Swine Flu in Mexico

[Garnet]

How concerned should we be? (http://www.nytimes.com/2009/04/26/world/americas/26mexico.html?_r=1&ref=world)

[VoxRat]

How concerned should we be? (http://www.nytimes.com/2009/04/26/world/americas/26mexico.html?_r=1&ref=world)

Speaking as a virologist, I'd say: "somewhat".

[Garnet]

I was hoping you'd answer, VoxRat. I shan't be pushing the panic button yet, then.

[Daynna]

I'm concerned that we are ALL GOING TO DIE.

Mostly, I'm worried we'll have to wear those surgical masks just as summer gets here. Those things get sweaty!

[VoxRat]

I'm concerned that we are ALL GOING TO DIE.Well, don't worry about that; that's pretty unlikely. But even nasty pandemics that come nowhere near 100% fatality can be pretty... nasty. I remember getting the "Hong Kong" flu in 1968. I was 16 years old; pretty much in "my prime". It was certainly enough to educate me to the fact that, even though "colds and flu" medicines are advertised sort of as one thing, the diseases are in whole different categories of seriousness.

I'd have to look up the mortality figures on Hong Kong flu; a lot of people died, but it was still a pretty small fraction of those that got sick.

Mostly, I'm worried we'll have to wear those surgical masks just as summer gets here. Those things get sweaty!Flu, like a lot of diseases, is seasonal. So the fact that it's summer means that there's going to be a major roadblock to the replication of this thing. I doubt that we'll need to wear surgical masks during the summer. But when flu season gets started again next Fall, if this thing hasn't been contained, Look Out!!!

[crazyfingers]

I can't say that I'm thrilled that I have to fly on 4 airplanes starting next Sunday to speak at conferences in Phoenix and Los Angeles.

Voxrat, are those drug store medical masks really any good for this? (Thinking about the airplane rides)

[VoxRat]

I can't say that I'm thrilled that I have to fly on 4 airplanes starting next Sunday to speak at conferences in Phoenix and Los Angeles.

Voxrat, are those drug store medical masks really any good for this? (Thinking about the airplane rides)I worry about airplane rides, too. The surgical masks probably are reasonably effective for coughs and sneezes. But I think if people really took HAND WASHING seriously, it would make a bigger difference.

Really, people: the OCD hand-washers aren't the crazy ones; it's the rest of us.

Well, OK. There's probably a Happy Medium.

[crazyfingers]

I can't say that I'm thrilled that I have to fly on 4 airplanes starting next Sunday to speak at conferences in Phoenix and Los Angeles.

Voxrat, are those drug store medical masks really any good for this? (Thinking about the airplane rides)I worry about airplane rides, too. The surgical masks probably are reasonably effective for coughs and sneezes. But I think if people really took HAND WASHING seriously, it would make a bigger difference.

Really, people: the OCD hand-washers aren't the crazy ones; it's the rest of us.

Well, OK. There's probably a Happy Medium.

Lysol wipes on my arm rest? (not panicking here. Just gathering knowledge)

[Joykins]

I can't say that I'm thrilled that I have to fly on 4 airplanes starting next Sunday to speak at conferences in Phoenix and Los Angeles.

Voxrat, are those drug store medical masks really any good for this? (Thinking about the airplane rides)I worry about airplane rides, too. The surgical masks probably are reasonably effective for coughs and sneezes. But I think if people really took HAND WASHING seriously, it would make a bigger difference.

Really, people: the OCD hand-washers aren't the crazy ones; it's the rest of us.

Well, OK. There's probably a Happy Medium.

Whenever my kids get sick I turn into Lady Macbeth and the skin peels off my hands and they get cracks too. I'm not OCD, I just hate getting sick.

IIRC the 1919 Spanish flu had a mortality rate ranging between 5-20% depending on where. That is the worst flu we know about. If I've been processing the stats correctly (and the figures are accurate), this flu has a likely mortality rate topping out at about 6% where it is highest (in Mexico) but the stats could be way wrong.

[Joykins]

This is probably the most helpful thing I've read tbh
http://www.cdc.gov/swineflu/guidance_homecare.htm

[LoneWolf]

How concerned should we be? (http://www.nytimes.com/2009/04/26/world/americas/26mexico.html?_r=1&ref=world)

Speaking as a virologist, I'd say: "somewhat".

Yeah, my friends in the CDC over here said pretty much the same thing. It isn't worth freaking out over, but it definitely needs to be watched.

[LoneWolf]

I can't say that I'm thrilled that I have to fly on 4 airplanes starting next Sunday to speak at conferences in Phoenix and Los Angeles.

Voxrat, are those drug store medical masks really any good for this? (Thinking about the airplane rides)I worry about airplane rides, too. The surgical masks probably are reasonably effective for coughs and sneezes. But I think if people really took HAND WASHING seriously, it would make a bigger difference.

Really, people: the OCD hand-washers aren't the crazy ones; it's the rest of us.

Well, OK. There's probably a Happy Medium.

Hey Vox, I have always wondered: doesn't obsessive cleaning just make it more likely that the more resilient pathogens will get a foothold? Or am I using faulty logic there?

[DMB]

So far, the fatalities among people in Mexico have been among those younger than 45, so the older population have some herd immunity, as you might expect with a virus that has been around for years and for which we have vaccines.

AFAIK the cases in the USA have been milder and no-one has died.

[Monad]

What we really need is drugs that can dampen a cytokine storm. The younger people die in these types of pandemic precisely because they have healthy functioning immune systems. That's my biggest concern. Co infection is also a big issue - a lot of people died in 1918-19 (which was also H1N1 but a different strain) from bacterial pneumonia.

eta it looks like this one is a human seasonal strain with genetic elements from both swine and bird flu so it's probably been stewing for some time in communities that have contact with pigs and fowl, constantly cross infecting and mutating till it has got to a point where it can spread between humans (the big problem most non human flu have is they can infect humans but because the initial site of infection is different in different species - in non human flu it's usually deeper in the lungs, not upper respiratory tract - infection requires prolonged exposure and further transmission is less likely - what it looks like here is it has switched the site of initial infection, probably through the seasonal flu element)).

http://news.bbc.co.uk/1/hi/world/americas/8018991.stm

[Pendaric]

This isn't how the world ends then. I saw the headlines on BBC News and I'll admit to fanciful thoughts of 28 Days Later and suchlike.

Guess I won't be being chased by zombies in the immediate future then (or if I am it won't be anything to do with this).

[Mung Dynasty]

Swine flew.

http://www.liveeverett.com/Portals/3/flying%20pig.jpg

[Norrin Radd]

I think I saw Randall Flagg skulking about.

[VoxRat]

...
Hey Vox, I have always wondered: doesn't obsessive cleaning just make it more likely that the more resilient pathogens will get a foothold? Or am I using faulty logic there?No, I don't think there's much chance of that.

Resistance can evolve in cases like antibiotics, where you're surgically targetting one enzyme; one chink in the critter's armor.

Washing physically gets rid of the little buggers.

You have some viruses, like polio (and a host of close relatives that you've undoubtedly had) that have evolved to survive the digestive tract. They are amazingly hardy and can actually survive exposure to soap and acid. But physical removal - they have no way around that.

And you have some bacteria that are good at holding on to their preferred surface (and can be pretty soap/chemical resistant) but I can't think of any that would be good at both (a) holding on to a surface like a hand, or a doorknob, AND (b) causing an internal infection, like flu. All viruses need to be somewhat mobile, which makes evolution of resistance to washing a pretty daunting challenge.

[Soul Invictus]

I don't understand this (http://www.forbes.com/feeds/hscout/2009/04/26/hscout626462.html):

"quote=Schuchat said Thursday that the virus in the United States is influenza A N1H1 mixed with swine influenza viruses. The virus contains genetic pieces from four different flu viruses -- North American swine influenza, North American avian influenza, human influenza viruses and swine influenza viruses found in Asia and Europe, she said[/quote]

How is this possible? Is this normal? The conspiracy theorist in me thinks this is some deliberate plan to make a stronger "new" virus.
:hmm:

[dancer_rnb]

All those crosses didn't have to happen at once.

Either that, or I must have been made in a lab somewhere.:)

[DMB]

I don't understand this (http://www.forbes.com/feeds/hscout/2009/04/26/hscout626462.html):

"quote=Schuchat said Thursday that the virus in the United States is influenza A N1H1 mixed with swine influenza viruses. The virus contains genetic pieces from four different flu viruses -- North American swine influenza, North American avian influenza, human influenza viruses and swine influenza viruses found in Asia and Europe, she said

How is this possible? Is this normal? The conspiracy theorist in me thinks this is some deliberate plan to make a stronger "new" virus.
:hmm:[/QUOTE]

Tamp your inner conspiracy theorist down! It would be really daft to create a global pandemic when no country would be immune.

[LoneWolf]

...
Hey Vox, I have always wondered: doesn't obsessive cleaning just make it more likely that the more resilient pathogens will get a foothold? Or am I using faulty logic there?No, I don't think there's much chance of that.

Resistance can evolve in cases like antibiotics, where you're surgically targetting one enzyme; one chink in the critter's armor.

Washing physically gets rid of the little buggers.

You have some viruses, like polio (and a host of close relatives that you've undoubtedly had) that have evolved to survive the digestive tract. They are amazingly hardy and can actually survive exposure to soap and acid. But physical removal - they have no way around that.

And you have some bacteria that are good at holding on to their preferred surface (and can be pretty soap/chemical resistant) but I can't think of any that would be good at both (a) holding on to a surface like a hand, or a doorknob, AND (b) causing an internal infection, like flu. All viruses need to be somewhat mobile, which makes evolution of resistance to washing a pretty daunting challenge.

Thanks, that clears it up.

[VoxRat]

I don't understand this (http://www.forbes.com/feeds/hscout/2009/04/26/hscout626462.html):

said Thursday that the virus in the United States is influenza A N1H1 mixed with swine influenza viruses. The virus contains genetic pieces from four different flu viruses -- North American swine influenza, North American avian influenza, human influenza viruses and swine influenza viruses found in Asia and Europe, she said

How is this possible? Is this normal? The conspiracy theorist in me thinks this is some deliberate plan to make a stronger "new" virus.
:hmm:
No, no conspiracy.
It's one of the special characteristics of influenza virus, as opposed to most viruses. It has 8 separate segments to its genome, in much the same way we have 23 different chromosomes. So whenever you get a mixed infection with two influenza viruses in one cell (not common, but given the billions of opportunities, it happens countless times every year around the globe) you have the opportunity to "mix and match". I.e. the progeny virus might have segments #1-4 and 6-8 from parent virus A, and segment #5 from parent virus B. This is called "reassortment". Just like with any random mutation, the reassortants are subject to natural selection: the ones that are best at spreading come to dominate.

[VoxRat]

All those crosses didn't have to happen at once.

... Exactly. Segment #5 might have been picked up in a pig virus X avian virus cross in one event, then THAT virus is the parent of another hybrid in which it picks up segment #3 from yet another virus, say one that's particularly good at infecting humans, etc....

[LoneWolf]

I have been very slowly making my way through a book called A Short History of Nearly Everything by Bill Bryson. A long but very entertaining read about science and how we know what we know about the universe and our world. There is some discussion in it about diseases and epidemics and it talks about one of the worst was the Great Swine Flu of 1918. Millions of people, to include over half a million in the US alone, died of it. And then it quickly burned itself out. But the following words were kind of spooky to read :

"No one can rule out the possibility that the Great Swine Flu epidemic might once again rear its head."

[Monad]

Yeah that's why I said these sort of variants tend to evolve where people have regular contact with pigs and fowl. Then there is more chance for someone who has human flu for it to swap genetic material in the host with genes from other variants. This has probably been stewing for some time in the local population.

[Notta]

When I was working at the National Institutes of Health, I was charged with writing a magazine article (never published) about pandemics. One of the KEY CHARACTERISTICS of a pandemic virus is one that has infected more than one species (bird and pig).

Flu viruses arise in birds; most wild birds and many domestic birds are host to numerous flu viruses. These generally do not cause illness in birds (just as SIV/HIV does not cause a fatal illness in chimpanzees).

Pigs also harbor viruses; SARS came from a pig-derived respiratory virus.

When a bird virus infects a pig, and the pig's DNA machinery mutates the bird flu virus, it becomes something much more dangerous. Humans and pigs share many of the same genes (which is why some heart-valve replacements come from pig hearts, and insulin used to be made in pigs). Once it escapes the pig and can infect humans, it's a virus of concern.

But the final step in whether something can create a pandemic is if it can be transmitted from human-to-human and not lose its virulence. For bird flu (H5N1), the human-to-human cases have been minimal. It also has lost virulence in those cases. Many of the second and third transmission cases fully recover.

But in this current outbreak, the human-to-human transmission seems to lose none of its strength, and it is quickly spreading. So, YES, this is a very dangerous virus! Why do you think Mexico is closing all schools, theaters, sporting events, etc.? Why do you think the British government has quarantined someone who recently came down with flu symptoms on a plane arriving from Mexico?

The Spanish flu of 1918-1919 mainly killed young adults aged 20 - 40. This flu is doing the same thing. Common flu (the kind we see each winter & spring) kills the very young and the very old. (By the way, the "Spanish flu" was the H5N1 "bird flu" virus.)

Based on what I had to research about an article on pandemic flu, I'm very scared. "Swine flu" is no less dangerous than "bird flu" -- considering that pigs are the 'mixing bowl' for the most dangerous flu viruses we've ever seen.

[Notta]

The CDC has always known it's not a matter of IF a new pandemic strain arises, it is WHEN.

And this one fits the bill very neatly.

[VoxRat]

When I was working at the National Institutes of Health, I was charged with writing a magazine article (never published) about pandemics. One of the KEY CHARACTERISTICS of a pandemic virus is one that has infected more than one species (bird and pig).

Flu viruses arise in birds; most wild birds and many domestic birds are host to numerous flu viruses. These generally do not cause illness in birds (just as SIV/HIV does not cause a fatal illness in chimpanzees). I don't know what the range of symptoms is in birds, but some of these certainly do cause significant disease in birds.Pigs also harbor viruses; SARS came from a pig-derived respiratory virus.Actually, it seems to have come from civet cats (http://www.bio-medicine.org/medicine-news/Origin-Of-SARS-Virus-Discovered-0D-0A-2029-1/). I don't think pigs were involved in that one, though early hypotheses to that effect were given a lot of press.

When a bird virus infects a pig, and the pig's DNA machinery mutates the bird flu virus, it becomes something much more dangerous.Well, now... wait a minute. The pig's DNA machinery has nothing to do with it. The virus, like any virus, mutates in the course of replication. RNA viruses (like influenza) mutate a lot faster than DNA genomes - orders of magnitude faster. So when a virus that is well adapted to birds finds itself in a new niche (mammals), mutations that favor replication in that new host will rapidly pop up, and will be rapidly amplified by natural selection.

...
But the final step in whether something can create a pandemic is if it can be transmitted from human-to-human and not lose its virulence. For bird flu (H5N1), the human-to-human cases have been minimal. It also has lost virulence in those cases. Many of the second and third transmission cases fully recover.

But in this current outbreak, the human-to-human transmission seems to lose none of its strength, and it is quickly spreading. So, YES, this is a very dangerous virus! Why do you think Mexico is closing all schools, theaters, sporting events, etc.? Why do you think the British government has quarantined someone who recently came down with flu symptoms on a plane arriving from Mexico?It definitely merits attention. The Spanish flu of 1918-1919 mainly killed young adults aged 20 - 40. This flu is doing the same thing. Common flu (the kind we see each winter & spring) kills the very young and the very old. (By the way, the "Spanish flu" was the H5N1 "bird flu" virus.)No, it was an H1N1 virus. But it does seem that both the H and N genes (the ones that occur on the surface of the virus) had been recently acquired from avian viruses. Here's a good summary (http://www.cdc.gov/ncidod/eid/vol12no01/05-0979.htm) from one of the leading experts on the subject.Based on what I had to research about an article on pandemic flu, I'm very scared. "Swine flu" is no less dangerous than "bird flu" -- considering that pigs are the 'mixing bowl' for the most dangerous flu viruses we've ever seen.I'm concerned. But I'm not "very scared". The mortality rate doesn't seem that bad. And I really doubt it's going to explode before next flu season, by which time we should have learned enough about it to prevent anything like the 1918 catastrophe.

But taking this seriously, and taking seriously the quarantine measures you mentioned by the Mexican and British governments, are among the factors that will prevent this from becoming a 1918-style catastrophe.

This time.

[dancer_rnb]

I have been very slowly making my way through a book called A Short History of Nearly Everything by Bill Bryson. A long but very entertaining read about science and how we know what we know about the universe and our world. There is some discussion in it about diseases and epidemics and it talks about one of the worst was the Great Swine Flu of 1918. Millions of people, to include over half a million in the US alone, died of it. And then it quickly burned itself out. But the following words were kind of spooky to read :

"No one can rule out the possibility that the Great Swine Flu epidemic might once again rear its head."

THE GREAT INFLUENZA by John M Barry indicates that the 1918 flu swept through at least two times, mutating in the process. Or was it three? Have to reread it. Anyways, the second wave was the worst.

Also, the government in the US kept minimizing the problem until it blew up in their faces.
Didn't want to effect the war effort.

[Notta]

Well, now... wait a minute. The pig's DNA machinery has nothing to do with it. The virus, like any virus, mutates in the course of replication. RNA viruses (like influenza) mutate a lot faster than DNA genomes - orders of magnitude faster. So when a virus that is well adapted to birds finds itself in a new niche (mammals), mutations that favor replication in that new host will rapidly pop up, and will be rapidly amplified by natural selection.I was trying to simplify the process by which viral DNA and host DNA can become intermixed. But I learned that the process by which this happened was due to reassortment, which you alluded to in one of your earlier posts. I'm concerned. But I'm not "very scared". The mortality rate doesn't seem that bad. And I really doubt it's going to explode before next flu season, by which time we should have learned enough about it to prevent anything like the 1918 catastrophe. While we are both entitled to our opinions, neither one of us has any factual evidence on which to base our concerns over whether this will 'explode' before the next flu season. All I'm saying is that it is currently following the pattern of the 1918 flu.

But taking this seriously, and taking seriously the quarantine measures you mentioned by the Mexican and British governments, are among the factors that will prevent this from becoming a 1918-style catastrophe.

This time.
I was wrong about the 1918 flu being a strain of H5N1 - it was H1N1. And so is this current virus.

All influenza type A viruses start in avians, though, and many of them cause asymptomatic diseases. All of the most virulent influenza type A viruses identified in the last century have started in birds, moved to pigs, and thence to humans. H5N1, while certainly deadly, has not yet made that jump from a bird-to-human to human-to-human infection that maintains virulence.

And I wouldn't take the stance that low fatality rates in the US mean the risks are not that high. As far as I can tell from the news reports, most US citizens who had it so far are teenagers/schoolkids. In the past flu pandemics, that age group had extremely low fatality rates. In Mexico, the highest fatality rate is in those under 40 and 20 - precisely the same group that died at a rate of 2 - 20%, much higher than usual for any age group during a flu epidemic.

All I currently really KNOW is that the CDC has declared a public health emergency in the US, and there was supposed to be a press conference at the White House at 12:30 today. No one who works at a national or international level on preventing a pandemic is taking this at anything less than the most serious levels.

And, on a more serious note, I took part in a two year bird flu vaccination trial at NIH, and flu manufacturers are in no way prepared to develop an effective H1N1 vaccine. Full human trials have not progressed beyond Phase I - so they haven't even tested people who had all or part of the first types of vaccines.

[VoxRat]

... While we are both entitled to our opinions, neither one of us has any factual evidence on which to base our concerns over whether this will 'explode' before the next flu season. All I'm saying is that it is currently following the pattern of the 1918 flu.This is very true.

I know some of the experts who will undoubtedly be opining on The News Hour and such this week.

I doubt there's unanimity of opinion amongst them about the likelihood of this turning into a 1918-like situation, just as opinions vary among them as to the probability of the H5N1 mutating into a major human threat.

[Notta]

I doubt there's unanimity of opinion amongst them about the likelihood of this turning into a 1918-like situation, just as opinions vary among them as to the probability of the H5N1 mutating into a major human threat.They've been trying to prepare world-wide for such an eventuality for the past 5 years or so.

All government & state offices have emergency plans for dealing with a pandemic illness. The infection & mortality rates in the next few weeks will give them a better indication of what they're dealing with.

[Notta]

Why are US news agencies not reporting possible flu cases in Canada and the UK? And New Zealand, France, and Israel have possible cases. Daily Mail (http://www.dailymail.co.uk/news/worldnews/article-1173263/Killer-pig-flu-threat-UK-Two-people-admitted-British-hospital-virus-killed-86-spreads-worldwide.html). Or is the Daily Mail an unreliable news source?

I know there are confirmed cases in NZ.

Why are US news outlets mum on this? Even the CDC's Web site confirms the NZ cases.

[VoxRat]

They've been trying to prepare world-wide for such an eventuality for the past 5 years or so. It's a lot like The Big Earthquake, in California. It's coming. It's not a question of "if", but "when". The chances are, for any given tremor, that it's not going to turn out to be The Big One. But sooner or later, one of them will. All government & state offices have emergency plans for dealing with a pandemic illness. The infection & mortality rates in the next few weeks will give them a better indication of what they're dealing with.Exactly.
Like I say, I'm concerned. The last thing we want is for people to start regarding these news flurries as Chicken Little episodes. That's partly why I worry that sometimes the news reports get a little panicky. If'n'when it turns out to be less of threat than hyped, or even if it was as bad a threat as all that, and it was averted by people and agencies taking judicious measures, there's the danger that in 2012, say, when The Real Thing breaks out, people will react with "yeah, yeah, yeah... just like that 2009 thing. Gimme a break."

[Puck]

I remembered reading something from the Jet Blue site last week and seeing this:

The total cabin air content on each of our aircraft is replaced more than 30 times an hour which is more than once every two minutes; this far exceeds the exchange rate in an office building. In addition, each two-minute cycle is made up of half fresh air and half recirculated air.

Our aircraft HEPA filters offer filtration comparable to those used in hospital operating rooms and are capable of trapping contaminants down to 0.3 micron in size.

Although that doesn't protect you from the person next to you I suppose, is filtering down to 0.3 microns enough to protect against this flu in general? I checked the AA site, and they only mentioned adding Oxygen to the cabin, but not anything about filtering, does anyone know if other airlines use a good filtering system?

[DMB]

All I know is that I pick up a respiratory disease on about 50% of long-distance flights I go on.

[Febble]

Excellent Flu Wikie (http://www.fluwikie.com/) here.

It was started by DemFromCT, one of the front-pagers at DailyKos and a pulmonary physician, and he has a good diary on DKos here:

http://www.dailykos.com/storyonly/2009/4/25/724448/-UPDATE:-More-Swine-Flu-Cases:-KS-and-NYC

[Notta]

All I know is that I pick up a respiratory disease on about 50% of long-distance flights I go on.For me, the infection rate is about 75%. Over the last three years (when I started traveling by air about once every 8 - 12 weeks), all but ONE upper respiratory infection I caught was in an airport or on an airplane (2 - 3 per year). I know I caught them from air travel because (1) I was seated next to a very sick person, and (2) no one else in my office or home had them, and (3) I came down with them within 3 days of being exposed to the ill person at the airport/airplane.

[VoxRat]

0.3 microns would certainly be good enough to stop pretty much any virus. The particles can be smaller than that, but they always travel in aerosol droplets.

No, the danger is more from the people crammed in near you at close quarters. I may have a better immune system than others here; I get sick after airtravel maybe 10% of the time. But it seems to me I get sick after air travel - usually respiratory things - a lot more than without air travel.

[Notta]

Vox, I remember reading a study about how cold and flu germs were spread. The biggest single method of infection is hand-to-mouth contact.

Cold and flu germs can live for more than a day on a hard surface (door knobs, table tops, telephones, etc.), so it is essential to keep your hands clean.

Asian cultures use the surgical masks when a person has a cold or flu to help prevent the aerosol spreading of infectious particles. Americans tend to think that you'd wear a mask to stop INHALING the particles. Wearing a mask for both reasons would be more helpful.

Even if you sit right next to a person suffering from a cold or the flu, if you're obsessive about not touching any part of your face without first washing your hands, you have a better chance of not coming down with an infection. This goes for touching things that then touch you face, such as a water glass or a sandwich, too.

One thing I noticed about working at NIH: it was the FIRST and ONLY place I've ever been employed where, if I came in sick, I was sent home ASAP. No one thought it was a good idea for me to sit in my office, wheezing and sneezing and infecting others, just to get some work done. When I taught, I actually spent two weeks in my classroom with a terrible case of flu, because my principal thought that only cancer treatments or surgery were appropriate 'sick day' excuses. I was usually ill with upper respiratory infections from September through May, with some severe bouts of bronchitis and pneumonia, all because my supervisors thought it's better to be sick and at work than take a day or two off. It's this attitude that will foster a pandemic in the US. Think of how fast flu will spread through a population that shares mass transit, workrooms, lunchrooms, and the like when people are pretty much mandated to come to work no matter how sick they are!

[VoxRat]

Vox, I remember reading a study about how cold and flu germs were spread. The biggest single method of infection is hand-to-mouth contact.

Cold and flu germs can live for more than a day on a hard surface (door knobs, table tops, telephones, etc.), so it is essential to keep your hands clean.
...
Even if you sit right next to a person suffering from a cold or the flu, if you're obsessive about not touching any part of your face without first washing your hands, you have a better chance of not coming down with an infection. This goes for touching things that then touch you face, such as a water glass or a sandwich, too.This is very true.

One thing I noticed about working at NIH: it was the FIRST and ONLY place I've ever been employed where, if I came in sick, I was sent home ASAP. ...One particular year I was teaching medical students medical virology, I had an uncanny knack for coming down with the disease in question, right about on schedule for the lecture on that disease. Including the flu. As I was boning up for the lecture the night before, going over the symptoms, I kept thinking... "ya know...? but.... nah! Must be psychosomatic." Well, that's one of the key things about flu symptoms: they tend to come on fast. One minute you can be fine, and half an hour later, there's often no doubt you're pretty sick. I did show up for the lecture, but colleagues were not shy about telling me I looked like death warmed over.


ETA: It was scary. I got the gastrointestinal thing right on schedule for the GI virus lecture. People started holding their breaths, waiting for the encephalitis virus lecture. Fortunately the pattern didn't hold up for that one. (Though I have had a bout of viral meningitis - which I can't really recommend with much enthusiasm.)

[Daynna]

Maybe I missed it in this thread. Does anyone know if the fatalities have been children and/or people with pre-existing health problems? Any healthy young adults?

[Notta]

Maybe I missed it in this thread. Does anyone know if the fatalities have been children and/or people with pre-existing health problems? Any healthy young adults?Many of the current fatalities have been in healthy, young adults.

[Daynna]

It's amazing to read this thread and just watch the conspiracy theories forming:

http://rr-bb.com/showthread.php?t=90470

Gets even better on page 2. I started to feel unclean by the third page.

(I don't read that forum, it was posted on FARK)

[sohy]

http://www.nytimes.com/2009/04/26/world/americas/26flu.html?ref=health



In each year’s flu season, most deaths are in infants and the aged, but none of the first ones in Mexico were in people over 60 or under 3 years old, a W.H.O. spokeswoman said. When a new virus emerges, deaths may occur in healthy adults who mount the strongest immune reactions. Their own defenses — inflammation and leaking fluid in lung cells — can essentially drown them from inside.


That gives at least a simple explanation as to why so many of the deaths occur in people in the prime of their lives. This was also the case in the 1918 epidemic.

[LoneWolf]

I know there are confirmed cases in NZ.


Are they confirmed? The last I heard they were only suspected, but that was just a quick blurb on CNN.

[Sodong]

Why are US news agencies not reporting possible flu cases in Canada and the UK? And New Zealand, France, and Israel have possible cases. Daily Mail (http://www.dailymail.co.uk/news/worldnews/article-1173263/Killer-pig-flu-threat-UK-Two-people-admitted-British-hospital-virus-killed-86-spreads-worldwide.html). Or is the Daily Mail an unreliable news source?

I know there are confirmed cases in NZ.

Why are US news outlets mum on this? Even the CDC's Web site confirms the NZ cases.There are 6 confirmed cases in Canada. We got a notice from Infection Prevention and Control last week about it. All patients presenting with flu symptoms are getting FRI screening and other precautions are put in place to deal with it. I work in the research wing of the hospital so I'm not as exposed as those on the front line. Also a level2 biohazard lab, so handwashing is frequent. I sure hope it doesn't get bad. We had the SARS thing not too long ago. I read somewhere (not sure where now) that this swine flu was not expected to be as bad as SARS. Sure sounds like it might rival it though. It worries me since my daughter is travelling overseas next week.

[kazzaqld]

I know there are confirmed cases in NZ.


Are they confirmed? The last I heard they were only suspected, but that was just a quick blurb on CNN.

The NZ Herald are saying it's Influenza A but not which strain.

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10568808

[Gooch's Dad]

(snip) When I taught, I actually spent two weeks in my classroom with a terrible case of flu, because my principal thought that only cancer treatments or surgery were appropriate 'sick day' excuses. I was usually ill with upper respiratory infections from September through May, with some severe bouts of bronchitis and pneumonia, all because my supervisors thought it's better to be sick and at work than take a day or two off. It's this attitude that will foster a pandemic in the US. Think of how fast flu will spread through a population that shares mass transit, workrooms, lunchrooms, and the like when people are pretty much mandated to come to work no matter how sick they are!

Hey, and I'm a teacher...I just have a cold (which I somehow caught in the Smoky Mtns) and it is trying to turn into an ear infection, but I'm about 99% sure I'm going to call sick tomorrow. And when I do get back to the classroom, I have 3 different hand sanitizer bottles to use, including one of the little ones to keep with me at all times.

I hand papers to kids, collect papers back from them, and it seems that nearly 1/3 of them are sick at any one time. I have no idea why my immune system is so weak this year, but this is the 6th infection I've gotten since September! 5 colds and one case of the stomach flu.

I didn't see any surgical masks for sale at the local Walgreens. I'll have to go ask about them specifically tomorrow. I don't care what the kids think, I'll likely wear one if there is any slight threat of this swine flu spreading.

[Laton]

Well, they say its flu...........


Goes off to fortify house in case of Zombies

[Lanakila]

I read through the symptoms and it sounds like what I have. My dr didn't test for it, but I work at an airport. I'm not panicking about myself as I feel like I am on my way towards recovering. But, I sure as hell hope my kids don't get this.

[Ray Moscow]

Why are US news agencies not reporting possible flu cases in Canada and the UK? And New Zealand, France, and Israel have possible cases. Daily Mail (http://www.dailymail.co.uk/news/worldnews/article-1173263/Killer-pig-flu-threat-UK-Two-people-admitted-British-hospital-virus-killed-86-spreads-worldwide.html). Or is the Daily Mail an unreliable news source?


The Mail is nearly as reliable as the US National Enquirer.

[Ray Moscow]

Vox, I remember reading a study about how cold and flu germs were spread. The biggest single method of infection is hand-to-mouth contact.

Cold and flu germs can live for more than a day on a hard surface (door knobs, table tops, telephones, etc.), so it is essential to keep your hands clean.
...
Even if you sit right next to a person suffering from a cold or the flu, if you're obsessive about not touching any part of your face without first washing your hands, you have a better chance of not coming down with an infection. This goes for touching things that then touch you face, such as a water glass or a sandwich, too.This is very true.

One thing I noticed about working at NIH: it was the FIRST and ONLY place I've ever been employed where, if I came in sick, I was sent home ASAP. ...One particular year I was teaching medical students medical virology, I had an uncanny knack for coming down with the disease in question, right about on schedule for the lecture on that disease. Including the flu. As I was boning up for the lecture the night before, going over the symptoms, I kept thinking... "ya know...? but.... nah! Must be psychosomatic." Well, that's one of the key things about flu symptoms: they tend to come on fast. One minute you can be fine, and half an hour later, there's often no doubt you're pretty sick. I did show up for the lecture, but colleagues were not shy about telling me I looked like death warmed over.


ETA: It was scary. I got the gastrointestinal thing right on schedule for the GI virus lecture. People started holding their breaths, waiting for the encephalitis virus lecture. Fortunately the pattern didn't hold up for that one. (Though I have had a bout of viral meningitis - which I can't really recommend with much enthusiasm.)

I'll bet they really dreaded the Ebola lecture, too.

Thanks for the reminder about washing one's hands frequently. I do that, especially when I've been out in public -- but probably not often enough.

[Ray Moscow]

I read through the symptoms and it sounds like what I have. My dr didn't test for it, but I work at an airport. I'm not panicking about myself as I feel like I am on my way towards recovering. But, I sure as hell hope my kids don't get this.

Flu of any sort is pretty bad.

I take the yearly flu shot, but AFAIK that doesn't offer any immunity against this swine flu strain.

[Notta]

Hey, and I'm a teacher...I just have a cold (which I somehow caught in the Smoky Mtns) and it is trying to turn into an ear infection, but I'm about 99% sure I'm going to call sick tomorrow. And when I do get back to the classroom, I have 3 different hand sanitizer bottles to use, including one of the little ones to keep with me at all times.

<snip>

I didn't see any surgical masks for sale at the local Walgreens. I'll have to go ask about them specifically tomorrow. I don't care what the kids think, I'll likely wear one if there is any slight threat of this swine flu spreading.
Here are some suggestions to minimize your contact with infectious kids:


Keep your tissues as far away from your desk as possible. Kids will have to stand far away from you to blow their noses.
Make every kid use hand sanitizer upon entering the room. The costs will come out of your pocket, but it helps both you and the kids reduce infections.
Clean your desks DAILY with antibacterial spray. I had my kids take turns doing this either during study hall or first thing in morning homeroom.
Don't forget to wipe your doorknobs, lab equipment, and pencil sharpener with disinfectant wipes.
The most contaminated surfaces in a school are computer keyboards in a lab. If you take kids there, have them disinfect their hands before and after using the keyboards.
Don't keep a water bottle on your desk and sip from it during class. Everytime you put your mouth on something, infectious germs are transferred. Keep your water bottle in your desk and drink BETWEEN classes after cleansing your hands.
It sounds like I'm a germaphobe, but I am actually a former medical microbiologist who had too many sick kids each year and who suffered greatly from infections while teaching. Many of these tips came from teachers who didn't get as sick as I did.

And, if the swine flu DOES become something to really worry about, your school will be closed temporarily. I believe it's on the emergency preparedness list for all states to help contain a pandemic flu.

[Oolon Colluphid]

Or is the Daily Mail an unreliable news source?
If that's a 'yes or no' question, I'd side with 'yes', unreliable. It's not quite a Sun or Mirror, but I would take anything in it with a big pinch of salt.

[Soul Invictus]

My vacation for Cancun is next week. Should I be concerned? How do you think this will affect me?

[DMB]

Reported cases now in Switzerland.

[Notta]

My vacation for Cancun is next week. Should I be concerned? How do you think this will affect me?Even though you'll feel silly, wear a surgical mask while walking through the airport in Mexico. Avoid large crowds, especially indoors. If you're near someone who's coughing and sneezing, move away. And wash or disinfect your hands constantly, especially on the plane, at the airport, in the hotel, and in restaurants.

US citizens are being warned to avoid travel to Mexico. If this thing gets very much bigger by next week, there may be travel bans, but that's a remote possibility right now.

[Lisa0315]

My vacation for Cancun is next week. Should I be concerned? How do you think this will affect me?Even though you'll feel silly, wear a surgical mask while walking through the airport in Mexico. Avoid large crowds, especially indoors. If you're near someone who's coughing and sneezing, move away. And wash or disinfect your hands constantly, especially on the plane, at the airport, in the hotel, and in restaurants.

US citizens are being warned to avoid travel to Mexico. If this thing gets very much bigger by next week, there may be travel bans, but that's a remote possibility right now.

Six of our managers just returned from Agua Prieta...I hope they are not carriers.

Lisa

[Ray Moscow]

Did anybody mention Laurie Garrett's book The Coming Plague (http://www.amazon.com/Coming-Plague-Emerging-Diseases-Balance/dp/0140250913) yet?

These things are pretty inevitable, but public health response can reduce their effect (i.e, can save many lives).

[crazyfingers]

Assuming that this thing continues and I have to travel next week, I expect to bring several face masks, a thing of Lysol wipes, baby wipes and a bottle of hand sanitizer for when I can't get to the restroom.

[Ray Moscow]

Reported cases now in Switzerland.

***Realises that my wife and I just spent 2 hours packed in a completely full aircraft with possibly infectious people***

OTOH, one can't live locked away, can one?

[VoxRat]

...Even though you'll feel silly, wear a surgical mask while walking through the airport in Mexico. Avoid large crowds, especially indoors. If you're near someone who's coughing and sneezing, move away. And wash or disinfect your hands constantly, especially on the plane, at the airport, in the hotel, and in restaurants....I don't think you'll feel silly at all. The mayor of Mexico City is wearing a surgical mask in public.

I suggest having fun with them. Draw big toothy smiles, or blood-dripping vampire fangs on them with marking pens!

[crazyfingers]

I suggest having fun with them. Draw big toothy smiles, or blood-dripping vampire fangs on them with marking pens!

:notworthy:

[Daynna]

Just saw a girl here on campus (in Pittsburgh, PA) wearing a surgical mask.

[Notta]

If you like reading about how pandemic viruses emerge, here's a paper that explains it with a diagram and everything. (http://www.clinicalfreedom.org/Nichol1.htm)

[Notta]

My vacation for Cancun is next week. Should I be concerned? How do you think this will affect me?Well, the official "travel warning" will be issued later today.

http://www.reuters.com/article/worldNews/idUSTRE53Q3F320090427 WASHINGTON (Reuters) - The U.S. State Department plans to issue a travel warning later on Monday urging Americans to avoid all "nonessential" travel to Mexico because of an outbreak of swine flu, a U.S. official said.

Swine flu has killed 103 people in Mexico and has spread to the United States. Spain has reported one case of the virus, the first to be confirmed in Europe.

"There will be a travel warning urging Americans to avoid all nonessential travel to Mexico because of the swine flu," said a U.S. official, who spoke on condition he not be named as the warning has not yet been announced.

A 'warning' is not the same as a 'ban'. But keep watching the news. WHO is assessing recent deaths in Mexico -- one of the reasons the death toll is climbing. I don't know if any new cases in Mexico are sprouting up. Most of the identified cases in other countries come from people who got sick within the past 2 - 3 weeks.

[VoxRat]

The data are still a little too sketchy to draw many firm conclusions. I remain "concerned", but not "very scared". However, my level of concern is ticked up a notch or two. >100 fatalities in Mexico, out of something like 1600 reported cases, that's a mortality rate not to be sneezed at.

[Ha! VoxRat made a jarringly inappropriate influenza funny!]

I wouldn't travel to Mexico at the moment if I didn't have to. And if I had to, it would probably be to meet with a bunch of virologists, who would probably have a lot of precautions in place.

[David B]

I've been reading for years now that another pandemic is not a matter of if but of when.

Maybe this will be the big one, maybe not.

If it is the big one, medical services will probably be pretty much overwhelmed, and people might start not turning up for work and stuff.

The advice in Britain at the moment, I understand, is that people with flu-like symptoms should not go to the doctor, or to casualty, but to phone up, and get some sort of test.

If it takes off, that sort of testing will be overwhelmed.

If I get it, in a pandemic, hospital would be the last place I'd want to be.

Too many sick people, too many opportunistic infections about, in hospitals, to want to be be there suffering from a dangerous flu in a system that would be pushed beyond its limits.

Any advice on what to do to survive a serious dose of flu at home?

Stock up on paracetamol? Fruit juice? If I really start to burn up, take measures to keep temperature down, like wrapping up in a wet sheet? Or what?

David

[Notta]

I've been reading for years now that another pandemic is not a matter of if but of when.

Maybe this will be the big one, maybe not.They thought the SARS outbreak was going to be 'the big one.' They were wrong about that.

If it is the big one, medical services will probably be pretty much overwhelmed, and people might start not turning up for work and stuff. If it IS the big one, all non-essential workers should stay home. I'd rather risk the wrath of my employer than come to work with people who are coming down with flu. Chances are, if it comes to pass it's a pandemic, there will be widespread emergency procedures that mandate that people stay home.The advice in Britain at the moment, I understand, is that people with flu-like symptoms should not go to the doctor, or to casualty, but to phone up, and get some sort of test.That's the best recourse. Hospitals are breeding grounds for all sorts of nasty bugs, and there's precious little you can do with a case of the flu if you don't get a shot of Tamiflu. If it takes off, that sort of testing will be overwhelmed.

If I get it, in a pandemic, hospital would be the last place I'd want to be.

Too many sick people, too many opportunistic infections about, in hospitals, to want to be be there suffering from a dangerous flu in a system that would be pushed beyond its limits.You're absolutely right. Stay home. Any advice on what to do to survive a serious dose of flu at home?

Stock up on paracetamol? Fruit juice? If I really start to burn up, take measures to keep temperature down, like wrapping up in a wet sheet? Or what?

DavidKeep enough food and water for two weeks. Stock up on fruit juices (in cans or juice boxes for kids), electrolyte replacements (Gatorade for adults, Pedialyte for kids), bouillon cubes, instant drink mixes, canned soups, etc. Don't worry about a temperature unless you're an adult and you have a sustained one (several hours or more than a day) of 103 - 104 degrees. Kids can spike an extremely high temperature and not have a problem. Cool compresses are better than an entire wet sheet. Suck on ice chips or popsicles. A tepid bath (not cool! it causes shivering and can bring on convulsions) is also useful if you can't get your temperature down.

However, people who die in flu pandemics do so because their immune system over-reacts and they die before their body can produce the proper antibodies. If you spend a couple of days or a week with this flu, you have a pretty good chance of recovery. (According to other research on other flu viruses.) Pandemics have caused death in a matter of hours or days, not a week or so.

[DMB]

Suggestions here on origin of outbreak http://www.timesonline.co.uk/tol/life_and_style/health/article6182789.ece

...The boy’s hometown, La Gloria, is also close to a pig farm that raises almost 1 million animals a year. The facility, Granjas Carroll de Mexico, is partly owned by Smithfield Foods, a Virginia-based US company and the world’s largest producer and processor of pork products. Residents of La Gloria have long complained about the clouds of flies that are drawn the so-called “manure lagoons” created by such mega-farms, known in the agriculture business as Confined Animal Feeding Operations (CAFOs).

It is now known that there was a widespread outbreak of a powerful respiratory disease in the La Gloria area earlier this month, with some of the town’s residents falling ill in February. Health workers soon intervened, sealing off the town and spraying chemicals to kill the flies that were reportedly swarming through people’s homes.

[DMB]

Interesting article here on the current outbreak:

http://www.timesonline.co.uk/tol/life_and_style/health/article6182047.ece

One encouraging discovery about swine flu is that analysis of its neuraminidase protein — the N of H1N1 — indicates that it should be sensitive to the antiviral drugs Tamiflu and Relenza, which target this protein. This bears out clinical experience so far, which suggests that patients respond well to the drugs.

However, Professor Barclay said that viruses with N1 neuraminidase were more likely than other strains to develop resistance to antivirals.

Peter Lachmann, Emeritus Professor of Immunology at the University of Cambridge, said: “Tamiflu resistance is extraordinarily widespread, and develops very quickly. We would be very lucky if this virus does not develop resistance.”

Yesterday I saw on TV smug claims from the British heath Secretary that Britain would be OK because they had enough antiviral doses for half the population.

[Oolon Colluphid]

I've been reading for years now that another pandemic is not a matter of if but of when.

Maybe this will be the big one, maybe not.They thought the SARS outbreak was going to be 'the big one.' They were wrong about that.
Another thing to bear in mind is that there's no quota on 'big ones'. If one goes through, another nasty virus won't sit on it's little RNA hands thinking sadly "Ho hum, missed my chance, maybe in another fifty years then".

There's nothing to stop 'big ones' coming along like the proverbial buses.

Now that's scary.

[Oolon Colluphid]

However, people who die in flu pandemics do so because their immune system over-reacts and they die before their body can produce the proper antibodies.
So what you need, in addition to the food supplies, is a mild immunosuppressant. Like cortisone?

So a corticosteroid like beconase, becotide inhalers, flixotide / -nase etc?

I think varieties of these are available over the counter (saw beconase in my local Tesco Express yesterday as a hayfever relief).

[Ray Moscow]

However, people who die in flu pandemics do so because their immune system over-reacts and they die before their body can produce the proper antibodies.
So what you need, in addition to the food supplies, is a mild immunosuppressant. Like cortisone?

So a corticosteroid like beconase, becotide inhalers, flixotide / -nase etc?

I think varieties of these are available over the counter (saw beconase in my local Tesco Express yesterday as a hayfever relief).

This is a good point. Is there something one can get OTC to suppress the immune system over-response in case one cannot get "real" medical treatment in time?

[DMB]

I just wish my immune system would attack foreign DNA and stop attacking me. :D

[VoxRat]

...
Another thing to bear in mind is that there's no quota on 'big ones'. If one goes through, another nasty virus won't sit on it's little RNA hands thinking sadly "Ho hum, missed my chance, maybe in another fifty years then".

There's nothing to stop 'big ones' coming along like the proverbial buses.

Now that's scary.The other thing to be aware of is that influenza pandemics are like California earthquakes: you KNOW they're coming. SARS was something else; not influenza. Being totally unknown, it was much more unpredictable.

[Joykins]

The data are still a little too sketchy to draw many firm conclusions. I remain "concerned", but not "very scared". However, my level of concern is ticked up a notch or two. >100 fatalities in Mexico, out of something like 1600 reported cases, that's a mortality rate not to be sneezed at.

[Ha! VoxRat made a jarringly inappropriate influenza funny!]

I wouldn't travel to Mexico at the moment if I didn't have to. And if I had to, it would probably be to meet with a bunch of virologists, who would probably have a lot of precautions in place.

Those "reported cases" in Mexico are cases of pneumonia requiring hospitalization according to the WHO (but not according to news reporters. Half the news accounts don't seem to make any distinctions at all between cases, hospitalizations, and deaths, and that's not to mention the obviously-impossible number typos I've seen in articles). This makes me think that the disease is more contagious/widespread and significantly less lethal than (at last suspected estimate) "150 (suspected) deaths and 2000 (suspected) cases" imply. Although even at normal flu mortality rates, widespread disease will carry more deaths with it so I'm sitting here with you resolutely not-sneezing at it.

[Lisa0315]

We just got a Corporate Advisory to postpone any trips to Mexico.

Lisa

[Notta]

Good. No sense in exposing yourself to a highly contagious disease even IF you're not going to die from it.

[Joykins]

Yep.

My husband is flying to NEW Mexico in a few weeks and I'm already proactively worried for him.

[BioBeing]

We have a big flu group here. One of our top guys has been warning about a 1918-like flu reemerging for ever.

Looks like I am now on antigen production duties.

[damitall]

I've been reading for years now that another pandemic is not a matter of if but of when.

Maybe this will be the big one, maybe not.They thought the SARS outbreak was going to be 'the big one.' They were wrong about that.

If it is the big one, medical services will probably be pretty much overwhelmed, and people might start not turning up for work and stuff. If it IS the big one, all non-essential workers should stay home. I'd rather risk the wrath of my employer than come to work with people who are coming down with flu. Chances are, if it comes to pass it's a pandemic, there will be widespread emergency procedures that mandate that people stay home.That's the best recourse. Hospitals are breeding grounds for all sorts of nasty bugs, and there's precious little you can do with a case of the flu if you don't get a shot of Tamiflu. If it takes off, that sort of testing will be overwhelmed.

If I get it, in a pandemic, hospital would be the last place I'd want to be.

Too many sick people, too many opportunistic infections about, in hospitals, to want to be be there suffering from a dangerous flu in a system that would be pushed beyond its limits.You're absolutely right. Stay home. Any advice on what to do to survive a serious dose of flu at home?

Stock up on paracetamol? Fruit juice? If I really start to burn up, take measures to keep temperature down, like wrapping up in a wet sheet? Or what?

DavidKeep enough food and water for two weeks. Stock up on fruit juices (in cans or juice boxes for kids), electrolyte replacements (Gatorade for adults, Pedialyte for kids), bouillon cubes, instant drink mixes, canned soups, etc. Don't worry about a temperature unless you're an adult and you have a sustained one (several hours or more than a day) of 103 - 104 degrees. Kids can spike an extremely high temperature and not have a problem. Cool compresses are better than an entire wet sheet. Suck on ice chips or popsicles. A tepid bath (not cool! it causes shivering and can bring on convulsions) is also useful if you can't get your temperature down.

However, people who die in flu pandemics do so because their immune system over-reacts and they die before their body can produce the proper antibodies. If you spend a couple of days or a week with this flu, you have a pretty good chance of recovery. (According to other research on other flu viruses.) Pandemics have caused death in a matter of hours or days, not a week or so.

Do you have a citation in support of the bit I've bolded, Notta?

[Notta]

We have a big flu group here. One of our top guys has been warning about a 1918-like flu reemerging for ever.

Looks like I am now on antigen production duties.It's never been a matter of IF a pandemic will occur again, but, rather, WHEN. And multiple ones at that, too.

[Notta]

However, people who die in flu pandemics do so because their immune system over-reacts and they die before their body can produce the proper antibodies.

Do you have a citation in support of the bit I've bolded, Notta?
Here's the wiki article on Cytokine storm.

Here's a more scientific resource: http://www.cytokinestorm.com/ (http://www.cytokinestorm.com/)

I admit, I always thought people died from a lingering illness and the complications of pneumonia during flu pandemics. The cytokine storm is the reason more healthy, young adults die than children or older people (who may have some slight immunity to a 'new' virus), which is one of the hallmarks of a pandemic virus.

[damitall]

However, people who die in flu pandemics do so because their immune system over-reacts and they die before their body can produce the proper antibodies.

Do you have a citation in support of the bit I've bolded, Notta?
Here's the wiki article on Cytokine storm.

Here's a more scientific resource: http://www.cytokinestorm.com/ (http://www.cytokinestorm.com/)

I admit, I always thought people died from a lingering illness and the complications of pneumonia during flu pandemics. The cytokine storm is the reason more healthy, young adults die than children or older people (who may have some slight immunity to a 'new' virus), which is one of the hallmarks of a pandemic virus.


Thanks, Notta. Interesting. ( I thought it was usually secondary bacterial pneumonia that killed one off, too)

[sohy]

The first US death was just confirmed. It was a 23 month old child in Texas.

[Shake]

I saw this image this morning:
http://d.yimg.com/a/p/afp/20090429/capt.photo_1240970625280-1-0.jpg?x=400&y=337&q=85&sig=qKWUyH6j.V_X3IjPiXTFHw--
And noticed the bottom right section. The conclusion I drew from that is that either the Asian flu and Hong Kong flu were not as deadly as the Spanish flu or reporting and medicine have gotten better. If things are closer to the latter explanation, then I'd say we don't have as much to worry about. Mind you, I'm not saying there isn't some concern, I just am also not going into panic mode just yet.

[Lisa0315]

I dreamed I had the flu last night but I kept trying to get to work anyway, only I was naked. :cool:

[Ray Moscow]

One light spot in all this gloom: apparently it's kosher to call it "swine flu" after all (http://www.google.com/hostednews/afp/article/ALeqM5jZnOBSUXy4BXO9LuOMmjzZwdJYAQ).

Earlier Israel's deputy health minister refused to call it "swine flu", preferring the term "Mexican flu" instead. Apparently Mexicans are more kosher than swine, which is at least saying something positive.

[DMB]

What a pity. Jesus and Mo had a word on this:

http://www.jesusandmo.net/2009/04/29/bacon/

[Joykins]

And noticed the bottom right section. The conclusion I drew from that is that either the Asian flu and Hong Kong flu were not as deadly as the Spanish flu or reporting and medicine have gotten better. If things are closer to the latter explanation, then I'd say we don't have as much to worry about. Mind you, I'm not saying there isn't some concern, I just am also not going into panic mode just yet.

Some people think that the Spanish flu was waaayyyyy out there on the edge of the deadliness/contagiousness combo even possible for the influenza virus. Most pandemics are not 1918, is what I keep telling my friends...

[DMB]

WHO has raised the level to 5, one below pandemic.

[Notta]

WHO has raised the level to 5, one below pandemic.That's not a good sign. The contagion level is worrisome, but one would expect to see more deaths right now if it were highly lethal. So you could end up with millions of people sick, but not a similar number dead.

Just in case, stock up on foodstuffs and drinks. If your country/city/town has a large outbreak, there will be widespread quarantines in place.

[Mung Dynasty]

Ok question: given that every year there is a new strain of flu and lots of people get it what is the difference between a normal year and a pandemic? I mean in a normal year you have human to human transmission all over the place anyway, and that seems to be the definition of a pandemic.

I understand that lethality is one obvious concern. I'm just curious about the definitions.

[DMB]

Pandemic.

Emergence of a disease new to a population.
Agents infect humans, causing serious illness.
Agents spread easily and sustainably among humans.

[VoxRat]

Ok question: given that every year there is a new strain of flu and lots of people get it what is the difference between a normal year and a pandemic? I mean in a normal year you have human to human transmission all over the place anyway, and that seems to be the definition of a pandemic.

I understand that lethality is one obvious concern. I'm just curious about the definitions.

People seem to use the word "pandemic" a little differently for different diseases. Generally it signifies: (a) the disease (or the strain of agent causing it) is new to the world's (human) population, and it's spreading rapidly and easily through the entire (human) population (i.e. not like Ebola in pockets of west Africa).

[Mung Dynasty]

Pandemic.

Emergence of a disease new to a population.
Agents infect humans, causing serious illness.
Agents spread easily and sustainably among humans.

Same as any flu year then. No real difference in terms of definition.

[Notta]

Ok question: given that every year there is a new strain of flu and lots of people get it what is the difference between a normal year and a pandemic? I mean in a normal year you have human to human transmission all over the place anyway, and that seems to be the definition of a pandemic.

I understand that lethality is one obvious concern. I'm just curious about the definitions.
Pandemic: An epidemic (a sudden outbreak) that becomes very widespread and affects a whole region, a continent, or the world.

An epidemic is localized, even though it may be quite lethal or contagious.

Pandemics do not need to be lethal to be classified as such. It only means that a large proportion (or even nearly 100%) of the human population has not been exposed to the disease before and is at risk of catching it.

We tend to think a pandemic always means high rates of death; in one respect, it's true. The death rate tends to be higher than in normal illnesses because it's a new disease and people do not have immunity towards it. There can be elevated death rates simply because it might cause a cascade of events where a person comes down with secondary infections that cause death (as in people who are HIV positive - they do not die from AIDS, they die from secondary infections they catch and cannot overcome due a poor or non-existent immune system).

But it doesn't have to mean that the majority of people who catch the illness are at risk of dying -- just a higher proportion than NORMAL.

For instance, I've seen some news reports saying that every year, about 36,000 people in the US die from flu-related illnesses (usually viral or bacterial pneumonia), and about 5 - 20% of Americans get the flu. (From the CDC Web site)

In a situation with a new, pandemic flu, you might see upwards of 20 - 50% or more of the ENTIRE POPULATION OF THE WORLD coming down with the flu, and maybe 20% of those dying.

If one in five people catches it, you're looking at over a billion people with the flu. If even only 5% of those die, you're counting 50 MILLION deaths, all within a matter of months.

It's about the numbers. Your individual chance of falling ill during a pandemic depends on how many sick people are around you. Your individual chance of dying during a pandemic is low. But when you realize we have nearly 7 billion people on the planet, if even only 1% get sick that's 70 million people.

At this point, I'd listen to the news and follow any directives from the workplace or a state government about travel restrictions, what to do if you start showing symptoms of the flu, and stock up on some food supplies to have at home. But I wouldn't panic and start thinking about the destruction of civilization as we know it.

[VoxRat]

Pandemic.

Emergence of a disease new to a population.
Agents infect humans, causing serious illness.
Agents spread easily and sustainably among humans.

Same as any flu year then. No real difference in terms of definition.

That's why I say the word seems to be used a little differently depending on what disease you're talking about.

The typical pattern in a regular flu season is that you have more or less regional expansions of maybe one strain in Western Europe, another in China, etc, with considerable slopping over the borders, and exceptions due to travel... In connection with influenza, the word "pandemic" suggests to me a particular new strain spreading like wildfire, everywhere.

[Notta]

Pandemic.

Emergence of a disease new to a population.
Agents infect humans, causing serious illness.
Agents spread easily and sustainably among humans.

Same as any flu year then. No real difference in terms of definition.No.

Most flus are not 'new.' That's why companies can create a flu vaccine; it's based on the type of flu that is most likely to be common during a flu season.

This swine flu is a new variant of H1N1. People have never been exposed to it before. In every 'regular' flu season, some people have had the exposure, and some haven't.

Each cold or flu you catch is UNIQUE to your immune system (which is why you get sick!), but you are exposed to many more that you don't catch, because you've already had them in the past and your immune system fights them off. So some people will catch a flu one year, and then go a couple of years or decades without getting one again, mainly because they are not susceptible to the specific variants that are floating around in the population.

But NO ONE has prior immunity to THIS flu, so EVERYONE is at risk for catching it. Just like during the Black Plague, not everyone caught the disease, but a large proportion did. Same thing with smallpox; many people caught it, many people died, but not everyone did. After centuries, smallpox and plague didn't kill as many people because they were the descendants of people who successfully fought off the initial infections. The Native Americans, who had no prior exposure to smallpox or plague, died at about a rate of 90% and nearly 100% who were exposed were infected.

Most flu viruses each flu season are repeats of prior flu viruses. Not so this time.

[Mung Dynasty]

Most flu viruses each flu season are repeats of prior flu viruses. Not so this time. Ok, so what you're saying is the primary difference is the degree of recombination?

[Notta]

Most flu viruses each flu season are repeats of prior flu viruses. Not so this time. Ok, so what you're saying is the primary difference is the degree of recombination?If by that you mean the change in proteins on the surface of the viral envelop, then yes. This one could also have some changes in the RNA inside of it. At any rate, it's a completely unique virus for the current human population.

[VoxRat]

Most flu viruses each flu season are repeats of prior flu viruses. Not so this time. Ok, so what you're saying is the primary difference is the degree of recombination?Sorta. Though the word is reassortment in this case; recombination, strictly speaking, is rare to non-existent in this kind of virus.

With influenza, you have two processes going on: antigenic shift and antigenic drift. There are a bunch of strains circulating worldwide every year, some H1N1, some H3N2, etc. etc. etc. This year's H3N2 in, say Italy, will have drifted, by accumulation of point mutations, from last year's, or last decade's, enough so that there's not a lot of effective immunity against it. But there's some - i.e. a significant fraction of the population is somewhat immune, so it dampens down the rate of spread.

Antigenic shift is what you get when a new reassortant emerges. Some genes (generally the H and N) that were brewing in some population, like birds or pigs, suddenly hook up with other genes making a virus that spreads efficiently in humans, and to which there is very very little herd immunity.

[Mung Dynasty]

K. Makes sense. So really they should put that or something like it in the Wiki definition.

[crazyfingers]

I am even less pleased about having to get on 4 airplanes next week.

[Joykins]

I've always had a working understanding of pandemic flu as being

* more contagious than usual, spreading worldwide and affecting a lot more people than usual, and

* more virulent than usual. Influenza rarely gets as high as 1% fatal, but you might see that during a pandemic, or higher; the 1918 pandemic seemed to range from 2-20% fatal. Based on my understanding of the stats, this certainly isn't as fatal as 1918 at this point.

[Oolon Colluphid]

K. Makes sense. So really they should put that or something like it in the Wiki definition.
It's Wikipedia. Go edit it! (But get a proper reference from a published source though.)

[BWE]

Hmmm. I just got an interesting automated e-mail. It appears that some gov't agencies are implementing some heightened alert measures in Oregon. I don't have to finish my project tonight it turns out and I can sleep pretty much all day tomorrow.

Any idea on first response systems activating in other parts of the country? In this case, it's only that conference rooms are being either closed or booked for other things, but it sounds like big mobilizations are in the works. I assume it's just that it's a be prepared kind of thing.


News?

[Ray Moscow]

I liked Ben Goldacre's column on it this morning:

Swine flu and hype – a media illness (http://www.guardian.co.uk/commentisfree/2009/apr/29/swine-flu-hype)

The thing is: these "warnings", although they don't usually play out to the worst-possible scenario, are not hype. There is a real risk of a very bad and deadly pandemic. Or it might not come to anything much. At this point, we're just guessing and taking some precautions.

[Oolon Colluphid]

According to the latest bulleting on my County Council's website, "It appears that in most cases outside of Mexico the disease is much milder and victims are making a full recovery. However the first death outside of Mexico was announced this morning."

[Ray Moscow]

Hmmm. I just got an interesting automated e-mail. It appears that some gov't agencies are implementing some heightened alert measures in Oregon. I don't have to finish my project tonight it turns out and I can sleep pretty much all day tomorrow.

Any idea on first response systems activating in other parts of the country? In this case, it's only that conference rooms are being either closed or booked for other things, but it sounds like big mobilizations are in the works. I assume it's just that it's a be prepared kind of thing.


News?

For me, it's just been the usual "don't go to Mexico" warnings.

The SARS thing really slowed down Asian business for several months, so I expect this one to cause similar problems even if it doesn't amount to much in the end.

[VoxRat]

... It's Wikipedia. Go edit it! (But get a proper reference from a published source though.)What...
You're suggesting "VoxRat told me so" is somehow not a proper reference?

:hmm:

[nygreenguy]

Hmmm. I just got an interesting automated e-mail. It appears that some gov't agencies are implementing some heightened alert measures in Oregon. I don't have to finish my project tonight it turns out and I can sleep pretty much all day tomorrow.

Any idea on first response systems activating in other parts of the country? In this case, it's only that conference rooms are being either closed or booked for other things, but it sounds like big mobilizations are in the works. I assume it's just that it's a be prepared kind of thing.


News?

Its shown up in the syracuse area. A bunch of schools are closed.

[Lisa0315]

... It's Wikipedia. Go edit it! (But get a proper reference from a published source though.)What...
You're suggesting "VoxRat told me so" is somehow not a proper reference?

:hmm:

Hey, if you tell me so and I repeat it, I dare anyone to challenge my source! :notworthy:

[Worldtraveller]

According to the latest bulleting on my County Council's website, "It appears that in most cases outside of Mexico the disease is much milder and victims are making a full recovery. However the first death outside of Mexico was announced this morning."
Careful. A lot of the reports of that are innaccurate. (Surprise huh?)

The first death outside of Mexico was in Houston, TX, USA. What all but acouple of the reports left out is that the child (23 months) came up from Mexico with his family and had been sick for a while.

The thing about the flu virus that I was reading is that it tends to get worse (as in the symptoms it causes) as it progresses through a few carriers, particularly within a family. Apparently, it mutates that quickly? I don't know the cause, and the report I was listening to didn't say why.

[Ray Moscow]

It doesn't seem likely to mutate that quickly. More likely different people just suffer differently -- or there might be multiple strains of this stuff involved in this outbreak.

[DMB]

I am even less pleased about having to get on 4 airplanes next week.

I got off one a few hours ago and I have two more next week. I must say I took antiseptic wipes with me to use as necessary and tried hard not to touch obvious things. But I had to get a trolley at Heathrow for my luggage, and who knows what could be on the handle? After handling that and getting in the car, I did my hands with an antiseptic wipe.

[Daynna]

I had intense nausea hit me in the shower this morning and ended up staying home from work. Then I read this:

http://www.nydailynews.com/ny_local/2009/04/28/2009-04-28_knocked_out_by_nausea_says_st_francis_senior.ht ml

Normally I would think it was just a stomach virus, but now I have swine flu! Not really, but it is amazing how easily a person can become paranoid.

[Oolon Colluphid]

You may be paranoid, but the virus is out to get us.

[VoxRat]

I had intense nausea hit me in the shower this morning and ended up staying home from work. Then I read this:

http://www.nydailynews.com/ny_local/2009/04/28/2009-04-28_knocked_out_by_nausea_says_st_francis_senior.ht ml

Normally I would think it was just a stomach virus, but now I have swine flu! Not really, but it is amazing how easily a person can become paranoid.
From that link:
Federal and city authorities are telling people to watch for fevers and coughs, but the Queens teens who got the deadly Mexican swine flu said the main symptom was sudden and terrible nausea.That does strike me as peculiar. For humans, influenza is pretty much exclusively a respiratory infection. Non-respiratory symptoms - fever, headache, everything-ache - are generally secondary to the "cytokine storm". If nausea is really one of the more prominent early symptoms of this strain, that suggests to me that the "cytokine storm" is unusually tempestuous.


You may be paranoid, but the virus is out to get us.I say, if it's causing all these problems, it must have a legitimate grievance. Clearly, we're doing something wrong; something that's giving it no other choice but to act out like this.

Clearly, what we should do is recall the doctors and slap them upside the head for not taking into account the virus's perspective. Oh, and put the virus in charge.

[Monad]

It doesn't seem likely to mutate that quickly.

Captain Trips!! - shifting antigen flu

[crazyfingers]

I am even less pleased about having to get on 4 airplanes next week.

I got off one a few hours ago and I have two more next week. I must say I took antiseptic wipes with me to use as necessary and tried hard not to touch obvious things. But I had to get a trolley at Heathrow for my luggage, and who knows what could be on the handle? After handling that and getting in the car, I did my hands with an antiseptic wipe.

Ya. I have the wipes and the hand sanitizer. I'm pretty sure that I can keep up with keeping my hands clean. I'm more concerned about a sick person on the plane contaminating the air.

[Ray Moscow]

It doesn't seem likely to mutate that quickly.

Captain Trips!! - shifting antigen flu

TBH, I do think about The Stand every time there's a flu outbreak. It's just fiction, right? Right?

[Lisa0315]

Ooohh! Captain Trips. I just remembered what that is from. Killer book and movie.

Lisa

[Late_Cretaceous]

I bet there has been a spike in sales of the movie / book The Stand as of late. Makes me want to watch the movie again/

[Garnet]

It doesn't seem likely to mutate that quickly.

Captain Trips!! - shifting antigen flu

TBH, I do think about The Stand every time there's a flu outbreak. It's just fiction, right? Right?

There, there. *pats Ray on the back* Of course it's fiction.


*surreptitiously slips sun glasses over her glowing eyes*

[Lisa0315]

Y'all better be heading to some cornfields and not Vegas right now! That little cabin in the woods is where we all need to be right now!

[kazzaqld]

I have come down with my first cold of the season - it's autumn in the Southern Hemisphere of course - and had to endure a heap of bad "swine flu" jokes at work yesterday. :o

Not going in today as I am slowly getting worse. :(

[Puck]

I went to wally today, and they are all out of hand sanitizer. Great. And I'm about out of the stuff. Fuck it, I'll carry a bottle of alcohol with me if I run out before I find some. If I run out of that, I've got good gin, but damn if I hate to waste good gin to kill flu germs.

[David B]

My view is bugger it.

If I get it, I get it, will probably survive it, and, presuming I do, will then have some sort of partial immunity to variants of the new strain which may pop up from year to year.

David

[RAFH]

Clearly, what we should do is recall the doctors and slap them upside the head for not taking into account the virus's perspective. Oh, and put the virus in charge.

Couldn't be any worse than most of what we've elected over the last several decades, either locally or nationally.

[Monad]

I bet there has been a spike in sales of the movie / book The Stand as of late. Makes me want to watch the movie again/

I have it on DVD.

The book however, is much much better

[Ray Moscow]

Y'all better be heading to some cornfields and not Vegas right now! That little cabin in the woods is where we all need to be right now!

I had a dream about a guy last night.

http://img129.imageshack.us/img129/8426/obama0201.jpg

[Worldtraveller]

Will hand sanitizers work on this flu virus? I thought soap was actually better in this case and the hand sanitizers were really only effective against bacterial things.

[VoxRat]

Will hand sanitizers work on this flu virus? I thought soap was actually better in this case and the hand sanitizers were really only effective against bacterial things.Flu virus is pretty easy to kill. The active ingredient of "hand sanitizers" I'm familiar with is alcohol. At 70% (that's typical, I think) it would be pretty effective against flu virus.

But I think it's much easier to "miss a spot" with the hand sanitizers. I would regard them as a stopgap when soap & water are not convenient.

[Ray Moscow]

Will hand sanitizers work on this flu virus? I thought soap was actually better in this case and the hand sanitizers were really only effective against bacterial things.Flu virus is pretty easy to kill. The active ingredient of "hand sanitizers" I'm familiar with is alcohol. At 70% (that's typical, I think) it would be pretty effective against flu virus.

But I think it's much easier to "miss a spot" with the hand sanitizers. I would regard them as a stopgap when soap & water are not convenient.

To repeat Oolon's question (from elsewhere), just how does soap or detergent kill flu viruses? I read one on-line comment that it binds to a lipids in their "shell" and denatures some of their proteins. Is that accurate?

How about bacteria?

Curious Ray

[VoxRat]

...To repeat Oolon's question (from elsewhere), just how does soap or detergent kill flu viruses? I read one on-line comment that it binds to a lipids in their "shell" and denatures some of their proteins. Is that accurate?

How about bacteria?

Curious RayEnveloped viruses, like influenza, rely on the integrity of a largely lipid membrane. These are held together by what they call "hydrophobic forces" - the same thing that makes oil separate from water. The definition of a detergent is a molecule that has both an "oily" end - one that wants to avoid water - and the opposite: a charged or polar end; one that is attracted to water. The oily end naturally joins all its oily brethren in a lipid membrane, but dragging that charged part along with it makes any kind of extended organized lipid membrane unstable. What happens is that the lipid molecules become incorporated into relatively infinitesimal "droplets" of the oily part of the detergent, surrounded by an outward-facing wall of electrical charge that needs to be in contact with water. (These structures are called "micelles").

Depending on the balance of hydrophobic/hydrophilic (oily/water-attracting) parts of the detergent molecule, it can be relatively strong (a denaturing detergent) or mild. The stronger ones not only disrupt lipid membranes, but they break up the hydrophobic interactions within typical proteins, and cause their complicated three-dimensional structures, upon which biological activities are generally dependent, to unravel. Soaps are generally denaturing detergents.

Bacteria are actually often more difficult to kill than viruses with soaps. A lot of them have various mechanisms that reinforce the integrity of the membrane with detergent-resistant scaffolding. But (a) a lot of them can be killed by soap anyway, and (b) washing physically removes most of the bacteria you'd be most worried about, even if it doesn't kill them.

[Ray Moscow]

Thanks, VR.

I suppose even gram-negative bacteria can be "washed away" with soap and water, too, even though it probably doesn't kill them directly.

[Monad]

eta it looks like this one is a human seasonal strain with genetic elements from both swine and bird flu so it's probably been stewing for some time in communities that have contact with pigs and fowl, constantly cross infecting and mutating till it has got to a point where it can spread between humans (the big problem most non human flu have is they can infect humans but because the initial site of infection is different in different species - in non human flu it's usually deeper in the lungs, not upper respiratory tract - infection requires prolonged exposure and further transmission is less likely - what it looks like here is it has switched the site of initial infection, probably through the seasonal flu element)).

Looks like this has been confirmed now - its going for the upper respiratory tract not deeper in the lungs like Bird flu does:

http://newsimg.bbc.co.uk/media/images/45725000/gif/_45725374_receptors_466.gif

http://news.bbc.co.uk/1/hi/health/8028371.stm

More infectious (easier to transmit human to human) but probably less harmful overall - it's basically just a seasonal flu with some genetic material from other strains.

[Ray Moscow]

Monad, what's causing most of the fatalities from this strain? More so than "seasonal" flu?

[dancer_rnb]

Thanks, VR.

I suppose even gram-negative bacteria can be "washed away" with soap and water, too, even though it probably doesn't kill them directly.

Gram negative bacteria have bare lipid membranes, so I think soaps will kill them easier than
gram positive ones. If I remember my decades old microbiology correctly.

[dug_down_deep]

http://imgur.com/27K39.jpg

[Monad]

Monad, what's causing most of the fatalities from this strain? More so than "seasonal" flu?

Not so sure now but maybe not "flu" as such. All the fatalities seem to have been in Mexico (except for that child - who had recently left Mexico though). From the above article:

However, there is one other reassuring aspect about what is known so far.

That is there seems to be nothing unusual as yet in another protein in the centre of the virus, called NS1, which is linked to the strength of the immune response the virus produces.

In some more pathogenic viruses, it is this NS1 protein which initiates a "cytokine storm", a particularly severe immune reaction that can be fatal in even healthy young people.

This does seem to tally with the fact that it seems to have been milder everywhere else. If it was provoking a cytokine storm you would expect it to affect younger and healthier people more severely. Not sure what the profile is of all the people who died in Mexico but perhaps they were more susceptible for other reasons - from what I've read a lot died of pneumonia, not directly of the flu which is more how seasonal flu kills when it kills - not 1918-19 type pandemic flu.

[Ray Moscow]

Maybe it's a secondary infection that's causing most of the deaths? That happened to coincide with this flu outbreak?

I'm not sure that's good news unless (as it appears) this secondary factor is not spreading so fast or far as the flu strain.

[Monad]

Maybe it's a secondary infection that's causing most of the deaths? That happened to coincide with this flu outbreak?

Not necessarily - viral pneumonia can be a complication of any flu - bacterial pneumonia can also set in as an opportunistic infection, which is one of the main causes of flu related mortality. Doesn't imply there was anything else involved.

[Joykins]

I personally think there were so many deaths in Mexico because there were a shitload of cases in Mexico most of which just ran under the radar of whatever public health reporting system they have there.

[Zygote]

Do we have any data on that?

I know that once the WHO numbers started coming out of Mexico, both fatality and total case numbers went down dramatically from what had initially been reported by Mexican officials.

Does anyone know how thorough or reliable the screening and testing situation is in Mexico? Are these deaths indeed just the tip of a very much larger iceberg?

[Joykins]

IIRC Mexico was only ever counting hospitalized cases. They don't--or didn't-- test people for flu in doctors offices there.

[hecaterin]

I have come down with my first cold of the season - it's autumn in the Southern Hemisphere of course - and had to endure a heap of bad "swine flu" jokes at work yesterday.And on facebook, right?

I've decided that absolutely everything is swine flu. Stubbed toes, sore muscles from the gym, hangovers, etc etc. See also http://xkcd.com/574/

[Matty]

I guess its getting more serious, support services are inundated. Yesterday i tried the Swine Flu Helpline and all i got was crackling.

[hecaterin]

Damn you Matty, I was going to use that line.

[Garnet]

*groans*

[dug_down_deep]

Matty's such a ham.

[Lisa0315]

Anyone want to toss the pigskin around?

[Notta]

I think Matty's been tossed around enough the past few days (he resigned as a mod at the other board). He needs your creamy bosoms instead.

[Lisa0315]

I think Matty's been tossed around enough the past few days (he resigned as a mod at the other board). He needs your creamy bosoms instead.

Yes, I agree. I heart Matty and Matty is completely welcome to nestle at the creamy bosoms for as long as he needs.

Lisa

[Matty]

Rawr :)

FTR "as an admin"., I'm still game on for modding if I'm wanted.




This lazy bastard took the week off work, supposedly with with swine flu. I told him" Thats not swine flu, thats just a piggin cold"

[David B]

'Science' says the 'Swine Flu Data 'Very Consistent' With Early Stages Of A Pandemic'

http://www.sciencedaily.com/releases/2009/05/090511151620.htm

The researchers' best estimate is that in Mexico, influenza A (H1N1) is fatal in around 4 in 1,000 cases, which would make this strain of influenza as lethal as the one found in the 1957 pandemic. The researchers stress that healthcare has greatly improved in most countries since 1957 and the world is now better prepared.

For every person infected, it is likely that there will be between 1.2 and 1.6 secondary cases. This is high compared to normal seasonal influenza, where around 10-15 percent of the population are likely to become infected. However, it is lower than would be expected for pandemic influenza, where 20-30 percent of the population are likely to become infected.

What we're seeing is not the same as seasonal flu and there is still cause for concern – we would expect this pandemic to at least double the burden on our healthcare systems. However, this initial modelling suggests that the H1N1 virus is not as easily transmitted or as lethal as that found in the flu pandemic in 1918,

For myself - I've stopped worrying about it.

David

[Garnet]

Yeah, me too. I'm glad that precautions were taken early on. Better safe than sorry. But it really looks like nothing to worry about now.

[Notta]

Right now, it's a mild illness. But the whole thing has been a good practice for when the more deadly types of viruses evolve.

[rlogan]

This flu has produced one of the highest hypeperinfection coefficients our lab has examined, due to robust media receptors enabling direct media-to-media transferrance along with immunity to perspective.

[Lisa0315]

This flu has produced one of the highest hypeperinfection coefficients our lab has examined, due to robust media receptors enabling direct media-to-media transferrance along with immunity to perspective.

:notworthy:

[Monad]

Yeah, me too. I'm glad that precautions were taken early on. Better safe than sorry. But it really looks like nothing to worry about now.

I think that depends. If you have a condition like asthma (as I have) I think there is some potential for worry - it does seem to be rather more infectious than seasonal flu and to be harder on people who have certain susceptibilities already. I'm not looking forward to anything that leaves me struggling for breath or ending up in hospital on a ventilator (been there 2 years ago)

http://news.bbc.co.uk/1/hi/health/8045364.stm

"To put that into context, normal seasonal flu every year probably affects around 10% of the world's population every year, so we are heading for a flu season which is perhaps three times worse than usual - not allowing for whether this virus is more severe than normal seasonal flu viruses."

[Joykins]

I would say I don't want to get it, expect it will, and expect I would get mild disease. I am hoping before it really rolls around in force, the asthmatics in my family would get a vaccine. And if we get it before then, I hope they can get Tamiflu or something.

[David B]

Apparently, though now off the front pages, it's still spreading.

http://news.bbc.co.uk/1/hi/health/8053437.stm

Cases up about 12% in the last 24 hours.

I'm not too worried, though.

David