Swine Flu, Mexico Lung Illness Heighten Pandemic Risk

[BigUnc]

What are you saying with that statement, exactly?

My Bad shanebp1978.Situation getting hectic at work. QueEx and Makkomen expanded on what I meant.Here's the CDC interim guidance for clinicians concerning those suspected of having H1N1


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Interim Guidance on Infection Control and Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A Virus Infection

April 20, 2009



BACKGROUND

Sporadic swine influenza A virus (SIV) infection of humans may produce a wide range of clinical signs and symptoms. Many human cases of SIV infection have had a history of recent direct physical contact with pigs prior to illness onset. However, close (within 6 feet), but not direct contact with pigs, also has been reported among human SIV cases. Limited, non sustained human-to-human SIV transmission has been documented in the published literature. In addition, some confirmed SIV cases have not had a history of exposure to pigs.


Although uncomplicated influenza-like illness (fever, cough or sore throat) has been reported in many cases, mild respiratory illness (nasal congestion, rhinorrhea) without fever and occasional severe disease also has been reported. Other symptoms reported with SIV infection include vomiting, diarrhea, myalgia, headache, chills, fatigue, and dyspnea. Conjunctivitis is rare, but has been reported. Severe disease (pneumonia, respiratory failure) and fatal outcomes have been reported with SIV infection. The potential for exacerbation of underlying chronic medical conditions or invasive bacterial infection with SIV infection should be considered.


This document provides interim guidance on infection control, antiviral treatment and chemoprophylaxis, and monitoring of close contacts of cases of swine influenza virus infection, including guidance for health care workers and public health personnel. The guidance will be updated as needed.


INTERIM RECOMMENDATIONS

For clinical care or collection of respiratory specimens from a symptomatic individual (acute respiratory symptoms with or without fever) who is a confirmed case, or a suspected case (ill close contact of a confirmed case) of swine influenza A virus infection:


Infectious Period

Persons with swine influenza virus infection should be considered potentially contagious for up to 7 days following illness onset. Persons who continue to be ill longer than 7 days after illness onset should be considered potentially contagious until symptoms have resolved. Children, especially younger children, might potentially be contagious for longer periods. The duration of infectiousness might vary by SIV strain.


Case definitions

A confirmed case of swine influenza virus infection (SIV) is defined as a person with an acute respiratory illness with laboratory confirmed SIV at CDC by one or more of the following tests:
real-time RT-PCR
viral culture
four-fold rise in SIV specific neutralizing antibodies
A suspected case of SIV is defined as a person with an acute respiratory illness who was a close contact to a confirmed case of SIV infection while the case was ill, or is an acutely ill person (acute respiratory illness) with a recent history of contact with an animal with confirmed or suspected SIV infection.
Close contact is defined as: within about 6 feet of an ill person who is a confirmed case of swine influenza A virus infection

Acute respiratory illness is defined as recent onset of at least two of the following: rhinorrhea or nasal congestion, sore throat, cough (with or without fever or feverishness)



RECOMMENDATIONS FOR PUBLIC HEALTH PERSONNEL

For interviews of healthy individuals (i.e. without a current respiratory illness), including close contacts of cases of confirmed swine influenza virus infection, no personal protective equipment or antiviral chemoprophylaxis is needed. See section on antiviral chemoprophylaxis for further guidance.


For interviews of an ill, suspected or confirmed SIV case, the following is recommended:

Keep a distance of at least 6 feet from the ill person; or
Personal protective equipment: fit-tested N95 respirator [if unavailable, wear a medical (surgical mask)].
For collecting respiratory specimens from an ill confirmed or suspected SIV case, the following is recommended:

Personal protective equipment: fit-tested disposable N95 respirator [if unavailable, wear a medical (surgical mask)], disposable gloves, gown, and goggles.
When completed, place all PPE in a biohazard bag for appropriate disposal.
Wash hands thoroughly with soap and water or alcohol-based hand gel.
Infection Control
Recommended Infection Control for a non-hospitalized patient (ER, clinic or home visit):

Separation from others in single room if available until asymptomatic. If the ill person needs to move to another part of the house, they should wear a mask. The ill person should be encouraged to wash hand frequently and follow respiratory hygiene practices (LINK). Cups and other utensils used by the ill person should be thoroughly washed with soap and water before use by other persons.
Recommended Infection Control for a hospitalized patient:

Standard, Droplet and Contact precautions for 7 days after illness onset or until symptoms have resolved.
In addition, personnel should wear N95 respirators when entering the patient room.
Use an airborne infection isolation room (AIIR) with negative pressure air handling, if available; otherwise use a single patient room with the door kept closed.
For suctioning, bronchoscopy, or intubation, use a procedure room with negative pressure air handling.
Recommended PPE for personnel providing clinical care to ill individuals:

Disposable gown, gloves, goggles, N95 respirator.
Antiviral Treatment
Antiviral treatment for confirmed or suspected ill case of swine influenza virus infection may include either oseltamivir or zanamavir, with no preference given at this time. Recommendations for use of antivirals may change as data on antiviral susceptibilities become available.
Initiate treatment as soon as possible after the onset of symptoms.


Oseltamivir: Antiviral treatment for confirmed or suspected ill case of swine influenza virus infection may include either oseltamivir or zanamavir, with no preference given at this time. Recommendations for use of antivirals may change as data on antiviral susceptibilities become available.

The treatment dosing recommendation for children who weigh 15 kg or less is 30 mg twice a day. For children who weigh more than 15 kg and up to 23 kg, the dose is 45 mg twice a day. For children who weigh more than 23 kg and up to 40 kg, the dose is 60 mg twice a day. For children who weigh more than 40 kg, the dose is 75 mg twice a day.
For ages 13 years and older: 75mg twice a day for five days
Zanamivir is an alternative for treatment of influenza in patients aged 7 years and older; dosage varies by age. This drug is not approved for treatment of influenza in children aged <7 years. It is an orally inhaled drug that is administered using a disk inhaler device twice a day for five days.

The treatment dosing recommendation for persons aged 7 years and older is 2 inhalations twice a day for five days (2 inhalations of 5mg each twice a day for five days)
Antiviral Chemoprophylaxis
Antiviral chemoprophylaxis (pre-exposure or post-exposure) can be considered for close contacts of a confirmed or highly suspected case of swine influenza virus infection.


Close contact is defined as: within about 6 feet of an ill person who is a confirmed case of swine influenza A virus infection (e.g. post-exposure chemoprophylaxis following unprotected close exposure).


Duration of antiviral chemoprophylaxis is 7 days after the last known exposure


Oseltamivir: Administered by mouth once a day for seven days following the last known exposure; dosage varies by age and weight for children aged 1 year to 12 years (available in suspension, 30mg, 45mg, 75mg capsules)

The chemoprophylaxis dosing recommendation for children who weigh less than 15 kg is 30 mg once a day. For those who weigh more than 15 kg and up to 23 kg, the dose is 45 mg once a day. For children who weigh more than 23 kg and up to 40 kg, the dose is 60 mg once a day. For children who weigh more than 40 kg, the dose is 75 mg once a day.
For ages 13 years and older: 75 mg once a day for seven days
Zanamivir is an alternative for chemoprophylaxis for patients aged 5 years and older; dosage varies by age. It is an orally inhaled drug that is administered using a disk inhaler device.

Dosing is 2 oral inhalations once a day for seven days (2 inhalations of 5mg each once a day for seven days)
Follow-up Monitoring of Exposed Close Contacts
Close contacts are defined as persons who were within about 6 feet of the confirmed swine influenza case while the case was ill up to 7 days after the case’s illness onset. Examples include household members, social contacts, public health care workers, medical health care workers, and others.

Close contacts should be monitored daily for fever (temp ≥38.0 ºC) and/or any respiratory symptoms up to 7 days following the last known exposure to anY ill person who is a confirmed case of swine influenza virus infection.
Close contacts of an ill person who is a confirmed case of swine influenza virus infection should be educated about the signs and symptoms of swine influenza virus infection and advised to contact public health staff if fever or feverishness or any respiratory tract symptoms occur up to 7 days following the last known exposure to the ill case

 

[Makkonnen]

Okay- this is very bad news. Lets see how Americans feel about a wide open border after this shit runs its course.


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Early swine flu victim's widow not told of disease

Early swine flu victim's widow not told of disease
Family of early Mexican victim of swine flu kept in dark about the disease

OLGA RODRIGUEZ
AP News

Apr 27, 2009 13:09 EST

The 39-year-old bricklayer fell ill two weeks ago and became one of the first Mexicans to die of swine flu. But no health worker has come to his home outside Mexico City to offer medicine or ask about the neighbors' pigs.

In fact, Gerardo Leyva Lolis' widow says nobody even told her he died of swine flu until The Associated Press informed her the case had been confirmed by the director of the hospital where he was rushed last week.

The family's experience raises troubling questions about Mexico's response to the epidemic and one of its greatest mysteries: why the disease is killing people in Mexico, but so far nowhere else.

"I don't know what to think," Antonia Cortes Borbolla said Sunday, holding back tears in the two-room wood and cinderblock home she shared with her husband and their three teenage sons in this rural town of 18,000 located 40 miles outside Mexico City.

Their neighbors — three of whom keep pigs in their yards — had harsher things to say about the failure of Mexican health officials to provide medicine to protect those closest to the swine flu victim.

"If it was (swine flu), why haven't they taken measures to protect the family?" asked Sandra Estrada, adding that she's worried because she visited Leyva while he was sick and her children have been cared for by the dead man's wife.

Epidemiologists need details about victims to locate the source of a viral outbreak and to understand how it spreads. There are antiviral drugs, including Tamiflu, that have been shown to be effective, but they need to be taken within days of the first symptoms. Experts also suggest they be given to those in close contact with flu victims, even if they don't show symptoms, to make sure they don't unwittingly spread the virus.

President Felipe Calderon announced an emergency decree Saturday authorizing health workers to isolate patients and enter and search their homes to combat this flu.

But no such effort has been made with Leyva's family. His widow said she has been asked little and told even less since his death on April 20.

The president's office referred all inquiries about the case to the federal health department, where a spokeswoman said she had no information. Victor Torres, assistant epidemiology director at the state health institute, told the AP he needed another day before he could talk about the case.

But details provided by his family suggest Leyva could have been infecting people all over the crowded capital and the surrounding state of Mexico.

Leyva's widow said he first noticed flu symptoms on April 13, and went to the local clinic in Xonacatlan (Shoh-nah-cah-TLAN). No one was available to give him a checkup, but he was given a shot and felt well enough the next day to make the 40-mile bus trip to Mexico City, taking subways to work despite a nasty cough.

Too sick to work again after that, he still had no medical care except for a penicillin injection his niece gave him. By the night of April 19, he was having trouble breathing and had an irregular heartbeat, and so his family took him to the nearby city of Toluca, where the poor can get discounted care at a large public hospital.

By 8 a.m. the next day, he was dead. His family was told the cause was a heart attack brought on by pneumonia.

Four days later, the Centers for Disease Control and Prevention in Atlanta announced that the flu killing people in Mexico matched a disturbing new virus detected in the U.S. that combines genetic material from humans, birds and pigs in a way scientists have never seen before — and that can be passed from human to human.

The news rocked Mexico's government, which had said for weeks that this year's higher flu caseload was nothing unusual. The toll has risen to more than 100 suspected deaths nationwide, with more than 1,600 people sickened. At least 40 swine flu cases — none fatal — have been confirmed in the United States and six in Canada.

As news spread about the dangerous new strain, two nurses from the local clinic visited the family's home last Thursday to say Leyva may not have died from pneumonia after all, and that an epidemiologist at the hospital wanted to see his widow.

She went in on Friday, but said the doctor did not tell her that her husband's death had been confirmed as swine flu. She said he gave her a hug of condolence and urged her to buy an antiflu drug and vitamin C if anyone in her family felt sick.

As of Sunday, she hadn't heard from any other health worker. The local pharmacy had no such drugs to sell, and she didn't have money to buy them anyway. Since her family seemed healthy, she left it at that.

Dr. Carlos Aranza, director of the Adolfo Lopez Mateos hospital where Leyva died, said state laboratory tests confirmed that swine flu killed him, as well as another patient there, a 42-year-old woman identified only as Gregoria.

Aranza also said that while the hospital had no antiflu medication to give the widow at the time, it now has Tamiflu in stock for those who need it.

Experts on epidemics suggest Mexican health officials should be more proactive in seeking out people who came into close contact with the victims, and in insisting they take antiviral drugs to prevent the spread of contagion.

"No matter whether the patients lived or died, their families should be offered prophylactic antibiotics," said Dr. Richard Wenzel, past president of the International Society for Infectious Diseases. "There would be an expectation that should happen anywhere in the world. And if they have trouble getting the drug they should ask for it."

Meanwhile, Cortes is struggling more than ever to make ends meet. Without her husband, her only income is from a plywood stand in front of her house where she sells candy and soda. She said sales are slow because her neighbors fear she might have swine flu and are staying away.

"I sleep on the same mattress under the same covers that my husband used. What contagion are they talking about?" she said. "I don't want anyone singling me out, as some already have, saying, 'The Leyva Corteces have the virus.'"


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Unless Tamiflu really works in an extremely percentage of cases- im talkin >99% - this is gonna be bad. Very very very 1918 style bad

350 Million Americans - Lets say 50% come into contact with it. Lets say its fatal for 1% of those people
That's 1.75 million dead.
I dont know if that many people would be in contact but the shit is totally out of the box.

BigUnc - you seen any pretty computer models for this one? I heard mathematicians were on it before the weekend.

I guess we could tell if it was outta control by whether or not the President is making public appearances.

 

[Makkonnen]

I have a serious question - i have scoured the internet looking for any interviews of confirmed swineflu survivors. I can't find shit. I find it kinda strange. I hear reports about people doing fine -no one has died in the US etc but Im not getting anything even from Mexico about people who've had this and recovered.

Have any of you????????????

 

[QueEx]

I have a serious question - i have scoured the internet looking for any interviews of confirmed swineflu survivors. I can't find shit. I find it kinda strange. I hear reports about people doing fine -no one has died in the US etc but Im not getting anything even from Mexico about people who've had this and recovered.

Have any of you????????????

Just observed one on CNN. A young woman, between 15 and 19, Arianna Anastos, described catching it, getting really ill, taking Tamiflu, and quickly recovering. Didn't get the location.

QueEx

 

[BigUnc]

---------

Unless Tamiflu really works in an extremely percentage of cases- im talkin >99% - this is gonna be bad. Very very very 1918 style bad

350 Million Americans - Lets say 50% come into contact with it. Lets say its fatal for 1% of those people
That's 1.75 million dead.
I dont know if that many people would be in contact but the shit is totally out of the box.

BigUnc - you seen any pretty computer models for this one? I heard mathematicians were on it before the weekend.

I guess we could tell if it was outta control by whether or not the President is making public appearances.

Computer models are being done but aren't of any use in decision making due to lack of hard data specifically:

The case fatality rate
The descriptive epidemiology
The epidemic curve


Subjective expectative values and I stress SUBJECTIVE are all over the charts but the high number was around 10 million deaths world wide. Don't panic I tossed it in the circular file.

Whats striking and something I haven't been able to ignore is the similarity between this and 1918:

1)Both outbreaks started in the spring.
2)Both were most fatal,so far, for otherwise healthy people between 20-40.
3) The first wave ,now as then, was marked by mild illness and relativly few fatalities. The second and third waves in 1918 was when most fatalities occured.

Don't panic but take prudent precautions if it hits close to home such as prepare for social isolation/distancing either self imposed or by government edict. Something along the lines of being housebound for a week or more. Trust me lawyers ae dusting off and updating legal authorities to enforce it if necessary.

 

[BigUnc]

Damn!!

unknown number of suspected cases in North Carolina per State health department. Specimens taken and patients ORDERED to home isolation.

 

[Makkonnen]

Just observed one on CNN. A young woman, between 15 and 19, Arianna Anastos, described catching it, getting really ill, taking Tamiflu, and quickly recovering. Didn't get the location.

QueEx

Thanks Que - that one point has been the most troubling.

Computer models are being done but aren't of any use in decision making due to lack of hard data specifically:

The case fatality rate
The descriptive epidemiology
The epidemic curve


Subjective expectative values and I stress SUBJECTIVE are all over the charts but the high number was around 10 million deaths world wide. Don't panic I tossed it in the circular file.

Whats striking and something I haven't been able to ignore is the similarity between this and 1918:

1)Both outbreaks started in the spring.
2)Both were most fatal,so far, for otherwise healthy people between 20-40.
3) The first wave ,now as then, was marked by mild illness and relativly few fatalities. The second and third waves in 1918 was when most fatalities occured.

Don't panic but take prudent precautions if it hits close to home such as prepare for social isolation/distancing either self imposed or by government edict. Something along the lines of being housebound for a week or more. Trust me lawyers ae dusting off and updating legal authorities to enforce it if necessary.

Damn. I really was kinda hoping CDC had better data than the shit trickling out to the public. I'm guessing the 1600 suspected cases in Mexico are only suspected because they didnt bother testing.


Just saw this evening's BBC News - they had a reporter at the Juarez border crossing. Mexicans arent allowed to assemble etc in Mexico and many wear masks(not that they do much) and thousands were in line for hours packed in tightly to cross the border - in line all day- no masks nothing but Border Guards looking for coughs

This shit is like a bad fuckin horror movie.

I can dig the housebound part. Bout to stock up on ammo, water purification batteries and add a little variety to the emergency stock I have now.

Damn!!

unknown number of suspected cases in North Carolina per State health department. Specimens taken and patients ORDERED to home isolation.

Man - I knew it. Shit has been on the mexican underground railroad for 24 days. WHO says it can't be contained period. Time to sitback and see what happens.

 

[BigUnc]

Confirmed case in Northern California. Child approx. 12 years old. Several other children who attended same school are presently ill. School to be closed.

 

[BigUnc]

Check that last post:

going through e mail queue on blackberry, as of 1 am Eastern Time
2 classmates of Sacramento case confirmed positive. Total California SIV now at 13.

 

[BigUnc]

Pretty sure this has already hit the news services but here it is anyway


5 probable in New Jersey

 

[Makkonnen]

BigUnc can I ask what it is you do?


Thanks for the updates

Looks like hard times might be coming

 

[Makkonnen]

Swine flu spreads to Middle East, Asia-Pacific

By ANDREW O. SELSKY – 26 minutes ago

MEXICO CITY (AP) — The swine flu epidemic crossed new borders Tuesday with the first cases confirmed in the Middle East and the Asia-Pacific region, as the number of deaths in Mexico blamed on the virus surpassed 150.

With the swine flu having already spread to at least six other countries besides Mexico, authorities around the globe are like firefighters battling a blaze without knowing how far it extends.

"At this time, containment is not a feasible option," said Keiji Fukuda, assistant director-general of the World Health Organization, which raised its alert level on Monday.

New Zealand reported Tuesday that 11 people who recently returned from Mexico contracted the virus. Tests conducted at a World Health Organization laboratory in Australia had confirmed three cases of swine flu among 11 members of the group who were showing symptoms, New Zealand Health Minister Tony Ryall said.

Officials decided that was evidence enough to assume the whole group was infected, he said.

Those infected had suffered only "mild illness" and were expected to recover, Public Health Director Mark Jacobs said. There are 43 more suspected cases in the country, officials said.

The Israeli Health Ministry on Tuesday confirmed the region's first case of swine flu in the city of Netanya. The 26-year-old patient recently returned from Mexico and had contracted the same strain, Health Ministry spokeswoman Einav Shimron.

Dr. Avinoam Skolnik, Laniado Hospital's medical director, said the patient has fully recovered and is in "excellent condition" but will remain hospitalized until the Health Ministry approves his release.

Another suspected case has been tested at another Israeli hospital but results are not in, the ministry said.

Meanwhile, a second case was confirmed Tuesday in Spain, Health Minister Trinidad Jimenez said, a day after the country reported its first case. The 23-year-old student, one of 26 patients under observation, was not in serious condition, Jimenez said.

With the virus spreading, the U.S. prepared for the worst even as President Barack Obama tried to reassure Americans.

At the White House, a swine flu update was added to Obama's daily intelligence briefing. Obama said the outbreak is "not a cause for alarm," even as the U.S. stepped up checks of people entering the country and warned U.S. citizens to avoid nonessential travel to Mexico.

"We are proceeding as if we are preparatory to a full pandemic," said Homeland Security Secretary Janet Napolitano.

The European Union health commissioner suggested that Europeans avoid nonessential travel both to Mexico and parts of the United States. Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus.

Mexico, where the number of deaths believed caused by swine flu rose by 50 percent on Monday to 152, is suspected to be ground zero of the outbreak. But Mexican Health Secretary Jose Angel Cordova late Monday said no one knows where the outbreak began, and implied it may have started in the U.S.

"I think it is very risky to say, or want to say, what the point of origin or dissemination of it is, given that there had already been cases reported in southern California and Texas," Cordova told a press conference.

It's still not clear when the first case occurred, making it impossible thus far to determine where the breakout started.

Dr. Nancy Cox of the Atlanta-based Centers for Disease Control and Prevention has said she believes the earliest onset of swine flu in the United States happened on March 28. Cordova said a sample taken from a 4-year-old boy in Mexico's Veracruz state in early April tested positive for swine flu. However, it is not known when the boy, who later recovered, became infected.

The World Health Organization raised the alert level to Phase 4, meaning there is sustained human-to-human transmission of the virus causing outbreaks in at least one country. Monday was the first time it has ever been raised above Phase 3.

Putting an alert at Phases 4 or 5 signals that the virus is becoming increasingly adept at spreading among humans. Phase 6 is for a full-blown pandemic, characterized by outbreaks in at least two regions of the world.

Fifty cases — none fatal and most of them mild — were confirmed in the United States. Including the New Zealand, Israeli and new Spanish reports, there were 92 confirmed cases worldwide on Tuesday. That included six in Canada, one in Spain and two in Scotland.

Symptoms include a fever of more than 100, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.

Amid the alarm, there was a spot of good news. The number of new cases reported by Mexico's largest government hospitals has been declining the past three days, Cordova said, from 141 on Saturday to 119 on Sunday and 110 Monday.

In a bid to prevent mass contagion, Mexico canceled school nationwide until May 6, and the Mexico City government is considering a complete shutdown, including all public transportation. The Cinco de Mayo parade celebrating Mexico's defeat of a French army on May 5, 1862 and Mexico City's traditional May 1 parade were canceled. More than 100 museums nationwide were closed.

At Mexico City's international airport, families grimly waited for flights out of the capital or country, determined to keep their masks on until they touched ground somewhere else.

Three games involving Mexico City soccer clubs were played with no spectators over the weekend. Decio de Maria, secretary general of the Mexican soccer federation, said plans for future matches would be announced on Wednesday.

"The idea is to look for the fewest number of games that have to be played behind closed doors," he said. "If it's necessary, we'll play all the matches behind closed doors. We don't foresee canceling any games."

Many residents of Mexico City wore blue surgical masks, though the CDC said most masks offer little protection. Many victims have been in their 30s and 40s — not the very old or young who typically succumb to the flu. So far, no deaths from the new virus have been reported outside Mexico.

It could take four to six months before the first batch of vaccines are available, WHO officials said. Some antiflu drugs do work once someone is sick.

Napolitano, the U.S. Homeland Security chief, said Washington is dispatching people and equipment to affected areas and stepping up information-sharing at all levels of government and with other nations.

Richard Besser, the CDC's acting director, said his agency is aggressively looking for evidence of the disease spreading and probing for ways to control and prevent it.

Flu deaths are nothing new in the United States. The CDC estimates that about 36,000 people died of flu-related causes each year, on average, during the 1990s in the United States. But the new flu strain is a combination of pig, bird and human viruses that humans may have no natural immunity to.

Besser said that so far the virus in the United States seems less severe than in Mexico. Only one person has been hospitalized in the U.S.

"I wouldn't be overly reassured by that," Besser told reporters at CDC headquarters in Atlanta, sounding a cautionary note.

The best way to keep the disease from spreading, Besser said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes, and staying away from work or school if not feeling well.

WHO spokesman Peter Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time.

Governments in Asia — with memories of previous flu outbreaks — were especially cautious. Singapore, Thailand, Japan, Indonesia and the Philippines dusted off thermal scanners used in the 2003 SARS crisis and were checking for signs of fever among passengers from North America. South Korea, India and Indonesia also announced screening.

Teams of doctors, nurses and government officials boarded flights arriving in Japan from Mexico, the U.S. and Canada to check passengers for signs of the flu, Japanese Health Ministry official Akimori Mizuguchi said.

World stock markets fell Tuesday as investors worried that any swine flu pandemic could derail a global economic recovery.

AP writers Mark Stevenson in Mexico City, Mike Stobbe in Atlanta, Ray Lilley in Wellington, New Zealand, Aron Heller in Jerusalem and Pan Pylas in London contributed to this report.

Copyright © 2009 The Associated Press. All rights reserved.
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[Makkonnen]

Worst case scenario underlies US pandemic plan

By RICARDO ALONSO-ZALDIVAR and EILEEN SULLIVAN – 29 minutes ago

WASHINGTON (AP) — Two million dead. Hospitals overwhelmed. Schools closed. Swaths of empty seats at baseball stadiums and houses of worship. An economic recovery snuffed out. We're nowhere close to what government planners say would be a worst-case scenario: a global flu pandemic. But government leaders at all levels, and major employers, have spent nearly four years planning for one in series of exercises.

Their reports, reviewed by The Associated Press, and interviews with participants paint a grim picture of what could happen if the swine flu gets severely out of control.

A full-scale pandemic — if it ever comes — could be expected to claim the lives of about 2 percent of those infected, about 2 million Americans.

The government estimates that a pandemic like the 1918 Spanish flu would sicken 90 million Americans, or about 30 percent of the population. Of those, nearly 10 million would have to be admitted to a hospital, and nearly 1.5 million would need intensive care. About 750,000 would need the help of mechanical ventilators to keep breathing.

No one would be immune from the consequences, even those who don't get sick, according to worst-case exercises run by local and national agencies.

Schools would be closed to try to block the spread of illness, for example, but school buses might be used to take flu victims to alternative clinics rather than overcrowded hospitals.

A 2006 report on the Washington region found both Maryland and Virginia would run out of hospital beds within two weeks of a moderate outbreak.

People who got sick would be isolated, and their relatives could be quarantined.

But even if families weren't required to stay home, many would do so to take care of sick relatives, or because they were afraid of getting sick themselves.

Hotels, restaurants and airlines would face loss of business as business travel and meetings would be replaced by teleconferences.

In the cities, commuters who do go to work might bike or walk instead of using mass transit.

People would avoid movie theaters and rent DVDs instead.

In 1918, authorities even called on churches to cancel services, to the chagrin of some pastors.

Society as a whole would go into a defensive crouch, and that would deliver a shock to the economy.

The Trust for America's Health, an independent public health group, estimated in 2007 that a severe pandemic would shrink U.S. output by about 5.5 percent.

Take a breath. Even if the new swine flu from Mexico turns out to be especially aggressive, the worst consequences could be averted.

Although some states are less prepared than others, the nation has made strides in stockpiling antiviral medicines, speeding the production of vaccines and laying down basic public health guidelines.

Homeland Security Secretary Janet Napolitano said Monday that the U.S. is preparing as if the swine flu outbreak were a full pandemic. It is not at that stage and may never reach it.

Disease detectives are following a series of outbreaks, of varying severity, all of which appear to be related to Mexico. A pandemic would spread throughout the world with explosive speed.

The government got serious about worst-case planning during the 2005 bird flu scare, as the lessons of Hurricane Katrina loomed large.

"We have a playbook that was developed and is being followed," said Michael Leavitt, who as secretary of Health and Human Services oversaw pandemic planning for President George W. Bush. "It's a substantially better picture than what we faced three years ago."
On the Net:

* U.S. information on swine flu: http://www.pandemicflu.gov

Copyright © 2009 The Associated Press. All rights reserved.
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[Makkonnen]

that worst case scenario article is bullshit - i think some of us could come up with worse scenarios

 

[Makkonnen]

fuck

A school here in SC is closed. Tests for swine flu come back today - teachers and students just got back from.....................wait for it...............Mexico.

 

[BigUnc]

BigUnc can I ask what it is you do?


Thanks for the updates

Looks like hard times might be coming

HazMat/Homeland Security/Emergency Management

If the virilence of this variant intensifies then worst case scenarios are plausible. Expect the pattern to be for it to hit an area then disappear only to re-appear again. A vaccine is forth coming but the current manufacturing process of using fertilized chicken eggs means it won't be available til October. Don't know yet if they can ramp up production. Newer methods of making vaccines are possible but as far as i know have not yet been approved.

Recieved a report saying the manufacturers of Tamiflu and Relenza, one of them GlaxoSmithKlein ( the other one I cant remember at the moment)saying if they ramp up to full production they will have enough for 500 million people in 1 year. Lawyers looking into the legalities of suspending patent law and letting others manufacture them both.

 

[BigUnc]

I've been waiting for this shoe to drop

Suspect cases in Columbia,Uraguay, Brasil

Season is changing to fall in the Southern Hemisphere. SIV may grab hold faster there.

 

[BigUnc]

UPDATE

Data dumps are coming fast and furious

One interesting item peeked my interest. Some are postulating as to the reason why otherwise healthy young adults are most affected. It's a phenomenom also seem in H5N1(Bird flu)called the "cytokine storm", whereas the immune system over reacts and essentially destroys the host in order to kill the virus.Google it for detailed info.

More cases in Southern Hemisphere, female age 21 confirmed in Costa Rica.

4 labs working on vaccine.

SIV moving in all compass directions. Suspect cases in China Poland, Egypt and a couple others that escape me at the moment plus a few more U.S. cities with Philly in the front probably because that means it's getting close.

 

[Makkonnen]

props BigUnc

 

[Panameno718]

Container of swine virus explodes on Swiss train!!!!


A container of flu virus samples packed in dry ice exploded on a Swiss train, injuring one person but posing no other risks to humans, police said on Tuesday. Skip related content
The box held vials of swine flu virus, although a different strain than the H1N1 variety that has caused about 150 deaths in Mexico and infected people in the United States, Canada, Spain and Britain.

A technician was transporting the container on Monday night to the Swiss national flu centre in Geneva, where scientists are developing a flu test for humans, police said.

One woman was hurt when the box exploded in reaction to the dry ice used to keep the samples cold.

After consulting virus specialists, the police decided to stop the St. Gallen to Geneva train before it entered the station in Lausanne.

The virus specialists confirmed that the samples being transported posed no risks to humans, police said.

http://uk.news.yahoo.com/22/20090428/twl-uk-flu-swiss-accident-sb-a7cf3b4.html

 

[Panameno718]

Two L.A. County deaths possibly related to swine flu, coroner says [Updated]
9:09 AM | April 28, 2009
The Los Angeles County coroner's office is investigating two recent deaths that officials say could be related to the recent global swine flu outbreak. However, no tests have come back positive for the swine flu, and medical examiners have not officially determined what caused the deaths.

[Updated at 9:30 a.m.: Coroner's spokesman Craig Harvey said his office would collect specimens from the deceased and send them to the county public health department, which would determine whether either person died from the swine flu. If so, the U.S. Centers for Disease Control and Prevention would be notified, Harvey said.]

Coroner's spokesman Craig Harvey said Bellflower Medical Center reported the death of a 33-year Long Beach resident Monday afternoon from symptoms resembling swine flu.

"It's that diagnosis that needs to be confirmed," Harvey said. "An autopsy will be performed to establish the cause of death."


The man was taken to the hospital Saturday, complaining of shortness of breath and lymphoma. Doctors later diagnosed the patient with pneumonia, Harvey said.

The second case involves a 45-year-old man from La Mirada, whose death was reported Monday to the coroner's office. The man died April 22 at Coast Plaza Doctor's Hospital in Norwalk.

Doctors said the man died of pneumonia but the L.A. County Health Department refused to accept the death certificate signed by the private doctor, Harvey said. The case was then referred to the coroner's office, which will conduct further investigation.

If confirmed, the deaths would be the first reported in the United States from the swine flu.

http://latimesblogs.latimes.com/lan...ssibly-related-to-swine-flu-coroner-says.html

 

[QueEx]

<font size="5"><center>
Swine flu kills first victim in U.S.</font size><font size="4">

The CDC says a 23-month-old child in Texas has died.
'My heart goes out to the family,' acting director says.</font size></center>


Los Angeles Times
By Mark Silva
April 29, 2009


Reporting from Washington -- The swine flu outbreak has claimed its first victim in the United States, according to the Centers for Disease Control and Prevention: A 23-month-old child in Texas.

Dr. Richard Besser, acting director of the CDC, confirmed the fatality in an appearance this morning on NBC's "Today" show.

With 64 confirmed cases of the disease nationwide according to the agency's latest accounting – including 45 in New York City – the agency says it's too soon to say how fast the flu is spreading.

Health authorities had anticipated the first U.S. death after the disease was suspected in the deaths of more than 150 people in Mexico, where the outbreak is believed to have begun. Yet the death of the toddler in Texas is tragic, Besser said.

"As a pediatrician and a parent, my heart goes out to the family,'' Besser said.


The flu case in Texas was one of six that had been confirmed in the U.S. in addition to 10 in California, 2 in Kansas and one in Ohio, according to the CDC's accounting Tuesday. In addition, other reports of illnesses from Chicago to New York have raised the possibility that the number of cases will continue to climb.

mdsilva@tribune.com


http://www.latimes.com/la-sci-flu-death30-2009apr30,0,4966691.story

 

[Panameno718]

WHO notches up swine flu pandemic alert
Global outbreak considered imminent; vaccine efforts will be ramped up............


Global health authorities warned Wednesday that swine flu was threatening to bloom into a pandemic, and the virus spread farther in Europe even as the outbreak appeared to stabilize at its epicenter. A toddler who succumbed in Texas became the first death outside Mexico.

New cases and deaths finally seemed to be leveling off in Mexico, where 160 people have been killed, after an aggressive public health campaign. But the World Health Organization said the global threat is nevertheless serious enough to ramp up efforts to produce a vaccine against the virus. The group raised its pandemic alert for swine flu to the second highest level Wednesday, meaning that it believes a global outbreak of the disease is imminent. It was the first time the WHO had declared a phase 5 outbreak.

WHO Director General Margaret Chan declared the phase 5 alert after consulting with flu experts from around the world. The decision could lead the global body to recommend additional measures to combat the outbreak, including for vaccine manufacturers to switch production from seasonal flu vaccines to a pandemic vaccine.

"All countries should immediately now activate their pandemic preparedness plans," Chan told reporters in Geneva. "It really is all of humanity that is under threat in a pandemic."

A phase 5 alert means there is sustained transmission among people in at least two countries. Once the virus shows effective transmission in two different regions of the world, a full pandemic outbreak — phase 6 — would be declared, meaning a global epidemic of a new and deadly disease.............

http://www.msnbc.msn.com/id/30398682/?GT1=43001

 

[Panameno718]

WHO raises flu threat level, warns pandemic imminent 30 Apr 2009 02:39:16 GMT
Source: Reuters
(For full coverage of the flu outbreak, click [nFLU])

* WHO says flu pandemic imminent

* Mexico says has 17 more suspected deaths

* Mexican toddler is first U.S. fatality (Updates with Mexico suspending all non-essential work and services; 17 more deaths suspected in Mexico)

By Laura MacInnis and Stephanie Nebehay

GENEVA, April 29 (Reuters) - The World Health Organization said on Wednesday the world is at the brink of a pandemic, raising its threat level as the swine flu virus spread and killed the first person outside of Mexico, a toddler in Texas.

"Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world," WHO Director General Margaret Chan told a news conference in Geneva as she raised the official alert level to phase 5, the last step before a pandemic. [nLT672274]

"The biggest question is this: how severe will the pandemic be, especially now at the start," Chan said. But she added that the world "is better prepared for an influenza pandemic than at any time in history."

Mexico said it had suffered another 17 deaths of patients potentially linked to swine flu, bringing the total to as many as 176, and called for a suspension of all non-essential work and services.

Already in Mexico City, a metropolis of 20 million, all schools, restaurants, nightclubs and public events have been shut down to try to stop the sickness from spreading, bringing normal life to a virtual standstill.

'THE HORSES ARE OUT'

Nearly a week after the H1N1 swine flu virus first emerged in California and Texas and was found to have caused dozens of deaths in Mexico, Spain reported the first case in Europe of swine flu in a person who had not been to Mexico, illustrating the danger of person-to-person transmission.

Both U.S. and European officials have said they expect to see swine flu deaths.

President Barack Obama said during an evening news conference at the White House there was no need for panic and rejected the possibility of closing the border with Mexico.

"At this point, (health officials) have not recommended a border closing," he said. "From their perspective, it would be akin to closing the barn door after the horses are out, because we already have cases here in the United States."

Obama also praised his predecessor for stockpiling anti-viral medication in anticipation of such an outbreak.

"I think the Bush administration did a good job of creating the infrastructure so that we can respond," Obama said. "For example, we've got 50 million courses of anti-viral drugs in the event that they're needed."

Despite worries that a major flu outbreak could hit the struggling global economy, world stocks rallied on Wednesday after the Federal Reserve said the U.S. recession appeared to be easing [nL29448979].

Almost all cases outside Mexico have had mild symptoms, and only a handful have required hospitalization.

MEXICAN BOY DIES IN TEXAS

Chan also urged companies who make the drugs to ramp up production. Two antiviral drugs -- Relenza, made by GlaxoSmithKline <GSK.L> <GSK.N> and Tamiflu, made by Roche AG <ROG.VX and Gilead Sciences Inc. <GILD.O> -- have been shown to work against the H1N1 swine flu strain.

Drugmakers have donated millions of doses of their drugs to the WHO. She also alerted governments to be ready to distribute stockpiles of their drugs. Vaccine makers were on standby to begin making a new vaccine if needed.

And Germany, Austria and Peru reported cases of the illness, bringing the number of affected countries to 10. Peru said its case involved a woman who had traveled to Mexico and its health minister immediately announced the suspension of all commercial flights arriving from that country.

Texas officials said a 22-month-old boy had died while on a family visit from Mexico, marking the first confirmed U.S. swine flu death. In the Texas border city of Brownsville, where the boy was first diagnosed, some residents said they were now reluctant to venture south to Mexico.

"I am extremely concerned because you could die," said Santiago Perez, 18, a student at Pace High School.

Kathleen Sebelius, Obama's newly confirmed health secretary, spent her first day in office on a media tour as the administration sought to calm fears while urging vigilance. "We know that the cases will continue to rise," Sebelius said. [nN29472306]

Mexico's central bank warned the outbreak could deepen the nation's recession, hurting an economy that already shrank by as much as 8 percent from the previous year in the first quarter. [ID:nN29421604]

France said it would seek a European Union ban on flights to Mexico [nLT437502].

The EU, the United States and Canada have advised against non-essential travel to Mexico, and many tourists were hurrying to leave, crowding airports. [ID:nN29407032] (Reporting by Maggie Fox and Tabassum Zakaria in Washington, Jason Lange, Catherine Bremer Alistair Bell and Helen Popper in Mexico City; Matt Bigg in Atlanta; Writing by Andrew Quinn and Dan Whitcomb; editing by Todd Eastham)

http://www.alertnet.org/thenews/newsdesk/N29472619.htm

 

[Panameno718]

Marine Tests Positive for Swine Flu

Updated 8:07 PM PDT, Wed, Apr 29, 2009

Related Topics: James Conway

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1st Lt. Christy Kercheval looks into a tunnel during US marine training at the Twenty-Nine Palms Marine Base on Nov. 14, 2005, near Twentynine Palms, California.

More than 30 Marines at a Southern California base are being confined to quarters after one tested positive for swine flu Wednesday.

Swine Flu in Song

Watch VideoA song making the rounds on YouTube about the swine flu crisis mentions canceled class, masks and Jamba Juice.
Swine Flu Cases on the Rise Worldwide
View SlideshowSwine flu cases are erupting worldwide. The WHO raised the alert level to a phase 5, one level short of declaring a full pandemic.
The Pentagon confirmed Wednesday that the Marine at the Twentynine Palms Base has the swine flu and is under quarantine, along with his roommate.

A Marine spokesman at the Pentagon, Maj. David Nevers, said the sick Marine is doing well and his condition continues to improve.

Nevers said approximately 30 others who had been in contact with the sick Marine at the Twentynine Palms base will be held in quarantine for five days as well as to see whether they show symptoms.

At the end of the five day period, if they display no flu-like symptoms they will be returned to full duty, according to a release from the base.

Meanwhile swine flu fears have led authorities to close a Northern California high school, while San Diego State University officials were investigating a student's illness.

Barracks and schools are breeding grounds for disease transmission because many people are in close quarters.

San Jose's Branham High School will be closed for a week because an unidentified student was suspected of having swine flu. The 16-year-old girl was last in school Thursday. Santa Clara County officials said her sample and 23 others were being tested.

San Diego State University officials announced late Tuesday that one of their students has a suspected case of swine flu, and was receiving treatment after experiencing fever, respiratory illness and testing positive for type A influenza. The student's condition is not considered life-threatening. The school planned a press briefing Wednesday.

Education officials urged parents of the state's 6.3 million students to keep sick kids at home but keep sending healthy children to classes.

Arthur Reingold, the head of the Division of Epidemiology at the University of California, Berkeley, said children are a common conduit for disease so schools are a good place to focus.

"In influenza viruses of any kind, much of the transmission in the community happens among school-age children," he said.

The problem lies in students, especially very young ones, who lack hygiene skills such as keeping coughs and sneezes to themselves, said Dr. Bonnie Sorensen, chief deputy director of the California Department of Public Health.

"Our schools are the germinators," she said.

State health officials said that as of Tuesday night there were 11 confirmed swine flu cases in California. Individual counties have reported other cases that have yet to be confirmed by the state.

Los Angeles County, the nation's most populous with more than 10 million people, had no confirmed cases as of Wednesday morning, said Dr. Jonathan Fielding, the county director of public health.

So far only a handful of public and private schools have closed in California because of confirmed swine flu cases or investigations into illnesses.

Teachers at Highlands Elementary School in Pittsburg contacted parents Tuesday night to tell them the school will be closed for a week after tests from Contra Costa County health officials revealed three probable cases among fourth-graders, Superintendent Barbara Wilson said. The cases had yet to be confirmed by the state.

School authorities, meanwhile, say parents shouldn't keep healthy children home.

"Our schools are safe. We want students to continue to come to school," said Jack O'Connell, state superintendent of public instruction.

San Diego and Imperial counties have five state-confirmed cases each of swine flu.

A private Lutheran elementary school in San Diego, Christ the Cornerstone Academy, was closed Tuesday after a 7-year-old boy was confirmed as having swine flu, said Jose A. Alvarez, a spokesman for the San Diego County Health & Human Services Agency.

It was not immediately clear how the boy contracted the illness. The boy's father and sibling also are suspected of having the flu, said Alvarez.

State officials confirmed one swine flu case in Northern California involving a Sacramento County student. Officials in Sacramento and Marin counties each reported two additional cases, and Santa Clara and Tulare counties each reported one.

Sacramento County health officials said a teenage student at St. Mel School in Fair Oaks who traveled to Mexico did not test positive for swine flu, but three other students did, including the one case confirmed by the state. The school will be closed for the rest of the week.

In Marin County, officials said a 60-year-old woman and her 20-month-old granddaughter tested positive for swine flu after a Mexico vacation that took them to Cancun, Cozumel and Playa del Carmen. They were not hospitalized but were staying home.

Copyright Associated Press / NBC San Diego

http://www.nbcsandiego.com/health/tips_info/39-Marines-Quarantined-Over-Swine-Flu-Fear.html?abc=123

 

[BigUnc]

No big changes as of today.

The pattern is repeating everywhere, you know the drill. X number of suspect cases in ___________ . Health authorities are blah, blah, blah.


A couple days ago FDA gave approval for modifications to the Tamiflu and Relenza dosing and prescribing regimen. DHS Secretary now has authority to give approval to Clinicians to exceed dose limits for both anti virals including prescrbing it to those that were previously contraindicated i.e. chidren under 1. Also gives approval for other persons ( no distinction was made as to education, training etc.) to administer anti virals and vaccines ( when they become available). The authority from FDA has been interpreted to mean OTC sales are permissable, for a fee and availability, if the situation warrants.

 

[Makkonnen]

Nebraska and Minnesota have confirmed cases

 

[Makkonnen]

10 confirmed Swine Flu cases from a school in South Carolina- that same school I posted about before.


CDC: 10 confirmed swine flu in SC

Thursday, April 30, 2009 at 11:47 a.m.

COLUMBIA, SC (AP) -- The Center for Disease Control and Prevention (CDC) has confirmed that 10 probable cases of H1N1 Swine Flu originating out of Newberry County are now confirmed.

This information comes as the CDC expands the number of swine flu cases in the United States to 109 confirmed infections in 11 states.

A South Carolina high school has also closed after students returned from a band trip to Walt Disney World in Florida with flu-like symptoms.

Greenville County School District spokesman Oby Lyles says officials decided to close Mauldin High School on Thursday as a precaution after 18 of 70 students returning from the trip reported illnesses. Lyles says the district is waiting for test results from state health officials.

A Department of Health and Environmental Control spokesman said he could not immediately comment on the school closing.

DHEC is investigating dozens of "suspected" cases of swine flu.

(Copyright ©2009 by The Associated Press. All Rights Reserved.)

 

[Makkonnen]

Georgia and Colorado confirmed cases

A high school here in Greenville closed today after a dozen students on a trip to Florida came back with the flu- they just sent samples to see if it swine flu

Florida will announce cases soon
Alabama and Maine may have cases too

 

[Makkonnen]

AP Investigation: First swine flu death shows Mexico's mixed efforts to contain a killer virus

OLGA R. RODRIGUEZ Associated Press Writer

3:57 PM MDT, April 30, 2009

Patients suspected of having swine flu lie in beds in Aurelio Valdivieso General Hospital in Oaxaca, Mexico, Wednesday, April 29, 2009. Mexico's first reported death from swine flu came from this hospital, according to Mexican federal health authorities. (AP Photo/Alexandre Meneghini) (Alexandre Meneghini, AP / April 29, 2009)





OAXACA, Mexico (AP) — Doctors couldn't figure out what was wrong with the first person to die of swine flu. The 39-year-old woman arrived at their hospital gasping for air, her hands and feet blue from oxygen-starved blood.

They administered antibiotics, but she only got worse. They hooked her to a ventilator. They sent a saliva sample to a local private lab. On April 12, her third day in the intensive care unit, the test results indicated it might be coronavirus — a highly contagious disease associated with severe acute respiratory syndrome, or SARS.

Dr. Jesus Salcedo, director of the Dr. Aurelio Valdivieso General Hospital, realized he had a potential crisis on his hands. The ward Adela Maria Gutierrez shared with at least 20 seriously ill patients had to be quarantined. His terrified staff demanded better protective gear or a transfer.

"The religious ones said, 'This is a punishment from God and we're all going to die,'" Salcedo recalled Wednesday in an exclusive interview with The Associated Press.

A day later, Gutierrez died — just before a second round of tests came back negative for coronavirus.

Hospital and health workers then began a desperate hunt to find the source of the mystery disease and who else may have been contaminated. It has since been identified as a mutated swine flu suspected in 168 deaths in Mexico that has spread to at least eight other countries, triggering an unprecedented global alert.

The case vividly shows why the virus has been so difficult to contain in Mexico.

The medical teams did some of the sleuthing that epidemiologists recommend for tracking a killer bug, interviewing 472 people who may have come into contact with Gutierrez, a mother of three who had been going door-to-door in a temporary job with Mexico's tax collection agency.

They took more samples from Gutierrez and sent them to Mexico's National Institute of Epidemiological Diagnosis and Reference, which forwarded them to a lab in Canada.

They closed the ICU to new patients until the exposed ones were well enough to leave, telling them they should return immediately if they had flu symptoms. None did, Salcedo said.

But the follow-up appears to have been weak — just like the initial response to swine flu outbreaks in other parts of Mexico, where health workers only started visiting the families of victims this week to see if they also contracted the illness.

In the end, only 18 people — all hospital workers — were tested for swine flu after Gutierrez's sample came back positive around April 20, said Dr. Ruben Coronado, director of Oaxaca's department of epidemiology.

In her last days, Gutierrez had worked closely with another temporary employee, interviewing taxpayers and filling out forms to update the tax registry. That woman had a bad cough, her family said, and was from Veracruz, the state where Mexico's earliest case of swine flu was confirmed: 5-year-old Edgar Hernandez, who survived.

About 450 people had been diagnosed in the Veracruz town of La Gloria with acute respiratory infections, but only 35 were tested for the new virus. Edgar's was the only test that came back positive.

Gutierrez lived in a two-story home where the family runs a convenience store. Her husband, a welder, declined to be interviewed.

"They're really afraid and they don't know what's going on," state Health Secretary Dr. Martin Vasquez said of the family.

Gutierrez was buried the day she died, odd in Mexico where a wake is customarily held overnight, with burial held the next day. Already rumors were circulating that she died of a very contagious disease.

Four houses away, Hermelinda Leon was too frightened to attend the wake. She, her husband and three children had all been ill with similar symptoms starting April 7. Leon had a fever of 104 degrees Fahrenheit and spent several days in bed before her doctor gave her antiobiotic injections. Antibiotics don't kill viruses, although they may work against related bacterial infections that sometimes occur.

"When they told me the neighbor died from a sore throat, I was worried because I was so sick from a sore throat, I felt like I was going to die," she said.

The Leon family recovered without the help of Tamiflu or other antiviral medicines. Salcedo said his hospital didn't have any at the time, but has since stocked up and is treating 11 people with Tamiflu.

Three days later, health workers came to interview Leon, who caters food to Oaxaca hotels. They asked about the family's illness, symptoms, their medications and said they would return to give them a special test. She said they never did.

A day after Salcedo learned from the Canadian lab that Gutierrez had swine flu, two other patients died of pneumonia in the Oaxaca hospital. They weren't tested for swine flu because they didn't show atypical symptoms, Salcedo said. Gutierrez's family also never showed any symptoms, he said.

Coronado said only 18 of all the people interviewed were tested for swine flu because the others didn't show signs of the disease — even though Leon's family had similar symptoms. Coronado told AP he wasn't familiar with the Leon case.

Of the 18 saliva samples taken from medical staff, 12 did not have enough cells to be tested. The other six came back negative for swine flu, Coronado said.

Health officials say Oaxaca's 11 current cases of suspected swine flu are unrelated to the tax workers, but the lack of followup with the Leon family suggests they haven't tracked down every connection. Three victims remain hospitalized and eight went home after receiving anti-viral drugs. No other cases in Oaxaca have been confirmed.

Salcedo guessed that no one else in the Gutierrez and Hernandez families got sick because their immune systems were simply strong enough to withstand the swine flu virus.

Mexico's Health Secretary Jose Cordova said it remains a mystery why some die and others don't even get sick. They still don't have enough information to determine the swine flu's contagion and mortality rates.

"We still don't know why it's more aggressive in some people and not in others," Cordova said.





Copyright 2009 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

 

[Makkonnen]

NJ and Delaware Confirmed cases

Florida and Pennsylvania likely cases



Mexican health officials are totally inept. We won't know shit about what to expect until this crap makes its way through our nation.


US Health officials aren't much better

Read the next story for proof

 

[Makkonnen]

Mom worries as swine flu hits 5 in N.Y. family
Slow school response, indifferent attitudes may endanger kids, she says
By JoNel Aleccia
Health writer
updated 3:30 p.m. ET, Thurs., April 30, 2009

One confirmed case of swine flu was scary enough, but Jacqueline Civitano spent this week worrying as five family members developed high fevers, coughing, dizziness and other signs of the virus that’s sweeping the globe.

By Wednesday, the fear had subsided for the Floral Park, N.Y., mother of seven, who was simply stuck in the house under isolation trying to entertain a crew of mildly sick, stir-crazy kids.

But she said there’s still plenty of worry to go around, judging by the community response to the outbreak, which began a week ago, when her 17-year-old son, Frankie, became one of more than 50 students from St. Francis Preparatory School in Fresh Meadows, N.Y., to contract the potentially deadly illness. A group of students from that school had just returned from a trip to Mexico, although Frankie wasn't among them.

“It was handled very poorly,” said Civitano, 41, a lawyer with the New York state court system. “It went from being not a big deal to being this big panic.”

So far, the U.S. has confirmed more than 100 swine flu cases in 17 states, and one death of a toddler who traveled from Mexico to Texas for treatment. In that country, 168 deaths have been linked to the outbreak and nearly 3,000 may be sick.

But when the swine flu was discovered in New York last week, communication lagged, information wasn’t clear and school officials’ reactions to news of the virus ranged from appropriate concern to a complete lack of interest, said Civitano, whose children range in age from 2 to 24 and who span the educational spectrum from elementary school through college.

“I just think we’re very ill prepared,” she said.

It took news crews parked in front of St. Francis and a text message about scores of sick kids from her son’s girlfriend before Civitano understood that the seemingly simple flu that kept Frankie home last Friday actually was something far more serious.

“When I called him in sick, they didn’t tell me that so many other kids were sick,” Civitano said. “Then we seen on the news they were testing for swine flu.”

Civitano said she heard nothing from the school, despite the growing roster of illnesses.

Brother Leonard Conway, principal of St. Francis, said health officials weren’t able to test suspected cases until Friday or confirm them until Sunday and school staff didn't want to speculate.

“We updated the Web site immediately each time we got confirmed, accurate information,” he said.

Hospital confirms flu infection
But Frankie’s 103-degree fever and his cough and headache worried Civitano, who called her family doctor, Dr. Vincent Alfieri, on Saturday. He prescribed preventive doses of antiviral medication for the family, and then sent Civitano to North Shore University Hospital, where doctors on Sunday confirmed that Frankie had a Type A influenza infection that didn’t match any already circulating strains.

“Because other kids had tested positive for swine flu, they assumed that’s what he had,” said Civitano, noting that Frankie’s sample was sent to the federal Centers for Disease Control and Prevention for confirmation.

By Monday, Civitano’s other children started coming down with flu symptoms. First Anthony, 19, who had a mild cough and sore throat, and then Brendan, 10, who has health problems, including diabetes.

“Anything for him can become so much more serious,” Civitano said.

Indeed, Brendan’s symptoms were severe: high fever, extreme headache and cough, nausea, dizziness and sensitivity to light and sound.

Nicholas, 2, was next with milder symptoms, and then Katie, Civitano’s 24-year-old daughter-in-law, called to say she’d come down with flu after visiting over the weekend. Fortunately, Katie’s 3-month-old baby was spared.

All this illness naturally concerned Civitano, who had heard news reports of deaths in Mexico. But she approached the situation with a matter-of-fact attitude:

“I said, ‘Great, here we go,’ ” recalled Civitano, noting that neither she nor her husband, Paul, a 45-year-old carpentry supervisor, have been ill at all.

In between comforting her sickly kids, Civitano reached out to alert school officials that others might have been exposed — and was surprised at the range of responses.

At the University of New Haven in New Haven, Conn., officials asked Anthony to stay away from class.

“Best to keep him home, just in case,” said Julie Winkel, a school spokesperson.

But at St. John’s University in Queens, staff told Christopher, 20, who had no symptoms, to come on in.

Since then, school officials have confirmed a case of swine flu in one student, alerted the campus community and urged students to take protective measures, said spokesman Dominic Scianna.

School officials dismiss concerns
And at Our Lady of the Snows, the elementary school where 5-year-old Katherine goes, school officials appeared to dismiss her concerns out of hand, Civitano said.

“I thought, ‘OK, you know what, I’d done my part,’ ” she said, noting that she kept Katherine home even though the child didn’t become ill. “I’m not going to take a chance on being responsible for infecting other kids.”

Sister Roberta Oberle, the school’s principal, declined to comment on the Civitano family’s situation.

Everyone at Civitano’s house is recovering now. That appears to be one hallmark of this virus: a sudden onset and an equally sudden easing of symptoms, she said.

“Brendan really got the worse dose,” Civitano said. “But by yesterday, it was like it didn’t happen.”

No one can return to work or school, however, until a week has elapsed since the last onset of illness, and until Dr. Alfieri clears them with a written note.

Civitano is certain life will return to normal, despite her brush with a near-pandemic virus. But she worries that other cases, in other communities, might not be so mild.

She wants school and public health officials to let parents and others know what’s happening early, and for them to take steps to prevent others from being exposed.

“You need to take this seriously,” she said. “You need to not downplay this, because when other kids get sick, it’s going to be too late.”
© 2009 msnbc.com Reprints

URL: http://www.msnbc.msn.com/id/30486742/

 

[BigUnc]

Still the same pretty much. H1N1 spreading rapidy across the planet.

The key is virulence.So far it's very contagious but not particularly deadly. If this strain becomes more deadly then it becomes a different game.I'm still expecting it to burn out fairly soon then the concern would be if it mutates and returns later on this year stronger and more deadly. Also H1N1 would have gotten a taste of Tamiflu. It may return more resistant to it.

 

[QueEx]

Thanks for keeping us up, Bro.

QueEx

 

[BigUnc]

Thanks for keeping us up, Bro.

QueEx

No problem. Ran across this open source article which has important info:



First genetic analysis of swine flu reveals potency
18:36 01 May 2009 by Debora MacKenzie

The H1N1 flu continues to spread around the world, with cases now confirmed from more than a dozen countries, from Hong Kong to Canada.

Yet the first genetic analysis of how well this virus transmits from person to person concludes that it spreads barely well enough to keep itself going.

The analysis also suggests the virus may have started circulating as long ago as January. But because there have been so few cases to analyse, the calculation is uncertain. It could have started more recently, or as far back as September.

Nicholas Grassly of Imperial College London and Andrew Rambaut of the University of Edinburgh, UK, have analysed the rate of spread. Their analysis is based on the small mutations that have accumulated in almost two dozen genetic sequences produced so far, from viruses collected from patients in Mexico and the US.


"The limited sampling so far gives rise to considerable uncertainty in the estimate," cautions Rambaut. But if the rate at which genes mutate is about the same for this virus as for other H1N1 viruses, the number of mutations that have accumulated so far suggests it has been circulating since January – or even September 2008.

Weak virus
If the new virus spreads from one infected person to the next at about the same speed as ordinary flu, that gives an idea of how many cases there may have been in that time. A mathematical model permits the calculation of an important variable called R0 – the number of additional people infected, on average, by each case. If R0 is less than one, an infection dies out.

Grassly also cautions that the estimate is very preliminary. But with the data available now, he gets an R0 of 1.16 – enough for the virus to keep going, but only just.

This could be good news. In epidemiological theory, at least, the lower the R0, the easier it may be to snuff the virus out by further hindering its spread.

But it may be too early for celebrations. The 1918 flu pandemic, caused by another H1N1 virus, started with a mild, early wave in spring and early summer. The flu lab at the Los Alamos National Laboratory in the US estimates that the R0 of the 1918 virus in spring was only 1.45. That shot up, they estimate, to 3.75 when the virus began its lethal second wave the following autumn.

Much may now depend on how quickly the new H1N1 virus from swine adapts to people.