Swine Flu- Its Back

From the Independent

Doctors shocked by spread of swine flu – and its severity

H1N1 virus returns, already claiming lives of 10 British adults with early signs that illness has spread to other European countries

The swine flu virus that swept the world last year causing a global health emergency has returned to claim the lives of 10 adults in the UK in the past six weeks.

The 10 deaths were in younger adults under 65 and associated with H1N1 swine flu. Most had underlying conditions but "a small proportion" were healthy before being struck down by the virus, according to the Health Protection Agency (HPA). More

Swine Flu Myths That Could Kill You

From New Scientist by way of Avian Flu Diary some popular myths about the H1N1 Flu. I like the format over at Afludairy as they are one of my prime sources for H1N1 info and link back to the main article. But if you prefer, you can go straight to the source.

Myth 1

The symptoms are like regular flu. You've got it if you've got a fever
Up to half the people who get swine flu never develop a fever, and some suffer from gastrointestinal symptoms as well as more standard flu symptoms. Read more

Go and read the updated symptoms list. You may save the life of someone you love.


MYTH 2

This is just mild flu. The death rates are even lower than for normal flu

Swine flu is killing young people rather than the very elderly, and although winter is just starting, more young people have already died of flu than normally die over the entire winter. Read more

I mentioned this earlier this week. The elderly are the usual victims of a flu season which at least in part is an expected outcome. The fact that this flu is killing the young will have a very different psychological impact should the trends continue.


MYTH 3

You're safe as long as you're healthy. Only sick, weak people get really ill

Most of the children who have died of swine flu were perfectly healthy beforehand, and many of the adult victims also had no underlying conditions. Read more

See Myth 2. Personally I know of two individuals, otherwise healthy adults, who have been hospitalized with pneumonia stemming from H1N1. One was hospitalized for 4 days and the other for the better part of September and almost died.

Go here and read more and the other 5 myths...

"Very Sobering" Flu Season

Most everyone it seems is dismissing the H1N1 threat as overblown. Some go so far as to see government conspiracy. I am not among those in either camp. I have said in previous posts that while there is no need to panic, it would be foolish not to keep a close eye on this matter. The prevalence of the virus in the southern hemisphere these last few months and the fact it never "went away" as is the usual case in this country during sumer months were all potential red flags. Combined with a tendency to strike the healthy and a high virulence capacity were more casuses of concern.

This has recently come to the forefront in the mainstream media headlines but nothing has truly driven home the fact like the graphics from the CDC and the commentary from Effect Measure. Effect Measure has an excellent if chilling explanation of the charts (especially needed since the graphics are so poor) and excellent commentary as well. In a nutshell, this flu season is shaping up to be like few others and while a typical flu season may kill more in number, these are typically the old an infirm. H1N1 victims are more often, much more often, infants, children, teens and healthy adults. As Effect Measure points out, these could triple or even quadruple and not reach what a "typical" season involves. But the psychological effects of so many young and healthy would be immense.

Monday morning, start of week three of the official flu season (which began October 4). CDC's scientific spokeswoman on the flu, Dr. Anne Schuchat has said we are seeing "unprecedented" flu activity for this time of year, including an unusual toll in the pediatric age group. What does "unprecedented" mean? It's not very specific on what precedents are included, but if we confine ourselves to the three years before this one, we can get a good idea of just how unusual this flu season is.

CDC Source, full size here; legible on the .pdf version (page 8) (hat tip OmegaMom)
Weeks are on the horizontal axis. There are five age group panels (0 - 4 years at the top, seniors at the bottom) and at the right side of each panel you will see lines gradually ascending from week 40 (October) to week 20 (April), CDC's traditional flu season. Everything to left of week 40 in each panel is prior to or just after the official flu season and is essentially zero for the three prior seasons, .....

...The "unprecedented" year we are having shows up in the left of each panel. The rates are a solid line running across the bars. the bars are case counts (note to CDC: lose the bars. They are obscuring the picture). To see how unusual this is, look at the top panel (0 - 4 years), where the solid line has risen to 1.4 cases per 10,000 infants and toddlers in week 40 (first week in October). In the three previous years that seasonal risk level isn't reached until the 3rd week in January. We are 3 months in advance of the last three years by this measure, and the case count for that age group is still rising.

For the 5 - 17 year old panel the difference is more dramatic. We've already reached the risk level we would normally see for the whole flu season, and we are just getting started. That's the group being hit the hardest, and half the fatalities since September 1 have been in the 12 - 17 year old age group, confirming that.

For adults between 18 and 50, the picture is like that for the under 4 year olds: about 3 months in advance compared to the bad flu year of 2007 - 2008 and already exceeding that for the entire flu seasons of the other two years. This is the age group populating the ICU beds. Even though population rates may be smaller, there are many more of them. ...

...It is true that seasonal influenza kills a lot of people every year. They are mainly seniors, people like me. People care about seniors, of course, but our deaths are considered part of the natural order of things. Old people die. If it's not one thing, it's another. And of course our mortality rate is very high, compared to all other age groups. Even if the number of infants, children, teens and healthy adults double or triple or quadruple, the number of deaths may not ever reach what happens normally to seniors during seasonal flu, but the psychological and social impact is considerably greater. That's one of the fallacies in comparing the numbers of deaths from this flu with the usual seasonal flu. More

A Sign Of Things to Come?

In what may be a sign of things to come in this country, Britain is reporting 100,000 new cases of swine flu recorded in the last week. Of those cases, 840 have been hospitalized and 63 in intensive case.

The situation is getting so bad that one patient has been sent to Sweden because of a lack of beds.

The WHO has stopped tracking swine flu cases and deaths around the world. Still, it is has asked countries to be on the look out for "unexpected clusters of severe or fatal cases of H1N1 or "unexpected, unusual or notable changes in patterns of transmission" (WHO Pandemic (H1N1) 2009 briefing note 3, 7/16).

One such notable event may be occuring in Mexico where it appears they are seeing a bit of a reurgence of the swine flu. Several states in southern Mexico have seen massive increases in swine flu infections in the past few weeks. H/T H5N1

Another notable event is a sharp increase in hospitalizations in Australia. Once again being tracked by H5N1, probably one of the best swine flu blogs out there and conveniently provided in the Swine Flu blogroll on the left column of this blog.

As if this weren't enough we are being told to expect shortages of any possible vaccine as the viruses aren't producing large quantities of active ingredient. (WSJ)

This virus is already acting different than other flu viruses. It has not tapered off in the summer months as most viruses do. Though not expected at this time, worst case scenarios suggest the possiblity that 40% of American workers could be affected.

Of course ultimately, these are only guesses. Perhaps the best advice is to "hope for the best and plan for the worst." This is common sense of course and good advice in any situations, be they medical, or weather or man made disasters.

Toward this end I offer this advice from Avian flu Diary:

The HHS’s Flu.gov website offers this advice on preparing for a pandemic:

You can prepare for an influenza pandemic now. You should know both the magnitude of what can happen during a pandemic outbreak and what actions you can take to help lessen the impact of an influenza pandemic on you and your family. This checklist will help you gather the information and resources you may need in case of a flu pandemic.

To plan for a pandemic:
Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.

Periodically check your regular prescription drugs to ensure a continuous supply in your home.
Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.

Volunteer with local groups to prepare and assist with emergency response.
Get involved in your community as it works to prepare for an influenza pandemic.


Given the current virulence of the novel H1N1 virus, having 2-weeks worth of supplies on hand is probably sufficient. And two-weeks is also a reasonable amount of supplies to have on hand to weather practically any other major disaster.

Why Keep An Eye on the Flu- Part 2

A while back I wrote about why we should keep an eye on the new H1N1 virus despite the waning coverage in the press and the mildness of the outbreak here in the states.

Despite the pandemeic declaration there is no need to panic, yet many signs to note in the developing situation. It is why I have kept the Flu blogs and links posted. Over at Effect Measure they rightfully say that this is a teachable moment and a time that we are blessed with to get prepared:

For years those concerned about the consequences of an influenza pandemic from an exceptionally virulent flu virus, like A/H5N1 ("bird flu") have despaired about motivating business, government and neighbors to take it seriously enough to make serious preparations. It's understandable. There's are a lot of potential catastrophes competing for our attention and while each can be made plausible if we can get someone to listen long enough, it's rare we can do this. As I said, too much competition. Now that a real life influenza pandemic has arrived, the concern of some is that the public isn't being told how bad this could become, possibly even 1918 level. My view is different. In terms of stimulating genuine pandemic preparedness, I think we are extremely lucky to have a pandemic that so far is nowhere near worst case scenario (and let's be clear: it isn't anywhere near worst case). The pandemic is no longer theoretical. It is here and tangible. And it is having some tangible effects in unlikely places...

Unlikely places like Hedge funds.

And there are some disturbing trends.

First the flu is not subsiding here in the US as summer begins. Typically the flu viruses taper off or disappear completely in the summer months. The question now becomes what will it look like when the usual flu season comes around in the fall and winter?

Second, the southern hemisphere (currently experiencing winter) is having a tough go of it:

It is still relatively early in the flu season south of the Equator, with the peak not expected until next month, but already Argentina and Chile are reporting serious demands on their medical system.

Elective surgeries are being canceled in some Buenos Aires hospitals, and mobile flu clinics are being dispatched to some neighborhoods. Of 111 people hospitalized in the country’s capital, 75 are on ventilators. (Avian Flu Diary)

Last but certainly not least is the disturbing news that the virus may be mutating into a more virulent strain:

Virologists in Sao Paulo, Brazil, have just announced they have indeed identified a variant of the flu gene after testing samples taken from a 26-year-old swine flu patient.
Lead researcher Terezinha Maria de Paiva, of the Adolfo Lutz Bacteriological Institute, says it is too soon to know if the new variant, dubbed the A/Sao Paulo/1454/H1N1 variant, will be more aggressive than the type A/H1N1 that prompted the official declaration of pandemic by the World Health Organization (WHO) but the patient from whom the sample was taken has completely recovered from his bout with swine flu. The patient began experiencing flu-like symptoms after returning from a trip to Mexico.

This one had a happy ending. As I said, its worth watching.

First Texas Resident Fatality of H1N1 Flu?

DSHS is reporting the first death of a Texas resident with H1N1 flu. A woman from Cameron County who had chronic underlying health conditions died earlier this week. the exact casue of death is till not known at this time.

Meanwhile:

H1N1/2009 (aka swine flu): where we are
Over at Effect Measure an excellent summation about where we are with the current Flu (soon to be) pandemic. I'll let it speak for itself while I get back to work...

H1N1/2009 (aka swine flu): where we are : Effect Measure

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