Could this be the beginning of a flu pandemic and what does that mean?

[cali]

We know that the Spanish flu pandemic of 1918-1920 killed something like 100 million people worldwide. Today the population of the world far, far exceeds that of 1918. Presumably we are better prepared to deal with a pandemic, but in what ways?

The WHO is concerned that this may be the onset of a pandemic. Is there information that we as citizens need to know? Personally, I'm pretty clueless about what if anything we should do if a pandemic does strike.

[wildflower]

1. Several people died in San Diego recently from recurrence of swine flu

By the way, you may want to correct the typo in your subject line; I read it as "flea pandemic" when I first saw it.

[Control-Z]

40. Link? n/t

[Taverner]

2. Which flu? Swine flu? Monkey pox?

Probably the best bet would be to wear a face mask, and wash your hands thoroughly before doing anything.

[havocmom]

13. Mexico City schools shut down due to swine flu outbreak

It is looking bad, actually.

[Taverner]

26. That sucks - I just wanted to know which flu was causing it...

There are quite a few this summer - West Nile, Monkey Pox, Swine Flu...etc...

[azmouse]

3. I'll admit to being a bit worried about this one

because I live in the Phoenix area with many Mexican immigrants.

I'm staying out of crowded areas and will wash my hands a lot. Not much else can be done.

[kestrel91316]

12. You're worried?? I'm in the San Fernando Valley in Los Angeles,

where latino immigrants outnumber Americans 2:1 by my unofficial estimation. And the population is 1 million official in 2000/probably realistically 2 million right now.

[phantom power]

4. soap and water are still the best prophylactic.

And avoiding unnecessary contact. Stocking up a bit on basic supplies might be good. Not because civilization will collapse, but because there may be buying panics.

[phantom power]

5. One way we are "better" prepared is...

our level of biological tools. The fact that you and I already know about this episode, and that they already know it is a new viral strain, is evidence of technology advantages.

It may or may not help prevent a localized outbreak from spreading into a pandemic. Assuming this is a pandemic.

[MADem]

6. I'd stock up on hand sanitizer, keep a bottle of bleach and water handy at home,

wear a mask outside and when interacting with people, wash hands constantly as well as stuff you have to touch that has been touched by others--and try to stay away from people as much as possible until the danger passed...I guess.

[csziggy]

7. Check the CDC site for updates

http://www.cdc.gov/flu/swine/investigation.htm

[Terran]

8. What "this" are you referring to?

You post is basically information-free.

[cali]

9. sorry, here.

http://www.dailykos.com/story/2009/4/24/724106/-Brief-Swine-Flu-Update

[kestrel91316]

10. Could be. What it means is this:

have a supply of face masks on hand so you can protect yourself when you go out in public:

http://solutions.3m.com/wps/portal/3M/en_US/IP/infectionprevention/product-info/product-catalog/?PC_7_RJH9U5230GE3E02LECFTDQ0U21_nid=GS1DVKPRL1beVHK1T0WDSNgl

[Mojorabbit]

11. and adding to this

it should be a niosh certified N95 mask to be of any use.

[kestrel91316]

19. Actually that's not vital. Colds and flu are not so much airborne and spread by inhalation

as they are spread by direct contact and via fomites. And the best fomite around is our own hands. When we tough doorknobs, telephone receivers, money, and other people's hands, we get the virus particles on our own hands, and then when we (usually unconsciously) touch our hand to our nose or mouth it's a done deal.

Which is why handwashing is how we best fight the spread.

[Mojorabbit]

20. Flu is spread from airborne droplets

the osha standards are for n95 and above. It is what hospitals are stocking up on for their staff and what we used at a minimum in the hospital for very contagious pathogens.

[kestrel91316]

22. Flu isn't spread by inhalation of those droplets, for the most part.

The nasal discharge winds up getting onto all sorts of stuff, and then our hands convey the virus particles to our face. Inhalation of airborne droplets is only one means of spread - we probably don't actually know how much each contributes, but we KNOW that handwashing and good sanitation is critical.

~~~~~~~~~~~~~~~~

According to the CDC (in their flu-control-in-childcare-settings, for instance):
http://www.cdc.gov/flu/professionals/infectioncontrol/childcaresettings.htm

Remind children and care providers to wash their hands or use alcohol-based hand cleaners, and make sure that supplies are available to prevent the spread of germs.
Encourage care providers and children to use soap and water to wash hands when hands are visibly soiled, or an alcohol-based hand cleaner when soap and water are not available and hands are not visibly soiled.
Encourage care providers to wash their hands to the extent possible between contacts with infants and children, such as before meals or feedings, after wiping the child’s nose or mouth, after touching objects such as tissues or surfaces soiled with saliva or nose drainage, after diaper changes, and after assisting a child with toileting.
Encourage care providers to wash the hands of infants and toddlers when the hands become soiled.
Encourage children to wash hands when their hands have become soiled. Teach children to wash hands for 15-20 seconds (long enough for children to sing the “Happy Birthday” song twice).
Oversee the use of alcohol-based hand cleaner by children and avoid using these on the sensitive skin of infants and toddlers.
Rub hands thoroughly until the alcohol has dried, when using alcohol-based hand cleaner.
Keep alcohol-based hand cleaner out of the reach of children to prevent unsupervised use.
Ensure that sink locations and restrooms are stocked with soap, paper towels or working hand dryers.
Ensure that each child care room and diaper changing area is supplied with alcohol-based hand cleaner when sinks for washing hands are not readily accessible. Alcohol-based hand cleaner are not recommended when hands are visibly soiled.

Keep the child care environment clean and make sure that supplies are available.
Clean frequently touched surfaces, toys, and commonly shared items at least daily and when visibly soiled.
Use an Environmental Protection Agency (EPA)-registered household disinfectant labeled for activity against bacteria and viruses, an EPA-registered hospital disinfectant, or EPA-registered chlorine bleach/hypochlorite solution. Always follow label instructions when using any EPA-registered disinfectant. If EPA-registered chlorine bleach is not available and a generic (i.e., store brand) chlorine bleach is used, mix ¼ cup chlorine bleach with 1 gallon of cool water.
Keep disinfectants out of the reach of children.

Remind children and care providers to cover their noses and mouths when sneezing or coughing.
Advise children and care providers to cover their noses and mouths with a tissue when sneezing or coughing, and to put their used tissue in a waste basket.
Make sure that tissues are available in all nurseries, child care rooms, and common areas such as reading rooms, classrooms, and rooms where meals are provided.
Encourage care providers and children to wash their hands or use an alcohol-based hand rub as soon as possible, if they have sneezed or coughed on their hands

~~~~~~~~~~~

What's most notable in this advice, in light of your suggestion that special pathogen masks are needed, is the utter lack of any recommendation to use any sort of mask at all. If a deadly strain of flu is in a hospital, YES, serious infection control measures will be taken. But that is a heck of a lot different from what advice will and should be given to the general public.

It reminds me of the overreliance on antibacterial everything rather than commonsense soap and water for decreasing the spread of pathogens. And your special masks are too expensive and uncomfortable and difficult to obtain for the public to EVER be expected to use them consistently. Simple, cheap, universally available molded surgical masks, along with staying out of public places and crowds as much as possible, and good hand hygiene will be the primary means of preventing public spread of infection in any flu pandemic. As they should be.

~~~~~~~~~

ETA: CDC recommendations for laypersons/public
http://www.cdc.gov/flu/protect/habits.htm
Note they do not recommend n95 masks, or any masks at all.

Avoid close contact.
Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.

Stay home when you are sick.
If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.

Cover your mouth and nose.
Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.

Clean your hands.
Washing your hands often will help protect you from germs.

Avoid touching your eyes, nose or mouth.
Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Practice other good health habits.
Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food

[Mojorabbit]

37. Good info

and accurate but it is spread by airborne means per this from your post "Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.". If one is going to be out in public where people are infected with flu and are coughing and hacking a mask is good to have and the govt recommends niosh certified n95. Beings as I am looking at it from a stand point of doing medical care no way will I do it without a mask. My husband has stockpiled the masks for his staff in his family practice office. Employees need to be protected.

[Mojorabbit]

14. We also had two mild pandemics

this century. Hopefully this will be a mild one. There is no way to tell till all the waves pass through. It is concerning that the death rate is higher in Mexico and that it is affecting a lot of people which are not the elderly or children. My main concern is that the seasonal flu this year was resistant to tamiflu. This one isn't yet but could well end up the same way which would cut down on our arsenal to fight it.I feel better about this virus so far as opposed to H5N1.

[Avalux]

15. What we know so far...

The swine flu (H1N1) cases in Texas and California are related to those in Mexico; however they seem to be milder. No reports of exposure to pigs in the US cases and those in California had recently visited the Dallas area. Texas officials concerned about the area between Dallas and San Antonio. So far, mortality rates are low (thank goodness).

Officials have indicated it is too late to contain a pandemic if it is to occur. The only sure prevention is to self-quarantine. Otherwise, follow basic sanitary rules of hand washing and wear a respirator when out in public.

[NNN0LHI]

16. Spanish flu pandemic of 1918-1920 DID NOT kill something like 100 million people

Most of those people died from complications such as bacterial pneumonia which is readily treated today with antibiotics. The first safe antibiotics were not invented until 1945.

See:

http://www.npr.org/templates/story/story.php?storyId=93747214

Bacteria Fingered As Killer In 1918 Flu Pandemic

by Joanne Silberner

Morning Edition, August 20, 2008 · What killed tens of millions of people around the world in the 1918 flu pandemic actually might not have been a flu virus. A new study in the Journal of Infectious Diseases blames different agents: bacteria.

The flu virus weakened lungs, opening the door to fatal bacterial pneumonia in most of the pandemic's 50 million victims, according to researchers at the National Institute of Allergy and Infectious Diseases.

The researchers based their findings on preserved lung tissue from 58 soldiers who were infected by the flu and died in 1918 and 1919. They found tissue changes that are the hallmarks of bacteria, not viruses, as well as the destruction of cells that normally protect lungs from bacteria.

They also studied case reports from 1918 in which doctors said they suspected a second infection. One doctor said that the flu "condemns," but secondary infections "execute."

The new research suggests that with the availability of effective treatments for bacterial infections, a modern-day flu pandemic might not be so deadly.




I have survived through two pandemics since the one in 1918 and did pretty good.

The "Asian Flu", 1957–58. An H2N2 caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.

The "Hong Kong Flu", 1968–69. An H3N2 caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968, and spread to the United States later that year. Influenza A (H3N2) viruses still circulate today.


Don

[kestrel91316]

17. WHO web page on this:

http://www.who.int/csr/don/2009_04_24/en/index.html

[kestrel91316]

18. The Mexico cases number over 800, have a fatality rate of almost 7%,

and are primarily in young, otherwise healthy adults. Not the usual increased incidence in infants and the elderly. When they see this, IIRC it means that immune system overreaction sort of like SARS is going on, rather than an ineffective, weak immune response like old and young are susceptible to.

[Avalux]

30. Out of the 800 reported cases in Mexico -

7 of them are laboratory confirmed as the same strain as in the US. Many are probably regular human influenza A and confirmation will be impossible. It does appear the unique swine/avian/human strain is not particularly virulent. is not a SARS-like illness.

[kestrel91316]

32. Well that's a relief.

[Mojorabbit]

38. They are still working on specimens

I think we will know by Monday which way this is going to go. I think we are up to 68 deaths and 1004 cases last I read. I am hoping it all fizzles out

[northernlights]

21. yes it could

But pandemics occur periodically and we are overdue for one. The question is whether it will be a particularly deadly strain. My personal plan is the same as my plan for any big storm emergency: be prepared to stay home for a couple weeks, whether it's a major power outage (I'm in Maine) in winter or an outbreak of a deadly something in town. But I pretty much always have a good supply of food for my family and am always pretty ready to live off it temporarily if need be. Just a doomsdayer by nature, I guess. :)

You can wash your hands till your skin falls off. But if you're standing in line at the supermarket, or sitting in a cubicle at work, and somebody coughs nearby, you may have been exposed. A face mask can limit your exposure, but not eliminate it totally. Viruses are reeeeeeelly small.

One thing to remember is that the 1917-1918 pandemic occurred during WWI and it's early victims were soldiers housed in very close quarters and under a lot of stress. And it was before the CDC or WHO. And before a lot was known about diseases and how they spread.

Here in the U.S., where we're mostly spread out it's easier to avoid. Also, due to increased knowledge and information sharing, governments can (and do, as per Mexico) quarantine to reduce spreading.

[Obamanaut]

23. Probably not. Fewer than 10 cases do not an epidemic, pandemic,

or crisis make. It is much too soon to hide under desks, run for the hills, or prepare for last rites of civilization as we know it.

From the link provided in your later post:



<snip>“It is not a pandemic alert, and guidance on that topic has not changed, but this is an "evolving situation", and the story and guidance could change. It's at the very least become a news story. It could easily fizzle out in a few days, but until it does, it bears watching (and not necessarily on the front page here.)”

http://www.dailykos.com/story/2009/4/24/724106/-Brief-Swine-Flu-Update

[northernlights]

28. There have been 800+ cases in 7 states across Mexico

with a quarantine in Mexico City now. And it's just hit in the U.S.

The OP didn't ask if it *is* a pandemic. They asked if it could *turn into* one. And the answer to that is yes, it could turn into one. That's why it's being watched so closely.

[Obamanaut]

35. No, the answer is not "yes", but rather "probably not." With the

numbers listed in the WHO report, you are more likely to be run over by a drunk driver. Stay indoors and be safe from them as well as pesky viruses.

http://www.who.int/csr/don/2009_04_24/en/index.html

<snip>

24 April 2009 -- The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported.

The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported.

Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California.

<snip>much more at link

My reading skills are not what they could be, but paragraph one (1) lists 5 in Calif, 2 in Tex. = 7

Gov of Mexico has reported three events, with more than 854 cases of PNEUMONIA (para 2). Of the Mexican cases 30 have been confirmed to be identical to the Swine Influenza A/H1N1. Paragraph 3.

I didn’t write the WHO report

[depakid]

41. Since we don't have serological results on most of the cases or deaths

there's no good way to estimate a cause-specific mortality rate. One could probably hazard a guess that it's a bit higher than the typical nasty A strain- and probability of death/age distibution will look more like a W shape than the U one sees with influenza.



Seems to me that we're pretty damn lucky that it's broken out now, rather than in late November.

[Mojorabbit]

39. It is 68 dead in Mexico

and there was a match in some of our cases with their flu. Still not a pandemic but bears watching.

[Mike 03]

24. This is what I think you do if a pandemic strikes:

You should, in advance, store up at least three months of water and food.

That is not because it takes three months for a pandemic to sweep through a community, but because you don't want to have to scramble around gathering supplies even if a pandemic is beginning in some distant part of your continent, because you don't know how long it will take for it to travel to where you live.

When the first person in your city or town gets it, there will be a few days before it is confirmed, so there's no way to know for sure when the contagion has actually breached the limit of your town.

1. You stay indoors to the extent possible.
2. You don't associate with others who have been socializing.
3. You eat food and drink water you have previously stored in preparation for this exact scenario.
4. Once you know for sure that people in your town are infected, you do nothing for two weeks. You have contact with no one. You do not leave your house.

5. Then, after fourteen to twenty one days, most of the damage will be done. Some people say fourteen days is sufficient before exiting the home, but I'm going to wait for three weeks.

Pandemics tend to sweep quickly through towns

[Control-Z]

42. Sounds about the same as what I was thinking.

I guess the tough part would be knowing if you've waited too long.

[Mike 03]

25. P.S. And if you are wondering who gets infected and succumbs to a pandemic in this day and age

and with all of this advanced warning, it is exactly the kind of people who laugh at a post like yours and think rumors of a pandemic are a conspiracy to sell Tamiflu.

On Edit: Just to clarify, although I'm certain we will eventually have a deadly pandemic, I'm not among those who believe this is it, happening right now. The jury is way, way out, IMO.

[depakid]

27. The data seems to confirm human to human transmission

and the genetic assortment is interesting:

The virus that has caused these infections is viruses are actually very interesting. They contain genetic segments as Dr. Schuchat said from four different virus sources.

So we have some gene segments that are North American swine influenza viruses. Some gene segments North American avian influenza viruses. One gene segment from a human influenza virus and two gene segments that are normally found from swine influenza viruses in Asia and in Europe.

We actually have complete genomic sequencing done for the first influenza viruses that were isolated from the ten-year-old and the nine-year-old. Those two viruses are very similar but not identical to each other. Now we have partial gene sequences for two additional cases from California.

We've found that the gene sequences from the viruses causing infection in those individuals are very, very similar to those in the initial two cases. So, we're seeing basically a virus that appears to be spreading from person to person in humans and viruses have very similar genetic characteristics to each other.

http://www.cdc.gov/media/transcripts/2009/t090423.htm

Looks at this point like the strains are treatable to some extent with oseltamivir (Tamiflu) and zanamivir (Relenza).

[NashVegas]

29. If So, It Means Less Pollution, Less Energy Use, and More Disease

As the bodies rot.

Okay, that was brutal.

Really? I don't know.

[opihimoimoi]

31. Until 30,000 gets the damn thing,,,its a Pub Diversion

[Mike 03]

33. Kicking, because

of the story (special report) I just heard on KNX 1070 AM radio out of Los Angeles...

This seems to be very much worth paying attention to.

Not everything we've been told appears to have been entirely accurate and truthful.

So here we go...

[marketcrazy1]

36. could you elaborate Mike

Not everything we've been told appears to have been entirely accurate and truthful.????
???????????

[Control-Z]

43. And...? eom

[lib2DaBone]

34. Can't Happen.. We are not allowed to discuss 'Conspiracy' Theories on DU

[Algorem]

44. too many motherfuckers anyhow.