World Health Organization says there are 40 confirmed US cases of Swine flu. No deaths.

[FedUpWithIt All]

http://www.latimes.com/features/health/sns-ap-un-who-swine-flu,0,5685926.story

WASHINGTON — President Barack Obama said Monday the threat of spreading swine flu infections is matter of concern but "not a cause for alarm." The United States and other countries across the globe increased their vigilance as the World Health Organization said there are now 40 confirmed cases in the U.S.

http://www.chron.com/disp/story.mpl/ap/top/all/6394437.html

Increasingly, the no deaths reports are very encouraging.

[phantom power]

1. I wonder why the mortality rate in Mexico has been about 5%?

At this point, I would expect at least a couple deaths in the US, assuming the same mortality rate. Better medical care?

[Puzzler]

2. I was aking my father (who is a retired cell-biologist) the same question.

He said that the mortality rate may me the same (or similar), but the number of people in Mexico City with very mild cases may be large... and this would have gone largely unreported a couple of weeks ago.

[phantom power]

3. True, mild cases are always underreported

[FedUpWithIt All]

4. Also, we have to consider the age group of the majority affected in the US

It is mostly kids back from spring break trips to Mexico. These kids are not in the concerning age group.

We also have to consider that there is still an approx 93%+ chance of recovering from this flu.

There are only 40 confirmed and only a handful of suspected cases at this point. This is not a huge sampling. Statistically it is not completely unreasonable that we have not seen a fatality.

[Mojorabbit]

5. I get emails from promed

which is for infectious disease specialists. They raised an interesting point. Mexico has a testing bias for hospitalized patients while we have a testing bias towards outpatient people. It may be why we have no deaths recorded. Time will tell once a good system for identifying infected are in place.

[nadinbrzezinski]

9. Also in mexico they increased the reporting from

the ever so popular only send reports of deaths, to negative reporting

Translation, every case that comes through the door, even a sprained ankle

So that will have interesting effects

[FedUpWithIt All]

11. Ah, interesting

:hi:

Have you heard something about an adult hospitalized in NY? I cannot tell if it is in a corner of a media report i missed or it is just hearsay.

[Mojorabbit]

13. I saw something about it on twitter

earlier but it is twitter though so far the news from there has been very accurate.
I see suspect cases in Lowell Mass and that the WHO has raised the alert level to 4.

[FedUpWithIt All]

14. The NY case, from what i heard on another site, is being kept as a pneumonia case.

And it may be severe.

I guess we will see.

I am also wondering if they are investigating pneumonia cases so as not to overlook underlying flu.

I am glad they raised the level. It is clearly sustained transmission.

[Mojorabbit]

21. I posted this downthread

from twitter
CBS 2 HD has learned of a confirmed case of swine flu at the Ernst & Young headquarters in Times Square.

I don't know if the same case or not. Things are moving so quickly.

[Puzzler]

7. When comparing this new flu to the "other" flus...

... it is also important to remember that the "regular" yearly flus also kill. I don't have the exact figure in front of me, but the regular yearly flu viruses in Canada alone kill at least 4,000 people per year (we have a population of around 30 million). Now, I am not intending to minimize the swine flu concerns, but it still is important to keep this in perspective. Some reporters seem to be under the impression that "normal" flu is not deadly... but it most certainly is.

[marshall]

15. It's the health care system

I read a report that quoted a Mexican doctor saying they could diagnose it but they had no supplies to treat it.

[FourScore]

6. Interesting thread. Thank you. n/t

[Mojorabbit]

8. twitter breaking news reports

AP: NY official says city has 20 more cases of swine flu, additional 17 probable cases.

Mexican Health Secretary Jose Angel Cordova Villalobos says all schools in the country will be closed until at least May 6 -

URGENT -- The number of suspected swine flu cases in Mexico has jumped to 1,995 as death toll hits 149. Live coverage at

[nadinbrzezinski]

10. hmm it is, as I said yesterday, accelerating

[RaleighNCDUer]

12. Still holding at 6+% mortality - which is really high for flu.

The 1918 pandemic only had 2-3% mortality, but was VERY virulent with a 25% infection rate.

If it were to get loose in the US, that would translate as 75 million cases and 1.5 million fatalities today.

If the new flu has a similar virulence and a 6% mortality, that's 4.5 million dead in the US alone.

I can understand why they're a little worried.

-----

Wash your hands. Go to the movies on Tuesday afternoon, instead of Saturday night.

[jsamuel]

16. 6% in Mexico, 0% in US

I am sure that some countries might have different death rates.

[nadinbrzezinski]

17. That will be part of the mystery, or we just haven't had enough infections yet

also they didn't start doing the mandatory reporting of every death until they realized it was that.

I wonder, aloud mind you, if we have a similar situation here and if we started testing material from people who died from pneumonia in the last few months would be positive for this

After all the first cases in Cali were in late march

In mexico they saw an uptick of flu when it should be crashing... and initially they thought it was the run of the mill flu

[Art_from_Ark]

23. Undoubtedly some countries will have different rates,

with the higher death rates occurring in 3rd world countries where the sanitary conditions are so bad, you can't even drink the friggin' tap water without risking your health.

[Hannah Bell]

18. of those 149, only 20 are*confirmed* as being due to this virus.

[Mojorabbit]

19. This just now on twitter

Swine flu reaches Asia. South Korea confirms the first case, according to officials quoted by Yonhap.

This is where it may get interesting if this flu mixes it up with some Asian strains of bird flu.

[Mojorabbit]

20. also on twitter

Australia: Queensland’s Pandemic Plan Activated in Response to 14 Suspected Cases.

New Jersey: Five Probable Cases of Swine Influenza Identified in Travelers from Mexico and California

North Carolina: Health officials involuntarily isolate an unspecified number of suspected cases and test for swine influenza.

Idaho: Four residents with influenza-like symptoms tested for swine influenza; three of the cases had traveled to Mexico or Texas

US, Texas, Dallas County: Health Officials Confirm Two Additional Cases of Swine Influenza; State Total Rises to Six

Australia: Queensland health officials remove two women with influenza symptoms from returning Quantas flight from Los Angeles in Brisbane

Yonhap news agency says now that the case is not confirmed in South Korea and tests are underway.

CBS 2 HD has learned of a confirmed case of swine flu at the Ernst & Young headquarters in Times Square.

[nadinbrzezinski]

22. It took tracking the tweat... but N.Carolina is isolating

people in home quarantines

http://www.starnewsonline.com/article/20090427/ARTICLES/904279972/1177?Title=No-N-C-swine-flu-cases-but-officials-preparing

[Mojorabbit]

24. More on twitter

which I am amazed has been so pretty accurate but maybe it is the sites I am following, I have no idea.

US, Arkansas: Health Officials Believe Swine Influenza Already "Spread Across" State.

US, Texas: Nueces County Officals Tracking Four “Possible” Swine Influenza Cases.

US, Santa Cruz: At Least One Suspected Swine Influenza Case Registered; Case’s Daughter Being Tested

US, Texas: Guadalupe County Teacher Displays Symptoms of Swine Influenza.

US, Arkansas: Residents of Tennessee Valley inundating hospitals for swine influenza testing.

[nadinbrzezinski]

25. Been tracing them

at this point I do expect to see first deaths

No way this rate can continue and no deaths

NO WAY now how

Even if this was run of the mill flu ... and it is not

Grim, yes

[Hannah Bell]

26. "grim" - no deaths, but "grim". okey dokey.

[Mojorabbit]

27. more from twitter

US, California: 20 people with "severe" influenza-like symptoms, some recently visited Mexico, according to public health officer.( I wonder what they mean by severe)

US, California: Santa Clara public health officials testing 12 samples for swine influenza virus.

US, California: San Diego County Reports Five Confirmed Cases and Two Probable Cases of Swine Influenza

Canada: Total of Eight Cases of Swine Influenza Identified Nationwide

US, Colorado: Possible Case of Swine Influenza Detected in an Ouray County Resident Returning From Mexico.

South Korea: Suspected Swine Influenza Case in Gyeonggi a 50-Year-Old Female Returned from Mexico Via Los Angeles

US, El Paso: Four Residents Being Tested for Swine Influenza

US, California: Two Additional Cases of Swine Influenza Confirmed in Students; Total of 13 Confirmed Cases Statewide

Officials confirm 2 more swine flu cases at St. Mel school in Fair Oaks, California, bringing the total cases in the state to 13.

[bottomtheweaver]

28. No wonder they were pushing twitter so hard.

Easier way to spread panic.

[Mojorabbit]

29. I am using two feeds

one is breaking news. Both have been very accurate and articles confirming them appear shortly in the msm.
I don't see any panic.
I for one am very glad to be able to get up to the minute information.

[Mojorabbit]

30. twitter update

Sources tells the BBC 8 possible swine flu cases in Wales, could bring total possible cases to 31 in the UK.

UPDATE -- Official says at least 23 possible swine flu cases in Scotland after at least 14 were discovered in the last hours.

FLU UPDATE -- Three of the 10 students, who travelled to Mexico on a school trip from New Zealand, have tested positive for swine flu.

FLU UPDATE -- Israel confirms first case of swine flu; British Airways is not canceling its flights to Mexico.

Sky News: World Health Organization says there are several swine flu cases in China.

Australia, Queensland: Six new suspected cases under investigation; total reaches 16. Some cases along the Gold Coast and in Brisbane.

US, Michigan: Authorities investigating possible swine influenza case in a 41-year-old woman from Kent county

Australia: Government gives health officials right to "forcibly" detain and disinfect suspected swine influenza cases

Austria, Steyr: One Suspected Swine Influenza Case Reported in a 28-Year-Old With Recent Travel to Mexico

Czech Republic: New suspected swine influenza case. Patient under observation at Motol Hospital in Prague.

Vietnam: Health Officials Report Ten Visitors from Mexico Under Observation for Swine Influenza

Russia, Moscow: Suspected swine influenza case diagnosed with Acute Respiratory Viral Infection; confirmatory tests pending.

Uruguay: Health Minister announces one suspected swine influenza case under investigation

Argentina: Ten suspected swine influenza cases reported. Reports indicate all flights to Mexico have been suspended.

Mexico: Health Minister announces 3 new fatal, suspected swine influenza cases occurring over the past 24 hours; total reaches 152.

Thailand: One suspected swine influenza case hospitalized in Bangkok. Patient returned from Mexico in early April.

Spain: Health officials confirm second swine influenza case. The individual is currently receiving treatment at a Valencia hospital.

Hong Kong: Tests four new individuals with influenza-like symptoms for swine influenza. Three cases under investigation yesterday cleared.

[davsand]

31. I have to wonder how many cases of ANY disease there are on any given day across the world.

I'm not minimizing the danger of a flu pandemic, nor am I denigrating the attention paid to Swine Flu right now, but I have to wonder how many cases of any given virus are gonna turn up worldwide if health officials were to make a concentrated effort to screen for it.

No doubt, this current round of flu is something to watch and most certainly the public health folks and the Emergency Services people NEED to be on top of it. I don't think that can be disputed. I feel a whole lot better knowing this is not the same crew running stuff now as it was for Katrina, but I will admit that I'm hoping this is all just an unnecessary exercise.

:shrug:

Laura (who is home with a sick kid today)

[Mojorabbit]

32. This fellow in Mexico just tweeted the press conference

that just ended
Happening now.
Press conference just started

Mexican health minister says they have a new death toll
Minister says they have checked 100 pct of all cases in public hospitals, there are new cases not considered, and add others

Mexican Health Secretary says 159 deaths 'confirmed' of swine flu, they are checking another 150 deaths.
Total of number cases, 2498 cases of possible swine flu in Mexico

1300 in hospitals in Mexico by swine flu right now
Jesus... the reporter just made like 10 questions at same time... She said, why the death toll is exclusive for TV (Televisa)

By laboratory tests, there are 26 cases of swine flu in Mexico; of that number, 7 people have died. (Yes, they dont have resources

Mexico City have more deaths, then Mexico State, then San Luis Potosí. Minister says there are no special treatment to dead bodies.

159 is the official... they have a lot more but they dont know if there's flu related or not...

BTW, the death rate is not falling or jumping, same level in the last days, but number of cases are doubled...

Confirmed by laboratory = 7 deaths. By Influenza, 159... other deaths, around 150... thats he said...

Health Secretary says there is no exponential growth of dead & contagied, but sustain

Televisa question, if they agree with the WHO about only 7 dead...

Not exponential, but stable (the death rate)... but number of cases are doubled...

Bad response... they need to say that they dont have equipment for tests... thats why they dont have too much confirmed deaths...

From a revised toll from all over the country.... yes.. they are working in the 'scientific method', u know, 1 + 1 + 1

I mean... yesterday 30, today 30 for example; nothing like yesterday 30, today 90...

yes, there are not less deaths, the illness is not peaking yet...

He's now talking about other 152 dead not in the official death toll... minister said 'we dont know'

They are working to confirm if other 152 aditional deaths are from flu... if confirmed, official death toll is over 300

2498 cases with 159 swine flu related deaths, and other 152 of unknown cause

66 more tests will be concluded tonight

I think thats to combat the panic... The are doing a terrible job...
Basically, they are saying, we have over 300 deaths... 159 of possible swine flu, others, 'they dont know', only 7 confirmed by laboratory

# Press conference just ended... was almost a riot... not good responses, reporters were angry and confused...


This does not sound good. Mojo

[FedUpWithIt All]

33. It seems that they are calling all influenza A positive results "confirmed"

Which according to the WHO is an official "suspect" case/death.

1. A Confirmed case of swine influenza A(H1N1) virus infection is defined as an individual
with laboratory confirmed swine influenza A(H1N1) virus infection by one or more of
the following tests*:
• real‐time RT‐PCR
• viral culture
• four‐fold rise in swine influenza A(H1N1) virus specific neutralizing antibodies.
2. A Probable case of swine influenza A(H1N1) virus infection is defined as an individual
with an influenza test that is positive for influenza A, but is unsubtypable by reagents
used to detect seasonal influenza virus infection OR
A individual with a clinically compatible illness or who died of an unexplained acute
respiratory illness who is considered to be epidemiologically linked to a probable or
confirmed case.

The WHO will only confirm cases that are tested at one of the "pre-approved" lab facilities.

[Mojorabbit]

35. There was this letter to the bbc today

I think they are overwhelmed.

The number of cases increases significantly every day. The number of fatalities is also increasing. At least three doctors are said to have died from swine flu. There is great fear among the medical community. We know that the situation is very serious and that we are at high risk of infection.

But we are more scared of carrying it into our homes and infecting our loved ones. One of my colleagues that was exposed chose to stay in a hotel rather than run the risk of infecting her daughters.

These fears are getting worse as we realise that it is not possible to get antiviral drugs from pharmacies and that in the health sector they are close to being delivered in droppers.

Despite this, the government says that it can rely on antiviral drugs to treat a million cases. We do not have easy access to these, even though we are part of the health sector.

In one hospital doctors were given the anti-viral rimantadine, even though there is resistance to this drug. Also, fewer samples are being taken from severe cases, as there is a lack of means of transporting and cultivating the samples.
Dr Guadalupe
http://news.bbc.co.uk/2/hi/talking_point/8018428.stm

[FedUpWithIt All]

36. Yes I saw that. Other letters have also reported the issue with the risks to Dr.s

Lot of talk from different sources about resource issues too.

Time will out the truth. Always does.

:hi:

[Hannah Bell]

34. Something different being reported in print media from the same news conference.

http://news.xinhuanet.com/english/2009-04/29/content_11276236.htm

MEXICO CITY, April 28 (Xinhua) -- Three more people died in the last 24 hours of swine flu, Mexico City officials told a Tuesday press conference, adding that local authorities had ordered the closure of more public places.

The total number of deaths in the city believed to be related to swine flu is now 25, while 89 people are in hospital with swine-flu symptoms, said Armando Ahued Ortega, head of the city's health department. He said that 31 people had been hospitalized on Monday while 14 had been discharged from hospital.

He said that Mexico City now has 320 people believed to have been infected with swine flu, down from 326 on Monday and 351 on Sunday. Five people died on Sunday, compared with three on Monday.

He said that Mexico City now has 320 people believed to have been infected with swine flu, down from 326 on Monday and 351 on Sunday. Five people died on Sunday, compared with three on Monday.

[Mojorabbit]

38. That article is six hours old

I may be wrong but this press conference just ended?

[Hannah Bell]

39. I understood it occurred this afternoon. It's 9 pm or later in most parts of Mexico now, I believe.

I'm not sure why they'd give two press conferences in one day & report different facts.

Here's the Latin american herald tribune, which reports precisely the opposite spin of your twitters:



http://www.laht.com/article.asp?ArticleId=333191&CategoryId=14091


Mexico Flu Deaths Rise to 155

MEXICO CITY – The number of deaths authorities are blaming on Mexico’s swine-flu outbreak stood at 155 on Tuesday, though only 20 of those fatalities have been definitively linked to the A/H1N1 virus.

Mexican Health Secretary Jose Angel Cordova announced a death toll of 152 in an interview Monday night with Televisa television, but municipal officials in this capital subsequently reported three more flu-related deaths.

Hours before, the secretary had said at a press conference that the panorama was “hopeful,” since the death rate due to the outbreak of swine flu had fallen over the past three days.

He also said that there had been a reduction in the number of people infected in the last few hours, since on Monday there were 110 cases compared with 119 on Sunday and 141 on Saturday.

Cordova said that starting Tuesday laboratory tests will start in Mexico to confirm the presence in patients of the A/H1N1 virus, since up to now samples have been send outside the country because of the lack of equipment for making the diagnosis here.

He said that by Wednesday, when additional equipment is due to arrive, Mexico will be able to carry out as many as 600,000 tests per day.

Mexico City’s mayor, Marcelo Ebrard, said Tuesday that since Saturday the cases of probable contagion of swine flu in the capital have diminished.


On edit: though it seems the press conference referred to in *this* report was Monday?
But the article is dated today, so it's not clear.

[Mojorabbit]

40. The whole thing is confusing

I looked for a msm report too and there have been so many press conferences I can't find it. It will come out in the news tomorrow one way or another. It would not surprise me if things are interpreted incorrectly. The situation is so fluid.

[Hannah Bell]

41. putting the sources together, i'd bet 159 = "suspected" & lab confirmation

is proceedings.

seems improbable 130+ lab results would all come back in one batch.

tomorrow we'll know more surely, agreed.

[Mojorabbit]

42. You are probably right.

It doesn't make sense to have a doubling of cases in one day. Hopefully this is the case.

[Hannah Bell]

37. Latin american print media say something different:

http://www.laht.com/article.asp?ArticleId=333191&CategoryId=14091

Mexico Flu Deaths Rise to 155

MEXICO CITY – The number of deaths authorities are blaming on Mexico’s swine-flu outbreak stood at 155 on Tuesday,

*though only 20 of those fatalities have been definitively linked to the A/H1N1 virus.*

Mexican Health Secretary Jose Angel Cordova announced a death toll of 152 in an interview Monday night with Televisa television, but municipal officials in this capital subsequently reported three more flu-related deaths.

Hours before, the secretary had said at a press conference that the panorama was “hopeful,” since

*the death rate due to the outbreak of swine flu had fallen over the past three days.*

He also said that

*there had been a reduction in the number of people infected in the last few hours, since on Monday there were 110 cases compared with 119 on Sunday and 141 on Saturday.*

Cordova said that starting Tuesday laboratory tests will start in Mexico to confirm the presence in patients of the A/H1N1 virus, since up to now samples have been send outside the country because of the lack of equipment for making the diagnosis here.

He said that by Wednesday, when additional equipment is due to arrive, Mexico will be able to carry out as many as 600,000 tests per day.

[FedUpWithIt All]

43. This thing has a whopping CFR of 27% according to the who official numbers. n/t

[OmmmSweetOmmm]

44. A 23 month old, confirmed death in Texas. Poor baby. :(

[FedUpWithIt All]

45. Sad news.

:(

[Mojorabbit]

46. As Swine Flu Spreads, Its Chances to Mutate Increase

TOKYO-Swine flu has reached Asia, with South Korea reporting its first suspected case yesterday. Like the vast majority of other cases outside Mexico so far, it is mild, but virologist Kennedy Shortridge warns that is no reason for complacency. He says that the farther the virus spreads, the more chance it will mix, or reassort, with other flu viruses in circulation and turn into something more lethal. "The prospects for change are considerable and worrying," he says.

Shortridge is a professor emeritus at the University of Hong Kong, where he led investigations into the initial emergence of H5N1 avian influenza in 1997, when it killed six of the 18 people it infected. The city squelched that outbreak by slaughtering all 1.4 million chickens and ducks in the territory.
snip

Analysis of flu specimens by Canada's National Microbiology Laboratory in Winnipeg and at the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia, have found that the virus is made up of pieces of human, swine, and avian viruses from North America, Europe, and Asia. The mixture "gives an order of complexity we really don't understand at this point," Shortridge says.

In particular, he says he is concerned that this patched-together virus might not be stable and could easily reassort with other viruses encountered in a human or animal host. The virus has now spread to Asia, where the H5N1 virus is circulating. And he says that in many areas there are strains of human H1N1 in circulation that are resistant to Tamiflu, the drug of choice for treating the disease in humans. He speculates that swapping one or more genes among these viruses could result in a virus that is more pathogenic or more easily passed from person to person or both.

As a precaution, Shortridge suggests sequencing as many viral samples as quickly as possible to watch for any telltale changes in the virus-a massive job requiring worldwide cooperation. He says such cooperation seems to be off to a good start, thanks to the experience of dealing with the 2003 SARS crisis and recent efforts to prepare for an influenza pandemic. "There is a success story in this in that the world is alert" to the possibility of a pandemic, he says. Still, he adds, even better collaboration and communication will be required in the face of a threat that could change overnight.
http://blogs.sciencemag.org/scienceinsider/