World Health Organization Says N1H1 Pandemic Over

Even if the World Health Organization’s global “swine flu” pandemic alert was lifted today, the international community was “lucky” the N1H1 virus did not mutate into a a more lethal form , says WHO Director-General Dr Margaret Chan.

“This does not mean that the H1N1 virus has gone away”  Dr. Chan told a press conference Tuesday.  “We expect the H1N1 virus to take on the behaviour of a seasonal influenza virus and continue to circulate for some years to come.”

“Continued vigilance is extremely important, and WHO has issued advice on recommended surveillance, vaccination, and clinical management during the post-pandemic period.” said Dr. Chan, adding that vaccination continues to be the most cost effective way to protect H1N1 high risk groups.

 In the past several months governments started scaling back their public health response to the  H1N1 crisis, but WHO officials felt they needed more evidence that there were no out of season outbreaks or changes in the intensity of infection rates before dropping the alert.

Controversy surrounding the organization’s decision to upgrade the H1N1 situation to a pandemic in the summer of 2009 surfaced after a Council of Europe investigation into alleged ties between certain WHO Emergency Committee members and pharmaceutical companies. Chan says the names of its emergency committee members will be released shortly but was unclear if the WHO would continue to disclose the identity of committee members in the future.

Although she agrees there needs to be changes in the guidelines for future pandemic responses, Dr.Chan remains confident elevating the H1N1 status to a pandemic was the right thing to do. “We followed exactly the epidemiological and biological criteria as agreed by the experts of the world. And his was a true pandemic.”

The WHO has been able to confirm that at least 18 500 people died from H1N1 virus but this remains a conservative preliminary estimate and the organization will need to a few more years to determine the full extent of the crisis.

“Pandemics, like the viruses that cause them, are unpredictable.  There will be many questions, and we will have clear answers for only some. “

Got Dengue Fever? Blame Climate Change

By Travis Martinez - University of New Mexico/Talk Radio News Service

As if melting glaciers, higher sea levels and unpredictable weather weren't enough, because of global warming, the human race faces the potential spread of infectious diseases. A panel of climate experts on Monday discussed the possibility of this occurring in North America.

“Climate change will likely alter the current distribution of vectors and/or pathogens,” said Mary Hayden, a scientist with Centers for Disease Control. “Two major climate factors that promote the reproduction of infectious mosquitos are precipitation and temperature.”

Hayden predicts that by 2050, Aedes aegypti, the yellow fever mosquito, will likely migrate from areas in Mexico to U.S. cities along the Eastern seaboard. Additionally, outbreaks of Dengue fever have already been reported in Key West, Florida.

“Unfortunately, we’re seeing that Dengue Fever is increasing in number and severity. In Mexico alone, since 2005, there has been a 600 percent increase in cases, with no known vaccine,” said Hayden.

The panel used years of data that shows correlations between increased rainfall accumulations in Africa and the reproduction of water-thriving mosquitoes, with the spread of diseases including Dengue Fever, Malaria, Cholera and Hantavirus.

According to the World Health Organization's website: “Change in world climate would influence the functioning of many ecosystems and their member species. Likewise, there would be impacts on human health. Some of these health impacts would be beneficial. For example, milder winters would reduce the seasonal winter-time peak in deaths that occurs in temperate countries, while in currently hot regions a further increase in temperatures might reduce the viability of disease-transmitting mosquito populations. Overall, however, scientists consider that most of the health impacts of climate change would be adverse.”

The panel on Monday urged Congress to develop a comprehensive disease control and monitoring system that will help combat the onset of diseases that have increased in recent years.

“I believe Congress should be focused on our ability to monitor and track diseases generally, but particularly with diseases related to climate change,” said panelist Lynn Goldman, a professor at the Johns Hopkins University Bloomberg School of Public Health. “Right now we are doing a good job, but certainly monitoring can be very much improved.”

OK Everybody, Back In The Pool.

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


Atypical Flu Update 05/06/09
Today’s numbers: 642 cases in 41 states. There are now 2 deaths
reported with one being wholly American. Whereas the first was a
Mexican child who contracted the disease in Mexico, the second, per
WebMD, had no reported connection with Mexico other than living near
the border in Texas. She was young, but had other conditions’
“co-morbidities,” including recent childbirth, obesity, and recent
pneumonia. Counting her as the as the only native fatality so far, the
mortality rate in the U.S. is 0.1 percent.
Worldwide, there 1516 confirmed cases in 22 countries, with 29 deaths
in Mexico out of 822 confirmed cases (3.5 percent mortality), and no
deaths so far reported outside of Mexico and the U.S.
The World Health Organization is still not recommending travel
restrictions, except to advise people who feel ill to stay home.
WHO alert status remains at stage 5. Clusters of cases do not seem to
be occurring yet, which may mean that the virus weakens with time.
Nevertheless, the Centers for Disease Control and Prevention remind us
that we have weeks of this contagion to go yet.
The overall severity of this flu outside of Mexico is “mild to
moderate” per the CDC.
Per Secretary of Health and Human Services Kathleen Sebelius, “School
closing has gotten a lot of attention. There's a balance with the
importance of making sure our children go to school every day. The
virus transmits very quickly child to child, the end result has been a
more mild version of the disease than was originally feared and the
lethality seems at a much less significant level”
The current guidelines are to keep schools open, even if some students
get the flu, as would be done during any normal flu season, she says,
though that makes it even more important to keep symptomatic children
home.
“So we're urging parents to take steps if your child is sick, please
do not send your child to school. If a teacher is sick, please don't
come to school,” sebelius said.
And home means home. “And parents, don't turn around and keep your
child home from school and send him or her to the mall. This is really
about staying home,” Sebelius added.
The recommended period of “grounding” is seven days, even if symptoms
resolve, because that is how long sufferers may remain contagious.
So, did the CDC, WHO and media over-react? This flu is looking less
scary by the day, but it started with a significant number of
fatalities, and it was clearly a very different strain than had been
seen before. While we may start to feel some relief at this point,
these things can change quickly. Washing our hands, avoiding others
when we have symptoms, and insisting on common courtesy (Hey, cover
your mouth when you cough), may help reduce the 35,000 deaths per
year, and billions of dollars in lost productivity we have come to
think of as “normal.”

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.

Bacon Won’t Close Borders

By Suzia van Swol, University of New Mexico, Talk Radio News Service
Wed, April 29, 2009
The death of a 23-month-old in Texas marks the first confirmed swine flu death in the U.S.

The Center for Disease Control and Prevention (CDC) has implemented its emergency response and has determined that the flu contains genetic pieces from four different virus sources, one of which is
swine flu. The CDC continues to evaluate information to determine the potential impact of an outbreak on an international level.

President Obama has asked for an additional $1.5 billion to combat the disease.

Today, U.S. Sen. Joseph Lieberman (I-CO) said that “this swine flu is moving very quickly and harmfully.” Symptoms include fever, cough, sore throat, body aches, headaches, chills and fatigue

On Sunday the flu was declared to be a public health emergency and the World Health Organization raised its pandemic alert to phase four.

United States Secretary of Homeland Security Janet Napolitano said that the U.S. has 50 million courses of anti-viral medication and 25 percent of the stockpiled courses are being released with priority given to
states with confirmed cases and border states. By May 3rd all states will ultimately get resources. Work has also begun towards developing a vaccine since the currently flu shot doesn’t protect against the
swine flu. “This will be a marathon, and not a sprint,” said Napolitano.

Warnings have been issued for non-essential travel to Mexico but closing borders “has not been merited by the facts” said Napolitano, and would have “very very little marginal benefit in terms of containing the actual outbreak of virus within our own country.”

Napolitano affirmed that although named “swine flu,” no signs of this newly identified H1N1 virus have been detected in our nation’s swine, no illnesses have been attributed to handling or consuming pork, and
that there is no evidence that one can get the virus from eating pork or pork products. The virus is actually spread from human to human, similar to a seasonal influenza.

RADM, Anne Schuchat, M.D., said that “we are dealing with a novel virus, we don’t know yet all of the characteristics of how it will behave in human populations.”

While 36,000 people die every year from regular seasonal flu, the new virus brings risk for a future pandemic since “the general population doesn’t have immunity to this virus,” said Schuchat.

According to Lieberman, 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.

“This is a case in which our government was prepared for the crisis, as best one can be prepared for a swine flu outbreak whose course is not clear,” said Lieberman.