Swine Flu

[stickman11]

Sell your way of recovery to the media + medical officals and make some $$$

You can get natural immunity by rooting around with pigs or spending a night in police custody.

 

[Dry Rot]

This may explain why the current strain is still hitting the northern hemisphere in late spring and why this mutation is not good news

E627K Acquisition in Swine H1N1 Raises Pandemic Concerns
Recombinomics Commentary 11:37
June 18, 2009

The recently released PB2 sequence from a patient in Shanghai (see updated map) contains E627K. This is the first reported acquisition of this change, which is present in virtually all human influenza A isolates, including the pandemic strain from 1918.

The current isolate, A/Shanghai/71T/2009, was collected May 31, 2009 and the sequence was deposited at Genbank on June 10, 2009. The isolate is closely related to the swine H1N1 currently spreading worldwide, and all positions upstream from E627K match the consensus sequence, indicating the E627K was not acquired through reassortment with human PB2 or other H1N1 viruses that were not closely related to the swine H1N1 circulating in the human population.

Acquisition of E627K is a concern because it allows for optimal replication at 33 C, the temperature of a human nose in the winter, in contrast to E627, which is in the avian version of PB2 and allows for optimal replication at 41 C, the body temperature of birds. The PB2 in the swine is of avian origin, and A/Shanghi/71T/2009 is the first public sequence from the circulating sub-clade with E627K.

In human seasonal flu, activity peaks in the winter months and only minimal levels are detected in humans over the summer. However, the swine flu has remained active and almost all influenza A detected in the northern hemisphere at this time is swine flu.

The appearance of E627K raises concerns that the level of swine flu with E627K will markedly increase in colder months. In 1918, the flu in the spring was mild, but the fall version of the virus, which had E627K, was much more virulent and targeted young, previously healthy adults, as previously reported for the outbreak in Mexico, and now being reported in United States and Canada, where levels are highest. This younger population target is also being reported in other countries worldwide.

Although the current case fatality rate is low, small changes like E627K could increase viral load, leading to high cytokine levels, which are associated with many of the deaths due to the current "milder" version of the swine H1N1. In contrast to the recent isolate from Brazil, A/Sao Paulo/1454/2009 which is identical to the HA consensus sequence, the A/Shanghi/71T/2009 has a unique change that is not found in closely related sequences.

This change is found in other H1N1 swine sequences (see list here) and the region surrounding E627K matches H3N2 seasonal flu in circulation in 1995. Moreover, the downstream region matches sequences found in human lethal infections in the H7N7 outbreak in the Netherlands in 2003, as well as the H5N1 outbreak in Hong Kong in 1997 (see matches here). However, in the above outbreaks, transmission to humans was not efficient, and the number of deaths was limited.

The only reported death in the H7N7 outbreak was a veterinarian infected with H7N7 containing E627K (and that case remains the only example of a human fatal bird flu infection not involving H5N1). The H5N1 sequence from Hong Kong was used to show the association of E627K with increased virulence in mice.

Thus, the acquisition of PB2 E627K in the swine H1N1 is readily explain by homologous recombination with locally related sequences containing E627K, which was a concern when the swine H1N1 begun transmitting efficiently in humans . This sustain efficient transmission lead to a phase 6 designation for the 2009 Pandemic.

The acquisition of E627K creates concern that the virus will evolve into a more lethal agent that will be associated with an increased case fatality rate in previously healthy young adults, as was seen in the 1918 Pandemic.

http://www.recombinomics.com/News/06180901/H1N1_Swine_E627K.html

 

[Dry Rot]

Am interesting view of an economist on the impact of swine flu on the NZ economy

Bank says H1N1 will trim GDP by 1-2%

(Source: Reuters)

The H1N1 flu pandemic is "bad news" for New Zealand's economy, a leading bank says.

"We'd pick that swine flu could knock 1% to 2% off New Zealand gross domestic product (GDP) in the next 12 months," Westpac Bank economist Sharon Zollner said.

New Zealand was likely to have been in recession for six consecutive quarters to mid-2009, and it was difficult to sift out the impact of swine flu from that downturn.

But she predicted the pandemic might lengthen the local recession "by a couple of quarters".

March quarter GDP statistics were due to be released next week, but economists said before the arrival of swine flu, the effects of the global downturn were expected to drive down New Zealand GDP by 1.4% in the year to March 2010, after falling 2% in the year ended March 2009.

"So far, New Zealanders seem to be treating the outbreak as an inconvenience rather than a catastrophe, suggesting the labour supply impact from illness will be the main issue," said Zollner...


Zollner said that so far it did not seem that people feared the virus enough to make significant changes to their daily behaviour.

"The virus appears a lot less scary than it did when news of it first broke," she said.
"A very large number of people are likely to become infected, but by most accounts the disease is mild, with a very low chance of death. So far, New Zealanders seem to be taking a `she'll be right' attitude'."

This could change when the first New Zealand deaths occurred.

Estimates of how many people will be affected ranged from 20% to 60% of the population, compared with the 5% of adults and 20% of children who get seasonal influenza and other flu-like illnesses annually.

Infected people would not only need time off work, but would be encouraged to stay away from work or school.

Some well people would need to stay home to look after the patients, and some might stay home out of fear of infection, or their workplace being temporarily closed.

This "negative labour supply shock" would also hurt consumer demand, because some sick leave might be unpaid, Zollner said.

Consumer demand could also fall if people start avoiding crowds, shopping centres, and social gathering places.

And health officials could close borders, restrict public gatherings, put patients in isolation, and shut schools and workplaces.

While this could delay economic impacts by slowing the virus spread, the general uncertainty and negative publicity could also hurt public confidence about the economy.

In a recession, where consumers are already holding off on major purchases, "sentiment is already fragile", said Zollner.

Tourism was particularly vulnerable, and seafood exports could be hurt if consumers overseas cut back on dining out.

"Exports" of education - teaching foreign students in New Zealand - could also be hard hit.

Treasury officials estimated GDP would be reduced by 0.7% to 2.1% in the first year and after four years the cumulative reduction would be 1.1% to 2.8% of one year's GDP.

"The eventual effects could well be larger given the current recession will have reduced firms' capacity to absorb another negative shock," said Zollner.

http://tvnz.co.nz/business-news/bank-says-h1n1-trim-gdp-1-2-2789700

 

[P.A.F.C]

http://www.theaustralian.news.com.au/story/0,25197,25660532-601,00.html

THE first death from swine flu in Australia has been confirmed at the Royal Adelaide Hospital.
A 26-year-old West Australian man, believed to be Aborigine, has been at the hospital since Monday in a critical condition.

The man was confirmed as positive for swine flu yesterday.

He was transferred to Adelaide from Alice Springs Hospital on Monday.

It is believed the man had other medical conditions.

 

[Leafie]

http://www.theaustralian.news.com.au/story/0,25197,25660532-601,00.html

Of course he had other medical conditions, if you have pre exisiting conditions and get swine flu of course it will have major effects on you!

about 2000 people have got swine flu, out of 20+ million Australians, I would hardly call that a epidemic or pandemic!!!

 

[mantis]

The story headline is incorrect, but the media have to leep up the hysteria for Dry Rot.

The guy probably would have died of his other conditions & as the Doctor said, the swine flu is very mild & people are only sick for a short time.

 

[fairdinkum]

The story headline is incorrect, but the media have to leep up the hysteria for Dry Rot.

After hearing about this story, I think DR has finally made the call to head to the bunker for a few months to ride this pandemic out in safety.

I'm gonna miss him while he's gone.

 

[Dry Rot]

After hearing about this story, I think DR has finally made the call to head to the bunker for a few months to ride this pandemic out in safety.

I'm gonna miss him while he's gone.

Bad luck FD. The bunker (called The Kennel) is fully armed with necessary medications but I'm still out and about - I'm better prepared than most to dodge it or handle it if it comes my way.

If you knew anything about flu pandemics, this first wave isn't the one to fear personally. The concern is that every new infection is a chance for mutation.

The concern and attention of northern hemisphere health officials about swine flu here is curious, is it not?

I don't know that they are worried about us.

 

[fairdinkum]

I'm only avin a larf, DR. Not trying to offend.

Personally, I reckon I have more chance of dieing in a car accident than I do of dieing in a 'swine flu pandemic' and, given how little I worry about dieing on the roads, I figure it is pointless worrying about swine flu.

But each t their own, my good man.

 

[Dry Rot]

I'm only avin a larf, DR. Not trying to offend.

Personally, I reckon I have more chance of dieing in a car accident than I do of dieing in a 'swine flu pandemic' and, given how little I worry about dieing on the roads, I figure it is pointless worrying about swine flu.

But each t their own, my good man.

No probs. My only point is that my worry isn't this first mild wave.

 

[Zarrix]

I'm sensing an easing in media hysteria. About time too. Hope it doesn't come back unless another strain is unleashed that is more malicious.

 

[Dry Rot]

I'm sensing an easing in media hysteria. About time too. Hope it doesn't come back unless another strain is unleashed that is more malicious.

A bit of pandemic history NB how it usually comes in waves might help your view of this.

 

[Geelong_Sicko]

If you knew anything about flu pandemics, this first wave isn't the one to fear personally. The concern is that every new infection is a chance for mutation.

A question. Are the survivors of the 'first wave' better equipped to survive subsequent waves of flu because their immune systems are boosted after combating the virus?

Should we be having 'flu piss-ups', drinking out of everyone else's pot glasses and coughing all over everything?

 

[Dry Rot]

A question. Are the survivors of the 'first wave' better equipped to survive subsequent waves of flu because their immune systems are boosted after combating the virus?

Should we be having 'flu piss-ups', drinking out of everyone else's pot glasses and coughing all over everything?

Good question - there have been reports of "flu parties" from overseas.

Most flu pandemics come in two three or waves, with the second or third the miost deadly. IIRC those got infected in the first wave of 1918 Spanish Flu apparently had some immunity against the later waves. Likewise, it is considered that the swine flu seems to be slightly related to Spanish flu, with few over 60 year olds getting it (unlike seasonal flu). IIRC Spanish Flu was a type of swine flu which circulated till 1957.

I suppose there are three counter arguments against swine flu now or holding "swine parties":

1. It will probably mutate and/or possibly get "mixed up" with an existing flu in future waves, so your level of immunity from getting it now is uncertain

2. Current swine flu has been more deadly overseas (but usually with those with some underlying problem, but not always). Would be a grim irony if you deliberately caught it, got a bad case and died. It seems to be bad for asthmatics and pregnant women.

3. For a public health/big picture perspective, I suppose authorities believe that every additional person who catches it gives it an additional chance to mutate.

 

[Eagle87]

Good question - there have been reports of "flu parties" from overseas.

Most flu pandemics come in two three or waves, with the second or third the miost deadly. IIRC those got infected in the first wave of 1918 Spanish Flu apparently had some immunity against the later waves. Likewise, it is considered that the swine flu seems to be slightly related to Spanish flu, with few over 60 year olds getting it (unlike seasonal flu). IIRC Spanish Flu was a type of swine flu which circulated till 1957.

I suppose there are three counter arguments against swine flu now or holding "swine parties":

1. It will probably mutate and/or possibly get "mixed up" with an existing flu in future waves, so your level of immunity from getting it now is uncertain

2. Current swine flu has been more deadly overseas (but usually with those with some underlying problem, but not always). Would be a grim irony if you deliberately caught it, got a bad case and died. It seems to be bad for asthmatics and pregnant women.

3. For a public health/big picture perspective, I suppose authorities believe that every additional person who catches it gives it an additional chance to mutate.

So in amongst your somewhat alarmist posts, are you going to give us some sort of potted history of EVERY pandemic or possible/likely pandemic (i.e. wasnt recorded as such due to different times and sophistication) and its following of this pattern?

Or, is it your intention to continually refer back to 1918 when, lets be honest, standards of health care and knowledge of proper treatment were somewhat backwards - not to mention the general health of the population was somewhat lower?

At the moment you are just alarmism dressed up to sound mildly educated.

 

[Dry Rot]

So in amongst your somewhat alarmist posts, are you going to give us some sort of potted history of EVERY pandemic or possible/likely pandemic (i.e. wasnt recorded as such due to different times and sophistication) and its following of this pattern?

Or, is it your intention to continually refer back to 1918 when, lets be honest, standards of health care and knowledge of proper treatment were somewhat backwards - not to mention the general health of the population was somewhat lower?

At the moment you are just alarmism dressed up to sound mildly educated.

If you just like pics there's this- - http://content.nejm.org/content/vol360/issue25/images/large/02f1.jpeg

Or a good discussion of these waves here http://content.nejm.org/cgi/content/full/NEJMp0903906

Past pandemics were characterized by a shift in the virus subtype, shifts of the highest death rates to younger populations, successive pandemic waves, higher transmissibility than that of seasonal influenza, and differences in impact in different geographic regions. Although influenza pandemics are classically defined by the first of these features, the other four characteristics are frequently not considered in response plans.

Yet the second feature, the shift in mortality toward younger age groups, was the most striking characteristic of the 20th-century pandemics.1,2 Exposure to influenza A/H1 subtypes before 1873 may have offered some protection to adults over 45 years of age during the pandemic of 1918 and 1919. A similar mechanism of antigen recycling might explain the partial protection against influenza-related death that was observed among people over 77 years of age during the 1968–1970 pandemic — a possibility supported by the prepandemic presence of antibodies to H3, which were isolated in people born before 1892.1 Another possible mechanism is immune potentiation, leading to an increased likelihood of lethal outcomes after influenza infection in specific age groups. Still other hypotheses include the possibility of bacterial superinfection due to asymmetric carriage rates, given that higher rates were found among young people in 1918 and 1919.1,2 Although the elderly frequently have the highest death rates during seasonal epidemics, their relative sparing during pandemics has not been generally appreciated. Advance knowledge of which subpopulations are most likely to be at increased risk for death can shape the optimization of control strategies.

The third feature, a pattern of multiple waves, characterized all three 20th-century pandemics, each of which caused increased mortality for 2 to 5 years (see chart).1 The lethal wave in the autumn of 1918 was preceded by a first wave in the summer that led to substantial morbidity but relatively low mortality in both the United States and Europe. Recent studies suggest that these early mild outbreaks partially immunized the population, decreasing the mortality impact of the main pandemic wave in the fall of 1918.2 In the United States, the 1957 influenza A/H2 pandemic had three waves in the United States, with notable excess mortality in the nonsuccessive winter seasons of 1959 and 1962 — the latter being 5 years after the initial emergence of the pandemic strain.1 From 1968 through 1970, Eurasia had a mild first influenza season, with the full effects on morbidity and mortality occurring in the second season of pandemic-virus circulation. The reasons for multiple waves of varying impact are not precisely understood, but they probably include adaptation of the virus to its new host, demographic or geographic variation, seasonality, and the overall immunity of the population.1,2 The occurrence of multiple waves potentially provides time for health authorities to implement control strategies for successive waves....

Does that help?

 

[Eagle87]

If you just like pics there's this- - http://content.nejm.org/content/vol360/issue25/images/large/02f1.jpeg

Or a good discussion of these waves here http://content.nejm.org/cgi/content/full/NEJMp0903906



Does that help?

Yes. But not really.

There is nothing in those reports that is conclusive of anything much at all. Maybe, possibly, could be seen as, perhaps ......

So this pandemic may be followed by a more serious strain or not. It may be followed by a plague that destroys everything or not. and so on.

Most importantly, the actions of individuals now will make absolutely no ****ing difference one way or the other ... unless we all move into your bunker.

 

[Dry Rot]

Yes. But not really.

There is nothing in those reports that is conclusive of anything much at all. Maybe, possibly, could be seen as, perhaps ......

So this pandemic may be followed by a more serious strain or not. It may be followed by a plague that destroys everything or not. and so on.

Most importantly, the actions of individuals now will make absolutely no ****ing difference one way or the other ... unless we all move into your bunker.

You asked about flu pandemic waves, no?

Past pandemics followed this wave pattern, and it's widely feared in the northern hemisphere that swine flu will follow this pattern. Maybe it won't. But it seems that the first wave of a flu pandemic is mild, therefore it's not possible to make a call with current swine flu.

Most importantly, the actions of individuals now will make absolutely no ****ing difference one way or the other ... unless we all move into your bunker.

A bunker may be useful but I live in a block of flats in inner Sydney. You're always welcome to drop in with a first growth claret from a good year....

 

[Eagle87]

You asked about flu pandemic waves, no?

Past pandemics followed this wave pattern, and it's widely feared in the northern hemisphere that swine flu will follow this pattern. Maybe it won't. But it seems that the first wave of a flu pandemic is mild, therefore it's not possible to make a call with current swine flu.



A bunker may be useful but I live in a block of flats in inner Sydney. You're always welcome to drop in with a first growth claret from a good year....

lol!

Very good.

Perhaps inner Sydney will be spared the apocalypse.

 

[TheBloods]

Or, is it your intention to continually refer back to 1918 when, lets be honest, standards of health care and knowledge of proper treatment were somewhat backwards - not to mention the general health of the population was somewhat lower?

Not aware of the flu pandemic (Hong Kong flu) in 1968-9?

 

[Dry Rot]

This is an interesting read from a Canadian perspective

http://www.theglobeandmail.com/news/opinions/the-pandemic-is-here/article1187501/actions.jsp

 

[Dry Rot]

Or, is it your intention to continually refer back to 1918 when, lets be honest, standards of health care and knowledge of proper treatment were somewhat backwards - not to mention the general health of the population was somewhat lower?

Here's someone now suspected of dying like they did in 1918 with advanced health care knowledge of proper treatment.

I hope the suspicion of a cytokine storm in her lungs is wrong, otherwise this is a nasty development.

A fatal puzzle: Escondido woman's death from swine flu baffles experts
By Keith Darcé, Union-Tribune Staff Writer

2:00 a.m. June 19, 2009

Adela Chevalier didn't fit the profile of someone who might die of swine flu.

The Escondido woman was young, having turned 20 in January. She was active and worked two jobs. And she was healthy — family members said she never had a serious illness before last weekend.

Statistics on swine-flu patients also were in her favor.

About 70 percent of people in the United States who have been hospitalized for the virus, also called H1N1 influenza A, suffered from some underlying health problem, such as asthma, diabetes, chronic heart disease or a weakened immune system, according to the federal Centers for Disease Control and Prevention.

But those factors weren't enough to save Chevalier on Monday, when she arrived at the emergency room of Palomar Medical Center in Escondido. Within a few hours, she had become San Diego County's first swine-flu fatality.

Chevalier's death has perplexed public-health officials and medical researchers. It also has panicked some county residents, especially in Escondido and San Marcos — where the victim lived and worked......

“It's clearly very shocking,” biomedical researcher David Woodland, who directs the Trudeau Institute in Saranac Lake, N.Y., said yesterday.

“One of the things that we've all been very concerned about with the outbreak of a new flu is that the severity of the infection could be much worse than the normal seasonal flu,” Woodland said.

An excessive immune-system response that triggers a lethal molecular battle within the body could explain the deaths of Chevalier and the handful of other young, healthy swine-flu patients, some scientists and epidemiologists said.

“It may be that the severity of the disease is due to the robust immune response of younger individuals,” Dr. Daniel Jernigan, deputy director of the CDC's Influenza Division, said during the agency's swine-flu briefing yesterday.....

The county Medical Examiner's Office is still days away from releasing its autopsy report on Chevalier, and the bits of information made public so far aren't enough to explain how she died.

“We just don't know at this point,” said Dr. Glenn Wagner, the county's chief medical examiner. “I know that she was reasonably healthy and a bit overweight.”

He also said Chevalier's lungs weighed more than normal, suggesting they were saturated with fluid.

The liquid might have come from intravenous fluid pumped into Chevalier by hospital workers as they fought to resuscitate her, or it could have come from her own body.

Medical examiners still must analyze tiny slices of Chevalier's lung tissue under a microscope to determine where the fluid originated and whether the volume was large enough to kill her, Wagner said.

If the fluid resulted from a battle spawned by her immune system, it might be evidence of a cytokine storm.

That potentially deadly process begins when an infection invades a person's respiratory tract. As viruses take over cells in the sinuses and lungs, the body releases messenger molecules known as cytokines to trigger an immune-system response.

Larger amounts of viruses cause more cytokines to activate, leading to a greater invasion of white blood cells that attack infected cells along with healthy ones that happen to be in the way.

Such collateral damage can be devastating to the lungs' delicate tissues, which allow oxygen molecules to mix with flowing blood.

“You've got damage caused by the virus itself, and damage caused by the immune response,” said Woodland, whose laboratory team studies how the immune system takes on viral and bacterial infections in the lungs.

When the fight is against a familiar infection, Woodland said, the immune system's barrage is typically measured. But with a novel disease, such as the H1N1 swine flu, the immune response might not occur until the lungs are filled with viruses. By then, a more massive counteroffensive can be disastrous.

“Fluid starts flooding into the lungs,” Woodland said. “You basically drown.”

Scientists have theorized that a similar process was responsible for the deaths of a surprisingly large number of young people during the influenza pandemic of 1918-19, which killed an estimated 50 million worldwide.

Several years ago, researchers triggered a cytokine-storm response in mice by infecting them with a genetically reconstructed version of the 1918-19 flu. The results of their study were published in the October 2006 edition of the journal Nature .

Scientists studying the current strain of swine flu aren't close to determining whether the virus has the genetic structure needed to trigger a cytokine storm, said Dr. Douglas Richman, a professor of infectious diseases at UCSD Medical Center and the San Diego VA Healthcare System in La Jolla.

“The question is whether this flu is more virulent than the garden variety flu,” Richman said. “The answer is that we don't know yet.”

http://www3.signonsandiego.com/stor...lu-baffles-experts/?northcounty&zIndex=119303

 

[Dry Rot]

A gimpse of what a serious flu pandemicx would be like

Swine flu doctors fear disease is out of control as 300 new cases are diagnosed per day

Jun 21 2009 Charles Lavery

Three hundred suspected swine flu victims are being diagnosed every day in Scotland as doctors fear the spread of the disease is spiralling out of control. .

Health chiefs even allowed hundreds of people to be diagnosed over the phone by staff with no medical training as they became swamped last week.

A Sunday Mail investigation today reveals bosses have identified the six worst swine flu clusters across the country.

One expert yesterday warned surgeries and hospitals could be "overrun".

It has also emerged that two thirds of the new cases are in the south side of Glasgow - which experts believe will be Europe's swine flu capital within days....

The Scottish Government introduced "clinical diagnosis" on June 11. That meant NHS staff could follow guidelines on a flow chart to determine if a caller had swine flu.

Staff were told patients in high-cluster areas - south-east Glasgow, south-west Glasgow, Renfrewshire, East Renfrewshire, Inverclyde and the Cowal peninsula - did not need swabbing or a doctor's visit.

Patients were told to send an unaffected family member to hospital for anti-virals.

They were not seen by a doctor and, in some cases, could not even speak to one by phone.

The Scottish Government secretly abandoned the policy on Thursday, admitting it had caused alarm.

On Monday 71 people were diagnosed as having the flu but on Tuesday it was 351.

On Wednesday there were 300 diagnoses, Thursday's total was 354 and on Friday 245 people were told they had the virus.

Government adviser Professor Hugh Pennington said: "To conduct diagnosis like this and expect it to be accurate is pie in the sky. We need lab testing.

"It is worrying and indicates that they are becoming overrun by the number of cases. When a 21-year-old pregnant woman called up with symptoms, she should have gone to the top of the list to see a doctor."....

http://www.sundaymail.co.uk/news/sc...w-cases-are-diagnioed-per-day-78057-21459588/

 

[mantis]

Dry Rot, if the media alarmists weren't beating it up, then most people wouldn't be going to the Doctors or hospitals. The hysteria is causing the problem, not the bloody flu.

 

[fairdinkum]

Most importantly, the actions of individuals now will make absolutely no ****ing difference one way or the other ... unless we all move into your bunker.

Very good.