US Declares Public Health Emergency Over Swine Flu 695
mallumax sends word from the NYTimes that US government officials today declared a public health emergency over increasing cases of the swine flu first seen in Mexico. Here is additional coverage from CNN. From the Times: "American health officials [say]... that they had confirmed 20 cases of the disease in the United States and expected to see more as investigators fan out to track down the path of the outbreak. Other governments around the world stepped up their response to the incipient outbreak, racing to contain the infection amid reports of potential new cases from New Zealand to Hong Kong to Spain, raising concerns about the potential for a global pandemic. The cases in US looked to be similar to the deadly strain of swine flu that has killed more than 80 people in Mexico and infected 1,300 more." Reader "The man who walks in the woods" sends a link to accounts emailed to the BBC from readers in Mexico. While these are anecdotal, they do paint a picture of a more serious situation than government announcements have indicated so far.
Re:Is this flu really "special"? (Score:5, Informative)
Those thousands that die are among hundreds of thousands or more who get infected. This strain has infected far fewer people, yet killed more of them, so the mortality rate is much higher.
If infection became widespread, as was the case in 1918, then we could be looking at serious losses.
Re:Is this flu really "special"? (Score:5, Informative)
Adding to the nuisance, is the fact that flu strains can swap components with one another to produce exotic variants quickly. Pigs are excellent for that, because they have their own strains, and some degree of susceptibility to certain avian and human strains.
It might well burn itself out; but it would be a pity if it were the start of Spanish flu 2.0 (now with high speed air travel!).
Re:Is this flu really "special"? (Score:5, Informative)
> This influenza virus is a strain that utilizes pig, bird, and human genetic information.
This influenza virus is a strain that utilizes pig, bird, and human influenza genetic information.
Re:Google mashup? (Score:2, Informative)
http://maps.google.com/maps/ms?ie=UTF8&hl=en&t=p&msa=0&msid=106484775090296685271.0004681a37b713f6b5950&source=embed&ll=17.14079,-45.175781&spn=114.994624,178.59375&z=3
Re:Is this flu really "special"? (Score:5, Informative)
Nope [cdc.gov]
Re:Is this flu really "special"? (Score:5, Informative)
The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiologic data are inadequate to identify the geographic origin of the virus.[1] Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The pandemic lasted from March 1918 to June 1920, spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 20 to 100 million people were killed worldwide.
While we, at least industrialized countries, are far better equipped to deal with another major outbreak than in 1918; I feel taking precautions would be the rational thing to do.
Re:Google mashup? (Score:4, Informative)
Re:What's next? (Score:5, Informative)
Chickens, Pigs, and Humans. In some parts of the world, they are in close proximity to each other.
The influenza variants that can attack either of these three animals are very similar to each other, but not identical.
So, normally a bird flu only affects birds, for example.
However, flu viruses are extremely mutagenic, and in reality mutate constantly.
A problem with flu vaccines is they must be made from a strain that exists in early summer (to have time to make enough) but there is a strong chance that the virus will have mutated enough by the winter that the vaccine is not as effective, or has no effectiveness.
Every once in a while, because of the similarity, a mutation will happen that allows that particular strain to cross a barrier; a bird flu might mutate into one that can infect pigs, for example.
Or a swine flu may mutate to one that can infect humans. Since it is a new strain, no-one has antibodies to fight it.
The 1918/1919 strain killed between 2 and 20% of those infected. A normal flu fatality rate is about 0.1%.
Similarly, the 1918/1919 strain tended to fell healthy adults under 65 with a majority between 20 and 40, and not those under 2 or over 70 who comprise the majority of more ordinary strains' fatal victims. It is this tendency that is most alarming with the current outbreak.
A mutation of the 1918/1919 variant is called "swine flu" and is common in pigs today. That particular strain cannot infect humans. It was previously believed that the 1918/1919 strain was originally a swine flu, but recent research suggests it mutated from a bird flu. No one really knows for sure, however.
The country that best handled the risk in 1918/1919 was Japan, who issued strict travel limits, and had a mortality rate of just over twice the normal at 0.425%. Island nations who did not do so suffered fatality rates of 5% and more.
Re:Is this flu really "special"? (Score:5, Informative)
While we, at least industrialized countries, are far better equipped to deal with another major outbreak than in 1918; I feel taking precautions would be the rational thing to do.
Don't be so sure about it my friend. My parents work in the NHS. The procedure for a flu pandemic assumes that society will collapse, which will likely be a reasonable assessment. All the preparations have been aimed at H5N1, so though the anti-virals stockpiled will most likely work*, the vaccines will not**.
I think this one is the real deal. The death rate is high, considering it's in Mexico, which may not be on a par with the UK in medical treatment but isn't sub-Saharan Africa or rural China either.
The BBC is quoting doctors as saying that this has been around for a week. If people in Mexico City are expressing symptoms, you can bet it's around the world now, by people carrying it during its incubation period. I live in London, and I bet you a tenner that someone, somewhere in this city has this right now.
*There are some reports that anti-virals are ineffective, I think they're hysteria.
**They probably wouldn't have anyway.
worry in october, not now (Score:5, Informative)
recall that the spanish flu of 1918 came out in the summer, and was mild
http://science.nationalgeographic.com/science/health-and-human-body/human-diseases/next-killer-flu.html [nationalgeographic.com]
then the cold weather came, and it came down like a scythe. we will experience media hype for a month or two, the swine flu will be forgotten, then it will suddenly resurge like crazy in october. the reason is the flu virus actually survives better in the cold air than the warm air, and travels greater distances. the warm summer air will help us fight the flu, for now. there was science a few months ago that proved that:
http://news.bbc.co.uk/2/hi/health/7276447.stm [bbc.co.uk]
thats why flu is always a cold month thing
so the thing to do is not worry now, worry later. the warm weather will mitigate the flu. then we should all keep a very wary eye come october, that's when the swine flu will prove if it is a superkiller or not
one more concern:
the cytokine storm
http://en.wikipedia.org/wiki/Cytokine_storm [wikipedia.org]
this explains why those who died of the spanish flu, and are dying of swine flu now, are young, healthy adults. perversely, the healthier you are, the more you will be prone to die of the swine flu: your body overreacts, like anaphylactic shock. less healthy immune systems mean you underreact, and your lungs aren't flooded to death by your won body. the very young, and the very old, they should be able to weather the swine flu. the worst case scenario (hopefully this just fizzles out like SARS), it is us in the prime of life, 25-45, who will bear the brunt of mortality when everyone gets it this fall, hospitals are swamped, and the tamiflu runs out. then you have children and elderly with no breadwinners to take care of them
prepare now, you have until fall until the scythe comes (hopefully, it won't, it could still fizzle out)
Re:Google mashup? (Score:5, Informative)
Re:Bring out your dead (Score:2, Informative)
I'm not dead!
Re:Is this flu really "special"? (Score:5, Informative)
*There are some reports that anti-virals are ineffective, I think they're hysteria.
The US Centers for Disease Control say the following [cdc.gov]:
"There are four different antiviral drugs that are licensed for use in the US for the treatment of influenza: amantadine, rimantadine, oseltamivir and zanamivir. While most swine influenza viruses have been susceptible to all four drugs, the most recent swine influenza viruses isolated from humans are resistant to amantadine and rimantadine. At this time, CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses."
Re:Is this flu really "special"? (Score:5, Informative)
Oseltamivir is the one the NHS has stockpiled, under the brand Tamiflu.
Those comments are horrifying (Score:5, Informative)
As a doctor, I realise that the media does not report the truth. Authorities distributed vaccines among all the medical personnel with no results, because two of my partners who worked in this hospital (interns) were killed by this new virus in less than six days even though they were vaccinated as all of us were.
I'm a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. Staff are starting to leave and many are opting to retire or apply for holidays. It is killing three to four patients daily, and it has been going on for more than three weeks.
I am a doctor and I work in the State of Mexico. We doctors knew this was happening a week before the alert was issued and were told to get vaccinated.
In the capital of my state, Oaxaca, there is a hospital closed because of a death related to the porcine influenza. Many friends working in hospitals or related fields say that the situation is really bad, they are talking about 19 people dead in Oaxaca, including a doctor and a nurse. They say they got shots but they were told not to talk about the real situation.
Two of my friends at work are sick, they were sick for a couple of days, they went to the hospital and they sent them back to work. The doctor told them it was just a flu until Friday when the alarm was spread, then they were allowed to go home. I work in a call centre and I'm worried because there are no windows in the building so it cannot be ventilated and around 400 people work there. We all have talked to our supervisor but no one has done anything not even sterilise or disinfect the area. We will be sick soon and, well, do the math - 400 can infect at least another two per day.
Re:Astragale (Score:3, Informative)
> I think this will be contained much like bird flu was.
"Bird flu" hasn't happened yet. That virus has not yet acquired the ability to pass from human to human.
Re:Is this flu really "special"? (Score:1, Informative)
If it travels through china and south america, we'll all be better off. If it hits the islamic countries, and kills a bunch, I'll start believing in god.
I'm sorry, did I miss the change in tagline?
"Slashdot: News for racists. Life for whites who matter"?
Just when the fuck did this become acceptable as long as it's -1 troll?
Sorry, I've been away a while, it's a bit of a shock.
Re:Is this flu really "special"? (Score:5, Informative)
It's a new strain of "swine" flu (only called that because it originated in swine) that contains elements of bird, human, and swine flu viruses. It is transmitted between humans. Stop spreading misinformation.
Re:Is this flu really "special"? (Score:5, Informative)
Is 7% a "high" death rate?
Wikipedia has normal flu mortality at 0.1%.
Re:Lifeless (Score:3, Informative)
Because the notions of "alive" and "not alive" are fuzzy human definitions only partially based in distinctive underlying natural phenomena. Key attributes frequently assigned to living things are metabolism and reproduction. Viruses reproduce, but in some sense have no metabolism. Historically, folks have gone back and forth over the years on whether both attributes are needed or only one. Eventually most folks realize they are arguing over a ambiguous border, and give it up.
In the context at hand it make a lot more sense to think of viruses as living. They reproduce, and are transmissible, which make an outbreak of a contagious virus look pretty much like an outbreak of a contagious bacteria, as opposed to a mass poisoning by a toxin.
Re:Is this flu really "special"? (Score:4, Informative)
Skyrocket, eh? Gilead Sciences [google.com], which developed Tamiflu/Oseltamivir, and Roche [google.com], which markets it, haven't moved much since the outbreak started on March 18 [wikipedia.org] (although this was apparently assumed to be regular flu for a few days, so it's hard to tell when people would have noticed this, although there is a weird spike in volume on March 18 even though the price barely moved (there was also a similar spike the last two days this week, but the price dropped 10%)). Further, the price hasn't moved much during any identifiable period I can see; GILD had an 8% bounce over two days at the beginning of April (which it has now lost), but this is much smaller movement than what was seen in January and February.
On the other hand Zanamivir (trade name Relenza), developped by Biota [google.com] and marketed by GlaxoSmithKline [google.com] has seen some movement. GSK, like Roche and GILD, had some movement since March 18 but nothing out of the ordinary (10% max movement and 0% net over the period), especially compared to the previous two months. Biota, on the other hand, has jumped nearly 40% this week, and has had an identifiable volume jump this week. Is this related to the pandemic? Maybe, but the company released a press release [abnnewswire.net] Thursday saying its royalties from Relenza for the first three months of 2009 (mostly before the swine flu) were sixteen times greater than the average royalties over the preceding two 3-month periods, and market regulators are wondering [theage.com.au] if there was some insider trading going on that anticipated the report. That's certainly likely to affect the price independent of the swine flu.
Since the price of any of these shares has not skyrocketed as you claimed, and arguably may have gone down, depending when you decide the information could have been reasonably public that people could have figured out to invest in these companies, it seems the opportunity for these people waiting around to make money is still there. Perhaps as someone thinking about these things without looking at any facts, maybe you should just jump right in.
P.S. Don't forget to check out the next season of The Sarah Connor Chronicles this fall on FOX.
Re:About covering your mouth... (Score:4, Informative)
The CDC actually advises to use a tissue and throw away as a preference, and the sleeve only if you don't have tissues available.
"Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. "
See: http://www.cdc.gov/swineflu/swineflu_you.htm [cdc.gov]
The advice from the CDC (Score:5, Informative)
http://www.cdc.gov/swineflu/whatsnew.htm?s_cid=tw_epr_68 [cdc.gov] http://twitter.com/CDCemergency [twitter.com]
CDC page pasted into comment:
What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.
Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm [cdc.gov]CDC and local and state health agencies are working together to investigate this situation.
Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people.
What are the signs and symptoms of swine flu in people?
The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.
How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.
Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).
How long can an infected person spread swine
Re:Is this flu really "special"? (Score:5, Informative)
Don't they have their own exotic diseases to worry about?
And this has an effect on the spread of this particular disease because...?
islamic countries
Less likely than China. Personal contact is already kept at a minimum.
No offense intended, but what the fuck are you talking about? In my experience, people in Muslim countries are more hands on than most western countries: greetings involve long handshakes, several kisses on the cheeks, hugs, and so on. Men are much less self-conscious about hugging, holding hands, or putting their arms over each other's shoulders (all out of friendship, so spare us the "OMG THEY ALL HAVE TEH GAY" comments). All in all, you will probably find much more interpersonal contact. I can only assume that the reason you see it as less is because of the extreme gender divide that exists in those countries.
Not to defend Mr. Coward's idiotic comments, but yours are equally uniformed.
Re:GERMS ARE GOOD..... (Score:3, Informative)
Flu viruses live in bird populations, and mostly people don't get sick from them because birds and humans are so dissimilar. But pigs can get the flu from birds -- mainly from drinking water that infected birds have crapped in -- and pigs and humans are so similar that we can catch many pig diseases. (This is why you can eat rare beef but not rare pork.) These viruses mutate in the pigs, that's why they're so deadly. The H1N1 strain that caused the 1918 pandemic is still around, it's just that it isn't as deadly any more because we've accomodated ourselves to it.
This current strain is not a "previously harmless germ"; it's new, and so no amount of previous exposure to other germs would have any effect at all on our reaction to this one. Worrying about over-sanitization leading to immune weakness is probably a valid concern, but it doesn't apply here, and invoking it is an example of one-theory-to-fit-everything sloppy thinking.
Re:Immune system overreacting (Score:5, Informative)
Cytokines are signaling proteins. They're used by cells to tell the body that the cells in the area are inflamed, which causes the immune system to react in those areas. In a cytokine storm, the immune system scrams and releases proteins to counter the feedback, but overcompensates, causing the cells to release more. The levels eventually reach critical mass, to the point that it disrupts many other cellular activities, which eventually leads to death.
In individuals who are immunocompromised, a cytokine storm can still happen, and it is more often lethal. Instead of the storm being a positive feedback loop, it's just a feedforward system; the body just produces so many cytokines that it disrupts ordinary function, and the immune system is not able to overcome the level of cytokines to stop the cascade.
However, there are drugs that exist that directly effect the creation and level of cytokines in the system, which is where intentionally weakening the immune system will help. Many drugs that work to prevent damage done by chronic inflammation will help, e.g. steroids, ACE inhibitors and anti-TNF-α drugs. [Tumor Necrosis Factor alpha is a cytokine]. Given along with influenza viral inhibitors (oseltamivir, zanamivir), these drugs should reduce mortality rates.
Sometime in the (Star Trek) future, we will find out which proteins are part of these Flu viruses are causing this cytokine action, and we can target it directly to stop a cytokine storm in flu cases. We already have leads on some of them, including genes PA, PB1 & PB2 in relation to nucleoproteins found in some flu viruses, including the Spanish Flu. Drugs like it may eventually become so common place to where it will be used to reduce the symptoms of the common flu in moderate to severe cases.
Re:Yawn (Score:3, Informative)
Wrong.
The primary cause of death during the 1918 "Spanish Flu" was "Ctyokine storms" - basically overactivity of the immune system in reaction to the virus if had never seen before. That's why it killed the young and healthy (i.e those with string immune systems) rather than the young and old who are nomally flu victims. I'm not aware of anything modern healthcare could do for them.
Everyone on the planet has been exposed to *some* type of flu virus, but not this one - it's a very unusual mix of pig, avian and human influenza DNA which your immune system has never seen before. All flus are different, which is why sometimes your annual flu shot protects you (when they guess right about the strains that are likely to be around that year), and sometimes doesn't (like last year, when they guessed wrong).
Re:Is this flu really "special"? (Score:4, Informative)
Mortality rate was -only- 2.5% of those infected during the 1918 Spanish flu pandemic. A normal flu is something like .1% of those infected.
Even with the 'official' death statistics - 80 out of 1380 - the death toll is about 5.7%. That's fucking huge, yet unofficial reports are claiming as high as 2-3x as many as the official death count (such as in the OP's linked article).
This is almost beyond scary.
Re:Is this flu really "special"? (Score:4, Informative)
That isn't what happened in 1918. Nothing tangible has changed since then in regards to how a flu pandemic affects us; we have a very limited capacity to vaccinate against every strain of influenza.
Every false alarm is essentially meaningless; the one time it isn't a false alarm, we really do need to react. When that happens, not acting quickly will cost lives. The 1918 outbreak infected a billion (half the population at the time) and killed upwards of a hundred million; a similar outbreak today might kill anywhere from 120-600 million. If the mortality rate does hit the double digits, and we've done nothing up until that point, we're fucked.
Also, you are badly misinformed about the nature of the casualties this time around. Most flu outbreaks only kill the old, the young and the immune compromised. This one killed healthy adults.
Re:Is this flu really "special"? (Score:3, Informative)
The regular vaccine does not cover this particular strain, so not really.
Re:About covering your mouth... (Score:3, Informative)
Thanks for the correction - I apparently confused this with a site called http://coughsafe.com./ [coughsafe.com.] However, the CDC also states, Then, clean your hands, and do so every time you cough or sneeze." The coughsafe.com website recommended the sleeve approach over any other, due at least in part, I imagine, to the fact that people are generally not going inconvenience themselves to wash their hands every time they cough or sneeze.
Official WHO and Federal Response Stages (Score:3, Informative)
The WHO stage remains at 3; the Federal phase remains at 0.
I'll worry when either or both of those numbers change.
http://www.pandemicflu.gov/plan/federal/fedresponsestages.html [pandemicflu.gov]
http://www.pandemicflu.gov/ [pandemicflu.gov]
Re:Is this flu really "special"? (Score:4, Informative)
Re:Google mashup? (Score:2, Informative)
Re:Is this flu really "special"? (Score:1, Informative)
Twenty years ago? Does the acronym "USSR" ring any bells?
Re:GERMS ARE GOOD..... (Score:3, Informative)
Similarly, if a cow gets sick, that's not really a concern for people; if you're a farmer, and your cow gets a bronchial infection, you don't have to worry about catching it if the cow coughs on you, because most cow diseases can't live in human hosts. However, if your pig gets the flu, then you do have to worry, because there are many variants of pig diseases that can live in humans.