swine flu
revere | December 28, 2009It's the end of the calendar year and the traditional time the media looks back on "the biggest stories of the year." There are websites about almost any subject (even one on a particular model of running shoe, I am told), but those of us who write specialized blogs (as opposed to ones about politics or current events) rarely expect our subject matter to show up on one of those lists. We've been writing about flu for over five years, here, and while re recognized the possibility our subject would come into vogue -- that's indeed why we were writing about it -- it still took us and everyone…
revere | December 25, 2009So far the pandemic of 2009 has been bad enough but not anywhere near as bad as one could imagine. Let's hope it stays that way. While winning new knowledge from actual disease and sickness is not anyone's favorite strategy, it is likely we will learn a great deal about influenza in the years to come as we begin to mine the wealth of data it is producing. Science, even at its most urgent, is still a slow, methodical process, but this pandemic and the resources devoted to tracking it and the tools being developed to analyze it is a watershed event in flu science. Dogmas will fall and probably…
revere | December 24, 2009Yesterday CDC had its last press conference of this calendar year on the flu pandemic (.mp3 here). CDC's Anne Schuchat did her usual competent job and was generally upbeat while trying to maintain the need for urgency in the vaccination campaign. She cited numbers of over 100 million swine flu and 100 million seasonal flu doses having been produced for consumption in the US and this is a real accomplishment. She also noted that availability of swine flu vaccine was now much greater. Indeed my medical center notified us that it was generally available regardless of previous priorities. Hence I…
revere | December 17, 2009Irony isn't dead. But it's on a ventilator. No wait. There aren't enough ventilators. So maybe it's just having labored breathing. From February 9:
The target grew out of discussions among a group of moderate Republicans, led by Sen. [Susan] Collins [of Maine], aimed at reining in costs and better targeting federal funds toward job creation. The effort amounts to "rebuilding" the Obama package, according to an individual familiar with the talks. The package would include tax cuts and investments intended to create jobs, such as infrastructure projects, but it would step back from spending…
revere | December 16, 2009A spot-on column in CIDRAP Business Source [subscription] by Center for Infectious Disease Research and Policy's (CIDRAP) Director, Mike Osterholm, reminded me to say something I've wanted to say for a long time. We should banish the word "mild" from the influenza lexicon. There's no such thing as a mild case of influenza, any more than there are "mild" auto accidents. There are cases that for reasons we don't understand don't make you very sick (or sick at all), and there are cases that can lay you lower than you ever want to be, including six feet under. What Osterholm does with great…
revere | December 13, 2009Red wine has been touted for its health benefits but these don't seem to extend to warding off swine flu. The virology laboratory in Bordeaux in the southwest of France tested via RT-PCR over 1200 nasopharyngeal swabs between May 1 and the first week in October and found 186 positive for the new pandemic strain. They looked at five of these cases more closely, monitoring them for duration of viral shedding. Two of the five kept shedding for 2 to 4 weeks (paper in Eurosurveillance by Fleury et al., v. 14, #49, December 10, 2009).
The first case was a non-obese previously healthy male in his…
revere | December 7, 2009Any concerns about the current swine flu vaccine inevitably bring up the swine flu episode of 1976. This is not 1976. For starters, this year we have a bona fide pandemic and in 1976 the virus never got out of Fort Dix, NJ. That in itself is a game changer. If there are any risks from a vaccine (and there are usually some risks, even though they are much safer than most over the counter drugs) and they are for a disease no one is at risk for, the risk - benefit equation has nothing on one side and if there is anything, no matter how rare, on the other, it makes it unfavorable for the vaccine…
revere | December 2, 2009While I was otherwise occupied with family matters last week there was news on the flu front that got past me. Declan Butler at Nature News reported on the extensive efforts to get a handle on the prevalence of swine flu infection in various populations by looking for evidence the immune system has reacted to the presence of the virus. All of the studies mentioned are still underway or being peer reviewed so Butler didn't report results, but Fergus Walsh did report some preliminary but leaked results from one of the smaller studies in the UK. Both reports have interesting information, but I'…
revere | December 1, 2009I don't know what happened in the Ukraine regarding swine flu (or some other illness) and without any hard facts we refrained from speculating on it (we did post once on the lack of clarity and WHO's reponse). We still don't know what to say about what did or didn't happen, although it appears others are now talking:
The global swine flu outbreak has become something of a political football in every country where the pandemic has spread, but Ukraine's response to the virus has achieved a new level of blatant politicization. According to a campaign advisor to Yulia Tymoshenko, the Ukrainian…
revere | November 30, 2009Swine flu started in pigs (although we don't exactly when or where), adapted to and passed to humans who returned the favor and passed it back to pig herds. Then we heard that turkeys in Chile had contracted the virus, followed by ferrets and a house cat. We can infect animals cross species with flu in the laboratory, but all of these are cases acquired in the natural world by animals interacting with humans. Once cats were on the menu, the next question was dogs, another population "companion animal" (aka, pet) in the US and Western Europe (and literally a menu item in many parts of Asia).…
revere | November 29, 2009We talk so much about the flu virus we thought we'd show you some nice pics that CDC has just put up. This is a review for many of you put reviews are always helpful. In these three pics, only one is the actual swine flu virus, the other two being "cartoon" depictions of a generic influenza virus. The cartoons are quite nice and helpful to see what you are looking at in the electron micrograph of influenza virions (virus particles), probably grown in tissue culture. I say "probably" because there is no other information on the site other than the micrograph was taken in the CDC Influenza…
revere | November 27, 2009It seems swine flu is full of surprises that turn out not to be surprises. Or so it's claimed. Or not. Here is CDC's Dr. Anne Schuchat, the agency's chief health officer and spokesperson on swine flu, responding to NPR's Melissa Block's question about what has been her biggest surprise:
Dr. SCHUCHAT: I shouldn't have been surprised, but I have been surprised about this disproportionate toll that it's taking in pregnant women. I think I'd never lived before a pandemic before, and I actually hadn't seen the really sorry and just the tragic stories of healthy pregnant women coming down with such…
revere | November 25, 2009In the US we are about to embark on the Thanksgiving holiday, a 4 day period where families get together for a celebratory meal (at least celebratory unless you are one of the original inhabitants of the continent). There is lots of intergenerational visiting (grandparents to great grandchildren and lots of mingling of people from disparate geographic areas). In the midst of a swine flu pandemic, the obvious question is the epidemiologic implications. Ordinarily there is some effect. Ordinarily.
Thanksgiving is typically followed by at least a modest bump in early seasonal flu cases,…
revere | November 23, 2009The US has ordered 250 million doses of swine flu vaccine, mainly from foreign manufacturers. That's a large proportion of the world's productive capacity. A couple of the biggest vaccine makers, Glaxo-SmithKline (GSK) and Sanofi Pasteur, have promised to make donations to WHO for use in the poorer countries and with some smaller donations that's maybe 160 million doses. Countries like the US that earlier had pledged 10% of their supply have yet to do so, and given the political problems of sending overseas vaccine when there's not enough for US citizens, well, good luck with that. So at best…
revere | November 22, 2009Since the way Chinese public health officials traditionally save face is by covering their ass, when I hear things like this I don't automatically believe it:
"With initial efforts of containment, actually we not only reduced the impact of the first wave to China, but we also won time for us to prepare the vaccine" now being given to China's people, [Chen Zhu, China's health minister] said in an interview during the Havana meeting of the Global Forum for Health Research.
After the swine flu first appeared in Mexico last spring, China put Mexican visitors — and people from other countries who…
revere | November 21, 2009The Norwegian Institute of Public Health is reporting sporadic occurrences of a mutation in a portion of the flu virus that is involved with the process by which it attaches to cells. I use the word "sporadic" because at this point there is no evidence that the cases where the genetic change has been found are epidemiologically linked. Therefore we don't see it spreading from person to person but rather arising in people after they have been infected. At least that's how it appears from reports, but we have only preliminary information at this point. According to WHO, the mutation has been…
revere | November 19, 2009The Director of Loyola University Medical Center's clinical microbiology laboratory is reported as saying that rapid flu tests are a public health risk. Here's some of what he said and then my explanation as to why it is misleading or just plain wrong:
Rapid influenza diagnostic tests used in doctors' offices, hospitals and medical laboratories to detect H1N1 are virtually useless and could pose a significant danger to public health, according to a Loyola University Medical Center researcher.
"At Loyola, we determined four years ago that the rapid tests for influenza detected only 50 percent…
revere | November 17, 2009The blogosphere (DemFromCT at DailyKos) and the main stream media (Alan Sipress at the Washington Post) brought us the two faces of the current flu pandemic. Like Janus, one took lessons from the present and past, the other looked worriedly to the future.
Dem's piece on flu at DailyKos (a regular feature of the world's biggest political blog) is superb. Most everyone who regularly reads about flu in the blogosphere (and it is a huge readership) knows that DemFromCT is the blog handle of an expert who has been writing about pandemic flu for years (as long or longer than we have and we are…
revere | November 16, 2009We were asked repeatedly offline and in the comments for our views on what was or was not going on in the Ukraine, but we steadfastly declined to post on it. We didn't know any more than you can find out from news sources, so we had nothing to add in the way of hard information, We did know there was a WHO team on the ground and we thought it best to wait to find out more. We still don't know much, except that news reports are suggesting that the health care system in the Ukraine is a shambles and its likely the chaos and panic were self-inflicted more than virally inflicted. Mike Coston over…
revere | November 15, 2009Any article entitled "On swine-flu conspiracy theories" should have an automatic warning label, but the one noted below, in the Canadian newspaper The Globe and Mail is really terrific (h/t ML). Conspiracy theories are all over the internet and they even show up here in the comments from time to time, but I'm glad to say our readership is saner than some. Like scientific theories, conspiracy theories aren't hard to formulate (humans being an inventive and imaginative species), but like good science, conspiracies aren't so easy to implement. It's not that conspiracies don't exist, the…