Congress Protects Pork

Coffee Brown, MD, University of New Mexico, Talk Radio News

Please don’t call it “swine flu” anymore.

That was the main message at the Senate Appropriations Committee Agriculture, Rural Development, Food and Drug Administration and Related Agencies Subcommittee hearing on the 2009 H1N1 virus.

Witnesses, Agriculture Secretary Tom Vilsack and Dr. Joshua Sharfstein, acting Commissioner of the Food and Drug Administration, answered
questions from Sens. Herb Kohl (D-Wis.), Sam Brownback (R-Kan.), Robert Bennett (R-Utah) and Mark Pryor (D-Ariz.) about the commercially regrettable naming of the 2009 H1N1 virus and about vaccines.


Vilsack said the USDA has been aggressively campaigning with trading partners to protect pork’s image as a safe food, but China and Russia
have suspended purchases of American pork. Prices have fallen about 20 percent, he said, versus about 45 percent during the 1976 swine flu
scare.

Brownback asked whether there should be more surveillance of animals, since several recent infections have been zoonotic, or transmitted from
animals to humans. Vilsack said that such surveillance is ongoing but that funding has been flat. He stressed that while the last round of bird flu was from birds to humans, this flu has so far only gone from humans to animals. “We should really be calling this the human flu,” he said.

Kohl wanted to know if vaccines would be ready for a possible reoccurrence of the current atypical flu in the fall, and mentioned previous estimates at similar hearings of four to six months to prepare such a vaccine. Sharfstein responded by emphasizing the uncertainties: time to develop the vaccine, time to test it, and the final decision whether full production was merited. He said that full production would not significantly reduce production of the usual seasonal vaccine, as that version will have almost finished the year’s order by the time a decision has to be made.

Kohl asked Sharfstein whether this strain would prove to be dangerous, and Sharfstein replied that it doesn’t look bad now, but viruses mutate, so he couldn’t make predictions about future behavior.

If There's No Pork, Where's The Beef?

Coffee Brown, MD, University of New Mexico, Talk Radio News


A typical flu season kill 37,000 Americans. The swine flu, officially known as "2009 H1N1", may be responsible for up to 160 deaths in Mexico and one infant death in the U.S.

Of those who have contracted the disease outside of Mexico, the illness has been relatively mild. So, what's the big deal?

"This is a whole new kind of flu," said Dr. Anthony Fauci, Director of the National Institute for Allergy and Infectious Diseases. Flu viruses mutate slightly every year, but not like this, Fauci said. Genes from four separate viruses - avian, human, and two kinds of swine flus, have combined into this strain.

Our vaccines and immune systems have "never seen anything like it," Fauci said. That's what makes it potentially more dangerous. While this means that we have little or no natural immunity, it does not necessarily mean that this flu must be any more infectious or virulent than the average flu.

So, why is it called "swine flu"? Actually, Sen. Pat Roberts (R-Kan.) really wishes we wouldn't call it that, as it's hurting the pork industry. Fauci agrees, "The name that is now being used is 'the 2009 H1N1 flu.'"

Despite Egypt's decision to eliminate all swine from the country, people can still eat pork without contracting the swine flu. The American Heart Association may advise moderation, but this flu is entirely unrelated to pigs. Still, the pork industry and health officials are going to have to come up with a catchier name than "2009 H1N1 flu" if they want us to stop calling it "swine flu."

Epidemic or Pandemic? An epidemic means that more cases are occurring than predicted. With seasonal flu, epidemiologists have so much experience that they can usually predict the number of cases fairly accurately. The number they are seeing right now wouldn't even be noticeable in the middle of flu season, but this one was winding down for the year. Since this is really a new type of flu, the CDC don't yet have the experience to predict a "normal" season or number of cases.

A pandemic occurs when a disease covers a large geographic area, such as a continent, or multiple continents, as this one has. The common cold is a type of pandemic, though we usually don't bother to call it that. Neither word actually refers to the severity of the disease, the likelihood that a sufferer will end up in the hospital or even die.

So what about the rising number of cases? If that makes you nervous, stop watching them, because the numbers will rise steeply with every re-count for the foreseeable future, whether this is a killer flu or of ordinary severity.

On April 29, 2009, the WHO raised the level of alert to "phase 5. "What does that mean? Phase 4 meant human to human transmission, phase 5 means the same thing, but in more than one country, phase 6 will mean clusters of cases, outbreaks, in more than one country. Phases 7 and 8 describe the trailing off of the disease.

So, is it going to get worse, or go away? It may do either. The behavior of flus is variable, and epidemiologists don't have enough information yet to predict this one's course. Almost any scenario imaginable could occur.

At a Senate hearing Wednesday, convened on short notice in response to this flu, John McCain (R-Ariz) asked, "Should we close the borders?"

"No," Richard E Besser, MD, Acting Director, Centers for Disease Control and Prevention, HHS,responded. That was tried during the SARS outbreak, and it appears to have been unsuccessful. Simulations suggest that closing the borders would have little, if any, effect on limiting spread, and it would tie up massive resources that could be put to much better use elsewhere. If we had been one of the later countries to be hit, we might have tried closing the borders to buy a few more weeks to get ready, but even then the gain would be slight, Besser said. The World Health Organization concurs.

That led Sen. Richard Burr (R-N.C.) to ask about resources. Besser told him that stockpiles of antivirals , masks, and respirators are sufficient, because they had been bought when funding was better. Recent cutbacks have cost public health thousands of jobs, lost or threatened, and have made it harder for states to exercise their pandemic control plans.

The Office of the Biomedical Advance Research and Development Authority , which prepares contingency plans and caches supplies, has never had its own funding, but has receives sporadic money from NIH, according to Fauci.

In his 100 day address last night, President Obama re-iterated many of these points, saying "We are continuing to closely monitor the emergency ... (This is) obviously a very serious situation," adding that schools with confirmed or suspected cases should close temporarily.

Obama is requesting $1.5 billion for the further stockpiling of medicines and equipment, and for logistical support. He echoed the CDC and WHO by reminding people, "I've asked every American to take the same steps you would take to prevent any other flu: Keep your hands washed; cover your mouth when you cough; stay home from work if you're sick; and keep your children home from school if they're sick."

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