WHO: only 7 swine flu deaths, not 152. So why are they raising the pandemic level again?

[Hugabear]

They tell us that it's not as bad as we all think...

http://www.smh.com.au/world/only-7-swine-flu-deaths-not-152-says-who-20090429-aml1.html

<snip>
A member of the World Health Organisation (WHO) has dismissed claims that more than 150 people have died from swine flu, saying it has officially recorded only seven deaths around the world.

Vivienne Allan, from WHO's patient safety program, said the body had confirmed that worldwide there had been just seven deaths - all in Mexico - and 79 confirmed cases of the disease.
<snip>

And then they go and raise the pandemic level to 4 to 5, the second-highest rating possible?

http://www.reuters.com/article/topNews/idUSTRE53N22820090429

<snip>
The World Health Organization warned on Wednesday that a global flu pandemic was imminent, raising its threat level as the swine flu virus spread and killed the first person outside of Mexico, a toddler in Texas.

"Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world," WHO Director General Margaret Chan told a news conference in Geneva.
<snip>

So which is it?

[Tangerine LaBamba]

1. One word:

Hysteria.

[kestrel91316]

27. Which WHO or CDC officials are hysterical? Do tell.

They are just following established medical criteria in hopes of avoiding a preventable medical catastrophe.

[Tangerine LaBamba]

32. Not either ..........

The reactions of some of the populace, who are behaving as if thousands had died.

Does that work for your cute little "Do tell"? I honest to god hope so, because I'm not sure if I can go on otherwise .......................

[NightWatcher]

2. a pandemic warning for 7 deaths? something smells

[Fla Dem]

62. Geographic spread is rapid, no vaccine to PREVENT catching H1N1 like other strains,

Concern virus may mutate to a more lethal strain as it is passes from human to human. This is a new, unknown virus. Therefore it's course is unknown. Everyone is potentially susceptible. Rather err on the side of caution.

[nadinbrzezinski]

3. I tried to explain this to you, but obviously missed the why

you think this is a conspiracy and the WHO is just getting their jollies out of it?

If you do... then there is nothing we can do about it and the pigs where thrown from the sky into La Gloria, after the bug was cooked by the CDC may find some appeal with you

[EFerrari]

4. After Katrina, I don't mind everyone being a little too careful.

:(

[suffragette]

7. Agree with you, Beth, and I like that agencies are being proactive

rather than waiting until things are worse.

[EFerrari]

19. Maybe the problem is, we're not used to a competent government taking

appropriate action. We're used to neglect or to fear mongering and it's going to be a while until we all recalibrate our expectations, imho.

[suffragette]

29. Great points

We've been in a place of distrust and the need to thoroughly examine actions for ulterior motives for so long that it will likely take awhile before those expectations and reactions shift.
Looking forward to it, though.

[JitterbugPerfume]

22. amen to that!

:hi:

[TwilightZone]

5. Person-to-person transmission in neighboring countries.

Someone posted a link to the explanation for level 5, and it said something like that. From the description, the increase in level seemed apt.

[Mike 03]

6. I admit, this is getting confusing, but I would rather err on the side of caution, I guess. NT

[kestrel91316]

30. Don't try to read CDC or WHO boilerplate. Stick with the public

information statements, lol.

I have a medical background and can't make sense out of some of their written policies and stuff.

[Deep13]

8. A pandemic refers to the geographic distribution, not the lethality.

Anyway, the deaths reported still amount to a small, but significant mortality rate similar to the 1918 flu.

[Skidmore]

48. Several members of my grandfather's family died in the 1918

pandemic. He never forgot how quickly they sickened and died.

[DevonRex]

9. Some of those bodies are long buried and won't be dug up for testing.

But if Patient G died of the flu and it was confirmed that it was swine flu, and Patient G's mother died of the flu, but not confirmed swine flu, a week earlier, then it is probable that Patient G's mother also died of swine flu.

[dogindia]

10. this seems very strange. So much alarm. Why?

Thousands and thousands die of flu every year. Why is this being hyped like this? It seems be be a kind of media event. Warnings are one thing but not that many have died.

[Mojorabbit]

23. The confirmed WHO totals

are always very much low balled. They started taking some country's lab results to add to their totals but do not do so for every country. At least this is how it has worked for the bird flu. I treat their numbers as totally unreliable after following the process for the past five years.
This is the reason for the upgrade I believe besides the geographic spread.
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x5543387#5561803

[Fleshdancer]

11. I thought it had to do with the speed and distance of its spread

and not due to the amount of deaths. :shrug:

[nadinbrzezinski]

15. Also I gave him in the boring details as to how defininte and probable

are classified

Hell, most of the cases in the US are probable, since we are not testing every thing for H1N1, but it is Influenza A, it is a possible one

[Fleshdancer]

18. I've learned a lot from your posts this week

You've been providing very useful information. :thumbsup:

[reggie the dog]

26. can you point me out some ot those details?

you seem much better informed than I am, do you have links please?

[nadinbrzezinski]

36. The mexican press has been doing yeoman's work in putting it in ahem

Spanish

http://www.eluniversal.com.mx/notas/594674.html

En rueda de prensa, el director del Centro Nacional de Vigilancia Epidemiológica y Control de Enfermedades, Miguel Angel Lezana, informó que el laboratorio podrá analizar cada seis horas un paquete de 65 muestras para determinar si existe la nueva cepa de influenza porcina conocida como AH1N1.

During a press conference, the director of the national center for epidemiological diseases (CDC equivalent), Migel Angel Lezana, said that the lab can test 65 samples every six hours, to determine if any has AH1N1

That is one example of good articles

I WISH our press did this

Oh and more technical

http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-1998-cdi2205-cdi2205a.htm

[reggie the dog]

60. thanks, sadly I am bilingual but english french not english spanish

I will try to make my way through those pages though, but my verb conjugations in spanish will leave me clueless as to know if something has happened, should have happend, could have happened, would have etc.

[Canuckistanian]

12. It's not based on "body count"

It's based on the potential to cause serious, widespread infection.

The same flu that manages to be adequately controlled in rich countries like the US can become a deadly killer of millions in underdeveloped countries.

Remember, this is a worldwide pandemic rating.

[Redbear]

13. There is a specific protocol dealing with number of countries

involved and whether the virus is now being spread person to person

It has nothing to do with death rates.

[dkofos]

14. Until they get their facts straight, they are just feeding the hysteria.

Along with the M$M.

[kestrel91316]

33. Who is feeding the hysteria? The CDC? The WHO??

The MSM is behind any "hysteria". Medical professionals are conducting themselves, well, PROFESSIONALY. They are doing their jobs - something in short supply under Bush.

[northzax]

39. no, they're just doing their jobs

which is to constantly be on alert for anything that even has a whiff of pandemic about it. That's one of the reason we have them. The problem comes from people who don't understand those reports blowing the information out of proportion, and from people making reasonable, if very conservative, decisions related to stopping the spread of the infection. people then hear 'flu' and 'pandemic' without getting all the details for themselves (because we are, after all, people. it's what we do) There has been some very good reporting, and some very bad reporting. but is it worth having half the threads in LBN and GD dedicated to it at this point? probably not.

[tridim]

16. Does anyone know how many people died of swine flu last year?

Did they even test for it?

[reggie the dog]

28. Did it exist?

I have a toddler, first we hear that it is us, the parents, in the at risk age category, now it is killing kids, do any scientists really know what the score it?

[tridim]

35. It just seems like it would be easy to lose specific strains in the big picture..

Considering some 30 thousand Americans die from the flu every year. That's a lot, even measured per day. I'm just wondering if they tested every casualty for the exact strain?

[kestrel91316]

34. Surveillance is ongoing. This particular flu did not exist last year.

It is a novel virus. That means NEW.

[endarkenment]

40. "They" have been tracking related influenza viruses for decades.

Because this particular branch of the flu is a known recurrent pandemic agent with varying lethality.

[Bucky]

17. They want to distract you from the Arlen Specter defection

Ha-ha, just kidding. Of course what they really wanna distract you from is Obama's plan to come take away your guns.

[EFerrari]

21. They can keep their guns but they have to take Cheney, too.

lol

[uppityperson]

20. To open up more testing, monitoring, investigations, to keep it from growing around the world

Realize that the number who have been diagnosed or dead is smaller than the number that truly have had it or died since not everyone has been tested.

Raising the level means that there are now more things available to monitor the situation, which is changing rapidly. As more tests become available, and more are tested, more will show up positive.

This does not mean OMG WE'RE GONNA DIE, but that they are more able to keep an eye on this unusual virus. Here in the USA, and in other countries (oh hell, what's the current term? Developed? Industrial? ) we will be watched more closely. In poorer countries, those without the sanitation, etc etc etc, once this starts spreading it could get very bad.

Upping the level/phase ALSO means they have recognized that it has spread to a couple countries and can spread further. Would you rather have them just ignore it and have, say, Nicaragua have a lot of dead people?

WHO is World Health.

[kestrel91316]

24. Oy. Teh stupid. It hurts.

FYI, they raised the level because this outbreak meets the criteria for raising the level. These things are done out of an abundance of caution. Would you have WHO wait until hundreds are dead before acting?

Mexico probably doesn't have the money to test even 1% of the suspected victims.

[nadinbrzezinski]

37. They now have a lab, as of today

they can test 65 samples every six hours

WHO and federal funds

One thing the alert raising does

:-)

I posted the link at the home thread and unthread here

[endarkenment]

38. It isn't even a level, it is a phase in their pandemic model.

And they are simply, as you say, following their own pre-existing classification guidelines for tracking H1N1 influenza. Actually they are being quite conservative in their approach.

I think what a lot of people don't get is that this strain of flu is very infectious once it starts transmitting within a species, and that the assumption from WHO and CDC, based on their decades of research, is that once documented widespread human-human infections have started a global pandemic is inevitable. That is why we are at phase 5. This bug is going to travel the globe, the remaining unknowns are how infectious and how lethal.

Still - don't panic, but do pay attention and be aware.

[readmoreoften]

45. Cuz the world's top epidemiologists are conspiring to profit off freeze dried food outlets.

:crazy:

What? Mexico doesn't have the money to test all their victims? Impossible! Cash is unlimited!

[bluedawg12]

51. "Alert" levels to prevent deaths from pandemics.

It's predictive, it is not a body count.

Boogers! :hi:

[Bluebear]

25. I imagine professional epidemiologists have made the determination

[bluedawg12]

46. Yes, if we waited for "death" rates to climb before mobilizing

then an alert level would not be very useful.

[Puzzler]

31. Just an aside, but the WHO has only had this rating system for 5 years

.

[Danger Mouse]

41. We want to be ready. That's all it is.

[FLAprogressive]

42. 7 *CONFIRMED* deaths....many more unconfirmed deaths in Mexico.

[BuyingThyme]

43. Point taken, but I don't think a disease has to be deadly in order to qualify for pandemicity.

[bluedawg12]

44. WHO Phase follows the spread of disease not death rates.

They cannot wait for death rates to climb before mobilizing resources.

[RamboLiberal]

47. Confirmed deaths are 7

A total of 159 people have died of pneumonia that may have been caused by the mutant H1N1 swine flu virus, Jose Cordova, the health secretary, said.

Ten of those had died in the last 24 hours.

-----

Mexican authorities have also revised down the confirmed death toll from swine flu from 20 to seven. No one outside Mexico has died.

Despite the slowdown in deaths, the overall number of people hospitalised with swine flu symptoms has continued to rise

By Tuesday night, there had been a total of 2,498 taken into care with respiratory problems believed to be related to swine flu. Of these 1,311 were still bed ridden and fighting the sickness while the others had left after successfully responding to treatment.

http://www.telegraph.co.uk/health/swine-flu/5240390/Swine-flu-Death-rate-slows-in-Mexico.html

I think they don't have the tests back yet on the other deaths. It's not as low as 7 and probably not as high as 159.

[bluedawg12]

49. It is not a pandemic level, there is no pandemic, it is an "alert" level.

That's very important, we don't want public health officials keeping tally of the dead after it's too late to thwart a pandemic, it's better that they alert the world to take measures to avoid a pandemic.

[sam sarrha]

50. they are making a determination between flu and Pnemunmonia..but dead is dead cause they got the flu

[bluedawg12]

53. Not really. The Alert is preventative based on spread.

I replied to your thread on the flu, pneumonia and "missed diagnosis" yesterday.

Not sure if you got a chance to read it. I reposted it today, "ARDS" a type of deadly lung inflammation caused by some viruses.

I reposted it on uppityperson's OP, which is a great source for info. on H1N1 in general, but just to let you know, I did reply to your question about missed diagnoses etc.


Here is where you can find it currently, it might help explain a little bit more. :)

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5561804&mesg_id=5562133

[sam sarrha]

52. first off, CYNICISM is a mental illness... here is a >>link>> explains the flu deaths.. the flu

still started it, so the flu in the end killed them..

http://www.voanews.com/english/Africa/2009-04-28-voa26.cfm
"...The head of a US research firm says the deaths caused by the swine flu outbreak may be partly due to an overactive immune system – not a weakened one..."

"...Moskowitz says the high immune response is caused by what's called a cytokine storm, a "tremendous outpouring of cytokines, of factors released by white cells that get other white cells really jazzed up." He says, "It's these white cells…that basically…turn the lung into a totally cellular organ like a liver, so it can't exchange gas anymore."SNIP

THIS SHOULD BE INVESTIGATED.. to see if it is a factor, but since it is REALLY cheap and easy they wouldnt use it

[bluedawg12]

54. I replied yo you on this yesterday Sam, it's called ARDS.

IT IS investigated. It is well known.

I described the cytokione storm to you yesterday...in a reply to your question.

Reposted here today:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5561804&mesg_id=5562133

[sam sarrha]

56. the article said it hadnt been tested on swine flu... it should be.. thank you for your wonderful,

informative and interesting post..

[bluedawg12]

59. Your very welcome, Sam. Keep us posted on this research.

It would be great to find something that's already there, on the market and maybe not all that expensive.

Anyway, this is interesting and it wil be fascinating to see how it would compare to steroids that are sometimes reqired to treat the inflammation.

One recent study looked at COX-2 inhibitors, like the commonly known Celebrex! So, never say never in science.

This might be of interst. :) Nonsteroidial anti-inflammatory drugs = ibuprofen, who knows, for early stages?

This is exciting stuff. :hi:

Am J Emerg Med. 2008 Jul;26(6):711-5. Links
The cytokine storm and factors determining the sequence and severity of organ dysfunction in multiple organ dysfunction syndrome.Wang H, Ma S.
Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Tsinghua University, Beijing 100730, PR China.

Multiple organ dysfunction syndrome (MODS) is a major cause of morbidity and mortality in intensive care units. It is being encountered frequently in critically ill patients owing to advancements in organ-specific supportive technologies to survive the acute phase of severe sepsis and shock. It is now believed that MODS is the result of an inappropriate generalized inflammatory response of the host to a variety of acute insults. The pathologic mechanisms of MODS were reviewed, and factors determining the sequence and severity of organ dysfunction were discussed in depth. In the early phase of MODS, circulating cytokines cause universal endothelium injury in organs. In the later phase of MODS, overexpression of inflammatory mediators in the interstitial space of various organs is considered a main mechanism of parenchyma injury. The difference in constitutive expression and the upregulation of adhesion molecules in vascular beds and the density and potency of intrinsic inflammatory cells in different organs are the key factors determining the sequence and severity of organ dysfunction. By activating the intrinsic inflammatory cell in a distant organ, organ dysfunctions are linked in a positive feedback loop through circulating inflammatory mediators. Antagonists targeted at adhesion molecules may alleviate the severity of endothelial damage. And nonsteroidial anti-inflammatory drugs or steroids administered judiciously in the early phase of MODS may retard the progress of multiple organ failure.

[bluedawg12]

55. This has been studied, there are publshed articles on this.

Here is my reply to your OP yesterday.

Cytokine storm can cause adult repsiratory distress syndrome, it can start off looking like pneumonia but can rapdily turn deadly.

It is well known, it has treatments, there is research on this.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5555735&mesg_id=5557592

[sam sarrha]

57. the article said it hadnt been tested on swine flu... it should be.. >>link>>

http://www.voanews.com/english/Africa/2009-04-28-voa26.cfm

"snip...The blood pressure drugs the company uses for West Nile haven't been shown yet to work for swine flu, so clinical trials are necessary. But he says these drugs are safe, cheap and available...snip"

^^^^^ that was what i was refering to... there is apparently no/or inconclusive data on this process and Swine flu

i used to do Biological research, and Taxonomy on Bacteria. thank you for the specifics, but i was dealing with more with the "over view"

[bluedawg12]

58. Yup. He should present his data .

This topic is under active investigation. He just needs to present his research to his peers in a published paper.

There is work being done on this. Hope it turns out to be useful. Keep us posted!


............
Mikrobiyol Bul. 2008 Apr;42(2):365-80.Links
Us D.
Hacettepe Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.

The most dramatic example of defining the pathogenicity of influenza virus A/H5N1 strains is the higher fatality rate of avian influenza epidemic (>50%) occured in Southeast Asia in 1997 comparing to the pandemic caused by influenza virus A/H1N1 in 1918 (5-10%) which was recorded as the most destructive pandemic in the world. When considering the fatal/total case numbers (208/340) reported by World Health Organization in respect of December 14th, 2007, the mortality rate has now reached to 61 percent. Recent studies have shown that the high fatality rate of avian influenza virus infections is a consequence of an overactive inflammatory response and the severity of infection is closely related with virus-induced cytokine dysregulation.

The most important feature of A/H5N1 immunopathogenesis is the appearence of hypercytokinemia ("cytokine storm") which is characterized by the extreme (exaggerated) production and secretion of large numbers and excessive levels of pro-inflammatory cytokines.

This phenomenon is blamed on the emergence of lethal clinical symptoms such as extensive pulmonary oedema, acute bronchopneumoniae, alveolar haemorrhage, reactive haemophagocytosis, and acute respiratory distress syndrome, associated with necrosis and tissue destruction.

Numerous in vitro, in vivo and clinical studies have pointed out that A/H5N1 viruses are very strong inducers of various cytokines and chemokines , in both humans and animals.

The privileged cells of cytokine storm are macrophages and CD8+ T-lymphocytes, while the primary contributor cytokines are TNF-alpha, IL-6 and IFN-gamma.

It has been detected that, mutations of some viral genes (NS1, PB2, HA and NA) are responsible for the cytokine storm, by increasing the viral replication rate, expending the tissue tropism, facilitating the systemic invasion and emerging of resistance against the host antiviral response. It has been shown that Glu92 and Ala149 mutations, and carboxyl-terminal ESEV/EPEV motif of NS1 protein have been implicated as determinants of virulence for A/H5N1 strains.

In addition, Lys627 mutation in PB2 protein, polybasic aminoacid mutations in the cleavage region of hemagglutinin (HA) polyprotein, and glycosylation and sialylation mutations in HA and neuraminidase (NA) proteins were found to enhance the immune-mediated patology of highly virulent A/H5N1 strains. In this review article, the immunopathogenesis of influenza infection and the mechanisms of cytokine storm caused by influenza A/H5N1 viruses have been discussed under the light of recent literature.
............

Curr Opin Anaesthesiol. 2009 Apr;22(2):143-9.
Alterations of mitochondrial function in sepsis and critical illness.Harrois A, Huet O, Duranteau J.
Département d'Anesthésie-Réanimation, AP-HP, Université Paris Sud XI, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

PURPOSE OF REVIEW: Septic shock is the consequence of a conflict between a pathogenic agent and the immune system of the host. This conflict induces an immune-mediated cytokine storm, with a whole-body inflammatory response often leading to multiple organ failure. Although extensively studied, the pathophysiology of sepsis-associated multiorgan failure remains unknown. One postulated mechanism is changes in mitochondrial function with an inhibition of mitochondrial respiratory chain and a decrease of oxygen utilization. RECENT FINDINGS: Mitochondrion is a key organelle in supplying energy to the cell according to its metabolic need. Hypoxia and a number of the mediators implicated in sepsis and in the associated systemic inflammatory response have been demonstrated to directly impair mitochondrial function. A large body of evidence supports a key role of the peroxynitrite, which can react with most of the components of the electron transport chain, in the mitochondrial dysfunction. SUMMARY: A pivotal role is suggested for mitochondrial dysfunction during the occurrence of multiorgan failure. Understanding the precise effect of sepsis on the mitochondrial function and the involvement of mitochondria in the development of multiple organ failure is fundamental. More human studies are thus necessary to clarify the mitochondrial dysfunction in the various phases of sepsis (early and late phase) before testing therapeutic strategies targeting mitochondria.

.............

PLoS ONE. 2009;4(2):e4643. Epub 2009 Feb 27.
Rapid regulatory T-cell response prevents cytokine storm in CD28 superagonist treated mice.Gogishvili T, Langenhorst D, Lühder F, Elias F, Elflein K, Dennehy KM, Gold R, Hünig T.
Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany.

Superagonistic CD28-specific monoclonal antibodies (CD28SA) are highly effective activators of regulatory T-cells (Treg cells) in rats, but a first-in-man trial of the human CD28SA TGN1412 resulted in an unexpected cytokine release syndrome. Using a novel mouse anti-mouse CD28SA, we re-investigate the relationship between Treg activation and systemic cytokine release. Treg activation by CD28SA was highly efficient but depended on paracrine IL-2 from CD28SA-stimulated conventional T-cells. Systemic cytokine levels were innocuous, but depletion of Treg cells prior to CD28SA stimulation led to systemic release of proinflammatory cytokines, indicating that in rodents, Treg cells effectively suppress the inflammatory response. Since the human volunteers of the TGN1412 study were not protected by this mechanism, we also tested whether corticosteroid prophylaxis would be compatible with CD28SA induced Treg activation. We show that neither the expansion nor the functional activation of Treg cells is affected by high-dose dexamethasone sufficient to control systemic cytokine release. Our findings warn that preclinical testing of activating biologicals in rodents may miss cytokine release syndromes due to the rapid and efficacious response of the rodent Treg compartment, and suggest that polyclonal Treg activation is feasible in the presence of antiphlogistic corticosteroid prophylaxis.

..........

[nadinbrzezinski]

61. Now it is up to 13 deaths as in lab confirmed

just trying to keep you informed

[flufileall]

63. What 'they' won't tell us about mortality projections

Amazingly, there has been a governmental repression of the 'realities,' as follows:

- The flu season in the Northern Hemisphere is in autumn. Hence that is the only true time as which the lethality of this strain may be deduced.
- This virus strain's activities represent more than just a standard 'antigenic shift,' whereby a mutuation is produced that leads to pandemic-levels of infection. This is a rapidly mutating strain of THREE DIFFERENT ANIMAL GROUPS, the combination of which has heretofore been unprecedented.
- This strain may easily dwarf the 20-30 million deaths of the 20th century's pandemics. An expert on Bloomberg news stated that in the winter season, at the time of maximal virulence, this strain may infect several BILLION persons, and lead to as many as 300 MILLION deaths.
My question is only a single one: rather than deciding whether to prioritize the dispatch of funds to various biotech companies in the creation of vaccines, is it not smarter to GO AHEAD and CREATE A SAFETY BUFFER. Even if the lethality rate ends up being small, at least we would have insurance that well may have saved our very lives!

Sean Guntur