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Salutations to all,

Quite a few news is emerging from the Influenza Network these days and some of them we do have to consider it individually.

H3N2, another flu virus has been identify in a patient returning from Mexico to B.C.(Canada).  The H3N2 (Brisbane) version was particularly morbid in Australia las Flu season in the southern hemisphere. Something to watch upon in the next few days.

More important for individual reasons to wash our hands often is a study done in Switzerland that shows that flu virus can live up to 17 days on money.

Washing Hands and Washing hands is a great protection against catching the flu.

Second Strain Might Have Caused Some Severe Cases In Mexico, Investigators Say

Via NPR

Quote

A new discovery from Canada raises the question — has a new mutation in an ordinary flu virus been causing some of the recent respiratory disease hospitalizations and deaths in Mexico?

It’s too soon to tell, but scientists in Vancouver are wondering. They’ve found two mutations in H3N2, a regular seasonal flu virus that’s been circulating in North America since last fall.(The swine flu virus is a type of H1N1.

The new version of H3N2 has shown up in a number of nursing home patients in British Columbia, though not yet in the general community there.

And this week the Canadian researchers spotted it when they did a complete genetic analysis of a flu virus that sickened a Canadian traveler who had just returned from Mexico.

This raises the possibility that the traveler became infected in Mexico, says Dr. Robert Brunham, chief of the British Columbia Centre for Disease Control.

If so, the H3N2 virus circulating in Mexico may have the same two mutations as those being found in British Columbia patients who haven’t been to Mexico.

"In British Columbia, the H3N2 virus causes more severe cases of flu than H1N1 does," Brunham says.

"So we wonder if some of the severe cases in Mexico may have been caused by the variant H3N2 virus."

However, health officials have so far only done close genetic analysis on one Mexico traveler. So they can’t say how many of the others have the new version of H3N2.

These findings if confirmed in more cases will become a problem in the determination of the strains included in the next vaccine production for the Fall season in the Northern Hemisphere.

Snowy Owl

Originally posted to Snowy Owl on Thu May 07, 2009 at 04:03 AM PDT.

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Comment Preferences

  •  Catching Flu From Money (5+ / 0-)
    Recommended by:
    Agathena, ovals49, ybruti, Fabian, mango

    Via http://well.blogs.nytimes.com/...

    Quote

    The influenza virus can survive on paper money for 10 or more days — suggesting that when we shop, spend and bank, there’s more than cash that is changing hands.

    The link between flu virus and paper currency is explained this week in a story on SmartMoney.com. The findings don’t mean we should fret about handling currency — but it does illustrate why health officials repeatedly tell people to wash hands frequently. From the SmartMoney report:

    Generally speaking, scientists interviewed by SmartMoney estimate the lifetime of a plain flu virus deposited on money at an hour or so. But mix in some human nasal mucus, and the potential for the virus to hang on long enough to find a victim increases, according to one of the few scientific studies done on flu transmission through cash.

    In a study conducted at Switzerland’s Central Laboratory of Virology at the University Hospitals of Geneva, researchers tested to see what would happen when flu virus was placed on Swiss franc notes. In some of these tests, researchers placed flu virus mixed in with nasal secretions from children on banknotes —and saw some unexpected results.

    When protected by human mucus, the flu cells were much hardier—in some cases, lasting up to 17 days on the franc notes. The virus that persisted for 17 days was a form of influenza A called H3N2. In an e-mail interview, Dr. Yves Thomas said samples of an influenza A strain called H1N1 also endured for quite a bit — in some cases, up to 10 days. That bug was similar but not identical to the virus at the center of the current swine flu outbreak, which is considered a new strain of H1N1.

    more at http://well.blogs.nytimes.com/...

    Achak

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:06:30 AM PDT

    •  Wow, and with all that cocaine that's on (3+ / 0-)
      Recommended by:
      jrod, Paladine, Snowy Owl

      paper currency, it makes one wonder whether credit cards aren't so evil after all . . . .

      •  Debit cards. No interest , not much nasty , maybe (1+ / 0-)
        Recommended by:
        Roadbed Guy

        drug dealers will take them.Have same 1.5% ad on charge as credit card (each use) , from companies that handle the transactions for merchants/banks.

        •  In an ideal world that might work (3+ / 0-)
          Recommended by:
          bronte17, Fabian, Abra Crabcakeya

          but I'm boycotting debit cards . . . frankly, I can't remember why (it's much like Peter and the giant Chicken in Family Guy who are always fighting but can't remember why -  clearly, however, something very traumatic happened in the past to engender such hard feelings).

          •  Better for us than credit , for sure , and less (1+ / 0-)
            Recommended by:
            Roadbed Guy

            than cash for many reasons. I still prefer cash , myself, and I use debit card for phone ordering so I can find out about in stock or not , not wait two weeks like you do mailing a check.I've forgotten how many businesses , industries even I've "boycotted". As I have gotten older , don't need or wrongly perceive need for stuff nearly as much.

            •  I realize it goes against the grain here at DK (2+ / 0-)
              Recommended by:
              Abra Crabcakeya, Snowy Owl

              but I kinda like my credit cards, especially - for only a $75/year fee - the free rewards that accrue . . . .

              •  I love my credit cards... (0+ / 0-)

                ...nothing beats them for convenience, and I always pay them off in full each month, so no interest either.

                "When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a communist." -- Dom Hélder Câmara

                by SLKRR on Thu May 07, 2009 at 05:32:16 AM PDT

                [ Parent ]

              •  Plus the merchant fees! (0+ / 0-)

                Visa/Mastercard are collecting 1-3% of a huge fraction of all retail sales (the credit card portion). It's charged to the merchant, who adds the cost into their pricing.

                Since it's basically a series of computer database transactions, I  cannot see the justification for charges this high. It should cost a flat 20 cents, not $5 to $15 on a $500 charge.

                Insanity is a perfectly rational adjustment to an insane world...

                by crazyamerican on Thu May 07, 2009 at 06:53:15 AM PDT

                [ Parent ]

            •  Debit cards are bad in the case of fraud (1+ / 0-)
              Recommended by:
              bronte17

              People have direct access to your bank account and you then have to fight to undo the transfer of money.

              In the case of the (evil) credit card, you at least are in a position to dispute a charge BEFORE you pay it.  The money does NOT come out of your account until you pay the credit card company.

              Happy little moron, Lucky little man.
              I wish I was a moron, MY GOD, Perhaps I am!
              -Spike Milligan

              by polecat on Thu May 07, 2009 at 06:38:37 AM PDT

              [ Parent ]

    •  It's not just money that spreads germs (0+ / 0-)

      the public pen you use to sign your credit/debit card slip or the stylus on the digital tablet see a lot of snotty hands.  Bringing one's own is a good idea.  

      Otherwise, keep your hands away from your face until you've had a chance to wash them.  For some people (yours truly) this is a surprisingly difficult behavior modification.  That's why I bring my own pen.

      "If you don't read the newspaper, you're uninformed. If you read the newspaper, you're mis-informed." -- Mark Twain

      by ovals49 on Thu May 07, 2009 at 07:28:20 AM PDT

      [ Parent ]

  •  Tip Jar for Hand Washing (13+ / 0-)

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:07:52 AM PDT

  •  People starting to laugh at the "overreaction " (3+ / 0-)
    Recommended by:
    bronte17, Fabian, OrangeMike

    of public health officials over swine flu might stop to think about how stringent measures put into place , public education cranked up at the beginning signs of epidemics /pandemics are the sign of those pros doing their work at  the highest level of proficiency.Starts but fizzles ; the clipboard crews have done a bang up job.

    •  Do Public Health Officials have a lot of Freedom? (2+ / 0-)
      Recommended by:
      bronte17, Abra Crabcakeya

      When Huge Economics are at stakes, when crowd control heading to underfunded and understaff hospitals are of concerns.  When Nations do not agree to READ what a Level 6 Pandemic is in Official WHO documents, etc.. what is left for us "Public Health Officials", what is left is to relay and diffuse preventive measures and trying our best to put into perspective the consequences of Ostriches Behaviors.

      Snowy

      In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

      by Snowy Owl on Thu May 07, 2009 at 04:23:19 AM PDT

      [ Parent ]

    •  "Overreaction" stories are just plain stupid -- (1+ / 0-)
      Recommended by:
      Abra Crabcakeya

      at least until the mexico fatalities are adequately explained.

      •  Flu is like a potential BIG nuclear accident... (1+ / 0-)
        Recommended by:
        Abra Crabcakeya

        Millions dead of flu is very unlikely, partly because such careful precautions are taken, but unthinkably bad if it did.

        I don't hear the media making the connection to a deadly strain, the 50% mortality of some avian strains .vs. the current H1N1/Mexico. And how strains appear unpredictably.

        Does anyone complain nuclear safety is a waste of time because we didn't have a meltdown?

        I hate the overreaction stories. Very stupid. Very dangerous.

        Insanity is a perfectly rational adjustment to an insane world...

        by crazyamerican on Thu May 07, 2009 at 06:45:30 AM PDT

        [ Parent ]

  •  Tips (4+ / 0-)

    Don't use money, use your ATM cards where you swipe them yourself.

    My local market supplies handy wipes to clean the handles of the baskets as you start your shopping.

    This above all: to thine own self be true...-WS

    by Agathena on Thu May 07, 2009 at 04:16:35 AM PDT

    •  Carry your own pen to sign in at docs' offices (4+ / 0-)
      Recommended by:
      bronte17, Agathena, Fabian, Snowy Owl

      and Rx counter, many people ar ethere because they are sick with a communicable disease , even if not necessarily dangerous one or easily transmitted.Cleaning hands thoroughly after bathroom visits , and a time or two more per day is likely enough for most of us , if not food prep or health workers.If the tips you and Snowy Owl,many others are giving get through to a lot of people the preventive health care benefits will be discernible if not necessarily strictly quantifiable.  

  •  Bacterial Contamination of Paper Currency (3+ / 0-)
    Recommended by:
    bronte17, ybruti, G2geek

    Bacterial Contamination of Paper Currency.

    ORIGINAL ARTICLES
    Southern Medical Journal. 95(12):1408&hyhen;1410, December 2002.
    POPE, THEODORE W. USAF, MC; ENDER, PETER T. MD; WOELK, WILLIAM K.; KOROSCIL, MICHAEL A.; KOROSCIL, THOMAS M. USAF, MC

    Abstract:

    One-dollar bills were collected from the general community in western Ohio to survey for bacterial contamination.

    Pathogenic or potentially pathogenic organisms were isolated from 94% of the bills.

    These results suggest a high rate of bacterial contamination of one-dollar bills.

    (C) 2002 Southern Medical Association
    PDF access via
    http://www.smajournalonline.com

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:17:55 AM PDT

  •  ‘Awareness of Humanity’ (0+ / 0-)

    ‘Awareness of Humanity’

    By Snowy Owl

    May 6, 2009

    Into shackled Labor via Perceptions,
    Comes forth within our Consciousness,
    A new network of Communication.

    ‘Awareness of Humanity’,
    That Transcend Beliefs, Languages,
    Cultures, Traditions, Sciences and Opinions,
    It is coming forth right before our Eyes

    Life Itself is Inter-Dependent
    We Now Perceive it more Clearly.

    Indeed, the Inter-Dependence of Life,
    At all Scales, Casts, Class and Layers.
    At the Micro, Meso, Macro and Mega Levels
    Life, in all Forms, is Inter-Dependent

    It is more obvious Day by Day.

    Inter-Dependence... Keeping us Aware,
    Making us Humble,
    More Sympathic and Empathic.

    We are discovering all these Gateways between Everything, year after year.

    No Solar flares from our Sun as
    Huge amount of Volcanic Ashes thrown out in Our Upper Atmosphere
    Indeed means Cooler Temperature for our Earth.

    Emergence of a new virus can affect all Humanity

    Global Economic downfall affects all Nations

    We are learning that we have to;
    All together put our shoulders to the Wheel,
    To reduce; conflicts, morbidity and mortality.
    There are no other Ways.

    Individual, Collective, National, Cultural, Scientific and Beliefs must Now,
    Share their ‘Know How’ and co-ordinate the Dispatching of Resources
    We are in this Together.

    It’s all Understood

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:26:24 AM PDT

  •  ‘Pandemic,’ not ‘Duck and Cove (0+ / 0-)

    The Geopolitics of Pandemics
    May 4, 2009 |

    by George Friedman at Stratfor.com

    WHO level 5 Panic reaction

    This panic had three elements.

    The first related to the global nature of this disease, given that flus spread easily and modern transportation flows mean containment is impossible.
    Second, there were concerns (including our own) that this flu would have a high mortality rate.
    And third, the panic centered on the mere fact that this disease was the flu.

    News of this new strain triggered memories of the 1918-1919 flu pandemic, sparking fears that the "Spanish flu" that struck at the end of World War I would be repeated. In addition, the scare over avian flu created a sense of foreboding about influenza — a sense that a catastrophic outbreak was imminent.

    By midweek, the disease was being reported around the world. It became clear that the disease was spreading, and the World Health Organization (WHO) declared a Phase 5 pandemic alert.

    A Phase 5 alert (the last step before a pandemic is actually, officially declared, a step that may be taken within the next couple of days) means that a global pandemic is imminent, and that the virus has proved capable of sustained human-to-human transmission and infecting geographically disparate populations.

    But this is not a measure of lethality, only communicability, and pandemics are not limited to the deadliest diseases.

    ‘Pandemic,’ not ‘Duck and Cover’

    To the medical mind, the word "pandemic" denotes a disease occurring over a wide geographic area and affecting an exceptionally high proportion of the population. The term in no way addresses the underlying seriousness of the disease in the sense of its wider impact on society. The problem is that most people are not physicians.

    When the WHO convenes a press conference carried by every network in the world, the declaration of a level 5 pandemic connotes global calamity, even as statements from experts — and governments around the world — attempt to walk the line between calming public fears and preparing for the worst.

    The reason to prepare for the worst was because this was a pandemic with an extremely unclear prognosis, and about which reliable information was in short supply.

    Snowy

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:32:31 AM PDT

  •  Debating the Wisdom of ‘Swine Flu Parties& (0+ / 0-)

    Debating the Wisdom of ‘Swine Flu Parties’
    By DONALD G. McNEIL Jr.
    NYTimes Published: May 6, 2009

    Hat Tip to Sally from Flutrackers.com

    What at first appears an absurdity — seeking out infection with swine flu instead of avoiding it — is being actively debated on flu Web sites and by some flu experts.

    Infectious disease specialists say they understand the logic — that surviving the current, apparently mild strain of the virus might be protective if a more virulent strain emerges next fall. But they are generally against it.

    Dr. Anne Moscona, a flu specialist at Weill Cornell Medical College, said she had been called by a reporter for a women’s magazine "asking if mothers should hold swine flu parties, like chicken pox parties."

    ("Chicken pox parties" — in which children gather so they can all be infected by a child who has the pox — are often held by parents who distrust chicken pox vaccine or want their children to have the stronger immunity that surviving a full-blown infection affords, and are willing to take the risk that their child will not get serious complications.)

    "I think it’s totally nuts," Dr. Moscona said. "I can’t believe people are really thinking of doing it. I understand the thinking, but I just fear we don’t know enough about how this virus would react in every individual.

    This is like the Middle Ages, when people deliberately infected themselves with smallpox. It’s vigilante vaccination — you know, taking immunity into your own hands."

    One of the first open debates of the idea of intentional self-infection was on Effect Measure, a public health blog with many posts by thoughtful people who say they are clinicians, epidemiologists, veterinarians and other professionals, sometimes in government, but who post under pseudonyms in order to speak freely.

    On April 28, a user calling herself OmegaMom posted: "Just a quick note — I just got a Tweet from a mom suggesting ’swine flu parties’ because the U.S. version seems to be a mild version. "Can you speak to the utter insanity of doing this, please?"

    Several posters weighed in to say it would be foolish given the number of deaths in Mexico, the lack of information on the virus and the unpredictability of flu.

    The chief moderator of another blog, flutrackers.com, who posts as Florida1, said one of her long-time members, GaudiaRay, had raised the idea for debate three days ago. She called him at home, she said, and he told her he had decided not to put his family at risk.

    Dr. Andrew T. Pavia, chairman of the pandemic influenza task force of the Infectious Diseases Society of America, opposes self-infection.

    The Centers for Disease Control and Prevention has not posted guidance on the question yet, but Dr. Richard Besser, the agency’s acting director, was asked about it this week and said "we don’t have a firm answer, but it’s our belief that protecting people from this infection is the right way to go."

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:48:03 AM PDT

    •  What about an engineered version? (1+ / 0-)
      Recommended by:
      Snowy Owl

      I know I ask too many questions perhaps...

      But what about the strategy to modify a deadly strain into a mild version and infecting everyone with that? As a desparate kind of vaccination? Is this possible? I think the gene splicing is not hard but are the right genes to make a mild version available?

      It would be easy to spread fast unlike manufacturing a world supply of vaccine. The moral questions are huge though...

      Insanity is a perfectly rational adjustment to an insane world...

      by crazyamerican on Thu May 07, 2009 at 07:21:26 AM PDT

      [ Parent ]

      •  This option is out of reach for quite (1+ / 0-)
        Recommended by:
        Paladine

        Sometime

        Vaccine must be evaluated, studied, tried, retried, checking the side effects, cultivated, dispatch, etc..

        There will be tomorrow, from memory here, a reunion of all vaccine producers and the WHO on the compositions od their productions for next fall.

        I will post when I have objective sources.

        Snowy

        In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

        by Snowy Owl on Thu May 07, 2009 at 07:46:21 AM PDT

        [ Parent ]

  •  European Centre of Diseases Control and Preventio (0+ / 0-)

    European Centre of Diseases Control and Prevention (ECDC), Updates, Statements, News

    All thanks to Ironorehopper Director of the Italian Forum of Flutrackers

    NOVEL INFLUENZA H1N1: ECDC SITUATION REPORT (Updated at May 7, 2009, 08:00 CEST)

    European Union and EFTA countries

    Within the last 24 hours, 17 new confirmed cases were reported in the EU and EFTA countries: eight cases in Spain, four in the United Kingdom, three in France and one case each from Poland and Sweden.

    This brings the total to 142 confirmed cases in 13 EU and EFTA countries.

    Currently 4 probable cases are reported, from France (3) and the United Kingdom (1). However, it needs to be noted that the number of probable cases reported changes on a daily basis as some become confirmed or are discarded. For the cases reported from Poland and Sweden, both had travel history to the United States. No new cases of in country transmission in the EU were reported.

    Influenza A(H1N1) infection Update 7 May 2009, 08:00 hours CEST

    To date, 142 confirmed and 4 probable cases are reported in 13 EU and EFTA countries;

    No sustained human-to-human transmission has been recorded so far in the EU;

    Outside of EU and EFTA countries, 2098 cases are reported, 2075 of which are confirmed;
    Mexico has reported over 1000 cases since the start of the outbreak.

    The Canadian National Microbiology Laboratory in Winnipeg reported today that they have completed full genetic sequencing on viral isolates from Mexico, Nova Scotia and Ontario (http://www.phac-aspc.gc.ca/media/nrr...6_h1n1-eng.php).

    The sequences have been submitted to GenBank®, a collection of all publiclyavailable DNA sequences from the National Institutes of Health in the US.
    On 5 May 2009, the Standing Committee on the Food Chain and Animal Health of the European Commission madea statement regarding the previously reported human-to-pig transmission in a swine herd in Alberta, Canada

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 04:56:45 AM PDT

  •  Recovered pigs may enter food supply, Canada says (1+ / 0-)
    Recommended by:
    Paladine

    Recovered pigs may enter food supply, Canada says

    SASKATOON, Saskatchewan (Reuters)

    Pigs that have been infected with the H1N1 flu virus could enter the human food supply once the animals recover and can be shown to pose no threat, Canadian health officials said on Wednesday.

    Officials spelled out their intentions after the World Health Organization cautioned on Wednesday that meat from pigs infected with the H1N1 virus should not be used for human consumption. However, it wasn't immediately clear if WHO's statement applied to animals that had recovered from the illness.

    Canadian authorities said they would allow all "virus-negative" pigs into the food supply, whether an animal never had the virus or had recovered from it, if they determine they pose no risk to humans.

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 05:02:25 AM PDT

  •  WHO says A H1N1 pigs must be kept out of food sup (0+ / 0-)

    WHO says A H1N1 pigs must be kept out of food supply

    All thanks to Crofsblog

    Via www.theglobeandmail.com
    TAN EE LYN
    Reuters
    May 6, 2009 at 4:28 PM EDT

    HONG KONG — Meat from pigs infected with influenza A H1N1 should not be eaten by humans, a WHO official said Wednesday, while stressing that existing checks were sufficient to safeguard the food supply from the new virus strain.

    Jorgen Schlundt, director of the World Health Organization's Department of Food Safety, Zoonoses and Foodborne Diseases, said care must be taken to ensure that pigs and their meat were checked for all diseases, including the H1N1 virus that may be present in the blood of infected animals.

    "Meat from sick pigs or pigs found dead should not be processed or used for human consumption under any circumstances," he told Reuters.

    It is possible for flu viruses such as the new H1N1 strain to survive the freezing process and be present in thawed meat, as well as in blood, the expert said. But he stressed that there was no risk of infection from eating or handling pork so long as normal precautions were adhered to.

    "While it is possible for influenza viruses to survive the freezing process and be present on thawed meat, there are no data available on the survival of influenza A H1N1 on meat nor any data on the infectious dose for people," he wrote in an e-mail reply to questions from Reuters about risks from the respiratory secretions and blood of infected pigs.

    Mr. Schlundt said it was still unclear whether and how long the virus, which is commonly known as swine flu but also contains human and avian flu pieces, would be present in the blood and meat-juices of animals which contracted it.

    "The likelihood of influenza viruses to be in the blood of an infected animal depends on the specific virus. Blood (and meat-juice) from influenza H1N1-infected pigs may potentially contain virus, but at present, this has not been established," he said.

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 05:08:17 AM PDT

  •  What have we learned? (0+ / 0-)

    What have we learned?

    Sincere thanks for Cottontop initiative at Flu Wiki for this Thread

    http://newfluwiki2.com/...

    Very informative comments from knowledgeable people.

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 05:18:58 AM PDT

  •  OK an Influenza Pandemic has begun; what should w (0+ / 0-)

    OK an Influenza Pandemic has begun; what should we do now?

    By the Doctor a very pro-active MD who has done extensive research in Pandemics and has significantly contribute in pandemic Preparedness.

    Gratton Woodson's (The Doctor) has written the Flu Treatment Manual

    His work has reach millions.

    IMO, this is really the question we should be addressing here now.  Why, because we probably have at least a few weeks but hopefully several months to act before things could become very bad.

    The "few weeks" scenario: The Mexican Flu in North America becomes virulent over the next month with a rising number of severe cases and deaths.  

    The "few months" scenario: The Mexican Flu dies out in the northern hemisphere but strikes the southern severely during which it reassorts or recombines with seasonal flu or H5N1 becoming significantly more lethal and Tamifu resistant.  In the fall of 2009, the significantly more vicious strain of Mexican Flu returns to the northern hemisphere and wreaks havoc here.
    The Doctor :: OK an Influenza Pandemic has begun; what should we do now?
    Since Mexican Flu has spread quickly among the human population and has now affected domestic swine, IMO it seems reasonable to assume that it has now established itself within these two mammalian species sufficiently to prevent its simply dying out.  So the third possibility that this new strain would simply go away as happened with the 1976 swine flu strain is now unlikely.

    So, here we are in the midst of a pandemic caused by a novel virus that bears many similarities to the 1918 Spanish Flu.  That said, we don't know what will come next although it is my guess that the most probable course is that the virus disappears from the NH, attacks the SH, evolves to a more lethal strain and returns the NH in the fall where it could have catastrophic effects.

    Despite the hope for "change" in government, it is clear that with respect to pandemic preparedness, in the US at least there has been none.  

    There are probably many reasons for this.  My analysis of this anomaly suggests that is it driven primarily by the government's need to prevent public panic. This was a premier concern of the prior US administration. Our governments are also very interested in supporting the global economy's health and are loath to do anything that could derail the hoped for recovery some say is underway.

    These two concerns apparently have a higher priority than the actual health of the public.  While this speculation may seem outlandish to some, in response I suggest that those of you who thinks so at least consider this view as a possibility.

    For those of you who think that there is a risk that we have a few "weeks" or "months" before TSHF it would be of interest to hear what you are doing to get prepared.  What do you suggest those new to this topic do?  

    Grattan Woodson, MD

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 05:24:55 AM PDT

    •  How to prepare? (1+ / 0-)
      Recommended by:
      Snowy Owl

      I see a lot of suggestions to buy everything imaginable to "sit in place" at home: stockpile water, food, fuel, supplies to hide at home for 3 or more months.

      Is this really what public health officials would have individuals do? It would cause massive distruptions to businesses selling necessities (food, etc), public services (water and electricity) if everyone stays home for 3 months.

      Or is this strategy advanced because more collective action is not expected? Isn't this "sit in place" strategy a bit pessimistic and unworkable?

      Insanity is a perfectly rational adjustment to an insane world...

      by crazyamerican on Thu May 07, 2009 at 07:12:29 AM PDT

      [ Parent ]

      •  It depends on so many factors (0+ / 0-)

        And Climate, seasons, continents, Nations, Regions, Resources, etc..

        But the point is Keep it simple and cheap but go ahead, basic medicines in your context, some water reserve and some food and certainly learn how to act if you or one in your famely becomes ill, learning up to when you must care for yourselve and when to go to the CLinic or the Hospital.

        If you do this, steadily you will not be a burden for the system and you will be safe.

        Hope this help

        Snowy

        In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

        by Snowy Owl on Thu May 07, 2009 at 07:50:30 AM PDT

        [ Parent ]

  •  Swine flu: what does "so far, so good" mean? (0+ / 0-)

    Swine flu: what does "so far, so good" mean?

    A Comment from the Reveres at Effect Measure

    Breathing easier, may be an apt phrase for an almost audible collective sigh of relief. So far, the incipient swine flu pandemic is not extremely nasty. Is this perhaps premature? The world's premier scientific journal, Nature, and many flu scientists, suggest it is:

    Complacency, not overreaction, is the greatest danger posed by the flu pandemic. That's a message scientists would do well to help get across.

    There is ample reason for concern: a new flu virus has emerged to which humans have no immunity, and it is spreading from person to person. That has happened only three times in the past century.

    Yet at this early stage, the consequences of the pandemic are so uncertain that communicating the risks is a delicate matter. Influenza viruses evolve rapidly, making it extremely difficult to predict what this strain might look like a few months from now.

    The risk is not hyping the pandemic threat, but underplaying it.

    (Editorial, Nature)

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 05:31:05 AM PDT

  •  Pro.Med also has a post suggesting secondary (0+ / 0-)

    infections may have caused most of fatalities, not cytokine storms or other direct effects from influenza. For instance, the boy in Perote ("index case") got better after two days of antibiotic treatment.

    Proud member of the "Dkos Swine Lobby" since April 2009

    by the fan man on Thu May 07, 2009 at 05:41:30 AM PDT

  •  New Study Finds U.S. Emergency Rooms 'At Breaking (0+ / 0-)

    Forget About Pandemic...New Study Finds U.S. Emergency Rooms 'At Breaking Point'

    All thanks to James Unland, an Executive Editorand Investigative Reporter

     

    "We're worried about a car crash that has 10, 15 or 20 victims ... let alone a pandemic."  Dr. Brent Asplin

        We don't need a pandemic to overwhelm hospital ERs...they're already overwhelmed!  ER utilization is growing at twice the rate of the U.S. population... to the point where, on average, every minute of every day an ambulance is diverted from its original destination hospital to another hospital because of ER overcrowding.  The National Academies, a prestigious confederation of scientific and medical research organizations, exhaustively studied hospital-based emergency care and issued a Report concluding that hospital emergency departments are "overburdened, underfunded and highly fragmented."  In addition, over 400 hospital emergency departments have closed over the last 10 years.  One of the experts on the study committee was Dr. Brent Asplin, head of an emergency department in St. Paul, Minnesota, who was good enough to talk about both the hospital ER crisis in respect to the present-day situation as well as implications in a pandemic context.

      Listen to streamed interview  (running time: 7:00)

    http://www.healthbusinessandpolicy.c...  

    A very good site IMHO

    Snowy Owl  

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 05:48:49 AM PDT

    •  Are Europeans wondering? (1+ / 0-)
      Recommended by:
      Snowy Owl

      Are Europeans wondering if the sad state of affairs in US healthcare doesn't put the world at more risk of a flu pandemic? Since people without access to care, without the ability to stay home from work when sick will more likely spread disease?

      Insanity is a perfectly rational adjustment to an insane world...

      by crazyamerican on Thu May 07, 2009 at 06:57:56 AM PDT

      [ Parent ]

      •  As a European Online news (1+ / 0-)
        Recommended by:
        Catte Nappe

        Mainly in French, British, German, Italy and Spain I can say that the overwhelmly are concerned about their own "Welcome Structures" for incoming Patients.

        There are Cultural Major differences.  Europe has seen them all, so, they are more concern about their infrastructures.  If Health Officine (not Executive Forces) implement NPI (Non-Pharmaceutical Interventions) like quarantine or SIP (Sit in Place) people are more incline to cooperate to such measures.

        While in Japan for instance, once they perceived themselves as probable carriers they feel they have a duty to protect others.

        These Realities explain why the Statement of a presumebly World Wide Health Response Trigger the WHO has to respect and adapt to Cultural Differences while at the same time doing their best via National Agencies to be efficient in reducing morbidity (Individually and Regionnaly) and mortality.

        Honestly, in such a context, most Health Authorities are doing pretty Good, and there are still a lot to be done.

        As for the Medias tough, it is an entirely different matter.

        Snowy

        In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

        by Snowy Owl on Thu May 07, 2009 at 07:09:07 AM PDT

        [ Parent ]

  •  Legal and Logistical Issues In a Pandemic (0+ / 0-)

    Legal and Logistical Issues In a Pandemic
    Declaration Of An Emergency
    Governmental Roles, Quarantines,Police Powers, Hospital 'Triage' and
    Capacity Issues and Related Topics

    Attorney David Massa, Chairman of the MidAmerica Public Health Law Emergency Response Committee and Partner in the St. Louis law firm of Gallop, Johnson & Newman, discusses numerous crucial legal, governmental and logistical issues that a pandemic would raise, including:

    (a) what laws govern emergencies, who declares emegencies and what is the significance of doing so?

    (b) how far-reaching can local and federal 'police powers' be during an officially declared emergency?

    (c) to what extent can there be cross-jurisdictional coordination in a region or city among federal, state, county and city agencies and, in this respect, do federal powers trump state and local powers through FEMA?

    (d) what issues are raised relating to the ability of hospitals to screen or 'triage' patients who are afflicted during a pandemic?

    (e) can a hospital turn away patients if it is functioning at capacity in respect to either the intensive care units or the general medical/surgical floors? (f) what issues arise with respect to possible 'quarantines' of people, either on a small area basis or a larger area basis, and who has the authority to impose such quarantines? and (g) what areas of law actually remain vague, unaddressed and/or in need of further clarification in the context of a possible pandemic crisis event?

    Listen to streamed interview (running time = 25 minutes)
    At http://easylink.playstream.com/...
    Get MP3 of This Interview (click to listen, right click to save)

    Learning a lot with this one
    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 06:20:21 AM PDT

  •  CDC - Human Swine Influenza - Daily Case Updates (0+ / 0-)

    CDC - Human Swine Influenza - Daily Case Updates

    All thanks to MHSC of Flu Trackers

    U.S. Human Cases of H1N1 Flu Infection
    (As of May 7, 2009, 11:00 AM ET) States Laboratory
    confirmed
    cases Deaths
    Alabama 4

    Arizona 48

    California 106

    Colorado 17

    Connecticut 4

    Delaware 38

    Florida 5

    Georgia 3

    Hawaii 3

    Idaho 1

    Illinois 204

    Indiana 15

    Iowa 5

    Kansas 7

    Kentucky* 2

    Louisiana 7

    Maine 4

    Maryland 4

    Massachusetts 71

    Michigan 9

    Minnesota 1

    Missouri 4

    Nebraska 4

    Nevada 5

    New Hampshire 2

    New Jersey 7

    New Mexico 8

    New York 98

    North Carolina 7

    Ohio 5

    Oklahoma 1

    Oregon 15

    Pennsylvania 2

    Rhode Island 2

    South Carolina 17

    Tennessee 2

    Texas 91 2
    Utah 8

    Virginia 11

    Washington 23

    Wisconsin 26

    TOTAL (41) 896 cases 2 deaths

    International Human Cases of Swine Flu Infection
    See: World Health Organization

    *Case is resident of KY but currently hospitalized in GA.

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 08:58:19 AM PDT

  •  Joint FAO/WHO/OIE Statement on influenza A(H1N1) (0+ / 0-)

    Credits to Crofsblog

    Joint FAO/WHO/OIE Statement on influenza A(H1N1) and the safety of pork

    To avoid any misunderstanding FAO, WHO and OIE would like to reissue their joint statement originally issued on 30 April.

    In the ongoing spread of influenza A(H1N1), concerns about the possibility of this virus being found in pigs and the safety of pork and pork products have been raised.

    INFOSAN information note

    Influenza viruses are not known to be transmissible to people through eating processed pork or other food products derived from pigs.

    Heat treatments commonly used in cooking meat (e.g. 70°C/160°F core temperature) will readily inactivate any viruses potentially present in raw meat products.

    Pork and pork products, handled in accordance with good hygienic practices recommended by the WHO , Codex Alimentarius Commission and the OIE, will not be a source of infection

    Authorities and consumers should ensure that meat from sick pigs or pigs found dead are not processed or used for human consumption under any circumstances.

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 10:07:29 AM PDT

  •  Keiji Fukuda: said it was “quite likely&rd (0+ / 0-)

    Keiji Fukuda: said it was "quite likely" the WHO would declare a pandemic in the near future

    Official says H1N1 could infect third of world

    Reuters
    May 7, 2009

    Third of the world’s population could be infected by the H1N1 flu virus in the next year, a top UN health official said today, urging Asian governments to stay alert for a potentially wider pandemic.

    Keiji Fukuda, acting assistant director-general for the World Health Organization (WHO), also said it was "quite likely" the WHO would declare a pandemic in the near future but a final decision had not been made.

    "This is a disease that could potentially infect a third or more of the world’s population in the next several months, in the next year," Mr. Fukuda told Asian health officials meeting in Bangkok by conference call from Geneva.

    He added that "even if the illnesses appear relatively mild on a global level, the global population level adds up to enormous numbers."

    But David Nabarro, the UN influenza co-ordinator, worried governments might get complacent because many people in harder-hit countries had experienced only mild symptoms from the flu and recovered without medicine.

    He said the most serious flu pandemic of modern times, which killed some 40 million people in 1918-19, started with a milder early wave of infections. "We have to maintain vigilance and understand that the virus we are dealing with could easily change and become much more ferocious. We cannot let down our guard, regardless of what we are seeing at the moment," Mr. Nabarro told the conference.

    Mr. Fukuda said there was no decision yet on whether to revise the WHO’s pandemic alert, now at 5. He said it could drop to 4 or rise to the top of its 6-point scale, which would activate emergency response plans to fight the virus.

    "I think all these possibilities are open right now, although again it’s quite likely we could go to Phase 6 in the near future," he said.

    http://www.theglobeandmail.com/...

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 11:07:36 AM PDT

  •  Antioxidant-Polyphenols in fruits inhibits flu vi (0+ / 0-)

    Antioxidant-Polyphenols in fruits inhibits flu virus

    Chemical in grapes inhibits flu virus

    May 31, 2005 (CIDRAP News)

    Resveratrol, a chemical found in grapes and other fruits, inhibits the reproduction of influenza viruses in cell culture and mice, according to a recent report in the Journal of Infectious Diseases.

    Rather than directly attacking the flu virus itself, resveratrol seems to block host-cell functions that are essential for viral replication, says the report by Anna T. Palamara and colleagues at the University of Rome. They write that the substance holds promise as a possible weapon against flu.

    Resveratrol is an antioxidant that is found in at least 72 plant species and is known to help protect the heart and nervous system and help prevent cancer, says the report.

    In an initial cell-culture experiment, treatment with resveratrol at 20 mcg/mL reduced flu virus replication 90%, and treatment with 40 mcg/mL blocked replication completely.

    However, because the higher concentration damaged the cells, the lower concentration was used in further tests.

    The researchers also tested the effects of starting resveratrol treatment at different intervals after infecting cells with the virus.

    Treatment was most effective—reducing viral growth 87.5%—when treatment began 3 hours after virus exposure. Effects were lower but still significant when treatment began 6 hours after infection, and treatment had no significant benefit if delayed until 9 hours after infection.

    Given these and other findings, the researchers concluded that resveratrol interferes with the manufacture of proteins made late in the viral replication process, such as hemagglutinin, and limits the transport of viral ribonucleoproteins from the cell nucleus to the cytoplasm.

    The authors also determined that the molecular mechanism for resveratrol's effects has to do with the inhibition of protein kinase C activity and its dependent pathways.

    "We have shown that RV [resveratrol], a natural polyphenol whose concentration in red wine is 1.5-3.0 mg/L, can inhibit the in vitro and in vivo replication of influenza A virus without producing any significant toxicity," the article states.

    The apparent ability of resveratrol to block host-cell functions that flu viruses rely on offers important advantages, the researchers say. Compared with existing anti-flu drugs, resveratrol would be less likely to induce resistance by flu viruses, and it would probably be effective for all types and strains of flu virus.

    "For these reasons, RV merits further investigation as a potential weapon for combating the growing threat of influenza," the authors conclude.

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 12:36:02 PM PDT

  •  Sources and Food Source of Resveratol (0+ / 0-)

    Heart felt thanks to Shannon an Old Timer in Flu Forums and an experts in efficient alternatives medicine duly corroborated.

    Sources

    Food Sources

    Excerpts;

    Resveratrol is found in grapes, wine, grape juice, peanuts and berries of Vaccinum species including blueberries, bilberries and cranberries (73-75).

    In grapes, resveratrol is found only in the skins (76).

    The amount of resveratrol in grape skins varies with the grape cultivar, its geographic origin, and exposure to fungal infection (77).

    The amount of fermentation time a wine spends in contact with grape skins is an important determinant of its resveratrol content.

    Consequently, white and rosé wines generally contain less resveratrol than red wines (4).

    Red or purple grape juices may also be good sources of resveratrol (3).

    The predominant form of resveratrol in grapes and grape juice is trans-resveratrol glucoside (trans-piceid), but wines also contain significant amounts of resveratrol aglycones, thought to be the result of sugar cleavage during fermentation (73).

    Many wines also contain significant amounts of cis-resveratrol (figure 1), which may also be produced during fermentation or released from viniferins (resveratrol polymers) (78).

    Red wine is a relatively rich source of resveratrol, but other polyphenols are present in red wine at considerably higher concentrations than resveratrol (see the separate article on flavonoids) (79).

    The total resveratrol content of some beverages and foods are listed in the tables below. These values should be considered approximate since the resveratrol content of foods and beverages can vary considerably.

    Total Resveratrol Content of Wines and Grape Juice (3, 87, 88)BeverageTotal resveratrol (mg/liter) Total resveratrol in a 5-oz glass (mg) White wines (Spanish) 0.05-1.80 0.01-0.27 Rosé wines (Spanish) 0.43-3.52 0.06-0.53 Red wines (Spanish) 1.92-12.59 0.29-1.89Red wines (global) 1.98-7.13 0.30-1.07 Red grape juice (Spanish) 1.14-8.69 0.17-1.30

    Total Resveratrol Content of Selected Foods (73, 75, 89)

    Food

    Serving Total resveratrol (mg)Peanuts (raw) 1 cup (146 g) 0.01-0.26Peanuts (boiled) 1 cup (180 g) 0.32-1.28Peanut butter 1 cup (258 g) 0.04-0.13Red grapes 1 cup (160 g) 0.24-1.25

    Supplements

    Most resveratrol supplements available in the U.S. contain extracts of the root of Polygonum cuspidatum also known as Hu Zhang or kojo-kon (80).

    Red wine extracts and red grape extracts containing resveratrol and other polyphenols are also available in the U.S. as dietary supplements.

    Resveratrol supplements may contain anywhere from 10-50 mg of resveratrol, but the effective doses for chronic disease prevention in humans are not known.

    Safety and Adverse Effects

    Resveratrol is not known to be toxic or cause adverse effects in humans, but there have been few controlled clinical trials. In rats, daily oral administration of trans-resveratrol at doses up to 300 mg/kg of body weight for 4 weeks resulted in no apparent adverse effects (81, 82).

    Pregnancy and Lactation

    The safety of resveratrol-containing supplements during pregnancy and lactation has not been established (80). Since no safe level of alcohol consumption has been established at any stage of pregnancy (83), pregnant women should avoid consuming wine as a source of resveratrol.

    Estrogen-sensitive Cancers

    Until more is known about the estrogenic activity of resveratrol in humans, women with a history of estrogen-sensitive cancers, such as breast, ovarian and uterine cancers, should avoid resveratrol supplements (see Estrogenic and Anti-estrogenic Activities above).

    Drug Interactions

    Anticoagulant and Antiplatelet Drugs
    Resveratrol has been found to inhibit human platelet aggregation in vitro
    (42, 84).

    Theoretically, high intakes of resveratrol (e.g., from supplements) could increase the risk of bleeding when taken with anticoagulant drugs, such as warfarin (Coumadin), and antiplatelet drugs, such as clodipogel (Plavix), dipyridamole (Persantine), non-steroidal anti-inflamatory drugs (NSAIDs), aspirin and others.

    References
    Written by:
    Jane Higdon, Ph.D.
    Linus Pauling Institute
    Oregon State University

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 12:46:27 PM PDT

  •  Resveratrol in grape juice, cranberry juice, and (0+ / 0-)

    Resveratrol in grape juice, cranberry juice, and in wine

    All thanks to Mingus a wonderfull Neighbors

    Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USA.

     

    Resveratrol is an antioxidant found in grapes, grape products, and some other botanical sources with antiinflammatory and anticancer properties.

    In grapes and wine, it occurs both as free resveratrol and piceid, the 3beta-glucoside of resveratrol. Here we report a liquid chromatography-mass spectrometry method to analyze total resveratrol (including free resveratrol and resveratrol from piceid) in fruit products and wine.

    Samples were extracted using methanol, enzymatically hydrolyzed, and analyzed using reversed phase HPLC with positive ion atmospheric pressure chemical ionization (APCI) mass spectrometric detection.

    Resveratrol was detected in grape, cranberry, and wine samples. Concentrations ranged from 1.56 to 1042 nmol/g in Concord grape products, and from 8.63 to 24.84 micromol/L in Italian red wine.

    The concentrations of resveratrol were silmilar in cranberry and grape juice at 1.07 and 1.56 nmol/g, respectively.

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 12:51:51 PM PDT

  •  In vivo anti-influenza virus activity of plant (0+ / 0-)

    In vivo anti-influenza virus activity of plant flavonoids possessing inhibitory activity for influenza virus sialidase.

    Sincere thanks to LMonty, a RN Old Timer in Flu Board, she exceptionnally conjugate alternatives medicine and pharmaceutical medicines, she has all my respect.
    Snowy

     The flavone showed significant anti-influenza virus activity in vitro similar to isoscutellarein-8-methylether (F36) (Nagai, T., Miyaichi, Y., Tomimori, T., Suzuki, Y. and Yamada H., 1990, Chem. Pharm. Bull. 38, 1329-1332), and more potent virucidal activity in ovo than F36.

    However, F36 completely prevented proliferation of mouse-adapted influenza virus A/PR/8/34 in mouse lung by the intranasal (0.5 mg/kg) and intraperitoneal (4 mg/kg) administrations, and it was more potent than the known anti-influenza virus substance, amantadine.

    Intranasal administration of F36 (0.5 mg/kg) also protected mice against a lethal influenza virus A/PR/8/34 infection.

    Isoscutellarein significantly inhibited lung virus proliferation when administered intranasally or orally to mice.

    F36 and isoscutellarein showed negligible toxic effect against mice.

    These results suggested that flavones, which have potent influenza virus sialidase inhibitory activity, have anti-influenza virus activity in vivo.  

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 12:59:15 PM PDT

  •  Predicted and Observed Times of Influenza Activit (0+ / 0-)

    Predicted and Observed Times of Influenza Activity and Epidemic Peaks in 1968/9

    (A) Predicted combined incidence using baseline model assumptions (bold lines show mean incidence).

    (B) Observed and predicted times in individual cities.

    Peak times from individual simulation runs and mean peak times with 1968/9 data are shown as blue and white dots, respectively. Mean peak times that would have occurred with 2002 travel patterns are shown as yellow dots. Predictions are based on 100 simulation runs. Influenza activity was defined as at least one new symptomatic case per 100,000 people in a given week.

    Despite large variation in the timing of predicted epidemic peaks in individual cities between simulation runs, the overall course of the pandemic was quite predictable (Figure 3A),

    Although there was markedly more between-run variability in the tropics and the south than in the north.

    The roughly ten-fold increase in air traffic since 1968 causes epidemics in most cities to peak between 1 and 2 months earlier than they would have done in 1968 (in some southern hemisphere cities the epidemic peaks 1 y earlier) and substantially reduces variation between simulation runs (Figure 3B).

    The model reproduced another interesting aspect of influenza epidemiology: the tendency for peak periods of influenza activity in the tropics to shift with latitude, so that in the northern tropics they are closer to countries north of the tropics, while the southern tropics tend to be more closely aligned with countries south of the tropics [24].

    This occurs despite the fact that the model has no explicit assumptions about seasonality for cities in the tropics; the behaviour arises only as a result of the strength of transport connections between different regions.

    It is also notable that the pandemic starts early enough to allow some probability of influenza activity in the south during the end of the flu season in 1968.

    Despite this, predicted epidemic peaks (the weeks with the greatest number of reported cases in each location) still occur in 1969 in the south.

    When we used the model to evaluate interventions using contemporary air travel and demographic data, we found that travel restrictions to and from affected cities would slow epidemic spread, but unless almost all air travel from affected cities (i.e., greater than 99%) was suspended, the potential for delaying the pandemic was limited (Figures 4–6 and Table 1).

    Even when 99.9% of air traffic was suspended, most cities had a low probability of ultimately escaping the pandemic (Figure 4), and delays large enough to be of clinical significance (6 months or more) were common only if interventions were made after the first few cases (Figure 5).

    Interventions that reduced transmission could typically lead to more pronounced delays (Figures 5 and 6 and Table 1), although only when Rt was reduced to slightly above one were these sufficient to delay epidemics until the next influenza season.

    These findings were not highly sensitive to assumptions about initial susceptibility and transmissibility.

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 01:06:55 PM PDT

  •  Doctor Wiscart - Health Care Provider Take Notice (0+ / 0-)

    Doctor Wiscart - Health Care Workers Take Notice

    ....As for genetics, I believe allergy may protect against avian influenza. That is those with allergies have a tempered innate immune response to unknown pathogens and less severe illness. Th2 cytokines may cause asthma and allergies nut are also anti-inflammatory. Anyway to find out from the family clusters? Check oyt the article I published in Chest 2002, Increase in asthma nd atopy- Survival of the fittest

    Attached Files chest.pdf (104.5 KB)

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 01:11:30 PM PDT

  •  Emergence of Novel Swine-Origin Influenza A H1N1 (0+ / 0-)

    Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans

    Hat Tip to Ironorehopper Director of the Ital Flu Trackers Forum

    From NEJM (New England Journal of Medicine)

    Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team

    ABSTRACT

    Background

    On April 15 and April 17, 2009, novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in specimens obtained from two epidemiologically unlinked patients in the United States.

    The same strain of the virus was identified in Mexico, Canada, and elsewhere.

    We describe 642 confirmed cases of human S-OIV infection identified from the rapidly evolving U.S. outbreak.

    Methods

    Enhanced surveillance was implemented in the United States for human infection with influenza A viruses that could not be subtyped. Specimens were sent to the Centers for Disease Control and Prevention for real-time reverse-transcriptase–polymerase-chain-reaction confirmatory testing for S-OIV.

    Results

    From April 15 through May 5, a total of 642 confirmed cases of S-OIV infection were identified in 41 states.

    The ages of patients ranged from 3 months to 81 years; 60% of patients were 18 years of age or younger.

    Of patients with available data, 18% had recently traveled to Mexico, and 16% were identified from school outbreaks of S-OIV infection.

    The most common presenting symptoms were;

    fever (94% of patients),
    cough (92%), and
    sore throat (66%);

    25% of patients had diarrhea, and 25% had vomiting.

    Of the 399 patients for whom hospitalization status was known,

    36 (9%) required hospitalization.

    Of 22 hospitalized patients with available data, 12 had characteristics that conferred an increased risk of severe seasonal influenza,
    11 had pneumonia,
    8 required admission to an intensive care unit,
    4 had respiratory failure, and
    2 died.

    The S-OIV was determined to have a unique genome composition that had not been identified previously.

    Conclusions

    A novel swine-origin influenza A virus was identified as the cause of outbreaks of febrile respiratory infection ranging from self-limited to severe illness.

    It is likely that the number of confirmed cases underestimates the number of cases that have occurred.

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Thu May 07, 2009 at 01:58:59 PM PDT

  •  H1N1 Influenza Information for Health Profession (0+ / 0-)

    H1N1 Influenza A Disease — Information for Health Professionals

    Published at www.nejm.org May 7, 2009 (10.1056/NEJMe0903992)

    In the first 2 weeks in April, cases of infection with an untypable influenza A virus began to be identified in Mexico and southern California.1

    Although the exact sequence of events is uncertain, by the third week of April it was established that the illness resulted from a triple recombination of human, avian, and swine influenza viruses; the virus has been found to be H1N1.

    On May 7, 2009, just about a month after the first case of this new H1N1 influenza was recognized, we are publishing articles providing background information about novel recombinant forms of H1N1 influenza causing human disease in the United States and a summary of the outbreak cases reported in the United States as of May 6.

    Our goal in publishing these articles is to provide clinical descriptions of patients with the condition so that health professionals can use this information in making the difficult decision about whether an individual patient has a suspected case.

    This decision will depend on the presence of typical, but unfortunately variable and nonspecific, symptoms; an epidemiologic link to other known suspected or established cases (though this may become less useful as the infection becomes widespread throughout the population); and, where appropriate, a positive identification of the H1N1 virus by the PCR test (see video for the correct method of obtaining a nasal sample).

    Making informed decisions is important for several reasons.

    First, credible suspected cases should trigger public health measures such as contact tracing and quarantine — which will benefit the community — and consideration for treatment with neuraminidase inhibitors, which will potentially benefit the individual patient.

    Although it has been just over a month since the first cases were identified, it seems unlikely that this outbreak will lead to widespread, severe illness and deaths.

    However, this may be just the first wave, and we will carefully monitor this outbreak.

    To help in this process, we have established the H1N1 Influenza Center at NEJM.org, which is open and available to all.

    We will post original research and other articles, as well as Journal Watch summary and commentary on important articles that may appear elsewhere.

    We have also posted historical pieces from our archive on the "swine flu" epidemic of the 1970s and the 1918 influenza epidemic.

    The H1N1 Influenza Center will also have links to the most up-to-date news on the outbreak, including material from sources such as the World Health Organization and the Centers for Disease Control and Prevention.

    One highlight is an interactive map from HealthMap showing the location of confirmed and suspected cases of H1N1 influenza in the United States and around the world (http://healthmap.org/nejm). This map, which uses information from many different sources, will be updated regularly.

    We hope that the H1N1 Influenza Center will be of value to health professionals as they participate in the control of this outbreak.

    Snowy Owl

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Fri May 08, 2009 at 02:54:29 AM PDT

  •  NEJM - Influenza A (H1N1) Reports - MAP (0+ / 0-)

    NEJM - Influenza A (H1N1) Reports - MAP

    at

    http://healthmap.org/...

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Fri May 08, 2009 at 03:17:57 AM PDT

  •  Swine-Origin Influenza A (H1N1) and HIV (0+ / 0-)

    Swine-Origin Influenza A (H1N1) and HIV

    The CDC offers guidance for HIV-infected patients potentially exposed to swine flu.

    Many HIV-infected individuals and their providers are understandably concerned about the risks of H1N1 infection. On April 30, the CDC issued interim guidance on this particular issue.

    At this point, sufficient data are not available to determine whether HIV-infected individuals are at increased risk for complications of H1N1 infection.

    Dr. Sierra-Madero has been actively calling HIV providers in Mexico City and has yet to hear of any cases of influenza A (H1N1) among HIV-infected patients during the current outbreak.

    Limited evidence from seasonal influenza studies indicates that influenza may be no more severe for most HIV-infected individuals than for healthy, HIV-negative individuals.

    Nevertheless, clinicians should be aware that HIV-infected individuals who acquire H1N1 infection — especially those with AIDS or low CD4-cell counts — may be at increased risk for more severe disease and complications.

    In addition, they may be at increased risk for secondary bacterial infections, including pneumonia

    .

    The CDC’s core recommendations for treatment and chemoprophylaxis in HIV-infected adults are the same as those for other populations at increased risk for complications from influenza:

    HIV-infected adults and adolescents who meet current case definitions for confirmed, probable, or suspected H1N1 infection should receive empiric antiviral treatment.

    HIV-infected adults and adolescents who are close contacts of persons with probable or confirmed H1N1 infection should receive antiviral chemoprophylaxis.
    HIV-infected adolescents and adults who are household contacts of a suspected case can consider antiviral chemoprophylaxis
    .

    There are no known contraindications for coadministration of oseltamivir or zanamivir with currently available antiretroviral medications.

    Comment: Clinicians should keep in mind the possibility of prolonged drug-resistant influenza virus infection occurring in immunosupressed individuals with lymphocytopenia (J Infect Dis 2009;199:1435).

    Although a reasonable estimate of the effectiveness of influenza vaccination for HIV-infected individuals cannot be made conclusively, a meta-analysis (HIV Med 2008; 9:57) suggests that it is around 50%; thus, it is prudent to immunize all HIV-infected persons against seasonal influenza each year. The ACIP recommends routine influenza vaccination for HIV-infected individuals; however, recent data indicate that vaccination rates remain low (J Infect Dis 2007; 196:339). Ongoing general information on the H1N1 epidemic can be found at http://www.pandemicflu.gov.

    Snowy

    In trouble to be troubled Is to have your trouble doubled. Daniel Defoe No "panic" in "pandemic."

    by Snowy Owl on Fri May 08, 2009 at 03:41:59 AM PDT

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