SPAN style="BACKGROUND-COLOR: #ffff00">only one of whom is thus far reported to be sick</span> -- as they fly in on business and holiday trips.
Mexico's foreign minister said <SPAN style="BACKGROUND-COLOR: #ffff00">Mexican citizens with no signs of infection had been isolated in "unacceptable conditions" in China</span>. Patricia Espinosa told a news conference Saturday that such measures were "discriminatory and ungrounded" and that the government is advising Mexicans to stay away from China.
She also criticized four Latin American countries -- Argentina, Peru, Ecuador and Cuba -- for suspending flights coming from Mexico against the recommendations of the World Health Organization.
More than 70 Mexicans are in isolation around China, according to Mexican officials, and that number is rising as Mexican travelers call in to their embassy to report their plight.
<SPAN style="BACKGROUND-COLOR: #ffff00">China has been rounding up all travelers aboard an AeroMexico flight from Mexico that arrived on Thursday in Shanghai with a 25-year-old Mexican man now ill with human swine flu in Hong Kong.</span>
That man is the only known Mexican sufferer in China to date. However, Mexicans on other flights say they have been singled out for harsh treatment.
<SPAN style="BACKGROUND-COLOR: #ffff00">Gustavo Carrillo, a 36-year-old general manager of a Mexican technology company in China who lives in Beijing with his wife and three sons, was taken off his Continental Airlines plane on Saturday and rushed into quarantine at a Beijing hotel. He had traveled to the U.S. from China on a business trip and hadn't visited Mexico.</span>
Mr. Carrillo said health officials took the temperatures of other passengers after the plane landed, but didn't check his after they saw his Mexican passport. Instead, they led him down the aisle past gawking passengers. "It was embarrassing and humiliating," he said. "It's just pure discrimination."
Mexicans who were on the flight to Shanghai with the 25-year-old flu victim complain about how China has enforced its quarantine, offering little information and only the most basic medical testing. Among them is a family of five, including three young children, who transited to Beijing. They were then roused from their hotel room in the Chinese capital in the early hours of Saturday and whisked to an infectious diseases hospital. There, according to the father, Carlos Doormann, AeroMéxico's finance director, they were <SPAN style="BACKGROUND-COLOR: #ffff00">isolated in a room with bloodstained sheets and what appeared to be mucus smeared on the walls.</span>
"I'm frustrated and sad," said Mr. Doormann, whose family has since been moved to the nearby Guo Men Hotel on the outskirts of the Chinese capital, where they are in quarantine along with five other Mexican nationals, including Mr. Carrillo.
<SPAN style="BACKGROUND-COLOR: #ffff00">According to accounts from Mexicans in the hotel, Mexican travelers arriving on various flights from Mexico and the U.S. were singled out by health officials who boarded their aircraft wearing white protective suits, masks and rubber gloves. They led away Mexican passport holders, while non-Mexicans watched from their seats.</span>
Several said that Chinese television camera crews and photographers surprised them at the doors of their aircraft as they emerged. They said the filming continued through the windows of an isolation ward at the Beijing Ditan infectious diseases hospital.
"We felt like we were in a zoo," said Angel Yamil Silum, a 27-year-old business student, who arrived in Beijing with his girlfriend on Saturday as transit passengers en route to Bangkok for a holiday and ended up at Ditan and then the Guo Men Hotel.
<SPAN style="BACKGROUND-COLOR: #ffff00">Chinese authorities allowed Mexico's ambassador to China, Jorge Guajardo, to enter the hotel on Sunday but refused him permission to see the quarantined Mexicans or to call up to their rooms</span>, Mexican officials said. The embassy is shuttling soft drinks, pizzas, chips and other Western food into the hotel along with CDs, toys for the children and other entertainment.
Chinese officials deny that Mexicans are being unfairly targeted. "There is no discrimination at all," said Zhang Jianshu, head of the news office at the Beijing Health Bureau. "We treat all people the same," he said, adding that there are many Chinese passengers in isolation. He said the measures are in line with the requirements of the World Health Organization.
The spokesman for China's ministry of health, Mao Qun'an, said he sympathized with the Mexicans. "We totally understand their feelings," he said. He added: "The isolation is not only good for their health, but is also good for the public. It's not discrimination at all."
China's government was widely blamed for a slow and ineffective initial response to Severe Acute Respiratory Syndrome in 2003 and appears eager to demonstrate to the Chinese public that it is taking the threat more seriously this time.
The Doormann family's ordeal began at 2:00 a.m. on Saturday when a Spanish-speaking woman, who identified herself as a Chinese health official, called their hotel room and instructed the family to "pack immediately and go to the hospital," Mr. Doormann said.
"I said, 'can't we wait? I have three little kids'," Mr. Doormann recalled. The children are ages 8, 6 and 5. But at 4:30 a.m. they were whisked through the dark streets of Beijing to Ditan, a recently opened showcase medical facility. Apart from the dirty sheets and walls of their room, Mr. Doormann said the bathroom had no soap or toilet paper.
After the personal intervention of Ambassador Guajardo, the family was moved to the Guo Men Hotel. Like their fellow Mexican guests, they have had no contact with Chinese government officials, except health workers, and have no idea how long they will have to stay. "We're held hostage here," said Mr. Doormann.
The Guo Men Hotel is a sprawling complex of aging buildings with green-tiled roofs surrounded by lawns and trees. Police and uniformed guards patrol the grounds. <SPAN style="BACKGROUND-COLOR: #ffff00">Twice each day, nurses leave thermometers outside the Mexicans' rooms. No other medical testing is carried out. The quarantined guests are allowed into the hotel grounds, although the hotel has "recommended" they stay in their rooms.</span>
Myrna Elisa Berlanga Morales, a 31-year-old administrative assistant from Mexico City, arrived in Beijing on the Continental flight on Saturday with two American friends. She asked why Chinese consular officials in Mexico issued her and other Mexicans visas when they were heading straight into quarantine in China. "They could have warned me," she said.
Her two friends had told her that her holiday in China "would be the most unforgettable 15 days of my life". She added: "Now I believe them."
—Kersten Zhang contributed to this article.
Write to Andrew Browne at andrew.browne@wsj.com
http://online.wsj.com/article/SB124137876507580987.html
. . . at your service:
<IFRAME SRC="http://www.cdc.gov/h1n1flu/images.htm?s_cid=tw_epr_105" WIDTH=780 HEIGHT=1500>
<A HREF="http://www.cdc.gov/h1n1flu/images.htm?s_cid=tw_epr_105">link</A>
</IFRAME>
Re: China Quarantines Mexicans
<center>
Chinese health inspectors wait to board an AeroMexico aircraft in
Shanghai. Photograph: Joe Chan/Reuters
</center>
<center>
Chinese health inspectors wait to board an AeroMexico aircraft in
Shanghai. Photograph: Joe Chan/Reuters
</center>
Re: China Quarantines Mexicans
Two countries with very little public health oversight. What coincidence.
Two countries with very little public health oversight. What coincidence.
Its not gone . . .
<font size="5"><center>
WHO says H1N1 flu cases, death toll rise</font size></center>
Reuters
Sat May 16, 2009
ZURICH (Reuters) - The number of confirmed cases of the new H1N1 flu has climbed to 8,451, including 72 deaths, the World Health Organization said on Saturday.
The number of countries reporting confirmed cases of H1N1, commonly known as swine flu, has risen to 36 with Ecuador and Peru confirming their first cases, the WHO said.
The vast majority of cases have been in Mexico and the United States.
The spread of the disease has led the WHO to declare a pandemic is imminent. On April 29 it raised its pandemic alert to 5 on a 6-level scale.
WHO Director-General Margaret Chan said on Friday there remained "great uncertainty" about the new strain, which continues to spread and could pose particular threats in Southeast Asia.
U.S. health officials later on Friday announced they were easing their warning on travel to Mexico.
The virus is behaving much like a seasonal influenza strain -- spreading rapidly and causing mainly mild disease, but severe illness in some people.
Seasonal flu kills 500,000 people a year, mainly the elderly or those with respiratory problems like asthma.
The WHO said Mexico has reported 2,895 confirmed cases including 66 deaths. The United States has reported 4,714 confirmed cases including four deaths. Canada has 496 confirmed cases and Costa Rica nine cases, both with one death.
The WHO's tally lags national reports but is considered more secure. Rising numbers can indicate that a backlog of cases is being processed, as well as the spread of the disease.
(Reporting by Jason Rhodes; editing by Myra MacDonald)
http://www.reuters.com/article/internal_ReutersNewsRoom_ExclusivesAndWins_MOLT/idUSTRE54F1N120090516
<font size="5"><center>
WHO says H1N1 flu cases, death toll rise</font size></center>
Reuters
Sat May 16, 2009
ZURICH (Reuters) - The number of confirmed cases of the new H1N1 flu has climbed to 8,451, including 72 deaths, the World Health Organization said on Saturday.
The number of countries reporting confirmed cases of H1N1, commonly known as swine flu, has risen to 36 with Ecuador and Peru confirming their first cases, the WHO said.
The vast majority of cases have been in Mexico and the United States.
The spread of the disease has led the WHO to declare a pandemic is imminent. On April 29 it raised its pandemic alert to 5 on a 6-level scale.
WHO Director-General Margaret Chan said on Friday there remained "great uncertainty" about the new strain, which continues to spread and could pose particular threats in Southeast Asia.
U.S. health officials later on Friday announced they were easing their warning on travel to Mexico.
The virus is behaving much like a seasonal influenza strain -- spreading rapidly and causing mainly mild disease, but severe illness in some people.
Seasonal flu kills 500,000 people a year, mainly the elderly or those with respiratory problems like asthma.
The WHO said Mexico has reported 2,895 confirmed cases including 66 deaths. The United States has reported 4,714 confirmed cases including four deaths. Canada has 496 confirmed cases and Costa Rica nine cases, both with one death.
The WHO's tally lags national reports but is considered more secure. Rising numbers can indicate that a backlog of cases is being processed, as well as the spread of the disease.
(Reporting by Jason Rhodes; editing by Myra MacDonald)
http://www.reuters.com/article/internal_ReutersNewsRoom_ExclusivesAndWins_MOLT/idUSTRE54F1N120090516
<font size="5"><center>
Swine flu could hit up to 40 percent in US</font size></center>
Graphic shows selection of U.S. influenza pandemics and resulting deaths
The Associated Press
By MIKE STOBBE
July 25, 2009
ATLANTA — In a disturbing new projection, health officials say up to 40 percent of Americans could get swine flu this year and next and several hundred thousand could die without a successful vaccine campaign and other measures.
The estimates by the Centers for Disease Control and Prevention are roughly twice the number of those who catch flu in a normal season and add greater weight to hurried efforts to get a new vaccine ready for the fall flu season.
Swine flu has already hit the United States harder than any other nation, but it has struck something of a glancing blow that's more surprising than devastating. The virus has killed about 300 Americans and experts believe it has sickened more than 1 million, comparable to a seasonal flu with the weird ability to keep spreading in the summer.
Health officials say flu cases may explode in the fall, when schools open and become germ factories, and the new estimates dramatize the need to have vaccines and other measures in place.
A world health official said the first vaccines are expected in September and October. The United States expects to begin testing on some volunteers in August, with 160 million doses ready in October.
The CDC came up with the new projections for the virus' spread last month, but it was first disclosed in an interview this week with The Associated Press.
The estimates are based on a flu pandemic from 1957, which killed nearly 70,000 in the United States but was not as severe as the infamous Spanish flu pandemic of 1918-19. The number of deaths and illnesses from the new swine flu virus would drop if the pandemic peters out or if efforts to slow its spread are successful, said CDC spokesman Tom Skinner.
"Hopefully, mitigation efforts will have a big impact on future cases," he said. Besides pushing flu shots, health officials might urge measures such as avoiding crowded places, handwashing, cough covering and timely use of medicines like Tamiflu.
Because so many more people are expected to catch the new flu, the number of deaths over two years could range from 90,000 to several hundred thousand, the CDC calculated. Again, that is if a new vaccine and other efforts fail.
In a normal flu season, about 36,000 people die from flu and its complications, according to the American Medical Association. That too is an estimate, because death certificates don't typically list flu as a cause of death. Instead, they attribute a fatality to pneumonia or other complications.
Influenza is notoriously hard to predict, and some experts have shied away from a forecast. At a CDC swine flu briefing Friday, one official declined to answer repeated questions about her agency's own estimate.
"I don't think that influenza and its behavior in the population lends itself very well to these kinds of models," said the official, Dr. Anne Schuchat, who oversees the CDC's flu vaccination programs.
The World Health Organization says as many as 2 billion people could become infected in thenext two years — nearly a third of the world population. The estimates look at potential impacts in a two-year period because past flu pandemics have occurred in waves over more than one year.
Swine flu has been an escalating concern in Britain and some other European nations, where the virus' late arrival has grabbed attention and some officials at times have sounded alarmed.
In an interview Friday, the WHO's flu chief told the AP the global epidemic is still in its early stages.
"Even if we have hundreds of thousands of cases or a few millions of cases ... we're relatively early in the pandemic," Keiji Fukuda said at WHO headquarters in Geneva.
The first vaccines are expected in September and October, Fukuda said. Other vaccines won't be ready until well into the flu season when a further dramatic rise in swine flu cases is expected.
First identified in April, swine flu has likely infected more than 1 million Americans, the CDC believes, with many of those suffering mild cases never reported. There have been 302 deaths and nearly 44,000 laboratory-identified cases, according to numbers released Friday morning.
Because the swine flu virus is new, most people haven't developed an immunity to it. So far, most of those who have died from it in the United States have had other health problems, such as asthma.
The virus has caused an unusual number of serious illnesses in teens and young adults; seasonal flu usually is toughest on the elderly and very young children.
___
Associated Press writer Frank Jordans in Geneva contributed to this report.
___
July 25, 2009 10:35 AM EDT
Copyright 2009, The Associated Press. All rights reserved
http://www.ajc.com/health/swine-flu-could-hit-99705.html?cxntlid=homepage_tab_newstab
Swine flu could hit up to 40 percent in US</font size></center>
Graphic shows selection of U.S. influenza pandemics and resulting deaths
The Associated Press
By MIKE STOBBE
July 25, 2009
ATLANTA — In a disturbing new projection, health officials say up to 40 percent of Americans could get swine flu this year and next and several hundred thousand could die without a successful vaccine campaign and other measures.
The estimates by the Centers for Disease Control and Prevention are roughly twice the number of those who catch flu in a normal season and add greater weight to hurried efforts to get a new vaccine ready for the fall flu season.
Swine flu has already hit the United States harder than any other nation, but it has struck something of a glancing blow that's more surprising than devastating. The virus has killed about 300 Americans and experts believe it has sickened more than 1 million, comparable to a seasonal flu with the weird ability to keep spreading in the summer.
Health officials say flu cases may explode in the fall, when schools open and become germ factories, and the new estimates dramatize the need to have vaccines and other measures in place.
A world health official said the first vaccines are expected in September and October. The United States expects to begin testing on some volunteers in August, with 160 million doses ready in October.
The CDC came up with the new projections for the virus' spread last month, but it was first disclosed in an interview this week with The Associated Press.
The estimates are based on a flu pandemic from 1957, which killed nearly 70,000 in the United States but was not as severe as the infamous Spanish flu pandemic of 1918-19. The number of deaths and illnesses from the new swine flu virus would drop if the pandemic peters out or if efforts to slow its spread are successful, said CDC spokesman Tom Skinner.
"Hopefully, mitigation efforts will have a big impact on future cases," he said. Besides pushing flu shots, health officials might urge measures such as avoiding crowded places, handwashing, cough covering and timely use of medicines like Tamiflu.
Because so many more people are expected to catch the new flu, the number of deaths over two years could range from 90,000 to several hundred thousand, the CDC calculated. Again, that is if a new vaccine and other efforts fail.
In a normal flu season, about 36,000 people die from flu and its complications, according to the American Medical Association. That too is an estimate, because death certificates don't typically list flu as a cause of death. Instead, they attribute a fatality to pneumonia or other complications.
Influenza is notoriously hard to predict, and some experts have shied away from a forecast. At a CDC swine flu briefing Friday, one official declined to answer repeated questions about her agency's own estimate.
"I don't think that influenza and its behavior in the population lends itself very well to these kinds of models," said the official, Dr. Anne Schuchat, who oversees the CDC's flu vaccination programs.
The World Health Organization says as many as 2 billion people could become infected in thenext two years — nearly a third of the world population. The estimates look at potential impacts in a two-year period because past flu pandemics have occurred in waves over more than one year.
Swine flu has been an escalating concern in Britain and some other European nations, where the virus' late arrival has grabbed attention and some officials at times have sounded alarmed.
In an interview Friday, the WHO's flu chief told the AP the global epidemic is still in its early stages.
"Even if we have hundreds of thousands of cases or a few millions of cases ... we're relatively early in the pandemic," Keiji Fukuda said at WHO headquarters in Geneva.
The first vaccines are expected in September and October, Fukuda said. Other vaccines won't be ready until well into the flu season when a further dramatic rise in swine flu cases is expected.
First identified in April, swine flu has likely infected more than 1 million Americans, the CDC believes, with many of those suffering mild cases never reported. There have been 302 deaths and nearly 44,000 laboratory-identified cases, according to numbers released Friday morning.
Because the swine flu virus is new, most people haven't developed an immunity to it. So far, most of those who have died from it in the United States have had other health problems, such as asthma.
The virus has caused an unusual number of serious illnesses in teens and young adults; seasonal flu usually is toughest on the elderly and very young children.
___
Associated Press writer Frank Jordans in Geneva contributed to this report.
___
July 25, 2009 10:35 AM EDT
Copyright 2009, The Associated Press. All rights reserved
http://www.ajc.com/health/swine-flu-could-hit-99705.html?cxntlid=homepage_tab_newstab
<font size="5"><center>
Swine flu could infect half of
U.S., panel estimates</font size></center>
The Washington Post
Via Newsday
August 25, 2009 By ROB STEIN.
WASHINGTON -
The virus could cause symptoms in 60 million to 120 million people, more than half of whom might seek medical attention, the President's Council of Advisors on Science and Technology estimated. The numbers were given in an 86-page report to the White House assessing the government's response to the first influenza pandemic in 41 years.
Although most cases probably would be mild, up to 300,000 people could require intensive care, which could tie up ICU beds in some parts of the country at the peak of the outbreak, the council said.
"This is going to be fairly serious," said Harold Varmus of New York's Memorial Sloan-Kettering Cancer Center, who co-chairs the 21-member council. "It's going to stress every aspect of our health system."
The estimates, released Monday, were the first specific numbers by experts on the possible impact of the pandemic in the United States. The "plausible scenario" is based on previous pandemics, especially the 1957-58 Asian flu, and how the swine flu behaved in the United States this spring and during the Southern Hemisphere's winter over the past few months, said Mark Lipsitch of the Harvard School of Public Health. He helped prepare the estimate.
"They are not a prediction, but they are a possibility," he said, noting the estimates are based on assumptions, including that the virus will not mutate into a more dangerous form or infect more older people.
"If it turned out to affect a lot more adults, the severity would be a lot worse," Lipsitch said.
While the seasonal flu causes about 36,000 deaths and 200,000 hospitalizations each year, the lack of immunity to the swine flu virus probably will lead to many more people becoming infected and possibly dying - as many as 90,000, the council said. And while most deaths during a typical flu season are among the elderly, swine flu is more likely to kill children and young adults, the panel said.
The report's primary purpose is to help guide planning to protect the public and improve the government's response to the outbreak. For example, it was estimated the outbreak could peak in mid-October, so the panel urged expediting the availability of a vaccine.
The panel also recommended clarifying how antiviral drugs should be used to fight the pandemic, speeding a decision about whether to approve intravenous antivirals in case they are needed, and improving the system for tracking the spread of the new virus.
http://www.newsday.com/news/health/swine-flu-could-infect-half-of-u-s-panel-estimates-1.1394964
Swine flu could infect half of
U.S., panel estimates</font size></center>
The Washington Post
Via Newsday
August 25, 2009 By ROB STEIN.
WASHINGTON -
- <font size="3">Swine flu could infect half the U.S. population this fall and winter,</font size>
- <font size="3">hospitalizing up to 1.8 million people, and </font size>
- <font size="3">causing as many as 90,000 deaths - more than double the number that occur in an average flu season, according to an estimate from a presidential panel. </font size>
The virus could cause symptoms in 60 million to 120 million people, more than half of whom might seek medical attention, the President's Council of Advisors on Science and Technology estimated. The numbers were given in an 86-page report to the White House assessing the government's response to the first influenza pandemic in 41 years.
Although most cases probably would be mild, up to 300,000 people could require intensive care, which could tie up ICU beds in some parts of the country at the peak of the outbreak, the council said.
"This is going to be fairly serious," said Harold Varmus of New York's Memorial Sloan-Kettering Cancer Center, who co-chairs the 21-member council. "It's going to stress every aspect of our health system."
The estimates, released Monday, were the first specific numbers by experts on the possible impact of the pandemic in the United States. The "plausible scenario" is based on previous pandemics, especially the 1957-58 Asian flu, and how the swine flu behaved in the United States this spring and during the Southern Hemisphere's winter over the past few months, said Mark Lipsitch of the Harvard School of Public Health. He helped prepare the estimate.
"They are not a prediction, but they are a possibility," he said, noting the estimates are based on assumptions, including that the virus will not mutate into a more dangerous form or infect more older people.
"If it turned out to affect a lot more adults, the severity would be a lot worse," Lipsitch said.
While the seasonal flu causes about 36,000 deaths and 200,000 hospitalizations each year, the lack of immunity to the swine flu virus probably will lead to many more people becoming infected and possibly dying - as many as 90,000, the council said. And while most deaths during a typical flu season are among the elderly, swine flu is more likely to kill children and young adults, the panel said.
The report's primary purpose is to help guide planning to protect the public and improve the government's response to the outbreak. For example, it was estimated the outbreak could peak in mid-October, so the panel urged expediting the availability of a vaccine.
The panel also recommended clarifying how antiviral drugs should be used to fight the pandemic, speeding a decision about whether to approve intravenous antivirals in case they are needed, and improving the system for tracking the spread of the new virus.
http://www.newsday.com/news/health/swine-flu-could-infect-half-of-u-s-panel-estimates-1.1394964
<font size="5"><Center>
New CDC estimates show what toll
swine flu is taking in U.S.</font size><font size="4">
Number of child deaths is four times as high as had been reported</font size></center>
Washington Post
By David Brown
Staff Writer
November 13, 2009
<SPAN style="BACKGROUND-COLOR: #ffff00">About 22 million Americans have become ill with pandemic H1N1 influenza in the past six months and 3,900 have died,</span> according to new estimates by the Centers for Disease Control and Prevention.
The number of pediatric deaths -- about 540 -- is four times as high as the number that physicians, hospitals and health departments had reported to the public health agency in Atlanta.
The new estimates, drawn from detailed surveillance and record-checking in 10 states, sketch the most detailed picture by far of the national toll from the new flu strain that emerged in California and Mexico in April.
"We feel we're finally able to update the public on how big a toll this virus is having so far," Anne Schuchat, a CDC physician helping to run the federal government's pandemic response, said Thursday. "I am expecting all these numbers, unfortunately, to continue to rise."
<font size="4">The Statistics</font size>
All of the estimates come with substantial uncertainty. For example, total H1N1 cases in the United States range from 14 million to 34 million, and total deaths from 2,500 to 6,100.
The CDC had previously said 129 people younger than 18 had died from H1N1 flu. That is compared with 88 deaths from seasonal flu in 2007-08 and 78 deaths in 2006-07 -- the most recent two flu seasons before the H1N1 strain emerged.
The new estimate includes deaths that occurred outside hospitals, patients who tested negative for H1N1 but almost certainly had it, and other overlooked cases.
"We don't think anything has changed," Schuchat said. "We think our 540 number is a better estimate for the big picture." She added, however, that the numbers affirm CDC's advice that "vaccination is the best effort to protect one's self or family."
As of Thursday, about 42 million doses of pandemic vaccine had been delivered to the federal government, which is distributing it to states and cities.
In an unrelated development, the World Health Organization on Thursday urged more aggressive use of antiviral medicines against the pandemic, especially in low-income countries where physicians may have been using the drugs only in severely ill people.
"People in at-risk groups need to be treated with antivirals as soon as possible when they have flu symptoms," Nikki Shindo, a WHO physician, said Thursday in a news briefing for reporters. "This includes pregnant women, children under 2 years old, and people with underlying conditions such as respiratory problems." Specifically, practitioners should not wait for lab test results or a worsening of a patient's condition before prescribing oseltamivir (Tamiflu), which is the main drug used against the H1N1 strain.
Roche, the Swiss pharmaceutical company that makes Tamiflu, is on track to make 33 million treatment courses a month by the end of the year, David Reddy, a company executive, said Thursday. The company has given 5 million courses to WHO and is delivering another 5 million.
Reddy said that more than 100 countries have Tamiflu stockpiles. The company's drug-safety tracking system suggests that at least 80 percent of the drug made in the past seven months has not been used.
Roche is selling Tamiflu at reduced prices to 72 countries, including Ukraine and several Central Asian nations formerly part of the Soviet Union, where the epidemic has been intense.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/12/AR2009111210635.html
New CDC estimates show what toll
swine flu is taking in U.S.</font size><font size="4">
Number of child deaths is four times as high as had been reported</font size></center>
Washington Post
By David Brown
Staff Writer
November 13, 2009
<SPAN style="BACKGROUND-COLOR: #ffff00">About 22 million Americans have become ill with pandemic H1N1 influenza in the past six months and 3,900 have died,</span> according to new estimates by the Centers for Disease Control and Prevention.
The number of pediatric deaths -- about 540 -- is four times as high as the number that physicians, hospitals and health departments had reported to the public health agency in Atlanta.
The new estimates, drawn from detailed surveillance and record-checking in 10 states, sketch the most detailed picture by far of the national toll from the new flu strain that emerged in California and Mexico in April.
"We feel we're finally able to update the public on how big a toll this virus is having so far," Anne Schuchat, a CDC physician helping to run the federal government's pandemic response, said Thursday. "I am expecting all these numbers, unfortunately, to continue to rise."
<font size="4">The Statistics</font size>
- The total number of people who have been hospitalized is 98,000,
- 36,000 of those hospitalized have been age 17 and younger;
- The vast majority of deaths -- about 2,920 -- have been in people age 18 to 64;
- In an average flu season, the seasonal virus contributes to the deaths of about 36,000 people -- 90 percent of whom are 65 or older, many of whom are close to death, with flu being only one factor leading to their demise. <SPAN style="BACKGROUND-COLOR: #ffff00">That is not the case with H1N1's victims, most of whom are much younger, and about 20 to 30 percent of whom were healthy before contracting the virus</span>.
All of the estimates come with substantial uncertainty. For example, total H1N1 cases in the United States range from 14 million to 34 million, and total deaths from 2,500 to 6,100.
The CDC had previously said 129 people younger than 18 had died from H1N1 flu. That is compared with 88 deaths from seasonal flu in 2007-08 and 78 deaths in 2006-07 -- the most recent two flu seasons before the H1N1 strain emerged.
The new estimate includes deaths that occurred outside hospitals, patients who tested negative for H1N1 but almost certainly had it, and other overlooked cases.
"We don't think anything has changed," Schuchat said. "We think our 540 number is a better estimate for the big picture." She added, however, that the numbers affirm CDC's advice that "vaccination is the best effort to protect one's self or family."
As of Thursday, about 42 million doses of pandemic vaccine had been delivered to the federal government, which is distributing it to states and cities.
In an unrelated development, the World Health Organization on Thursday urged more aggressive use of antiviral medicines against the pandemic, especially in low-income countries where physicians may have been using the drugs only in severely ill people.
"People in at-risk groups need to be treated with antivirals as soon as possible when they have flu symptoms," Nikki Shindo, a WHO physician, said Thursday in a news briefing for reporters. "This includes pregnant women, children under 2 years old, and people with underlying conditions such as respiratory problems." Specifically, practitioners should not wait for lab test results or a worsening of a patient's condition before prescribing oseltamivir (Tamiflu), which is the main drug used against the H1N1 strain.
Roche, the Swiss pharmaceutical company that makes Tamiflu, is on track to make 33 million treatment courses a month by the end of the year, David Reddy, a company executive, said Thursday. The company has given 5 million courses to WHO and is delivering another 5 million.
Reddy said that more than 100 countries have Tamiflu stockpiles. The company's drug-safety tracking system suggests that at least 80 percent of the drug made in the past seven months has not been used.
Roche is selling Tamiflu at reduced prices to 72 countries, including Ukraine and several Central Asian nations formerly part of the Soviet Union, where the epidemic has been intense.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/12/AR2009111210635.html
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