(Swine flu) Can some of the DU'ers who study molecular biology or recombinomics please explain

[FourScore]

some of the theories (if there are any) on why the swine flu cases in the US are milder than in Mexico?

[aquart]

1. Nobody knows.

[FourScore]

2. Interesting thread at this link.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5543387&mesg_id=5543387

[targetpractice]

5. That is a good thread so far. n/t

[targetpractice]

3. I've read...

A larger portion of US cases are in children where symptoms are milder... The swine flu is most severe in young adults (20-45).

I would guess that the most severe cases in Mexico City are ending up at the hospital, and there are probably many more milder cases in that city that haven't been reported.

[mike_c]

4. echoing "nobody knows" but with a caveat....

I believe the death rate in Mexico is along the lines of six percent or so, just by offhand estimation, and might be even lower if mild cases are under-reported there, which is likely. The number of infections in the U.S. is so far pretty few, relatively speaking, so combined with the low-ish mortality rate (so far), it's not especially surprising that this flu APPEARS less virulent or less severe here than in Mexico. There is also some difference in health care delivery, especially early on before this beast was identified.

That will likely change as the number of infections north of the border rises-- but note that it might also be offset by the season. It's quite late for a new pandemic strain to emerge this year. Not impossible, of course, but influenza does not enjoy summer weather very much.

[tabatha]

6. Not an expert at all, but

--- possibly lack of sanitary conditions
--- lower immunity

[tabatha]

7. Thom Hartmann is talking about this with an expert right now.

Not sure - but could be immune systems.

[TwilightGardener]

8. Flu complications--well-off Americans are more likely to go to the doctor or

hospital when they feel sick, therefore they get better prevention of what often kills you with the flu--lungs filling with fluid, pneumonia. If you're poor, you don't go, you develop complications, your lungs take a hit, you have poor gas exchange, you die. The folks in America getting the flu were rich enough to travel to Mexico, either for leisure or professional reasons. Therefore they're well-off enough to run to the doctor for flu treatment. That's my theory, anyway.

[JenniferJuniper]

9. Is Tamiflu helping with the symptoms?

If so, the fact that Americans tend to seek care more quickly would make a big difference. The sooner it is taken, the better.

[Mojorabbit]

10. I got this in my email

from pro med which is an infectious disease update. Here is a snip

In an earlier posting, this moderator pointed out that the reported cases
in Mexico were hospitalized pneumonia cases, with surveillance data coming
from inpatient facilities.

In contrast, the information on the reported
cases in the USA involved surveillance data coming from outpatient
facilities. This difference in sentinel reporting sites biases reported
cases in Mexico to be more severe cases as they are cases that were severe
enough to merit hospitalization.

In turn, the use of outpatient sentinel
surveillance sites in the USA leads to a bias selecting milder cases --
those that do not require hospitalization. One suspects that once the
countries heighten ILI surveillance to include both inpatient as well as
outpatient facilities, these disparities will lessen.

One also suspects
that the true number of cases in Mexico is significantly higher than the
currently reported approximately 1500 cases, which would further lower the
calculated case fatality rate (CFR). (Information on the actual number of
reported cases in Mexico is not readily available on the Ministry of Health
website, so all figures are estimates based on earlier figures provided in
CDC and WHO reports and on newswire reports. Hopefully these figures will
be available on a regularly updated basis to permit following the course of
the outbreak).