Swine Flu

[Ray Moscow]

It's official: Swine flu (H1N1) is pandemic.

The declaration seems a bit obvious and late, but apparently this pushes the drug companies to start making vaccine.

Swine flu pandemic declaration to trigger vaccine switch (http://www.newscientist.com/article/dn17291-swine-flu-pandemic-declaration-to-trigger-vaccine-switch.html)

The World Health Organization has declared H1N1 swine flu an official pandemic – level six in the WHO's rating scheme. This means the world's vaccine industry can now switch from making vaccine for ordinary flu to pandemic vaccine.

However companies are not likely to change production until they have finished their current production run of ordinary flu vaccine in July or August. That will be the case, even though that vaccine will be useless if swine flu behaves like previous pandemics and replaces the current, ordinary flu viruses.

The WHO's declaration of level six activates a slew of government pre-orders for pandemic vaccine. These will take precedence over recent orders for H1N1 vaccine. Countries that don't have pre-orders will face delays.


I'm getting all sorts of warning emails about travel (including to such danger spots as the UK and Finland) that don't say much of anything except that I'm supposed to be "alert".

[Faerie]

Had a chat with the b/f about this last night. The statistics dont seem alarming (148 deaths worldwide, aprox 28 000 reported cases according to the news report), I'm wondering what we're NOT being told? Its only the beginning of flu season this side of the world, but we have'nt had a confirmed case here in SA as yet.

[Valheru]

^^^ Yes. The number of worldwide infections and the number of deaths seem ridiculous compared to influenza or the common cold.

What aren't they telling us, because the statistics don't gel with it being elevated to a level six fuck up.

My conspiracy-theory corpuscle is tweaking. Let's create a boogey man and sell billions of dollars worth of unnecessary snake oil anti-virals.

[Ray Moscow]

They say that even though the current variants appear relatively mild, they could turn very nasty without warning.

[DMB]

The problem as I understand it is that once it becomes widespread within the human population, there is a danger of it picking up mutations that will make it a lot more virulent. This is apparently what happened with the great flu pandemic at the end of WW1: it was mild to start with but then it came back and killed a hell of a lot of people.

[Faerie]

Have our first confirmed case here in SA today.



South America bears brunt
2009-06-18 09:07

Buenos Aires - The H1N1 flu deaths of two people in Argentina and a mutation of the H1N1 virus detected in Brazil have added to fears that South America is entering a harsh winter beset by the flu pandemic.

While big pharmaceutical firms are ramping up efforts to mass-produce a vaccine for H1N1, they are still months away from having enough stocks - too late for the Southern Hemisphere's winter flu season.

South America has already recorded five deaths from the disease: two in Chile, one in Colombia last week and, most recently, those of a three-month-old girl and a 28-year-old man with leukemia in Argentina's capital Buenos Aires.

The number of infected cases is outstripping figures put out regularly by the World Health Organisation.

According to the latest statistics on Tuesday Chile's confirmed number of patients with H1N1 flu soared by several hundred from 2 355 to 3 125.

Other national health authorities also registered increases with Argentina reporting 733, Peru with 113, Brazil 69, Ecuador 84, Venezuela 44, Uruguay 36, Paraguay 25 and Suriname 13.

Those figures are far overshadowed by the data from North America, the apparent source of the pandemic.

Mexican authorities say they have had 109 deaths and 6 294 infected cases. The United States on Tuesday added a nine-year-old boy to its death toll, bringing it to 47, alongside 17 855 infected cases. Canada has six deaths and 3 515 infections.

Central America and the Caribbean have also been hit, registering nearly 800 infections and three deaths (one each in Costa Rica, the Dominican Republic and Guatemala).

Although the A(H1N1) virus has been classed as relatively mild since first being detected in April, its unusually strong effect on the young, on those with other underlying health problems, and on the poor have made it a redoubtable challenge.

Some major drug companies have started producing a vaccine for pre-clinical testing, but one of them, Switzerland's Novartis, told the Financial Times it did not intend to give it away to poor countries.

US rival Baxter said on Tuesday it should have its H1N1 vaccine commercially available in July.

But there were underlying fears that the virus currently spreading around the world through human-to-human contact might mutate further, possibly into a more deadly form, as happened with the 1918 Spanish flu which killed tens of millions.

Those fears heightened a little on Tuesday, when a Brazil's Adolfo Lutz Bacteriological Institute said its researchers had identified and isolated a new strain of the A(H1N1) virus in a Sao Paulo patient.

It was not yet known whether that variant, called A/Sao Paulo/1454/H1N1, was more aggressive than the more common type.

The institute said in a statement the mutation comprised of alterations in the Hemagglutinin protein which allows the virus to infect new hosts.

.

[Faerie]

Swine Flu is now officially the latest conversation point here. We've had a marked spike in cases since the 18th, with both cases and deaths doubling over the weekend. Nine of the 18 deaths were pregnant women in their last trimester. Only one of the babies thus far were saved, they did an emergency ceasar (10 weeks early) and the baby is healthy and clear of the virus (??? not sure how that is possible?).

Stumbled upon this website which seems to be updated fairly accurately:

http://www.theora.com/swineFlu/

Is the media in your local area still all over this or has it mellowed out over your summer season?

[Monad]

A good blog on the Flu:

http://afludiary.blogspot.com/2009/08/swine-flu-paradox.html

[Notta]

^^^ Yes. The number of worldwide infections and the number of deaths seem ridiculous compared to influenza or the common cold.

What aren't they telling us, because the statistics don't gel with it being elevated to a level six fuck up.

My conspiracy-theory corpuscle is tweaking. Let's create a boogey man and sell billions of dollars worth of unnecessary snake oil anti-virals.Level six doesn't mean it's more dangerous, but that it has a high likelihood of infecting people in every country, and it's a new variant that few people have an immunity to. It's about the level of contagion and how widespread it is -- globally.

Plus, many of the deaths have been young children and pregnant women, who seem to be particularly at risk. Those two groups are not often the most vulnerable in a flu epidemic. The more people who get infected, the more likely it will spontaneously mutate into something more virulent, too (think how HIV has mutated).

[Monad]

^^^ Yes. The number of worldwide infections and the number of deaths seem ridiculous compared to influenza or the common cold.

What aren't they telling us, because the statistics don't gel with it being elevated to a level six fuck up.

My conspiracy-theory corpuscle is tweaking. Let's create a boogey man and sell billions of dollars worth of unnecessary snake oil anti-virals.Level six doesn't mean it's more dangerous, but that it has a high likelihood of infecting people in every country, and it's a new variant that few people have an immunity to. It's about the level of contagion and how widespread it is -- globally.

Plus, many of the deaths have been young children and pregnant women, who seem to be particularly at risk. Those two groups are not often the most vulnerable in a flu epidemic. The more people who get infected, the more likely it will spontaneously mutate into something more virulent, too (think how HIV has mutated).

Yep - read that blog post above. The paradox here is that this is a lot milder for most people than seasonal flu and is not hitting older people as much (who tend to be the group that dies the most from seasonal flu) so the mortality figures are way lower than the worst case projections (thankfully). However out of the younger people it is affecting certain groups seem to be hit really hard - people with compromised immune systems like pregnant mums, people with conditions like asthma, and just occasionally it develops into a really severe respiratory infection even in people with no underlying conditions. So although the number of people dying is much less there is a significant group of largely younger patients who are heading straight for intensive care and that is a significant difference from seasonal flu. It kills less but hospitalises more.

In the U.K., where swine flu sparked a summer wave of illness worse than the previous 10 winters, about 1 in 10 patients hospitalized for the virus end up in intensive care, according to Liam Donaldson, England’s chief medical officer. In Australia, that proportion is about 25 percent, he said.

“They have had a relatively high level of intensive care admissions amongst hospitalized patients,” Donaldson told reporters in London yesterday. “We might end up like that, but we can’t be 100 percent sure.”

Bypass Patients

While fewer than 0.5 percent of swine flu sufferers may need hospitalization, those who do can remain in intensive care for up to three weeks, occupying a bed that could be used for 15 heart bypass patients. Christchurch Hospital, the biggest on New Zealand’s South Island, postponed non-emergency procedures requiring an ICU stay such as heart bypass as flu patients -- three-quarters needing mechanical ventilation -- filled up the 12-bed unit and nine other hastily created intensive-care beds, according to Shaw.

What’s more, a 10th of those critically ill patients needed their blood pumped through an artificial lung, a procedure known as extracorporeal membrane oxygenation, or ECMO, that only one hospital in New Zealand offers.

“I’ve seen nothing like this,” said John Beca, head of pediatric intensive care at New Zealand’s national children’s hospital in Auckland. Five of Beca’s six ECMO units have been used simultaneously this winter. He’s ordering three more.

“If you quantify the impact in terms of the number of life-years lost, then this pandemic could well end up being more severe than a typical flu season,” Neil N. Ferguson, professor of epidemiology at London’s Imperial College, said in an Aug. 13 telephone interview.

In some patients, the virus causes such a severe assault on the respiratory tract that the lungs become inflamed and the grape-like sacs where gas is exchanged are injured, causing bleeding and a critical loss of oxygen supply.

“We are all concerned given the severity of this disease and the significant critical care support and resource utilization required for the successful treatment of these patients,” said Lena Napolitano, chief of acute care surgery at the University of Michigan Health System at Ann Arbor.

Studies in the U.S. show that the group of patients requiring mechanical ventilation for at least four days is growing six times faster than the rest of hospitalizations, said Marya Zilberberg, a scientist with the Amherst EviMed Research Group at the University of Massachusetts.

http://www.bloomberg.com/apps/news?pid=20601202&sid=a9vKlznnyeQ4

It also spreads very fast - maybe somewhat more infectious than seasonal flu (I suspect the mildness is a factor here as many people have sub acute cases). In Australia and NZ it rapidly replaced all cases of seasonal flu - out-competed them.

I'm just recovering from a severe asthma exacerbation and have been on Prednisol all month (so my immune system is already low) so I really can't afford to get this right now.

[Ray Moscow]

Hey, no problem: only half the US will get swine flu!

More than half of U.S. may get H1N1 this fall and winter, White House science panel says (http://www.scientificamerican.com/blog/60-second-science/post.cfm?id=more-than-half-of-us-may-get-h1n1-t-2009-08-25&sc=DD_20090826)

The H1N1 swine flu could kill as many as 90,000 Americans and land up to 1.8 million in the hospital, according to a report issued yesterday by the President's Council of Advisors on Science and Technology (PCAST).

The findings are "not a prediction," the authors make clear, but rather "a plausible scenario" to help ready the country's government and health care system.

The advisors estimate that 40 to 60 percent of the U.S. population could contract the virus this fall and winter, compared with the average of 5 to 20 who get the seasonal flu. "The absolute number of deaths is expected to be at least as high, if not substantially higher than for the seasonal flu," simply because more people are likely to get the H1N1 swine flu than the seasonal flu, the authors write.

I think this assumes that it doesn't turn into a nastier, more dangerous strain.

[Monad]

"The absolute number of deaths is expected to be at least as high, if not substantially higher than for the seasonal flu," simply because more people are likely to get the H1N1 swine flu than the seasonal flu, the authors write.

It also assumes you can just extrapolate from seasonal flu when in fact there is growing evidence that the two diseases have very different profiles. As I posted above, swine flu kills a lot less people because it doesn't hit older people as hard but puts proportionately more younger people in hospital with 10% or more (up to 25% in Australia) of those needing intensive care. Of course as you say, all that could change, but if it does there is still greater likelihood it will change to something more like 1918 flu than seasonal flu because 1918 flu also had this profile but was much more aggressive..

[Monad]

Well I guess, given that "Swine" flu already contains elements of bird as well as swine and human flu, that this was inevitable at some point:

http://news.bbc.co.uk/1/hi/sci/tech/8224923.stm

bit worrying though

[Valheru]

I think I may have had a swine flu bout this last week, although nothing was diagnosed, and I recovered as usual.

Coulda been, or not....?

[Notta]

Stick out your tongue and let me take a look....

[Ray Moscow]

I was around a colleague who was recovering from the flu (but still coughing) a few weeks ago and had some mild stomach bug a few days later. I hope that was it!

[Anne]

hmm...

I recently read that the Spanish flu was also called the swine flu and that there was a flu referred to only as H1N1 in Russia in the 30's and 50's and 70's...

I read this in Bi8ll Bryson's A Short History of Everything, published in 2003.

[Matty]

awesome book. Ecveryone, especially the non scientists out there, should read it. It is one of the best laymans explanations of why who what and where we are, its hard to descrbe how effective it is. I have both the bog standard version and the limited edition illustated heardback which is even cooler. I keep the posh one at home and lend the older copy out to everyone i can possibly bug with it.


and yeah Swine flu, the scariest disease since SARS and BSE.

[Matty]

Stick out your tongue and let me take a look....

Watch it Val, shes gonna rufy you.