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, Interesting)
Yes, this flu is different. It is primarily killing young healthy adults. It looks to work the same way as the 1918 flu, killing those with the healthiest immune systems through the "cytokine storm".
http://en.wikipedia.org/wiki/File:W_curve.png [wikipedia.org]
Not terrible surprising (Score:4, Interesting)
Re:Is this flu really "special"? (Score:2, Interesting)
Others have mentioned the rather high (apparent) mortality rate (the numbers are quite thin at this point). Another factor increasing the attention is that the flu season is usually over by now.
Re:Not necessarily over-reacting (Score:5, Interesting)
I caught a few minutes of a press conference on CNN. Janet Napolitano, the Secretary of Homeland Security started it by saying something to the effect of 'this makes things sound worse than they are, but it allows us to activate public health resources'.
So perhaps the vocabulary is poor, but the reaction doesn't really resemble crying wolf.
Actually... (Score:3, Interesting)
Making the public slightly paranoid can help prevent the spread of the flu.
You would get your resources wasted and your hospitals swarmed with everyone who feels a bit tired or has a cough.
And there is no better place to catch a disease than a crowded hospital.
Well... except maybe going for a swim in the local sewer.
From the TFA:
Officials said they had confirmed eight cases in New York, seven in California, two in Kansas, two in Texas and one in Ohio, and that the cases 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.
So far, there have been no deaths from swine flu in the United States, and only one of the people who tested positive for the disease has been hospitalized, officials said.
19 people out of 306 million found to have something like the disease that has killed 80 in Mexico.
1 of those 19 was actually kept in the hospital while others were sent home.
Also...
In the United States, the C.D.C. confirmed that eight students of a high school in Queens had been infected with swine flu, the first confirmed cases in New York City, Mayor Michael Bloomberg said at a news conference on Sunday. Mr. Bloomberg said that all of the cases had been mild and hospitals in the city had not seen more patients with severe lung infections.
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About 100 students at St. Francis Preparatory School in Fresh Meadows, Queens, became sick in the last few days, and some family members have also taken ill. Mr. Bloomberg said the school would be closed on Monday, and that officials would then reassess whether to reopen the school.
Yes... those 8 cases are all from that school.
Note the numbers.
8 people actually sick. 100+ immediately think that they are going to die. 0 of them hospitalized.
Immune system overreacting (Score:4, Interesting)
Here's a question for somebody who knows the immune system:
Apparently this flu is so deadly because the immune system overreacts (cytokine storm) and destroys more than just the virus. Would intentionally weakening the immune system then increase ones chances of surviving? From what I've read, it seems both sugar and alcohol would have an immediate weakening effect on the immune system. So to increase the chance of survival if infected: lots of sugar and alcohol?
Re:Is this flu really "special"? (Score:5, Interesting)
What is really valuable about this is that it looks to be a fairly safe, almost ideal model for the real thing. A test for how competently a pandemic is managed locally. Listening to the news this morning (we are 16 hours ahead of the US), our authorities seem to have concentrated all their efforts in micromanaging the school threat, and ignored contamination of everyone else on the plane. Provided the officials stay inside the school, they should be safe.
Personally, I'd prefer a bunch of veterinarians running it who aren't allowed to shoot and burn. At least they have a holistic approach. However, I'm getting old and cynical. Younger people seem to prefer touchy-feely sorry-about-the-megadeaths administrators.
Re:Is this flu really "special"? (Score:5, Interesting)
The flu kills thousands of people every year. Why does this one have a special name?.
Flu usually kills the very old and the very young. From what I have read, this one is different; it kills young and healthy persons, a segment that rarely dies from normal flu. The so called Spanish Flu (or Grippe) from around the first world war had a very similar fatality pattern. Since that pandemic attack killed at least 50 million people around the world it is clear that this new flu must be taken very, very seriously. There doesn't seem to be that much hard evidence around regarding the symptoms though; does it attack the lungs in the same way as the Grippe? It appears that the Grippe turned peoples own immune system against themselves which is why young healthy persons with good immune systems died in such large numbers and often so violently fast.
From what little info I have seen it appears that this swine Flu attack and kills some young and healthy persons, while other victims have very mild symptoms; that is the exact same pattern as the first major wave of the Grippe. According to some researchers this attack pattern caused the Grippe virus strain to be refined to the extremely deadly strain it was when it attacked again. Some victims died within an hour of having the first symptoms, and people would literally drop dead without warning while walking in the streets, pupils in classrooms would suddenly fall over their desk dead.
--
Regards
Re:Is this flu really "special"? (Score:4, Interesting)
Re:That's it... Keep'em distracted (Score:5, Interesting)
Honestly people, it's the flu. We get a new one every year... sometimes several. I stopped getting flu shots decades ago and have been a LOT healthier since that time...
I really hope this doesn't prove to be the "No wireless. Less space than a nomad. Lame" comment of pandemics.
From what I am reading, this virus is distinct in that there is no natural immunity in humans (unless, I assume, you recover), that it kills those with the strongest immune systems, and the number of known cases are doubling daily. And that it's pretty lethal, at least in Mexico. Some of the estimates by doctors in the linked story says that Mexico is underrepresenting the death toll by 10x.
Comments like "The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses" do not give me too much comfort either.
As I understand it, viruses with a higher rate of mortality burn themselves out very quickly. If this is just lethal enough that most infected people survive long enough to pass it on... but a significant number of those infected experience the cytokine storm... we could all be in serious trouble. I'd rather have the CDC and WHO overreact than under-react.
I guess we'll know soon (and that's assuming there's no dramatic mutation... there were three major waves of the 1918 pandemic as it came sweeping through the population and picked off the survivors of the previous one. The 2nd I think was the most lethal.)
W
Great Influenza (Score:2, Interesting)
It mentions that these killer strains of flu are an anomaly in a virus that mutates rapidly, and so the general trend is for an outbreak to become less and less deadly as it continues (i.e., subsequent generations revert to the mean). Also, there were multiple strains in play at different times during the whole 1918-1920 crisis.
Re:Is this flu really "special"? (Score:5, Interesting)
stay the f*** home from work/school when you are sick, that would help
If only it were that easy. Even when I'm ill with things that make me unable to work (such as vomiting every half hour) employers tend to be unsympathetic, even more so when its something where you feel miserable and are sick with something contagious (such as normal influenza), making staying at home little more than a dream. Schools aren't much better and sometimes much worse. For example, school nurses usually have a set fever number where they will not send kids home if they don't reach it (such as 100 degrees) and so even when you are visibly sick, feeling miserable but yet can't hit the magical 100 degree fever, you are stuck in school transmitting whatever you have. And most parents send students to school even with high fevers, when kids are visibly sick, and even when they are vomiting.
Re:Is this flu really "special"? (Score:5, Interesting)
Most of the deaths in Mexico were young adults. From the WSJ:
"Mexican health authorities said the death toll from the new strain of A/H1N1 swine flu remains at 20, and they are continuing to investigate whether more than 1,000 others were infected with the mysterious bug, which attacked in three geographically diverse areas of the country and is taking its heaviest toll in young adults."
Imagine it's scary for you too. Because it is.
Environmental Factors? (Score:5, Interesting)
Re:Environmental Factors? (Score:3, Interesting)
> Sorry to point out the obvious here but Mexico City is located more then a mile above
> sea level (higher elevation then Denver). Could environmental factors be the reason that
> people are dying of respritory complications in Mexico
Do cities at high elevations normally see a much higher than average death rate from influenza?
Re:Not terrible surprising (Score:3, Interesting)
Re:Google FluTrend (Score:5, Interesting)
That is absolutely NOT TRUE. Flu is considered an unstable virus. Its outer outer sheath of proteins are different all the time. BUT, this particular strain had to get its input from a number of different strains. It is POSSIBLE that a few of the genes that it picked up were from ones that CDC (and other experts) picked to be the likely strains. IOW, it is POSSIBLE that it has proteins from what was the suspected strains. At this time, it is not known EXACTLY what strains this came from.
What is more interesting, is this one has elements of Avian flu. It is possible that doing a vaccine directly against it MAY be what causes the issues, since it is current suspected that an immune storm is causing the issues.
Re:Max Brooks was right (Score:3, Interesting)
Things are falling apart pretty rapidly here in Arnette TX. Yesterday in the supermarket there were two guys fighting over the last can of tinned pineapple. They started shoving, then one smashed the other in the face with the tin, grabbed his basket and left him on the floor clutching his bloody face.
The national guard finally arrived this morning, but they seem more interested in keeping control of the food than in protecting anyone from the rioters.
I've got that old saying stuck in my head, the one about the world only ever being three missed meals away from anarchy. By my count we're at around 1 1/2 right now...God help us all.
Re:Is this flu really "special"? (Score:3, Interesting)
First-hand reports from doctors in Mexico City (Score:5, Interesting)
There are first-hand reports that the number of fatalities reported publicly and the mortality rate are under-reported in the news. Emails to the BBC [bbc.co.uk] from doctors and others in Mexico tell a different story than we're getting from the Mexican government and the CDC- here are two of the most interesting:
I'm a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. There is a severe emergency over the swine flu here. More and more patients are being admitted to the intensive care unit. Despite the heroic efforts of all staff (doctors, nurses, specialists, etc) patients continue to inevitably die. The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses. It is a great fear among the staff. The infection risk is very high among the doctors and health staff.
There is a sense of chaos in the other hospitals and we do not know what to do. Staff are starting to leave and many are opting to retire or apply for holidays. The truth is that mortality is even higher than what is being reported by the authorities, at least in the hospital where I work it. It is killing three to four patients daily, and it has been going on for more than three weeks. It is a shame and there is great fear here. Increasingly younger patients aged 20 to 30 years are dying before our helpless eyes and there is great sadness among health professionals here.
Antonio Chavez, Mexico City
I work as a resident doctor in one of the biggest hospitals in Mexico City and sadly, the situation is far from "under control". 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. The official number of deaths is 20, nevertheless, the true number of victims are more than 200. I understand that we must avoid to panic, but telling the truth it might be better now to prevent and avoid more deaths.
Yeny Gregorio Davila, Mexico City
Mortality Rates and Flu 'Waves' (Score:1, Interesting)
At present, about 1300 cases are being reported in Mexico, and 80 deaths are being attributed to swine flu - mortality rate is about 6%. Now it's likely that more deaths than 80 were caused by swine flu, but since nobody was looking for swine flu, nobody attributed these deaths to it - which would increase the mortality rate. However, it is just as likely that many cases of swine flu have gone unreported (infected individuals not seeking medical care, etc.) - which would decrease the mortality rate. Overall, it probably balances out. The other important thing is the incidence rate - how many exposed people can be expected to become infected. I don't know what this is, neither does the CDC, etc. If it's low - we're probably going to be OK; if it's high - we could be screwed. Because . . . . pandemic flu comes in waves (incidence rate/mortality rate can vary highly from wave to wave - so the below is not really realistic, it's just an example).
If the incidence rate approaches 100%:
Wave 1 - 6% mortality rate = 94% of the infected survive; 94% of the original population survives;
Wave 2 - 6% mortality rate = 94% of the infected survive; 88.4% of the original population survive;
Wave 3 - 6% mortality rate = 94% of the infected survive; 83.1% of the original population survive;
Wave 4 - 6% mortality rate = 94% of the infected survive; 78.1% of the original population survive;
Wave 5 - 6% mortality rate = 94% of the infected survive; 73.4% of the original population survive;
Wave 6 - 6% mortality rate = 94% of the infected survive; 69% of the original population survive;
Wave 7 - 6% mortality rate = 94% of the infected survive; 64.8% of the original population survive;
Wave 8 - 6% mortality rate = 94% of the infected survive; 61% of the original population survive;
Wave 9 - 6% mortality rate = 94% of the infected survive; 57.3% of the original population survive;
Wave 10 - 6% mortality rate = 94% of the infected survive; 53.9% of the original population survive;
Get the picture?
Re:Is this flu really "special"? (Score:2, Interesting)
We don't really know the carrying capacity of the Earth, and at any rate allowing billions to die isn't a valid solution by any reasonable moral standard.
That's interesting. So your statement preemptively declares all opposing positions as being "unreasonable". You also assume that "valid" solutions must be moral as you define it and that we must have a solution.
Why is death by disease immoral? Why is not making extraordinary efforts to treat the diseases of others immoral? By who's standard other than yours?
If you are a religious person than I can understand your position. If you are not then I wonder how you arrived at it. I don't know where you are coming from here, but I do wonder about the large number of people in the West who renounce or ignore religious faith and yet still have this sense of moral certainty and who freely make moral judgement of one and all.
I'm not trying to pick on you personally, but /. is full of people who on one hand are quite certain in their moral judgements and yet mock religion and the religious. It's sort of a "mock religion" they seem to follow if you'll pardon the pun.
Re:Is this flu really "special"? (Score:1, Interesting)
More likely is that it kills via the immune system overreacting (cytokene storm, or cytokene feedback loop) and affects people with stronger immune systems more potently. Incidentally, this is also how H5N1 is speculated to kill. I'm never one to make light of tragedy, but if this gets serious it'll be a chance to test new treatments that have been underway to prevent cytokene feedback from killing patients, which could give us a huge advantage in the long run. (Especially if H5N1 becomes efficiently human-to-human transmissible.) While it can take months to develop a vaccine, if a drug can be produced that counteracts the most lethal symptom of the disease until it naturally runs its course, that could save countless lives and -be ready any time we need it-.
Re:I wouldn't particularly worry (Score:5, Interesting)
I have a better suggestion: Beer Bread.
get a case of cheap beer and a couple of bags of cheap flour. doesn't even matter if it's self rising, but you'll get more of a traditional bread if it is.
Using the very simplest method, mix 3 cups of flour with a can of beer; don't stir it until smooth, just get the biggest lumps out.
put it in a backing container. I've used everything from breadpans to tinfoil bent to approximately the right shape and hot coals from a fire.
Oven at 375f for about an hour.
Eat. freak out at how good it tastes, smells. Watch your friends drool uncontrollably at the smell.
it gets better if you it "properly", but as stated it's damned good.
Properly would be: add anything from 1 Tablespoon to a 1/2 cup sugar; type of sugar makes the taste highly variable, I like a little Turbinado ("Raw" sugar).
Butter. grease the pan with it. some people say pour some melted butter over the loaf when you 1st put it in, I wait until it looks like the top of the loaf is starting to split then pour about a 1/4 stick, melted, on top. it lets the bread continue to rise and makes the sides touching the pan get extremely tasty.
After you get jaded with the basic product, you can try changes; different beers make different tastes, (Guinness Beer Bread is unbelievable), you can add cheese to the dough, nuts, whole wheat flour, fruit, etc. Makes really interesting cinnamon rolls.
Looking at things in the context of the thread, put your flour in a airtight container in a cool place, and it'll last forever; put your beer alongside of it, the same. and you can always find other used for the beer in the post-flu apocalypse world. and making your own beer isn't hard, making your own flour just involves an extreme amount of hard work, which you can trick someone else into doing in exchange for beer.
In conclusion, here are suggestions for A Smart Geeks cheap survivalist Shopping list for Monday, April 27th, 2009: 2 SKS rifles, 1000 rounds of ammunition, 20+ lbs of flour, 8+ cases of beer, lots of multivitamins, a variety of over-the-counter drugs, Toilet Paper, feminine hygiene products (yes, even if you are a single guy. The female Mutant survivors will think you are a god) and waterproof containers for everything. If you live near a Military base, hit a surplus store and buy a couple of cases of MRE.
How was THAT for a weird post?
Re:Is this flu really "special"? (Score:4, Interesting)
>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.
Uh, "society will collapse" is a "reasonable assessment"?! Did society collapse in 1918? I don't recall reading about it. Why is it any more likely now, with far better supportive care, and far better understanding of the causes? This is ridiculous, "society" in some form has managed to exist for at least ~8000 years, through a lot worse epidemics than this.
Brett
Im a mexican... (Score:1, Interesting)
It is true:
Im a mexican, i live in Nuevo Leon, and what the papers and news say is probably only the 10% of the real.
Even the newspapers contradict themselves: They said that where no cases in my state...and in the next page, they said that were 10 cases...
Today they said that there were 1 dead....
An hour ago , the goverment announced that schools will be closed from tomorrow until new advice.
And in the center the things are ever worse...
A friend of mine lives in mexico city told me tha the situation is totally awry:
- No people in street
- only went outside for food, medicines, work
- all wearing masks
- people stopping to go to work
Taking account that our sanitary infrastructure is not the better and that the people here have the tendency to ignore what government says and that most of our cities tend to be overcrowded...
This not seems very well...
Im seriously thinking to get a van, gas, food, some stuff and some weapons(any) and secure a cabin in the mountains....just in case....
Re:Is this flu really "special"? (Score:5, Interesting)
Re:Is this flu really "special"? (Score:3, Interesting)
It's worse among doctors. It doesn't surprise me that the BBC article contains reports about residents and interns dying. I wonder how many patients get infected via sick doctors?
Large teaching hospitals are dependent on residents who work 80 hours a week to barely cover the workload. If someone calls in sick, then it means your already overworked and fatigued colleagues will have to cover for your "weakness." Oftentimes the onus is on you to find your replacement. And so the culture discourages it - either through active hostility or feelings of guilt and/or machismo on the part of the sick person. This culture is learned in med school and residency then gets carried forward.
I'm a resident physician and every year I have to do some online training for all hospital employees that says to stay home if you're sick, and we residents just laugh. The idea of calling in sick for a low grade temp and a cough is so out of the realm of possibility, it's absurd. I'm not saying this is a good or noble thing - there's a lot of things about the culture of medicine and residency (such as work hours) that are fucked up and end up adversely affecting patient care.
Re:Is this flu really "special"? (Score:3, Interesting)
I've lived in the are of Mexico hardest hit (just moved back to the states last year), and I visit regularly still. A couple of notes, first of all Mexico isn't as undeveloped as you may believe. In my experience the big difference between Mexico and the US is the standard of living. Mexico has everything the US has, and medically may be a bit better off since I believe it has a more socialized medical system. There are however two big issues, first the fact that penicillin and other antibiotics are readily available over the counter, and just like in the US it isn't uncommon for people to take medication until they feel better and then stop. Doing this with antibiotics causes a really big concern for drug resistant strains to show up. Also as some others have pointed out the flu virus actually spreads better in colder climates. Some of you may not be aware but not all of Mexico is warm like Cancun or Acapulco. Mexico City and especially Toluca are pretty high up in the mountains (7,349 and 8,790) and they do get downright chilly at night even in the summer.
My guess as to why this got bad so quick is the government trying not to panic everyone. You have to remember that parts of Mexico are completely dependent on tourism, and with the bad economy and the drug violence already going on I'm not sure the government didn't want to make matters worse by announcing a pandemic as well.
I've been following Mexican news and talking to family in the area and the situation is now completely out of control. The government has shut down all the schools in the affected areas, business, and restaurants are all closed. To put this in perspective imagine the whole state of New York shutting everything down for ten days because of the flu. The military is handing out what masks they have (everywhere is out of of them now). Major sporting events are being played without an audience (literally the stands are completely empty). What businesses are open (like banks) are rotating their staff every couple of hours to keep the number of people in one area at a time down. According to my relatives in the area the streets are deserted and even the grocery stores are empty. There is full on panic there.
BTW, the running joke down there is that Obama brought the virus with him, since the outbreak coincided with his visit. Obviously not true, but amusing.