Flu ( incl Swine, Bird etc ) 01 (Apr 09 - Sep 12)

[LenaHuat]

WHO has decided to spare the poor swine (who's not suffering from this) and the miserable swine farmer (who's suffering in miserable agony) and renamed the swine virus, "Influenza A (H1N1)".

From the Spanish flu to the Asian flu, this family of viruses (with its mutants) is here to warn humanity that humankind is not mighty.
So warps and woofs, it's of one fabric, influenza.

[iam802]

Hong Kong Confirms Swine Flu Case, Declares Emergency (Update4)

http://www.bloomberg.com/apps/news?pid= ... refer=home

May 1 (Bloomberg) -- Hong Kong confirmed its first swine flu case today, prompting the government to declare a public health emergency.

The unidentified man flew into the city yesterday from Shanghai on China Eastern Airlines Flight 505 after originally departing from Mexico, Chief Executive Donald Tsang said. The University of Hong Kong confirmed the infection at 8 p.m. today.

“I’d urge Hong Kong citizens to not panic,” Tsang said at a news conference. “School classes, public exhibitions, economic activities can all proceed as usual.

“I want to emphasize that I’d rather take a stricter approach than missing the opportunity to contain the virus before it spreads.”

The patient is in Ruttonjee Hospital in the city’s Wanchai district, Tsang said. The infected man was staying at the nearby Metro Park Hotel, which police cordoned off.

.....

[BlackCat]

Funny. http://www.ritholtz.com/blog/2009/05/not-winnie-the-pooh/

[mojo_]

here's the cartoon BlackCat is referring to

[kennynah]

and if the piglet sneezes...the Bear will be dead....get ready for a Bull to appear....

[mojo_]

K...

[winston]

If the experts cannot answer a simple question like the only below, then why are so many people predicting the "Best Case" scenario while ignoring the "Worst Case" scenario ?

=================================================

The Associated Press

(AP) — "That is the big question: Is it stabilizing or not? And it is too early to say, but I think we are getting systems in place where we are going to be able to get a handle on this soon."-Dr. Steve Waterman, the head of a team from the Centers for Disease Control and Prevention, from Mexico City where officials are confronting the swine flu outbreak.

[mocca_com]

seem like it is getting worse despite it is in a stablization phrase.

WHO Expecting to Designate Flu Outbreak as Pandemic (Update1)
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By Tom Randall and Dermot Doherty

May 3 (Bloomberg) -- The World Health Organization may declare the outbreak of H1N1 influenza a pandemic even as many cases of swine flu show symptoms no more severe than seasonal flu, health officials said.

The WHO raised its six-tier alert to 5 on April 29 and a further elevation would signal a pandemic, alerting governments to enact plans to curb the disease. Ireland became the 17th country yesterday to confirm swine flu and the new virus may be spreading in five nations among people unconnected to Mexico, where cases were first reported.

“At this stage we have to expect that phase 6 will be reached; we have to hope that it won’t be,” Michael Ryan, the Geneva-based agency’s director of global alert and response, said at a news conference yesterday. “I would still propose that a pandemic is imminent.”

Still, the WHO isn’t seeing sustained community transmission outside of North America for the virus, he said.

International health experts said the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century’s three pandemics occurred. The WHO hasn’t had a single phase 6 alert since it introduced the six-level system in 2005. Before this week, the warning had been at phase 3 since 2007, when it was elevated for an outbreak of avian flu, according to the WHO Web site.

Tracked One Week

In little more than a week, world health authorities have tracked the emergence of the flu from an outbreak in Mexico and a few cases in Texas and California to more than 650 confirmed illness in 17 countries across the globe.

The virus has now struck more people in that time than H5N1 avian influenza, with 421 confirmed cases, has in the past six years. Still, while bird flu has killed almost two-thirds of its victims, fatalities from swine flu are less than 3 percent of those infected, according to WHO data.

The pathogen has shuttered schools and offices in Mexico and the U.S., the next hardest hit country, stirred governments to use their treatment stockpiles, and spurred a quest for a vaccine before the beginning of the next flu season.

The number of confirmed dead from the H1N1 virus in Mexico is 19, up from 16 on May 1, said Mexico’s health minister Jose Cordova at a news conference in Mexico City. Cordova said the number of Mexico’s confirmed cases, including the deaths, rose to 473 from 443, as laboratories in the country work through a backlog of samples.

Campaigning Ban

The government put in place a ban on public campaigning for the July 5 mid-term elections and Mexico City is considering extending its school closures an extra week.

“Mexico has been living up to its duty” to fight the disease, Cordova said.

“We are in a stabilization phase,” he said. “Still, it is too soon to say we are past the most complicated moment.”

The WHO’s statistics, which lag reports by national and local agencies, confirmed 397 cases in Mexico and 658 worldwide. It listed illnesses in the U.S., Canada, the U.K., Austria, Germany, the Netherlands, Denmark, Switzerland, Spain, Israel, Hong Kong, New Zealand, France, South Korea and Costa Rica.

The virus is already at pandemic level, according to Ira Longini, a researcher at the University of Washington in Seattle who advises the U.S. government on flu.

“The definition of a pandemic is that the new virus has spread to several countries and is transmissible,” Longini said in an interview yesterday. “It’s hard to imagine it’s not going to continue to spread in some form.”

Share Information

Ireland yesterday confirmed is first case, a man who had recently returned from a trip to Mexico, according to a statement last night from Tony Holohan, chief medical officer of the Department of Heath and Children.

U.S. President Barack Obama spoke yesterday by telephone with Mexican President Felipe Calderon to share information about their countries’ efforts to limit the spread of the influenza. They stressed the importance of continuing close cooperation between their governments, according to a White House statement.

“This is a new strain of the influenza virus, and because we haven’t developed an immunity to it, it has more potential to cause us harm,” Obama said yesterday in his weekly radio and Internet address. “This creates the potential for a pandemic, which is why we are acting quickly and aggressively.”

Expanding Wave

Obama has asked U.S. lawmakers for $1.5 billion to battle the outbreak and prepare for it to resurface during flu season.

Still, he said the virus hasn’t been as virulent in the U.S. as in Mexico and antiviral treatments have shown to be effective.

The U.K., U.S., Germany, Canada and Spain each confirmed cases in people who didn’t travel to Mexico. The expanding wave of sickness has been similar to seasonal flu, though health authorities are taking no chances with a virus that may flash across the globe, infecting a population with no natural immunity, said the U.S. Centers for Disease Control and Prevention.

New York officials said they suspect more than 1,000 cases, so many that the government has stopped testing all but the sickest there.

Evidence suggests “transmission is widespread, and that less severe illness is common,” the Atlanta-based CDC said in a report May 1. In Mexico “a large number of undetected cases of illness might exist in persons seeking care in primary-care settings or not seeking care at all,” the CDC report said.

Schools Close

In the U.S., at least 433 schools had closed in 17 states, leaving parents to find other arrangements for 245,449 students, according to the Education Department. Five colleges closed, the department said in an e-mail.

The CDC raised its flu count yesterday to 160 cases in 21 states, including the only U.S. fatality, a 22-month-old child who died April 27 at a Houston hospital. The Boston Globe reported that New Hampshire became the 22nd U.S. state with an illness after authorities confirmed its first H1N1 infection, which had been reported April 30 as probable.

Batches of seed virus are being developed for potential vaccine production, according to WHO. Paris-based Sanofi-Aventis SA, Baxter International Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc of London are talking with world health authorities about producing shots, the agency said.

Production of vaccines against the new H1N1 influenza will be completed “in parallel with or after the seasonal vaccine is produced,” Nancy Cox, chief of the flu division at the CDC’s Center for Immunization and Respiratory Disease, said at a news conference in Atlanta on May 1.

The three main seasonal flu strains -- H3N2, H1N1 and type- B -- cause 250,000 to 500,000 deaths a year globally, according to WHO. The new flu’s symptoms are similar, including fever and coughing, nausea and vomiting, according to the CDC.

Authorities advised hand-washing, hygiene and staying home if sick as the most effective ways to control the outbreak.

To contact the reporters on this story: Tom Randall in New York at [email protected]. Dermot Doherty in Geneva at [email protected]

Last Updated: May 3, 2009 01:20 EDT

[millionairemind]

May 2, 2009, 10.42 am (Singapore time)

Swine flu may be less potent than first feared

ATLANTA - The swine flu outbreak that has alarmed the world for a week now appears less ominous, with the virus showing little staying power in the hardest-hit cities and scientists suggesting it lacks the genetic fortitude of past killer bugs.

A flu expert said he sees no reason to believe the virus is particularly lethal. And a US federal scientist said the germ's genetic makeup lacks some traits seen in the deadly 1918 flu pandemic strain and the more recent killer bird flu.

Still, it was too soon to be certain what the swine flu virus will do. Experts say the only wise course is to prepare for the worst. But in a world that's been rattled by the spectre of a global pandemic, glimmers of hope were more than welcome Friday.

In New York City, which has the most confirmed swine flu cases in the US with 49, swine flu has not spread far beyond cases linked to one Catholic school. In Mexico, the epicentre of the outbreak, very few relatives of flu victims seem to have caught it.

Officials in Mexico have voiced optimism for two days that the worst may be over. But Dr Scott F Dowell of the US Centres for Disease Control and Prevention said it's hard to know whether the outbreak is easing up in Mexico. 'They're still seeing plenty of cases,' Dr Dowell said.

He said outbreaks in any given area might be relatively brief, so that they may seem to be ending in some areas that had a lot of illness a few weeks ago. But cases are occurring elsewhere, and national numbers in Mexico are not abating, he said.

Worldwide, the total confirmed cases neared 600, although that number is also believed to be much larger. Besides the US and Mexico, the virus has been detected in Canada, New Zealand, China, Israel and eight European nations.

Scientists looking closely at the H1N1 virus itself have found some encouraging news, said Nancy Cox, flu chief at the federal Centres for Disease Control and Prevention. Its genetic makeup doesn't show specific traits that showed up in the 1918 pandemic virus, which killed about 40 million to 50 million people worldwide.

'However, we know that there is a great deal that we do not understand about the virulence of the 1918 virus or other influenza viruses' that caused serious illnesses, Ms Cox said. 'So we are continuing to learn.'

She told The Associated Press that the swine flu virus also lacked genetic traits associated with the virulence of the bird flu virus, which grabbed headlines a few years ago and has killed 250 people, mostly in Asia.

There were still plenty of signs Friday of worldwide concern.

China decided to suspend flights from Mexico to Shanghai because of a case of swine flu confirmed in a flight from Mexico, China's state-run Xinhua News Agency reported.

And in Hong Kong, hundreds of hotel guests and workers were quarantined after a tourist from Mexico tested positive for swine flu, Asia's first confirmed case.

Evoking the 2003 Sars outbreak, workers in protective suits and masks wiped down tables, floors and windows. Guests at the hotel waved to photographers from their windows.

A top Mexican medical officer questioned the World Health Organisation's handling of the early signs of the swine flu scare, suggesting on Thursday that a regional arm of the WHO had taken too long to notify WHO headquarters of about an unusually late rash of flu cases in Mexico.

The regional agency, however, provided a timeline to the AP suggesting it was Mexico that failed to respond to its request to alert other nations to the first hints of the outbreak.

The Mexican official, chief epidemiologist Dr. Miguel Angel Lezana, backtracked on Friday, telling Radio Formula: 'There was no delay by the Mexican authorities, nor was there any by the World Health Organization.'

In Mexico, where swine flu has killed at least 16 people and the confirmed case count has surpassed 300, the health secretary said few of the relatives of 86 suspected swine flu patients had caught the virus. Only four of the 219 relatives surveyed turned up as probable cases.

As recently as Wednesday, Mexican authorities said there were 168 suspected swine flu deaths in the country and almost 2,500 suspected cases. The officials have stopped updating that number and say those totals may have even been inflated.

Mexico shut down all but essential government services and private businesses on Friday, the start of a five-day shutdown that includes a holiday weekend. Authorities there will use the break to determine whether emergency measures can be eased.

In the Mexican capital, there were no reports of deaths overnight - the first time that has happened since the emergency was declared a week ago, said Mayor Marcelo Ebrard.

'This isn't to say we are lowering our guard or we think we no longer have problems,' Mr Ebrard said. 'But we're moving in the right direction.'

The US case count rose to 155 on Friday, based on federal and state counts, although state laboratory operators believe the number is higher because they are not testing all suspected cases. The US death toll remained at one - a Mexican toddler who visited Texas with his family and died there.

President Barack Obama voiced hope on Friday that the virus may turn out to be no more harmful than the average seasonal flu.

'It may turn out that H1N1 runs its course like ordinary flus, in which case we will have prepared and we won't need all these preparations,' Mr Obama said, using the flu's scientific name.

The president stressed the US government was still taking the virus very seriously, adding that even if this round turns out to be mild, the bug could return in a deadlier form during the next flu season.

New York officials said after a week of monitoring the disease that the city's outbreak gives little sign of spreading beyond a few pockets or getting more dangerous. Mayor Michael Bloomberg said the outbreak in New York had so far proved to be 'a relatively minor annoyance.'

Researchers will get a better idea of how dangerous this virus is over the next week to 10 days, said Peter Palese, a leading flu researcher with Mount Sinai Medical School in New York.

So far in the United States, he said, the virus appears to look and behave like the garden-variety flus that strike every winter.

'There is no real reason to believe this is a more serious strain,' he said.

Palese said many adults probably have immune systems primed to handle the virus because it is so similar to another common flu strain.

As for why the illness has predominantly affected children and teenagers in New York, Palese said older people probably have more antibodies from exposure to similar types of flu that help them fight off infection.

'The virus is so close,' he said.

In the United States, most of the people with swine flu have been treated at home. Only nine people are known to have ended up in the hospital, though officials suspect there are more.

[helios]

got this from a good blog article ... ...


Staying Effective

In a flu pandemic, first using small stockpile of secondary drug could delay resistance to primary stockpiled medication.
“This reduction in resistance was predicted to benefit not only local populations, but also those in distant parts of the world where the pandemic would subsequently spread through air travel.”

With cases of swine flu increasing around the world, many countries are investing in large stockpiles of a single drug, [b]Tamiflu (oseltamivir). But the strategy could be problematic. Influenza viruses can become resistant to antiviral drugs. The widespread use of a single drug is likely to increase the risk that a resistant strain will emerge. If such a strain were to spread widely, the effectiveness of antiviral drugs in treating infected patients, as well as their ability to slow the spread of a pandemic, would be greatly reduced.[/b] In a global influenza pandemic, small stockpiles of a secondary flu medication—if used early in local outbreaks—could extend the effectiveness of primary drug stockpiles, according to an international team of researchers.

In a study published in PLoS Medicine, the team led by Joseph Wu of the University of Hong Kong used a mathematical model to represent the global spread of pandemic influenza. The researchers found that treating as few as only the first 1 percent of the population in a local epidemic with a secondary drug rather than with oseltamivir, could substantially delay the development of resistance to oseltamivir. This reduction in resistance was predicted to benefit not only local populations, but also those in distant parts of the world where the pandemic would subsequently spread through air travel.

This strategy is predicted to be effective because it delays use of the primary stockpiled drug until a certain proportion of the local population (about 1.5 percent according to the model) has been infected with virus that remains susceptible to the primary drug. With drug-sensitive virus in the majority as people recover from infection and develop immunity, the researchers say only a minority of further infections are likely to be resistant to the primary drug.

Technically, such a delay could be achieved by postponing the launch of any antiviral intervention. However, because even a short delay would mean denying antiviral drugs to people who would benefit from them, the researchers instead propose the deployment of a small stockpile of a secondary antiviral during the early phase of the local epidemic.

The model, prepared before the current swine flu crisis, considered two possible strategies, "early combination chemotherapy" (treatment with two drugs together while both are available, assuming that clinical trials show such a combination to be safe for patients) and "sequential multi-drug chemotherapy" (treatment with the secondary drug until its stockpile is exhausted, then treatment with the primary drug). While either strategy could be effective in principle, only the sequential strategy would be practical in responding to the currently emerging H1N1 swine flu, because the safety of combining zanamivir with oseltamivir (for combination therapy) is not established. In the context of the currently emerging swine flu, the secondary drug could be Relenza (zanamivir), the only other approved drug to which the new H1N1 strain has been found to be susceptible.

After simulating the impact of these strategies in a single population, the researchers then introduced international travel data into their model to investigate whether these two strategies could limit the development of antiviral resistance at a global scale. This analysis predicted that, provided the population that was the main source of resistant strains used one of the strategies, both strategies in distant, subsequently affected populations would be able to reduce the consequences of resistance, even if some intermediate populations failed to control resistance.

Source: http://www.tjols.com/article-1351.html