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Laurie Garrett of the Council on Foreign Relations and a well-known authority on emerging infectious diseases was on PBS's Newshour last night and she made a very important but little appreciated point. Mexico has made a major national sacrifice for global public health by shutting down its country…
[NB: I have been traveling and offline all day. No way I can even read much less respond to the many excellent comments, tips, questions. Thanks to all. Help each other. Back at home base now.]
Closing US borders with Mexico for swine flu is fruitless since the virus is already planted in a dozen…
Just a brief note to remind everyone about the case definitions CDC is using for reporting on swine flu (or whatever name we collectively settle on). In order to make sure numbers are comparable from day to day and place to place we have to decide on criteria for knowing we have something to count…
One of the things we are told is not the responsibility of government but an "individual responsibility" is not working sick or sending our kids to school when they are sick. I pointed out that the ability to do this may depend on others, particularly employers. Employers also have a responsibility…
There were 3 flu pandemics in the 20th century and each has gotten an unofficial name. 1918 was the Spanish flu, so named because the Spanish were the only ones honest enough to acknowledge its presence initially and thus got stuck with the blame. Like the other two pandemic viruses it probably…
A reader (hat tip, sandy) has pointed me to a very interesting interview with CDC's chief virologist, Ruben Donis, in Science Magazine's blog, ScienceInsider. In it he provides further information on the confusing reports about the species origin of the current swine flu, originally said to be of…
There is a tendency to be preoccupied with the latest in fast moving events, but I want to pause for a moment to make a point that has been lost in the discussion: we are witnessing a medical science landmark. Never before have we watched a flu outbreak of global dimensions unfold in real time. Nor…
In June 2005 a reader over at the old site suggested we put up some of our flu related material on Wikipedia. That sounded like a great idea to me. Even better, why not start a special purpose wiki -- a flu wiki -- to harvest the vast knowledge of the hivemind? Many, if not most, of the problems…
A student once complained that no horse was too dead for me to stop beating it. Long time readers are familiar with that here. Over the years I have said that the best way to prepare for a pandemic -- or any other grave threat to our communities -- is to strengthen its public health and social…
This has been a supremely frustrating day for me since I am traveling and must attend to professional business having nothing to do with the current outbreak. I is incredibly maddening to be away from fast moving events. I'll return home Friday night. In the meantime I will do what I can late in…
As is usual (routine? no, nothing routine about this) in an evolving epidemic contradictory and confusing numbers are appearing. Some of them are the result of information lags (tallies not being updated), some are the result of using different criteria for counting (suspect versus probable versus…
The first death in the US from swine flu in a Texas toddler is being widely reported, but a piece just in from Bloomberg says the infection was acquired in Mexico:
The first confirmed U.S. swine flu death was a 22-month-old child from Mexico, according to a Houston official.
The toddler was brought…
CDC guidelines for antiviral therapy for swine flu infection:
This swine influenza A (H1N1) virus is sensitive (susceptible) to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir. It is resistant to the adamantane antiviral medications, amantadine and rimantadine. (CDC)…
As cases continue to accrue in different places we will hear more talk about quarantine and isolation. These are two terms that are frequently confused, which is too bad, because isolation makes sense for influenza and quarantine doesn't. So what do they mean?
What quarantine and isolation have in…
It would be nice to think that the 28 cases at the NY Prep School are it for the city and that the virus has been contained there. But that was always more a wish than a plausible reality:
CBS 2 HD has learned of a confirmed case of swine flu at the Ernst & Young headquarters in Times Square.…
Now that the initial rush is over, time to settle in for the long(er) haul. It's 3 am here. Good time to clear the air and lighten up:
The Daily Show With Jon Stewart
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Snoutbreak '09 - The Last 100 Days
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Daily Show Full Episodes
Economic Crisis…
One of the things we'd like to know about the swine flu virus is its Case Fatality Ratio (CFR, commonly called a case fatality rate, although it isn't technically a rate but a proportion). But what is a CFR? And how is it different from a mortality rate?
The CFR is an estimate of the probability…
The daily CDC conference call was not particularly informative, but these daily briefings are still extremely valuable. Things are happening fairly fast but nothing we didn't expect. There are now 40 confirmed US cases in the same 5 states (California, NY, Texas, Kansas, Ohio). The 28 new cases…
Usually "What did you expect?" is a rhetorical question, but we have a more serious point to make. Let's start with the familiar and move on to the less familiar. Many of you are coming here to find the latest news about swine flu. It's an imprecise term that covers two different things: what has…
The White House briefing today had Obama written all over it. It's themes were Obama, it's tone of quiet, serious confidence were Obama. The sense of total command of the situation was Obama. There was the Obama-ese call for "personal responsibility." Government can't do everything. There are…
The White House held a briefing this afternoon with the Secretary of Homeland Security, Acting Director of CDC and Nat'l Security adviser to the President in attendance. If you have been following this you wouldn't have learned much, but the overall tone was one of serious concern but steady…
If there was ever a graphic illustration of how global interconnectedness affects public health, it's the swine flu affair. Wherever it started, the current crop of cases seems related to Mexico, either as the epicenter or via travelers. Four US states have cases. Those not on the Mexican border…
[For our many new visitors, the Freethinker Sermonette is a regular Sunday feature here.]
With swine flu and everything, some people might think of turning to a Higher Power for protection. Head to the UK. Because The Force is with them. In fact, it's even on the Force. The police force:
Eight…
A concise summary of some additional developments, courtesy Bloomberg:
Three teachers and 22 students from Auckland’s Rangitoto high school are being tested for swine flu after returning to New Zealand’s most populous city from Los Angeles following a three week trip to Mexico, Stuff.co.nz reported…
Canadian Press (Helen Branswell, with contributions from AP reporters) AP has a piece up about how Mexicans are coping that is worth a read, but we were drawn to this description of how the Mexican authorities first recognized something was amiss:.
Health authorities started noticing a threefold…
There may not have been much news at the CDC briefing, but it is coming thick and fast now. The CDC works through state health departments and defers to them on information about what is going on in their localities. Hence all questions about this were deflected at the 1 pm CDC briefing. I think I…
CDC has just concluded a press briefing and the big news is there is no big news. In fact there was hardly any small news. The major questions have been identified -- how transmissible, what is the epidemic curve, are there more cases in the US, are there subtle genetic differences in the US and…
There will be an update from CDC later today and WHO's expert committee established under the new International Health Regulations (IHR) meets via teleconference this morning North American east coast time at 10 am (4 pm Geneva time) to consider whether the swine flu situation merits declaring it “…
Some end-of-the day (but not end-of-the-world) bits and pieces in the emerging swine flu story.
From Helen Branswell (Canadian Press):
In Mexico, Secretary of Health Jose Angel Cordova Villalobos said in a television interview that there have been 45 deaths, but only 16 of those were directly…
Two recent sources of information, a conference call for clinicians and a just concluded media conference call held by CDC Acting Director Richard Besser.
Clinician call:
An emergency conference call for the Clinician Outreach and Communication Activity (COCA) was announced just hours ago on the…