Saturday, May 23, 2009
Wednesday, May 20, 2009
"We were surprised by the frequency of obesity among the severe cases that we've been tracking," said Anne Schuchat, one of the CDC epidemiologists managing the outbreak. She said scientists are "looking into" the possibility that obese people should be at the head of the line along with other high-risk groups if a swine flu vaccine becomes available.
And it is entirely possible that there's something to that, though the article gives us no direct evidence to support it.
But if any such evidence exists, it certainly isn't to be found anywhere in the MMWR paper. And the paper's authors make no claim that it is, so don't blame them for the inaccuracy.
Tuesday, May 19, 2009
Friday, May 15, 2009
Dr. Gibbs, who had studied the gene sequences of the swine flu virus posted on public data banks, argued that it must have been grown in eggs, the medium used in vaccine laboratories. He reached that conclusion, he said, because the new virus was not closely related to known ones and because it had more of the amino acid lysine and more mutations than typical strains of swine flu.
His theory was reported by Bloomberg News on Tuesday. Even though scientists at theCenters for Disease Control and Prevention were skeptical and some prominent virologists openly derisive, news outlets have repeated and magnified the theory, adding speculation about bioterrorism that even Dr. Gibbs repudiated. He was also interviewed Thursday on the ABC News program “Good Morning America.”
Dr. Fukuda said a W.H.O. panel of experts had concluded that “the hypothesis does not really stand up to scrutiny.” The lysine residues and mutation rates were typical, he said, and many swine flus seem unrelated because not enough pigs are tested each year.
The article went on to make some astute points about the damage that misinformation like this has caused in the fight against diseases like AIDS and polio.
This is why the cultural expectation in science is that you publish, then pronounce. Or, in cases where the early dissemination of your research could save lives, that you at least get your work through the peer review process before typing up your press release.
Because science matters. Getting it wrong matters. Reducing the public's trust in the people working to protect them matters.
Dr. Gibbs should have known better.
Thursday, May 14, 2009
- Only 30% of Americans would get a vaccine against the H1N1 "swine flu" virus, if one were available.
- A whopping 38% of those surveyed managed to combine ALL of the following: Not vaccinated against the flu, not practicing good hygiene, and not restricting travel or mall shopping.
- "The same was true of 25% of health care workers polled, 28% of caregivers in nursing homes and 33% of those whose children are vulnerable due to asthma, diabetes, or HIV. Particularly concerning is that only 48% of these children were vaccinated." (emphasis added)
- These people all provide care to those who are at high risk of severe complications (including death) from "regular" seasonal flu.
- Are you forgetting the poor hygiene issue? Handwashing, good cough/sneeze etiquette, and the like are not just for special occasions. They save lives every day.
Sunday, May 10, 2009
- Making sure there is food in the house
- Contacting healthcare providers
- Helping provide care for children or other dependents
- Helping provide care for pets
- Contacting family members
- Picking up medicine from the pharmacy
Friday, May 8, 2009
Thursday, May 7, 2009
In a story on the Hong Kong quarantines today entitled Flu Lockdown Spurs Quarantine Debate, Peter Stein gets it wrong when it comes to the evidence for/against the effectiveness of the quarantine measures, saying:
"No new cases of the A/H1N1 virus, also known as human swine flu, have emerged in Hong Kong since officials ordered nearly 300 people quarantined at the Metropark Hotel Friday, apparently vindicating the policy."
He is right in noting that no new cases of the virus occurred... but he neglects to mention the fact that this means none occurred in the people who were quarantined, either.
That means is that none of these people who were locked away from their lives for days on end could have transmitted the virus to anyone.
The lack of new cases that Mr. Stein puts forth as evidence of the quarantine's apparent effectiveness is exactly the same thing that would have happened had there been no quarantine at all.
Wednesday, May 6, 2009
Tuesday, May 5, 2009
Q: It depends on further mutations?
Y.G.: It depends on mutations and whether the virus further reassorts with other viruses—like H5N1. That could be a super nightmare for the whole world.
Q: You’re talking about the Armageddon virus?
Y.G.: The chance is very, very low that these two viruses will mix together, but we cannot rule out the possibility. Now, H5N1 is in more than 60 countries. It’s a panzootic, present everywhere except North America.
Q: If the nightmare comes true?
Y.G.: If that happens, I will retire immediately and lock myself in the P3 lab. H5N1 kills half the people it infects. Even if you inject yourself with a vaccine, it may be too late. Maybe in just a couple hours it takes your life.
Sounds pretty scary, and it could be... but you'll recall that he said the chance of it happening is very, very low.
This is a good illustration of the difference between a hazard (something that can cause harm) and a risk (the likelihood of that harm actually occurring).
An H5N1/H1N1 recombinant virus represents a serious hazard, but the risk of it actually happening is thankfully rather low.
That doesn't mean we can afford to take our eyes off the ball, however. The H5N1 virus is no less of a threat today than it was before the H1N1 outbreak began, and we ignore it at our peril. President Obama says that the President of the United States needs to be able to walk and chew gum at the same time, and he's right. Here's to hoping the global public health preparedness community can do the same.
Monday, May 4, 2009
- 279 confirmed cases in 36 states
- > 99% of probable cases so far have tested positive
- > 700 probable cases in 44 states
- Median age of confirmed cases: 16 years old
- Age range for confirmed cases: 3 months to 81yrs
- 62% of confirmed cases are in patients < 18 years old
- The most recent confirmed case occurred on May 1st
- 35 known hospitalizations
- 1 known death
Sunday, May 3, 2009
Saturday, May 2, 2009
- How many people have the disease?
- How many people have died?
- How readily is it transmitted from person to person?
- What risk factors are there for infection (does it spread well among people crammed into the same airplane for several hours, but poorly in more open settings; are smokers or the elderly or some other group more likely to catch it)?
- How lethal is the virus to those who catch it?
- Who is most at risk of severe disease?
- When it does kill people, is it the flu infection itself (primary viral pneumonia) that causes death or is it secondary bacterial pneumonia that moves in after the flu virus is gone?
Friday, May 1, 2009
Dr. Besser, Acting Director of the CDC, Secretary Sebelius of the Department of Health and Human Services, and Secretary Napolitano of the Department of Homeland Security did an excellent job of answering questions from the public.
can you tell me about disinfections techniques. In particular are anti-bacterials good against flu virus thanks
Yes, thankfully the flu virus is easier to kill than bacteria, so any disinfectant designed to kill bacteria (antibacterial disinfectants) should also protect you against the flu.
For more useful information on this topic, see these pages from www.pandemicflu.gov:
Thursday, April 30, 2009
Wednesday, April 29, 2009
"Complete rubbish???For a start... still, not yet a SINGLE PIG INFECTION was reported, as far as I'm aware. Could you please answer two things?
1 - If no pigs seem to be affected at all, how on earth a pig flu virus turned suddenly to a human airborne disease? - First human cases from other species Flu virus begun by direct contact with the infected animals
2 - This virus is indeed a genetic chimera; independently of what people think about its origins, so probably can infect humans, pigs and birds, so how can it survive in Nature without an epidemiological reservoir?"
Thanks for commenting. Yes, actually: it's complete rubbish. But I can certainly understand why the situation would be confusing to someone who hasn't studied the flu... especially because this strain was unfortunately saddled with the misnomer "swine flu." What we're really all paying attention to right now is a HUMAN flu with swine-, avian- and human-flu progenitors.
This flu has four grandparents, if you will: two from different regions of swinelandia, one from birdlandia, and one from humanistan –and it LIVES in humanistan: really, it’s a human flu, even if it is an immigrant.
So, to answer question 1:
What does it mean that we haven’t seen any cases in pigs yet? It could mean any one of a number of different things:
1. The virus may cause asymptomatic infection in pigs or cause only very mild symptoms. That is, they might get infected and be able to spread the disease (both to humans and other pigs) without showing any sign of having the disease.
2. It may be that the cases in pigs have simply been missed, even if the disease was severe. There are a number of diseases that cause illness in pigs, including “normal” swine flu, and the affected farmers may not have recognized that anything new was happening. We can’t be sure yet where the virus first emerged, but there may simply not be a very robust veterinary public health surveillance infrastructure in the country of origin.
3. The recombination may have occurred a human, instead of a pig. We are also capable of being infected by human, swine and avian flu strains.
4. Even if the recombination DID occur in pigs, that doesn’t mean that the new virus was best-suited to reproducing in pigs vs. humans. Remember, the pig in question would have been infected by 2 or more strains of flu at the same time; its immune system was likely compromised. A compromised immune system may be the reason it was infected by more than one flu strain in the first place. Even if not, the infections, themselves, would have worn down its immune response. (Secondary bacterial pneumonia is what usually kills most people who are killed by seasonal influenza.)
If this is true, even if the virus was better-suited to humans than pigs, the virus may have reproduced sufficiently in this one pig to infect a human handler and enter into circulation in the human population. It might never have been, and might never be, primarily a disease of pigs.
As for question 2:
What is the “epidemiological reservoir?” Humans appear to be the primary host species for this virus. That’s why I saw “swine flu” is really a misnomer. As far as anyone knows right now, this is solely a disease of humans, and WE are how the virus is “surviv[ing] in nature.”
What's more, this virus would be a profoundly stupid bioweapon. No one would benefit from it.