swine flu
gregladen | August 3, 2012There is a novel strain of swine flu of the H3N2 type with a lot of infections in humans over a short period of time but over a large geographic area.
The CDC reports 12 cases this week, 1 in Hawaii, 10 in Ohio, and one in Indiana. Seventeen more cases were reported since about one year ago. Most of the cases are found in individuals who had direct contact with swine, but some cases appear to be person to person transmission.
A large number of the recent cases seem to have been in individuals who had contact with swine at a fair. This is fair season across much of the US, and apparently…
mpendergrast | June 21, 2010Mark Pendergrast writes: To kick off this book club discussion of Inside the Outbreaks, I thought I would explain briefly how I came to write the book and then suggest some possible topics for discussion.
The origin of the book goes back to an email I got in 2004 from my old high school and college friend, Andy Vernon, who wrote that I should consider writing the history of the EIS. I emailed back to say that I was honored, but what was the EIS? I had never heard of it. I knew Andy worked on tuberculosis at the CDC, but I didn't know that he had been a state-based EIS officer from 1978…
revere | April 26, 2010What are we to make of the swine flu pandemic? The only thing I feel confident about is that it will be some time before we really know. A great deal of data and experience was gained in the year since the pandemic H1N1 took everyone by surprise but it will be a while before we can harvest all of it. Meanwhile I can say things were better than we thought they might be and certainly better than everyone's worst fears, but how much better -- better, how bad -- they were we just don't know. It was a very good year for people in my age category (over 65) as for reasons now becoming a bit clearer…
revere | April 22, 2010It was a year ago today we put up our first post about swine flu: "The California swine flu cases." I think we were the first blog to notice it, and it began this way:
Late yesterday afternoon a Morbidity and Mortality Weekly Report (MMWR) Dispatch appeared on CDC's website that is unique in my experience. MMWR is usually heavily vetted and edited and nothing gets out of there fast. Indeed, in recent years, nothing at all got out of CDC very fast. And yet here is this Dispatch, with text referring to the same day of issue (April 21), reporting on two young patients with febrile respiratory…
revere | April 9, 2010This week Canadian public health researchers published the long awaited paper on possible association between vaccination for seasonal influenza the previous flu season and risk of having a medically diagnosed infection with pandemic influenza during the first wave of infections (April to July) just as that season was ending. When preliminary results were first announced there was only vaccine against seasonal flu, which was still being given, and the results were contrary to what we thought we knew about flu biology and the immune system. Inevitably it became caught up in the wider anti-…
revere | April 1, 2010The AMA just took over a journal called Disaster Medicine and Public Health Preparedness. In fact they proudly announced they were the exclusive publisher and distributor of the journal, formerly published by Lippincott, Williams and Wilkins. I wouldn't even know about it except it was in connection with a press release of an article likely to be of interest any health care worker: ":Which Health Care Workers Were Most Affected During the Spring 2009 H1N1 Pandemic?" by Santos, Bristow and Vorenkamp of Weill-Cornell Medical School in New York. And the AMA even said it was redesigning the…
revere | March 30, 2010There is a good Canadian Press by Michael Macdonald about the often long time it takes to make a full recovery from flu. A full blown case of classical influenza can really lay you low for days or weeks. People often report never having felt so sick. But once you are "recovered" and back to work or your daily activities you aren't necessarily fully recovered:
Marga Cugnet thought she knew what she was in for when she came down with swine flu last October.
But the health administrator from Weyburn, Sask., said she was annoyed and somewhat dejected when the potent H1N1 virus left her with…
revere | March 29, 2010A day or two after CDC's Morbidity and Mortality Weekly Reports (MMWR) released a report about risks to pregnant women from pandemic 2009 flu, CDC held a suddenly announced press briefing about the current H1N1 situation (I listened in but a transcript should be up on the site by the time you read this; check this page). The occasion for the briefing was a worrisome increase in hospitalizations and deaths in CDC's Georgia backyard. Despite housing CDC, Georgia has one of the lower flu vaccination rates in the country and now is experiencing an unexpected recrudescence of H1N1 flu, with…
revere | March 26, 2010We continue to learn a great deal about influenza infection as researchers harvest information from the recent swine flu pandemic. The pork producers don't like to call it "swine flu" but it may well be that its long sojourn in that animal since 1918 (did we give Spanish flu to pigs or did pigs give it us?) may hold an important clue to why older people suffered less than younger ones. It seemed fairly likely that the difference was related to immunity, but since H1N1 came back in 1977 after being absent since 1957, it wasn't clear why younger people born after 1977 would be as immune as…
revere | March 23, 2010We are now almost through the period considered to be the traditional flu season (to the end of March in the temperate northern hemisphere) and so far the amount of documented influenza infection is at a relatively low normal level and pneumonia and influenza deaths are about usual for this time of year. Said another way, there so far has been no big "third wave" of pandemic swine flu. Most flu experts didn't know what would happen but if they had to bet, probably would have bet on a resurgence. I suppose it could still happen, since the original transmission in the community occurred "out of…
revere | March 19, 2010As predicted, the pandemic of 2009 is beginning to yield more data, some of it directly applicable to pressing practical questions. The answers are still preliminary, and, as with all science, subject to revision. But it's what we have at the moment, and a letter that just appeared in the CDC sponsored journal Emerging Infectious Diseases, addresses an important question. During a flu outbreak, can hospitalized patients contract influenza from blood transfusions? Since people getting transfusions already have compromised health (else why would they be getting a transfusion?), they are at high…
revere | March 6, 2010Two days ago I went with my daughter to the pediatrician to check out her 20 month old who had a fever and rash. Viral origin, probably. Also an ear infection. Pretty much par for the course at this time of year. But lots of little ones and their older sibs weren't so lucky this flu season. As we've had too many occasions to mention, the severity of the 2009 pandemic has yet to be gauged, but trying to compare it to seasonal flu is misleading as its epidemiology is very different. Nowhere is this seen more clearly than in the melancholy figures for pediatric deaths.
Since the beginning of…
revere | February 26, 2010It is becoming conventional wisdom that the 2009 H1N1 pandemic was not as severe as a bad seasonal flu year. That might be true, although I don't find it much comfort because a bad seasonal flu year is no less bad for being more familiar. But I am not yet willing to assent to the conventional wisdom yet. I don't think we have had sufficient time to collate all the information that would enable us to make that kind of judgment, which sometimes takes years to evaluate. However bad it was or wasn't, the pandemic flu strain could kill you just as dead as any other flu. CDC has just released…
revere | January 22, 2010It was some time after the pandemics of 1957 and 1968 that we were able to judge their severity and it will likely be some time after this one has finally burned itself out, most likely to become "just another" seasonal flu, that we will be able to gauge the 2009 swine flu pandemic. A lot of data is being generated but it will take time to harvest it and send it to the scientific market for consumption. A report in today's Lancet reminds us that we aren't seeing all there is to see, even with unprecedentedly rapid means of communication and better surveillance than ever in the history of our…
revere | January 21, 2010In my regular science trawling I noticed a fascinating paper in Nature (epub ahead of print) that I haven't seen anything about in the news. It seems to me it's worth a discussion, if for no other reason than it uses a relatively new approach, small interfering RNA (siRNA), to dissect the functions in the host cell the virus needs for the only thing it wants to do, make a copy of itself. It also lets me try out on you a new analogy I cooked up for a short talk on flu for high school students and their parents and teachers. It turns out that parts of it will be useful to explain the new siRNA…
revere | January 17, 2010There is an old vaudeville joke where a man goes to the doctor complaining about pain in his arm:
Doctor: Have you ever had it before?
Man: Yes, once before.
Doctor: Well, you have it again.
CDC reported on their weekly FluView website on Friday that the Iowa Department of Public Health (IDPH) reported to CDC that in September a boy (age not stated) had a flu like illness from which he fully recovered and for which he hadn't required hospitalization. In November IDPH determined it was swine flu, but not the pandemic H1N1 but a swine-origin H3N2. According to CDC there was "no clear exposure"…
revere | January 13, 2010The finger pointing and the told-you-so-ers are out in force these days and WHO seems to be one of their targets. In the face of wealthy European countries cutting their swine flu vaccine orders because of limited demand, critics are claiming that WHO exaggerated the threat in league with or under the influence of Big Pharma vaccine makers out to make a killing. This is really two issues. One, did WHO appropriately appraise the risk; and two, were they unduly influenced by greedy drug makers. I think the answer to these questions are "Yes" and "No."
In our view WHO was caught between a rock…
revere | January 4, 2010In early September swine flu was just ramping up in the US and there was no vaccine. CDC envisaged adequate vaccine supplies by end of October but in reality this was too optimistic. For a period of weeks, the news was full of stories of long lines at vaccine clinics and the frustration of worried parents who were anxious about the health of their children in a pandemic where children seemed to be most at risk. The flu struck in North America first, but eventually made its way to over 200 countries on every continent, some of them desperately poor. They didn't have to worry about too much…
revere | January 3, 2010New York Times correspondent Don McNeil is an excellent medical reporter. He always asks intelligent questions at the CDC pressers and he writes good articles. And he's written one for The Times yesterday that I agree with, although his support for it seems to me less than objective. In essence he asked the country's flu establishment how well the US handled swine flu. None of his sources are CDC employees but all of them are deeply involved in flu and flu policy in one way or another. And they gave themselves a big pat on the back. I hope they didn't wrench their shoulders. That might be a…
revere | January 2, 2010It's easy to lose track of current events during the holidays, so here's an update of the week's most important news. We lead off with a breaking swine flu story: