Swine Flu Emerging In South America

By Aaron Richardson-Talk Radio News Service

With the flu season just beginning in the southern hemisphere, the H1N1 virus, better known as the swine flu, is showing no signs of going away. Dr. Jon Andrus of the Pan American Health Organization said earlier today that the spread of the virus is increasing and that its future impact remains uncertain.

“What may be happening in Chile is what happens with the usual evolution of a pandemic.” said Andrus.

According to Andrus, the World Health Organization is expecting an outcome similar to the pandemics of 1957 and 1968, in which 1 million to 4 million people may have died. While saying that the outbreak is moderate, the World Health Organization will soon increase the virus to phase six status, making it is a world-wide pandemic.

On June 1, the WHO met with health experts from over 30 countries to discuss how to help the public understand the meaning of the phases. “This virus is so unpredictable” said Andrus, who said he could not predict when the virus will peak. The Pan American Health Organization will be monitoring the new cases being reported in the upcoming months.

Vaccinations: The Illusion Of Adult Invincibility?

By Celia Canon- Talk Radio News Service

Adults are more at risk of catching potential deadly disease than they might realize, according to the American Medical Association.

Jason Spangler of Partnership for Prevention, AMA representative Dr. Litjen Tan and Executive Director of the National Foundation for Infectious Diseases Len Novick combined forces in a call for action to alter this risk.

Spangler, Dr.Tan and Novick want to push for greater awareness on the possibility to reduce death by vaccine-cured diseases by checking adults’ updates on their vaccinations.

As the concern for the H1N1 virus dissipates, the environment has recently been propitious to the discussion of how the spread of potentially deadly viruses could be prevented following recent estimates of a total 46 H1N1-caused deaths worldwide.

The collaboration of Partnership for Prevention, NFID and AMA leads expert to agree that “there is no strong infrastructure to immunize adults in the United States”, said Tan.

According to them there will not be an improvement in the number of deaths by curable viruses so long as adults continue to believe in what Novick calls an “illusion” that adults do not need vaccines as much as children or the elderly.

As Novick said, both patients and their physicians are to blame for this problem, as patients “wait for doctors to raise the issue (of vaccination)”, while vaccines for adults are existent “but not used as recommended”.

Tan said, “There needs to be commitment... States need to strengthen support for adult vaccination and appropriate budgets accordingly,” to which he added that vaccinations should be switched from Medicare’s Plan D, which covers the costs of prescription drugs for beneficiaries of Medicare to Plan B, where outpatient care expenses are reimbursed. Tan argues that this change in category will encourage physicians to use vaccines as “preventive services in part B.”

In addition, the NFID advocates its professional practice toolkit which aims at listing the options doctors have in order to address this issue, such as putting pamphlets on vaccination in waiting rooms.

Partnership for Prevention saluted the efforts of both the AMA and the NFID in identifying the consequences of the lack of vaccination in adults and the recommendations that both organizations made to counter this problem.

Pandemic Or What?

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

There are three main differences between a normal flu and a pandemic flu, as described by the Department of Homeland Security: incidence, virulence, and demographics.
Incidence refers to how many of us will get it. In a normal year, about 15 percent of 300 million Americans, or about 45 million people will get infected. In a pandemic, rates rise to 25-50 percent, or 75-150 million cases.
Virulence refers to how many of us will die of the infection. In a normal year, that’s about 0.07 percent, or about 35 thousand out those 45 million. In 1918, mortality was about 2.5 percent, which would be about 7.5 million deaths, given today’s population.
Demographics refers to which of us are at most risk. In a normal year, nearly all deaths occur in people over 65 years old. In 1918 and 1957, mortality was highest among school-aged children and young adults.
This summary, with some calculations, comes from information provided by DHS and presented at GlobalSecurity.Org
Let’s compare the 2009 A-H1N1 Flu. “Atypical flu” may be a handier name. “Swine flu” is passe’.
Incidence: As of 05/02/09: There have been 615 confirmed cases in 15 countries. Attack rates so far are too low and data too incomplete to meaningfully calculate.
Virulence: Mortality in Mexico, the country hardest hit so far, is 16 out of 397 cases: about 4 percent, which works out to four thousand per hundred thousand (a common way of expressing this type of number).
The one U.S. death might properly have been considered a Mexican death, since that child contracted the disease there. If calculated as U.S. data: one death out of 141 cases: about point seven percent. If that fatality is not charged to the U.S. account, the mortality rate outside of Mexico is zero percent as of this writing.
Demographics: Reports say that the Mexican victims were young, but I have not been able to locate details to confirm that. The World Health Organization says that more study would be needed to confirm that younger people are more at risk.
Other: The other elements of this flu that merit precautions are that it is genetically unique, meaning we may have no immunity, and that it is slightly out of season, meaning that it exhibits at least some unpredictable behavior.
We are still at phase 5, so clusters of cases in multiple countries, which would define phase 6, have not yet been confirmed.
Per the WHO, there no travel advisories at this time.
Do masks help? Yes, no, and maybe. Yes: as tiny as viruses are, they could slip right through any screen that we could breathe through, but the virus is carried in droplets of exhaled moisture, and those droplets do stick to the mask. No: But the masks dry, and it’s not clear whether the virus survives and detaches into the inhaled air. Maybe: the real test would be whether people with masks get fewer infections (though such people probably also take more precautions in general), and the Centers for Disease Control and Prevention says that data is not yet available.

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."

Readers: Please send questions, tell us what you need to know.

Swine Flu At Level Five

By Suzia van Swol, University of New Mexico-Talk Radio News Service
The World Heath Organization has raised the alert level for the swine flu pandemic of the phase 5, one step away from the highest level.

The CDC continues to evaluate information to determine the potential impact of an outbreak on an international level.

In Mexico more than 2,000 people have been hospitalized and 149 people have died from the flu. In the United States there are 66 confirmed cases in six states; New York, California, Texas, Kansas, Ohio, Indiana. Globally there are 39 confirmed cases in six other countries including New Zealand, Spain, Great Britain, Germany, Canada, and Israel.

Today, the House Sub-Committee on Health heard testimony from the U.S. Department of Health and Human Services to understand the full impact of the virus.

U.S. Rep. Henry A. Waxman (D-CA) said that, “We should not wait for public health emergencies to come up with ad-hoc responses. Not even counting this recent flu outbreak, about 35,000 Americans die of regular seasonal flu each year.”

The Centers of Disease Control and Prevention has determined that the swine flu is highly contagious and contains genetic pieces from four different virus sources. There is no evidence that the illness comes from pork products, but it seems to come from human to human contact. Symptoms include high fever, body aches, coughing, and sore throats, all similar to regular seasonal flu, but the regular flu shot is not preventative of this new virus.

Anne Schuchat, M.D., acting director for Centers for Disease Control and Prevention said that “it’s a very unusual virus and we don’t believe that humans have experienced it before.”

U.S. Rep. Phil Gingrey (R-GA) , M.D. said that America needs to be careful “not over reacting to the point that we create a pandemic of panic.” Gingrey said that although it is reassuring that Americans are prepared for an outbreak, he said that “I fear we are getting ourselves in a frenzy.”