WHO: Swine Flu is Public Health Emergency

[steven johnson]

Source: Wall Street Journal

The World Health Organization declared a deadly new strain of swine flu to be a "public health emergency of international concern," as health officials identified possible new cases in two additional U.S. states and called the disease widespread.
Several children at a school in the New York City borough of Queens may have been infected, and two people were confirmed with the disease in Kansas, according to reports from local health departments. The U.S. Centers for Disease Control and Prevention said it expects to find more cases soon throughout the country.
In Geneva, WHO Director-General Margaret Chan warned Saturday that the virus had the potential to cause a pandemic, but cautioned that it was too early to tell whether it would erupt into a global outbreak. Following an emergency meeting Saturday, a WHO panel declared the developments thus far a public health emergency and urged governments around the world to intensify surveillance for unusual outbreaks of flu-like illness and severe pneumonia. But the panel held off on raising a global pandemic alert, saying it needed more information before making a decision.


Read more: http://online.wsj.com/article/SB124069763075656299.html?mod=googlenews_wsj

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Students Fall Ill in New York, and Swine Flu Is Likely Cause
Daniel Barry for The New York Times
St. Francis Preparatory High School in Queens where eight students may have been exposed to the swine flu virus.
By DONALD G. McNEIL Jr.
Published: April 26, 2009
Tests show that eight students at a Queens high school are likely to have contracted the human swine flu virus that has struck Mexico and a small number of other people in the United States, health officials in New York City said yesterday.
The students were among about 100 at St. Francis Preparatory School in Fresh Meadows who became sick in the last few days, said Dr. Thomas R. Frieden, New York City's health commissioner.

Outside New York, at least 11 swine flu cases have been confirmed in the United States - in California, Texas and Kansas, where two cases were reported on Saturday. There have been no deaths and officials said most of the 11 seemed to be recovering.
The outbreak has killed at least 68 people in Mexico and infected about 1,000 others.


http://mobile.nytimes.com/2009/04/26/world/americas/26flu.xml

[caseymoz]

1. They can't contain this. It's probably the BIG ONE.

If it's already that widespread, we'll have an epidemic within two weeks and a pandemic within the month. Tops.

I hate to be a doomsayer. And I'm not professional, but that's what I see happening.

[Warpy]

2. The good news is that it's hitting at the end of flu season

the bad news is that it'll be back next fall, in all likelihood, and run its course then.

In the meantime, wash your hands frequently and train yourself not to touch your face with your fingers. Those are the best protections I know of besides the usual ones of not smoking and eating a balanced diet.

[semillama]

3. Additionally, what else is good about hitting at the end of flu season

is that it allows for a development of a vaccine prior to the start of next flu season.

I just got over a spot of flu this week, and it gave me chills to read about this stuff.

[caseymoz]

7. Oh, I don't know if that's good news.

The Spanish Flu, unlike any other, didn't obey any rules about "the flu season." It also didn't keep to the rule of killing just the very young and the old. It killed people of all ages. No age group was spared. It would indicate that the worse the flu, the less respect it has for common pattern.

It's not hitting at the end of the flu season, that would have been March. The fact that it's popping up in so many places when the flu season is over is unsettling to say the least.

Those measures of washing hands and not touching your face are minimal-- flu is an airborne virus. They've found at least a major reason why it spreads most in the winter. According to some new studies and reports, here and here. The reason why it spreads in the winter: the air is dryer, especially indoors.

You could find plenty of articles that show a strong correlation between influenza and dry air. One that I can't find now explained that in the dry air, the water from cough or sneeze, containing virus, evaporates, instead of settling to the ground or to a horizontal surface. When it evaporates, the virus then floats around in the air freely.

Indications are then, get a humidifier.

Here's an article with Science Daily that indicates that masks are effective in cutting down the chance of catching the flu.

My suggestion is, if virus settles onto the ground and surfaces: don't do anything to disturb it till it's past it's "expiration date." Don't dust the surface, wet it down first and wipe it. Don't do anything like vacuuming that could kick up virus into the air, and if you have sick people in the house, handle their linens very carefully. And for goodness sake, wipe your hand frequently with towlets, after you touch any uncleaned surface.

I'll add: if these precautions save you and other people in the first wave, it will probably spread again after people think it's over, until it finds and infects all the vulnerable people. Just stick with the habits till there's a vaccine, or until antivirals are against it are widely available.

[mr11]

10. Wow! all that? How would you know the "expiration date:" :/

But you are right not just washing your hands will prevent it. Thanks for the info.

[caseymoz]

12. The flu virus can only remain intact for a certain amount of time without somebody to infect.

I thought Expiration Date was a wry way of saying it.

[mr11]

19. I see:)

[Dreamer Tatum]

6. Guess we're all dead, then. Thanks for the info. nt

[caseymoz]

9. Even in the big one the vast majority of people survive.

And some people are just naturally resistant to getting it. The BIG ONE is one in ten people at most. Really damn high, but not the end. You would probably get it and survive-- you'd feel like you're going to die. You might lose the lottery, and if not, you'll definitely know people who did. That's the way it was with the Spanish Flu. Society didn't fall.

If they could prevent secondary bacterial pneumonia, that would prevent a lot of mortality.

I'm sorry the BIG ONE was so misunderstood.

[Mari333]

21. lol nt

[winyanstaz]

4. hmmm, something stinks.............

Didn't I read an article a while back about how the last remaining swine flu viruses were being played around with by the government? Or was that the Spanish flu?
I also am hearing rumors that this is swine flu mixed with avian flu and is something that had to have been made in a lab. Anyone have any info on this?

[mrs_p]

5. swine flu naturally occurs in pigs

and swine flu mixed with avian flu naturally occurs in pigs -- it's called reassortment where genes from several viruses can recombine into a new virus. this is what makes influenza magic...

here's a thread with more info: http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x3847924

[caseymoz]

11. That's why raising fowl and pigs together should probably be outlawed.

They spread flu too easily to one another, and as it goes back and forth, it invents new strains.

[mrs_p]

17. it's complicated

ALL subtypes of influenza have been found in waterfowl (16 HA and 9 NA), and waterfowl are considered the reservoir hosts. poultry seem to be more susceptible to the highly pathogenic avian influenza (HPAI) strains, so we see higher mortality in them when there is an HPAI outbreak - which has huge economic repercussions. theoretically, avian strains can be transmitted between birds and pigs; however, i don't recall any data showing that bird strains mutate in pigs and then are transmitted back to birds.

[caseymoz]

23. Interesting, thank you.

I wonder if there is actually a return vector going from pigs and back to birds? I know said that none has been detected but I hope someone is at least looking at that. Or if there a return vector from human beings back to birds and swine? Just pondering. It seems like there must be a way to get a handle on this problem, that has been so costly, and is likely going to be even more costly in the next few years.

[SpiralHawk]

25. Social intercourse among avian entities and swine...

[caseymoz]

27. Which implies that when pigs fly, we'll have the deadliest strain of flu

That's the most encouraging news I've heard in a week. :bounce:

[BadgerKid]

20. Attempts to disarm viruses?

I think the article you might be thinking of had to do with experiments into how to disarm the virus that caused a historical major flu outbreak.

[caseymoz]

24. It's extremely unlikely that the government had anything to do with this.

Virulent flu is a very dangerous to try to weaponize. The risk with any biological weapons is that once they get out, they have a mind of their own. The last thing you want is for the disease agent to attack your own army and people. Unlike, say a nuclear bomb, biologicals have their own "built in" retaliation.

So why experiment with anthrax and such? Because it's more of a disease agent that can quickly infect and kill people on initial exposure, spread quickly in 1- generations, and then dies out when people take simple precautions. It won't 3come back and hit your own people. That's what national bio-weapon researchers really want (of course, terrorist bio-researchers are totally different).

A deadly flu, though, is not limited that way. Once its out, it can easily invade your own army and country, and even hit them worse than your enemies.

Somewhat off topic: no country is likely to weaponize small-pox, because it is far too contagious and does have quite a mind of its own. It will come back and feed on your people. Now almost all nations realize that (I wouldn't bet on North Korea, though). Terrorists, however, probably don't.

[madrchsod]

8. this started showing up in mexico in march of this year.....

no one has a clue yet the extent and severity of this strain....there is no restrictions on travel to mexico.

[caseymoz]

13. Yes, but it just kept spreading.

We did have a March that was colder than usual. The fact that it's still spreading is an anomaly. I'd like to what weather was like in the provinces in Mexico where it began, whether they were desert provinces or tropical ones, and just how dry it was.

[madrchsod]

14. we had a "light" flu season in the usa this year

i was thinking the same thing about the weather since these virus love dry weather.

[smoogatz]

15. What's interesting about this flu is that it seems to be highly virulent

but not extremely deadly--so lots of people get sick, but only a few actually die. No reports of hospitals in Mexico being overwhelmed, or mass graves, etc. Not yet, anyway.

[mrs_p]

16. good point!

just because a strain is highly infectious doesn't mean it is highly pathogenic. there is a difference, even though the media is going to blow everything out of proportion. if this was a highly pathogenic flu, we would be seeing a much higher death rate (for example, high pathogenic avian influenza kills ~70% of those infected). we aren't seeing those numbers yet.

[caseymoz]

26. So far, mortality looks to be running at between 5-10 percent.

That's still damn high, but it's not a cataclysm. Is there any word on the age groups being killed? That would be another indication of how serious it is.

As a disease kills a population, I would think it tends to select for less virulent strains, so the infected individual has more time to come into contact with others, and spread the virus. In human beings, this less virulent strain exploits the fact that we take care of our sick. The longer the infected person is cared for, the higher the chance that the flu could infect the care-giver, or bystanders.

The way to make flu far less deadly is to prevent the secondary pneumonia, which is usually bacterial, and which is the leading cause of death in flu victims.

[Babel_17]

18. How will it mutate in human hosts

This is a new breed of the flu. Now that it has human hosts it can mutate in ways that are highly relevant to us.

The odds are in our favor in the short term, I guess, that it will mutate slowly and in ways that we can deal with.

But it's different enough that we can't rely much on the pattern of other types of flu outbreaks.

Worst case scenario is that it quickly changes to become resistant to treatment, and becomes more easily spread, and becomes more lethal.

Imo this new strain is worthy of all the attention it is getting.

[mrs_p]

22. worthy of attention, but not panic

i work on influenza and have read many erroneous statements regarding how flu mutates and spreads. flu has been around for some time and the epidemiologists, i trust, know what they are doing. flu DOES follow certain patterns, not that this time can't be different, but this is not the first flu epidemic/pandemic we have seen. and while flu can and most likely will mutate in the human host, the season is nearly over and our own host defenses will win in the end. i think there have been ~80 deaths out of 1300 reported cases in mexico so far. that is ~6% death rate, mostly in the immune compromised (old and young and sick). while high, still within normal flu patterns.

[caseymoz]

29. That's the best news I've heard, that it's showing a standard mortality pattern.

It means we have a nasty version of the flu, but not a catastrophically bad one. It could probably even quit till the actual flu season, then. Then we'll have time to have vaccines available. And the WILL be available.

[caseymoz]

28. Actually, IMHO, mutation in human populations would favor less virulant strains

This is pretty much a repeat of my conjecture above. Remember that all diseases adapt themselves to infecting as many hosts as they can. They will evolve toward a form that does this most effectively. This implies that disease agents gain nothing from only killing, but if they spread themselves to more hosts most effectively by killing you, they will. If straining your body to death will allow them to spread to more than one other host, they will evolve toward that. However, if the environment changes and they will more effectively spread themselves by not killing, that is the direction their evolution will tend to go.

What would this mean? As a disease kills a population, and it grows less dense and more wary, my guess is that the disease tends to select for less virulent strains, so the infected individual has more time to come into contact with others and spread the virus that way. In human beings, a less virulent strain exploits the fact that we take care of our sick. The longer the infected person is cared for, the higher the chance that the flu could infect the care-giver or bystanders.

If you want to know, however, it would save the vast majority of flu deaths by preventing the secondary pneumonia infections. Usually this is from opportunistic bacterial, and it is by far the leading cause of death for flu victims. So, I would suggest anything that would shore up the exhausted immune system toward the end of the flu infection. Antibiotics aren't the right idea, because you can't guess which antibiotic would be effective against the particular bacteria. But you can keep the person's sick room as clean and antiseptic as possible. Handle their linens carefully, though. Those would be loaded with virus. And wear a mask. They do cut the chance of infection, greatly.