influenza

...as any other vaccine. One of the things that was frustrating about the recent report of some (a few) nurses who were concerned about the safety of the swine flu vaccine was the utter ignorance by medical professionals of how the vaccine is made: the swine flu vaccine is no different in terms of manufacture than other influenza vaccines. And since the seasonal flu vaccine is different every year, there's never extensive testing (i.e., months and months) of each year's vaccine. If there were, the vaccine would never be released in time. But don't believe the Mad Biologist, I CAN HAZ…
Last week the Times ran a story by Andrew Pollack, Benefit and Doubt in Vaccine Additive, that covered some of the ground I trod in my Slate story, "To Boost or Not to Boost: The United States' swine flu vaccines will leave millions worldwide unprotected. Pollack also had the room to explore something I lacked room for -- the fascinating history of adjuvants, and the strange mystery of how they work. Like so many things that work in medicine, adjuvants were discovered more or less by accident -- and were in fact a "dirty little secret" in a fairly literal sense. As the Wikipedia entry…
One of the thing we need to pay attention to during TEH SWINEY FLOO! is the role of bacterial infections in flu-related mortality: a fair number of the deaths ultimately could result from a secondary bacterial infection by organisms like Staphylococcus (including MRSA), Streptococcus, and some of the Gram-negative organisms. Unfortunately, this is happening in a significant fraction of cases: Nevertheless, the 22 cases (among 77 deaths confirmed to be from H1N1) emphasize that bacterial co-infections are playing a role in the ongoing pandemic, something that was not clear at first, the CDC…
While I think making swine flu vaccination mandatory for healthcare workers is bad policy, since it feeds into anti-vaccine paranoia: people forced to take the vaccine will assume that they are guinea pigs and this, in turn, will lead others to think something is wrong with the vaccine. Having said that, I'm concerned by the response of Long Island nurses unions--they apparently don't think the vaccine is unsafe but oppose it anyway. But these reactions by nurses are more troubling (italics mine): "This vaccine has not been clinically tested to the same degree as the regular flu vaccine,"…
Taking a brief hiatus from my hiatus to discuss a question I've been asked a number of times in recent weeks by friends and family: what about flu shots? Are you getting one for yourself? Your kids? The answer is yes to both, with more explanation after the jump. First, for readers unfamiliar with this blog, let me be frank regarding my opinion on vaccine "controversies," such as "vaccines cause autism." As I've discussed here several times already (and more can be found by searching my older posts), this assertion is completely unsupported by many scientific studies, so this is not a…
Bestest public service announcement EVAH!: Seriously though, www.flu.gov has some good information. And someone at HHS was being very clever when he or she thought of soliciting videos for a public service announcement.
My latest piece for Slate examines the unsettling consequences of the United States' choice of swine flu vaccines. The good news about these vaccines is that, to judge by the first vaccine trial results, published last week, they appear to work fast, safely â and at about a half to a quarter of the doses that the CDC expected. This means we effectively have about two to four times as many vaccines as we had figured we would. Since we ordered 195 million doses, we could vaccinate damn near the whole country. If the fast-tracking efforts continue to work and the flu peaks closer to Christmas…
Even with the H1N1 pandemic flu going around you should still be vaccinated against the seasonal flu. revere has the details. I guess that means Dr. Doug Bremner must think that revere is an idiot. After all, Bremner tells us that the flu vaccine is all a plot for big pharma to make money, don't you know? Subtlety and weighing of risk-benefit ratios in a manner that doesn't turn into an anti-big pharma rant is beyond him. Fortunately it is not beyond revere: The truth is this. No one knows what's going to happen. We're all guessing. But in my estimation, the risk-benefit calculation for…
...the rest of us. Shorter version: you are an ambulatory germ dispersal unit, so be responsible. I try to make it a regular habit to go through the ScienceBlogs 24-hour feed, and in doing so, I came across this post by ScienceBlogling Jason Rosenhouse talking about his experience with what might have been TEH SWINEY FLOO!, and my jaw dropped when I read this: I didn't even cancel any of my classes, though I did cancel some office hours to get home and back into bed more quickly. I became more troubled as none of the commenters seemed bothered by this. Fortunately, Orac showed up and…
A couple days ago, while waiting for the T, a guy about ten feet away sneezed several times without even attempting to cover his face; he didn't even make a 'matador', bullshit fake effort. Because of the angle of the light and what not, I could easily see the massive spray of mucus flying out of his nose. I mean stuff everywhere. Kinda like this: (from here) Long time readers of this blog will know my battle cry, "WASH YOUR DAMN HANDS!", but other forms of public hygiene, such as not spraying your snot hither and yon, matter too. In fact, it's important enough that public health…
...I was wrong. African-Americans and Latinos are already showing elevated numbers of swine flu hospitalizations in Massachusetts: Since its arrival in Boston in late April, swine flu has proved to be a particular source of misery to the city's African-American and Hispanic residents, causing hospitalizations at far higher levels than other groups, disease trackers report. More than 3 of every 4 Bostonians who have spent time in the hospital because of the viral ailment are black or Hispanic, a finding that may reflect broader social ills, the top official at the Boston Public Health…
In the midst of the concern about TEH SWINEY FLOO!, very few people (other than the Mad Biologist), have been discussing the double whammy of influenza followed by bacterial infections. A couple of years ago, I first started describing reports of KPCs: No, KPC isn't a new fast food restaurant. It's short for Klebsiella pneumoniae carbapenemase. The bad news: it's very hard to treat. The good news: it's very rare...for now. Actually, the correct term is KPC-possessing K. pneumoniae [these genes are now showing up in other bacteria], but we'll just use the slang 'KPC'--it's what all the cool…
The CDC's expert committee has released its recommendations for who should receive the swine flu vaccination (TEH SWINEY FLOO!): 1. Pregnant women; household contacts and caretakers of children under 6 months old; health-care workers and emergency medical services workers; children and young adults ages 6 months through 24 years; adults ages 25 through 64 who have underlying medical conditions that put them at higher risk. 2. Healthy adults ages 25 through 64. 3. Healthy adults ages 65 and older. This is a good list, but I have several concerns, stemming from the apparent lack of recognition…
The swine flu pandemic (S-OIV) currently sweeping the world is the result of an influenza H1N1 virus that made the leap from pigs to humans. But this jump is just the latest leg of a journey that has taken over 90 years and shows no signs of finishing. Today's pandemic is a fourth-generation descendant of the 1918 flu virus that infected around a third of the world's population. This original virus is an incredible survivor and one that has spawned a huge legacy of daughter viruses. By importing and exporting its genes, it has contributed to several new strains that have been responsible for…
tags: NYC, New York City, Manhattan, swine flu, influenza, A/H1N1 Influenza, New York Academy of Sciences, NYAS This is an overview of the NYAS symposium about Influenza A/H1N1 "swine flu" outbreak that I was invited to attend on 28 May 2009 in NYC. Under the auspices of the New York Academy of Sciences' Emerging Infectious Diseases and Microbiology Discussion Group, vaccine experts, epidemiologists, and policymakers from around the United States met in New York City to discuss the current outbreak of Influenza A/H1N1 -- "swine flu." The program presented information about influenza…
I hope the swine flu outbreak focuses attention on the importance of vaccination. When you consider seasonal (annual) influenza (which kills ~36,000 per year) and how lackidaisical people are about vaccination, I can only hope that this makes people realize just how important vaccination for annual influenza is. Because I'm guessing, that right about now, people would be lining up for a vaccine. It's easy to be sanguine about vaccination, or to 'debate' whether vaccines actually work, when such beliefs are viewed as having little or no consequence. But the specter of a pandemic has a funny…
tags: TEDTalks, Laurie Garrett, H5N1 Influenza, influenza, virology, epidemics, streaming video Recorded in 2007, as the world worried about a possible avian flu epidemic, Laurie Garrett, author of "The Coming Plague," gave this powerful talk to a small TED University audience. Her insights from past pandemics are suddenly more relevant than ever. [21:05]
Back to the grind this week unfortunately, but the swine flu/H1N1 story is still developing and still fascinating. The most recent numbers show 286 confirmed US cases in 36 states. There are many remaining questions on the evolution and epidemiology of this strain--and many pundits sure they know what's going to happen next. Mike takes one of them down--Wendy Orent, who I've blogged about previously. Orent is claiming (based on a black/white version of the evolution of virulence in pathogens) that the spread of this strain is attenuating the virus, and that future outbreaks will be…
Wendy Orent, having decided that Paul Ewald is the end-all and be-all of evolutionary epidemiology, is again repeating the mantra that pandemics will evolve to become less deadly. Never mind that, as ScienceBlogling Greg Laden reminds us, the first wave of the 1918 pandemic was far milder than the lethal second wave. Orent, in The LA Times: As with any new outbreak, unraveling all of this flu's mysteries will take time. But, using the lens of Darwinian evolution, certain aspects are starting to come into focus. For one thing, it's clear that the virus, which originated in Mexico, is most…
Over at DailyKos, DemfromCT has an excellent post explaining why it may be beneficial for schools to close temporarily, even if they only have one confirmed case of swine influenza: H1N1: Why Do Schools Close, And When Do They Open? DarkSyde also has one up on the basic biology and evolution of the flu. Nick Kristof discusses our lack of attention to public health and what it means in the event of a pandemic in today's NY Times. [Updated: and via the comment theads, this post which further discusses what I mentioned here regarding testing--and how the confirmed cases are only the tip…