swine flu
grrlscientist | May 28, 2009Because of my affiliation with ScienceBlogs and SEED Media Group, I am attending a symposium hosted by the New York Academy of Sciences (NYAS) that focuses on H1N1 Influenza [website].
This symposium will explore the 2009 H1N1 (swine) Influenza outbreak by hosting presentations on the new recombinant virus, epidemiology, treatment, vaccine development and the public health implications of a worldwide pandemic [PDF].
This event is also being held as a live, streaming Webinar and this recording, I am told, will be available for the general public to access sometime next week. I will be taking…
revere | May 28, 2009Influenza surveillance in the US has at least five component parts (depending on how you count it is as many as seven). We discussed the virologic surveillance system in another post. CDC has two surveillance sub-systems that look at hospitalized cases with laboratory confirmed influenza, the New Vaccine Surveillance Network (NVSN) and the Emerging Infections Program (EIP). The NVSN is confined to cases in children less than five years old, while the EIP covers all ages. Let's take a look at the most recent EIP data.
EIP doesn't cover the entire country. Instead it collects data from 60…
revere | May 27, 2009Yesterday New York reported two more swine flu deaths (a 41-year-old woman from Queens and a 34-year-old man from Brooklyn). CDC and just about everyone else who knows anything about influenza have been telling people to expect this. The influenza virus kills people all the time. We don't know exactly how many but we know that many people die of various immediate and underlying causes that wouldn't have died at that time if they hadn't become infected with the influenza virus in the period prior to their demise. Influenza is like heart disease or diabetes or cigarette smoking: a major cause…
revere | May 26, 2009Last week another expedited-review paper appeared in the high profile journal Science, this one summarizing the genetics of the novel H1N1 influenza A virus causing the current outbreak cum pandemic. This time there is quite a bit of interesting material in this paper for non-virologist scientists with a strong interest in knowing what we are dealing with. And the first conclusion is that we are indeed dealing with swine influenza, whatever else you want to call it. Here is a short summary of the paper, which can be found here.
Influenza was identified as a viral disease in 1930 when it was…
revere | May 25, 2009The World Health Organization (WHO) is not the world's health department or the world's doctor. It is an intergovernmental agency that is part of the United Nations (UN). The UN, despite what hard right wingnuts might think, is not a world government. The international system is technically anarchic, meaning that there is no governing body above nationally sovereign states. For the most part, WHO has no powers beyond those granted it by its member nations (for more background, see our five part series over at the old site here, here, here, here, here). It is only within the last few years…
revere | May 24, 2009On Friday Department of Health and Human Services Secretary Kathleen Sebelius announced that the US was asking vaccine manufacturers to get ready to make an vaccine against this year's swine flu. Before a vaccine can be made there is a substantial amount of preparation that needs to be done, so this just gets the process started. And the first thing that is needed is a vaccine seed strain. We've been hearing from CDC that a seed strain was in preparation. So what's a vaccine seed strain? Two good news articles, one in Nature by Declan Butler, and one in ScienceInsider by Jon Cohen have some…
revere | May 23, 2009Queens, a borough of the city of New York, seems to be a hotspot for swine flu and a New York Times reporter on the city beat, Anemona Hartocollis, has been writing very astute and perceptive pieces from there. Yesterday she had one on the problem posed by the "worried well" who are flooding Emergency Rooms in quest of reassurance. Articles about worried parents who bring relatively well kids to the Emergency Room (ER) are not uncommon. They usually include interviews with harassed and overburdened emergency room doctors and nurses dismayed at the unnecessary demand and its consequences for…
ddobbs | May 22, 2009
Having lived with fire ants, stepped in fire ants, laid down with fire ants, and been bit just about everywhere by fire ants, the news that parasitic flies turn fire ants them into zombies by eating their brains pleases me immensely.
Speaking of pleasure: Vaughn whacks the dopamine = pleasure meme.
Sharon Begley says Obama may get a lot done, but he can't erase stereotype threat (so far).
We may be dozing, but Europe is ordering its swine flu vaccine. D'oh! Update: We're getting a start too.
"Good night, sleep tight, I love you." Why consistent bedtime routines work.
Why the best…
revere | May 22, 2009There is as yet no vaccine for the novel H1N1 (swine flu) pandemic strain of influenza now causing widespread illness in North America and what appears to be the start of growing outbreaks in Japan and parts of Europe (but check out this excellent piece over at ScienceInsider). WHO says most developing nations are not able to track influenza, so what is happening in Africa and parts of Asia is not known with any confidence. While the clinical illness from this virus doesn't seem very different than seasonal flu, the fact that most of the world's population has no immunity to it means there is…
revere | May 21, 2009Military planners are fond of saying that no battle plan survives the first contact with the enemy. The same can be said for the military's pandemic flu plans, although they aren't telling us exactly what those plans are. Some good reporting by Associated Press's Lolita Baldor has uncovered some of it:
The rapid spread of swine flu from Mexico surprised Pentagon officials, who had been focused on a possible Asian-borne pandemic in a response plan that would give the military a last-resort role in helping to impose quarantines and border restrictions.
Drafted and overhauled several times in…
revere | May 20, 2009A kind reader directed my attention late yesterday to an article on the Boston Globe's web site about three schools closing in Boston because of absenteeism from flu-like illnesses. I was struck by a comment made by a freshman at Boston Latin that seemed to get it exactly right:
The closing surprised freshman Wilhelmina Moen, who noted it was nice that authorities were concerned about the student's health.
"I'm not that worried," said Moen, who lives in Brighton. "It's the same thing as the other kind of flu. That flu kills too." (Stephen Smith, Andrew Ryan, Elizabeth Cooneym Boston.com)
So…
revere | May 19, 2009Is it a pandemic or is it not a pandemic? Since the world has never had a chance to make a call like this at the outset of a pandemic, nobody is quite sure how to handle it. The usual definition -- an epidemic (an increase in cases beyond what is expected) of global dimension -- has a lot of wiggle room and WHO and everyone else is busy wiggling. One reason is not whether this meets the definition or not but what the consequences might be of calling this "a pandemic":
Britain, Japan, China and other nations urged the World Health Organization on Monday to change the way it decides to declare…
revere | May 18, 2009Five more schools in the New York City borough of Queens have closed because of suspected swine flu cases. Eleven schools have now been closed there and hundreds of students are down with a flu-like illness. Parents are understandably concerned, the more so because not many days ago Mayor Bloomberg and the city's health commissioner (just named by Obama as the next director of CDC) were reassuring city residents this was pretty much lie seasonal flu.
We thought that was something that might come back to bite them, and now it has:
The city’s schools seem to have become both a sentinel and an…
revere | May 17, 2009At Friday's press briefing on the swine flu outbreak, Canadian Press's Helen Branswell twice asked whether CDC's weekly flu surveillance data showing the uptick in swine flu but also an unexpected prevalence in seasonal influenza was an artifact of increased testing or something new and unusual. CDC's Dan Jernigan was not especially clear, but seemed to acknowledge there was a lot of seasonal flu around:
The CDC said part of the increase is certainly due to the fact that much more influenza testing is going on these days, because of concerns about swine flu. But the agency said it seems that…
revere | May 15, 2009It is clear that if you want to get a so-so paper published in a top tier journal, the best way to do it is to write about a breaking medical news event and get there first. We saw this with avian influenza and SARS and now it's being repeated with swine flu. The Scientist had a story yesterday about how The New England Journal of Medicine (NEJM) and Science, two of the highest profile science journals in the world, pushed through some swine flu papers at record speed last week:
An international research team led by Neil Ferguson of Imperial College London published a report online today (May…
revere | May 14, 2009A reader (hat tip River) sent me a link to a New York Times piece quoting a physician who recently saw swine flu cases in Mexico City. He called attention to what seemed like an anomalous clinical presentation of many cases. Besides a higher proportion of gastrointestinal symptoms (nausea, vomiting, diarrhea), Virginia Commonwealth infectious disease specialist Dr. Richard P. Wenzel was surprised that many cases, even severely ill ones, did not have fever:
Many people suffering from swine influenza, even those who are severely ill, do not have fever, an odd feature of the new virus that…
revere | May 13, 2009Over at ScienceInsider (Science magazine's blog) Jon Cohen speculates about why swine flu seems to have spread faster and more widely in North America (Mexicon, US, Canada) than Europe and Asia. CDC thinks one reason is that by the time it was discovered here it had already spread widely. The Europeans, with advance warning, were then able to contain it with aggressive use of antivirals among travelers from the affected areas. I'm not ready to buy this.
This doesn't make sense to me, although nothing about flu viruses make sense, so I could be wrong about this. But it wouldn't explain why…
revere | May 13, 2009Flu can be a nasty illness, nasty enough to kill you. Pregnant women are at more risk than others because their physiology is altered. They are carrying a foreign body (the fetus) so their immune response is not the same, and their cardiovascular and respiratory physiology are also different. CDC is reporting about 20 swine flu cases in pregnant women, and late yesterday they gave a more detailed description of three cases, one of which ended fatally:
Patient A. On April 15, a woman aged 33 years at 35 weeks' gestation with a 1-day history of myalgias, dry cough, and low-grade fever was…
revere | May 12, 2009Trying to figure out where the incipient swine flu pandemic is heading and how fast it is heading there is shooting at a moving target, and this one is moving pretty fast. The best we can do at this point is use whatever information we have to make some educated guesses about different scenarios along with how likely various scenarios are. We used to do this on the back of an envelope, Now we use computer programs. I'm not sure we are doing much better (or much worse), but we can make use of more information and the answer looks prettier when displayed.
Expedited publication of such an…
revere | May 11, 2009Yesterday DemFromCT had another in his continuing series at DailyKos on Flu and You (Part VIII). He extended an earlier post (part II) on a critical piece of public health infrastructure, laboratory surveillance. One of the graphics is this chart of influenza positive tests reported to the CDC by the WHO/NREVSS collaborating laboratories:
What you see in this chart is a weekly record of what seasonal influenza types and subtypes are circulating in the community (influenza A/H1N1, A/H3N2, B; swine flu makes a late appearance, far right). Flu seasons differ on dominant subtypes, whether they…