Yesterday's webcast on the swine flu outbreak

Here is yesterday's webcast from the Department of Health and Human Services and the Department of Homeland Security.

 
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.

More on face masks

I just ran across a very helpful article on the use of face masks to prevent the transmission of influenza-like illness in the home.  The researchers asked parents who had children with respiratory illness to wear either surgical masks, non-fit tested P2 masks (= N-95 masks), or no mask to see if the masks protected them against infection. 

The key findings were: 

"We estimated that... the relative reduction in the daily risk of acquiring a respiratory infection associated with adherent mask use (P2 or surgical) was in the range of 60%–80%." (emphasis added) 

"Adherent" in this context means that the people actually wore the mask most or all of the time.  And...

"... [less than] 50% of those in the mask use groups reported wearing masks most of the time."

You can't win if you don't play, folks.  The take home message here is: Masks help... but only if you use them consistently.

Interestingly, the authors also found no significant difference in adherence between P2 (N-95) mask users and surgical mask users, despite the widespread opinion that N-95 masks are more uncomfortable than surgical masks.

From the Comments: Disinfection

Disinfecting surfaces in your home and workplace is an important way to protect yourself against the flu (including this H1N1 strain).  Pay particular attention to places you're likely to put your hands, like doorknobs, keyboards, mice (the computer kind), faucet taps, countertops, etc.  

Don't forget: Be careful not to mix different kinds of cleaners (i.e. bleach-based and ammonia-based) or you'll have definite toxic fumes to deal with, instead of possible swine flu.

 

john said...

can you tell me about disinfections techniques. In particular are anti-bacterials good against flu virus thanks

APRIL 28, 2009 6:49 AM 

PanFluWatch said...

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:
http://www.pandemicflu.gov/plan/healthcare/influenzaguidance.html
http://www.pandemicflu.gov/plan/individual/panfacts.html

APRIL 28, 2009 7:20 AM 

Catch it, bin it, kill it

A very good public service ad from the UK's Department of Health: Catch it, bin it, kill it.

In addition to giving advice to the "sneezer" depicted in 

the video, this also illustrates why it's so important to 

wash your hands frequently during this outbreak --even 

when you're not aware of having gotten anything on them.

Reality wins

Yesterday, the WHO moved to increase the Pandemic Alert Level to Phase 5 (defined below).

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

I'm glad they have finally chosen to acknowledge reality and follow their own guidance.  We will need the WHO to be a credible player if we are to have any hope of coordinating a global response to the pandemic.

Edging closer to Phase 6, an Official Pandemic

The BBC just reported that there has been a confirmed case of human-to-human transmission in Spain. 

Here is the definition of Phase 6:

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

"Community level outbreaks" are "sustained disease outbreaks in a community," and that criteria hasn't been met by this case; we'd need to see more than one generation of human-to-human transmission before we could call it a sustained disease outbreak in this community, but hope is swiftly waning that this outbreak will fail to become a pandemic --especially since we haven't been able to contain it in the Northern Hemisphere, where the flu season is coming to an end.

Today also saw the first confirmed death from the H1N1 strain in the US, a toddler from Texas.  My heart goes out to the parents and to the families of all of those who have died in Mexico, already.  I hope that not too many more of us will have to face what they've been through.

From the comments: Is the bioengineering theory really rubbish?

Doxocopa writes:

"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?"

Hi Doxocopa,

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.