Attention, DU Science Nerds! Regarding Swine-Avian Virus "Crisis"...

[elehhhhna]

If anyone here knows their hind end from a hot rock re: flu viruses, etc., I'd appreciate your assessment of the "When Pigs Fly" flu. Seems it's no cause for hysteria, right?

[aquart]

1. Hasn't killed an American yet, if that's what you mean.

I think that's a very correct way for it to behave.

[elehhhhna]

3. When you consider that rural Mexico's healthcare access is

actually worse than ours, that public health initiatives there barely exist, and that there's a major lack of clean water and sanitation, it's hardly surprising that rural mexicans are suffering more than "we" are.

[NutmegYankee]

7. The quality of healthcare is probably the major factor.

Those who are in danger (since most people with even a bad flu like in 1918 recover on their own) can receive very good medical care here in the US to get them through the worst.

[nadinbrzezinski]

19. You are aware that the clusters are NOT in rural mexico

unless Mexico City and surrounding areas of the State of Mexico are rural

Or for that matter St Louis Potosi or Mexicalli

By the by Health Care officers in the US EXPECT to see deaths, and are right now doing reviews of recent pneumonia deaths

What does that remind me off?

Oh yeah, 1919

[BlooInBloo]

22. Laura Bush has killed more Americans, in fact.

[NutmegYankee]

2. Depends on the method of dispersal and it's effects.

I don't know right now. Some versions in the past (Spanish flu of 1918) killed healthy people because it turned their immune system into overdrive and destroyed their lungs. The biggest danger is an outbreak that may not kill many, but will quickly overwhelm the hospitals. That and the PANIC that comes with it.

[DarthDem]

4. Right

Unless this strain has some ridiculously long incubation period, most of the cases should be showing up now - - and the only deaths so far are in Mexico. (I'm not minimizing those very sad deaths at all, but just pointing out that there are some very basic differences between, e.g., Mexico City and the U.S. in terms of sanitation and other key factors.) The main danger is that people will panic. Mexico's president, to his enormous credit, seems to be taking appropriate measures and encouraging calm.

[MercutioATC]

5. There is NEVER cause for hysteria.

That's the problem many here (and everywhere) seem to have. They think their only choices are to panic or completely ignore the issue.

Early reports suggest that this virus is prime for going pandemic. It's already gone human-human, it has avian and swine components to which we have little or no resistance, it has a 7% mortality rate...which means it can spread more widely because it doesn't kill most of its hosts.

We still don't know a lot about it, though. Viruses, by nature, mutate. What we see this week could be something completely different this time next month.

It bears watching. It warrants some basic preparations (which one should make anyway).

It is NOT cause for panic.

[DarthDem]

8. 7%?

A 7% mortality rate? Where did you get that figure?

[bicentennial_baby]

10. 6.8%...1000 cases, 68 deaths, Mexico

[Hanse]

13. I doubt it's that high.

There have only been 16 confirmed deaths so far.

Some of the American patients are claiming their symptoms were rather mild, so there are probably far more than 1,000 that have been infected.

[stray cat]

14. Likely - the cases are not based on infection but cases that get reported

7% of people who report being sick or end up going to the doctor because its bad enough for treatment.

[nadinbrzezinski]

20. 68 is the number, not 16

[Hanse]

23. There are 68 possible deaths.

16 confirmed.

[nadinbrzezinski]

24. No 68 confirmed and no deaths today

which by the by, is good news

We also have 6 cases of this now in NYC and two in Kanasas to add to the others clusters in Texas, Arizona and California

Look for the AP, try to read that

And this is so NOT serious that the WHO has declared an emergency and airports are on the lookout for people with symptoms

[Hanse]

28. According to the Mexican government...

There have been 81 (formerly 68) deaths to the flu, of those 20 (formerly 16) have been confirmed to be the variant of the swine flu that's of concern.

[nadinbrzezinski]

29. According to the AP 68 have been linked

as is, slow response has spread this to the four winds

SO if this had the potential, some rules were kind of violated.

But that is another story

I realize that if this happened in the US... there is no way any major airport in the US would have been closed either

Quite inconvenient

[Hanse]

30. Linked, but not confirmed.

Are you saying W.H.O. and the Mexican government have mishandled the situation, and that you personally know better? Would you have closed the airports?

[nadinbrzezinski]

31. Yes I would have closed the airports, buss depots, the metro...

in fact early plans when the first warnings were issued called for exactly that

What is the word I am looking for?

Oh yeah not politically expedient...

And that is one of the complaints that many people who have worked in these things say... you win some, you loose some

Isolation of an infected population is quite standard actually

Or why else do you think they are fully activating the plan that includes forced isolation of the sick in quarantine?

[Hanse]

32. " What is the word I am looking for?"

Panic.

[nadinbrzezinski]

34. And you've worked in disaster services?

I am sure you have

What I stated is quite common, textbook in fact.

Don't ask me, pick a public health book

[Hanse]

35. Have I ever quarantined 22 million densely populated people?

No, I've never done that before.

[nadinbrzezinski]

36. Once again, closing airports is part of the suggested plan

and RIGHT NOW the MEXICAN GOVERNMENT is getting ready to quarantine as many as needed

Now I am sure they are just panicking and all this is ahem unnecessary.

:sarcasm:

Jeesus age... I know that most people are ignorant of SOP in these cases, but hell, we have done that in the past

pick up a book and read about the response to 1918 and the way PUBLIC health worked back then

Oh and here is a free clue... effectively they are doing that... when asking people to stay home... SOP as well

It is called individual home quarantine

And it can and does break the cycle

[MercutioATC]

12. 1000 cases, 68 reported deaths....roughly 7%.

The actual mortality rate will probably differ as more people are infected and the virus mutates, but 7% is a reasonable accurate starting point.

[DarthDem]

15. Not Actually

Mortality rates take into account the total number of confirmed cases, and have to estimate for those cases that resolve without a report to any medical providers or authorities. And there are likely many more cases here than have been reported. The mortality rate of the Spanish Flu in 1918 is estimated at 2.5% to 5%, worst case. There's no evidence to suggest that this is more virulent - - quite the opposite, in fact.

Citing a mortality rate that high is exactly the sort of thing that can lead people to panic. Relax a bit.

[MercutioATC]

18. You're right.

We're probably getting lousy reporting out of Mexico. 7% would be the upper threshold.

[roamer65]

6. Hard to say at this point.

Medicine has vastly improved since 1918. We have developed far more treatments and medicines (i.e. antibiotics, expectorants, decongestants, anti-virals, etc). It will take a far more deadly virus to have the same percentage of deaths as the 1918 virus in the present-day developed countries.

I am worried about developing nations on this one, espcially the ones fighting high rates of HIV infection. This virus could further decimate their populations.

If you catch this virus and the following congestion seems to be going into your lungs, don't fool around. Get to a doctor immediately. You don't want pneumonia.

[Ian David]

9. Buckle your seatbelt when you're in a car, don't smoke, wash your hands, wear helmet on a motorcycle

And don't worry about swine flu so much.

[stray cat]

11. Severity looks more severe in terms of pneumonia in healthy individuals

It may tie up health services. It is susceptible to tamiflu at present and survival rates look good if its properly handled and diagnosed and treated early. But flu can kill and this one is no exception - it is worth watching as most healthy individuals don't normally take the flu seriously and this one may be worse for the healthy with a good immune system. No reason to panic but do be aware. Wash your hands often and if you get the flu you might want to start on tamiflu as it is most effective if given early.

[Avalux]

16. No cause for hysteria.

What we know so far is that the confirmed cases in the US are the same strain of H1N1 influenza A as those in Mexico. This is a unique swine influenza A, with components of human and avian influenza A; so we haven't seen it before. It appears to be spread easily from human to human and most curious - is infecting healthy young people (unlike human flu which is worse for those with weaker immune systems).

What we don't know is HOW this virus came to infect humans, the extent of the infection rate (this is evolving) and the mortality rate. Sorting all of this out could take some time.

We just have to wait and see what happens.

[madrchsod]

17. 22 million people live in the greater mexico city area.......

should`t there be a lot more deaths?

[rucky]

26. Swine flu historically has less than a 1% fatality rate of cases.

in the US. The one that hit Fort Dix in the '70's had a mortality rate of under 0.5%. This one so far is 0% in the US...

Higher in Mexico - 7% for the current pandemic. There's a few theories why, but the air quality in Mexico City makes the most sense to me...

http://news.yahoo.com/s/ap/20090425/ap_on_he_me/med_swine_flu_victims

[madrchsod]

37. you mean the air that can give one diarrhea ?

[Yo_Mama]

21. No hysteria yet

The bottom line is that there are currently confirmed cases in at least three states (TX, CA, KS) with probables in several more. It's uncontainable, because the distribution and tracing of the cases proved that there had to be intermediate persons in the chain of infection.

However, right now there is no cause to panic, because the first sets of US cases were only picked up by special tracing programs designed to find new viruses crossing the border. The virus is spreading, but it appears to be making people only mildly ill. The one person in the US who was hospitalized was an immune-suppressed person.

The KS cases were traced to a Mexican contact. The probables in NYC are being tested because of a Mexican link. Several of the CA cases are not traceable to a Mexican link. That's why they are so completely certain that it is spreading through the US population to some extent.

It may well be widely distributed across the US by now. There have been no unusual pockets of death from pneumonia/influenza reported. You can check that for yourself at CDC's MMWR report on Wonder at
http://wonder.cdc.gov/mmwr/mmwrmort.asp
In fact, deaths from those causes are currently running significantly lower in the US than last year. For week 15 09, there were 820 US deaths in reporting locations attributed to pneumonia/flu. In weeks 15 and 16 of 08, the number was well above 900 both weeks.

The reason why the public health authorities in WHO, Canada, the US and the UK are so concerned is that the virus is novel, and they believe that the human population will have little resistance to it. They are already talking about maybe adding a vaccine for this strain into next year's standard vaccination.

The risk is that this virus could mutate into a more lethal version. Since Mexico is reporting associated deaths, the question is whether that has already happened or whether there is just so much of it around of it in some locations that the usual non-causative deaths (where flu was only a contributing factor) are being reported in alarming numbers.

There was an unusual rash of pediatric deaths from flu in the southern US a couple of years ago. Testing showed that the deaths were associated with a bacterial infection. That is one of the risks of flu - that someone who is sick with another infection, but whose immune system is curbing that infection, will be worn down by fighting the flu virus and become ill with a secondary bacterial infection.

Some of the reports associated with the Mexican deaths do appear to fit the pattern of secondary bacterial infection rather than a lethal flu. Also, not all the samples sent for gene sequencing and identification to US and Canadian labs are testing out as being this new flu strain. The US got 14 and only 7 matched, and as of this morning Canada still was reporting that only 12 out of their 18 matched. So it is quite possible that the flu circulating in Mexico is also a relatively mild strain. In a huge city, you are always going to have a number of deaths from respiratory distress initiated by flu. For example, TB is widely spread in Mexico. A person who had little too no symptoms from TB might experience a sudden burst of TB in their lungs from fighting a flu infection, and die. But the real cause of death would be the TB, and not the flu.

Right now it is just a situation in which you should take common sense measures. If you've been ill recently and still aren't feeling too chipper, and you come down with a flu-like illness, consider going to the doctor earlier than you otherwise would. Get plenty of sleep, eat well, avoid sick people and wash your hands. If you are sick, don't go to work and cough all over everyone else.

It wouldn't be time to get hysterical until the MMWR started showing unusual rates of death from pneumonia/flu.

[nadinbrzezinski]

25. Bingo, right now doing the tracing on map

bad habit of mine

[Snazzy]

27. thoughtful post, thank you

(and a useful link)

Welcome to DU.

:toast:

[myrna minx]

33. Thank you for your thoughtful post.

I think this is the best response I've read on the subject today.