Swine Flu

[campbell]

Nice to see more of your sly swiping without any actual content as usual

You really are one of the worst posters on BF and getting worse daily.

I suspect all of us, myself at the top of the list (as a very regular international traveller), are very interested in following developments on Swine Flu. What we are going to correct is people who present that information in a manner that is alarmist and isn't actually based on fact but rather on a series of maybe's and possiblys...

fact is, I nursed a patient with it the other night, I know the actual clinical manifestations and treatment for the patient now. I also know what DR is actually saying what could happen and is being talked about by clinicians locally here.Not alarmist, just manifestations of what could occur within the disease changes we are expecting.

You travel often , so do I. I on the other hand have had actual contact with the disease, I actually treat the disease, and enjoy the educational qualities of what Dr puts out there for others to read.
I find them interesting and informative from a clinical point of view.

 

[Eagle87]

No probs. Hopefully some people here are interested.

Some other bits



http://www.timesonline.co.uk/tol/life_and_style/health/article6677542.ece



http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090628/mild_h1n1_090628/20090628?hub=Health

Now you are simply regurgitating the same stuff ad nauseum....

We get it. Some countries health systems may not cope IF we have a massive surge in swine flu cases outside the normal number of flu cases. This is of course, in line, with memos circulated in health systems every year i.e. "if X happens we wont cope; we are stretched; at breaking point... etc etc"

Much of this stuff is lobbying for more funding, some is no doubt genuine concern ... but its all based on what if's and so on and some of these people are paid to talk about worst case scenarios - health systems are not usually funded for worst case and worst case will require emergency funded - just like in the case of a natural disaster and so on....

Surely you get this?

I mean, I have seen memo's that suggest that in the event of a terrorist attack ALL of our state based health systems couldn't cope.... is that something we should have a thread on and propose what might happen if the worst case comes up? Or should we perhaps keep informed and not panic?

 

[Eagle87]

fact is, I nursed a patient with it the other night, I know the actual clinical manifestations and treatment for the patient now. I also know what DR is actually saying what could happen and is being talked about by clinicians locally here.Not alarmist, just manifestations of what could occur within the disease changes we are expecting.

You travel often , so do I. I on the other hand have had actual contact with the disease, I actually treat the disease, and enjoy the educational qualities of what Dr puts out there for others to read.
I find them interesting and informative from a clinical point of view.

This is your standard response to everything. "I know more than you because I am (a) a nurse or (b) indigenous or (c) whatever..."

Then you add absolutely nothing except "Accept my superiority because I know more" .... your not that clever, you impress no-one and again you add nothing.

There is no SECRET information re Swine Flu that only you or insiders are aware of. Its Flu - there are no "actual clinical manifestions" that give you ANY special knowledge ... its Flu!

At this stage there is plenty of information widely available about Swine Flu and they all say that its relatively mild most of the time - like normal flu.

Sure, it MAY mutate but DR isnt saying that - he is presenting his stories and his take on them from, largely, a tabloid viewpoint - he leaps to the worst case scenario. There is no justification for that, at all, there just isn't.

But feel free to allow us a small insight of your extra special knowledge that the WHO arent talking about, you know, the "changes WE are expecting"?

What are they? I just want to pin you down on this. What are YOU and your learned colleagues keeping from us?


By the way, you travel a lot? Really? I have been through 5 countries swine flu scenarios on arrival at airports this week, you?

 

[fairdinkum]

Nice to see more of your sly swiping without any actual content as usual

You [campbell] really are one of the worst posters on BF and getting worse daily.

Hard to disagree with this.

 

[campbell]

Not sure if their is any interest here for this from Qld Health.

http://www.health.qld.gov.au/swineflu/html/atsi_info.asp

 

[Dry Rot]

Some good news - Vitamin D may be your friend (something you can do - for Eagle 87)

In early April of 2005, after a particularly rainy spring, an influenza epidemic (epi: upon, demic: people) exploded through the maximum-security hospital for the criminally insane where I have worked for the last ten years. It was not the pandemic (pan: all, demic: people) we all fear, just an epidemic....

I guess our hospital was under luckier stars as only about 12% of our patients were infected and no one died. However, as the epidemic progressed, I noticed something unusual. First, the ward below mine was infected, and then the ward on my right, left, and across the hall - but no patients on my ward became ill. My patients had intermingled with patients from infected wards before the quarantines. The nurses on my unit cross-covered on infected wards. Surely, my patients were exposed to the influenza A virus. How did my patients escape infection from what some think is the most infectious of all the respiratory viruses?

My patients were no younger, no healthier, and in no obvious way different from patients on other wards. Like other wards, my patients are mostly African Americans who came from the same prisons and jails as patients on the infected wards. They were prescribed a similar assortment of powerful psychotropic medications we use throughout the hospital to reduce the symptoms of psychosis, depression, and violent mood swings and to try to prevent patients from killing themselves or attacking other patients and the nursing staff. If my patients were similar to the patients on all the adjoining wards, why didn't even one of my patients catch the flu?

A short while later, a group of scientists from UCLA published a remarkable paper in the prestigious journal, Nature. The UCLA group confirmed two other recent studies, showing that a naturally occurring steroid hormone - a hormone most of us take for granted - was, in effect, a potent antibiotic. Instead of directly killing bacteria and viruses, the steroid hormone under question increases the body's production of a remarkable class of proteins, called antimicrobial peptides. The 200 known antimicrobial peptides directly and rapidly destroy the cell walls of bacteria, fungi, and viruses, including the influenza virus, and play a key role in keeping the lungs free of infection. The steroid hormone that showed these remarkable antibiotic properties was plain old vitamin D.

All of the patients on my ward had been taking 2,000 units of vitamin D every day for several months or longer. Could that be the reason none of my patients caught the flu?...

Could vitamin D explain these three mysteries, mysteries that account for hundreds of thousands of deaths every year? Studies have found the influenza virus is present in the population year-around; why is it a wintertime illness? Even the common cold got its name because it is common in cold weather and rare in the summer. Vitamin D blood levels are at their highest in the summer but reach their lowest levels during the flu and cold season. Could such a simple explanation explain these mysteries?

The British researcher, Dr. R. Edgar Hope-Simpson, was the first to document the most mysterious feature of epidemic influenza, its wintertime surfeit and summertime scarcity. He theorized that an unknown "seasonal factor" was at work, a factor that might be affecting innate human immunity. Hope-Simpson was a general practitioner who became famous in the late 1960's after he discovered the cause of shingles. British authorities bestowed every prize they had on him, not only because of the importance of his discovery, but because he made the discovery own his own, without the benefit of a university appointment, and without any formal training in epidemiology (the detective branch of medicine that methodically searches for clues about the cause of disease).

After his work on shingles, Hope-Simpson spent the rest of his working life studying influenza. He concluded a "seasonal factor" was at work, something that was regularly and predictably impairing human immunity in the winter and restoring it in the summer. He discovered that communities widely separated by longitude, but which shared similar latitude, would simultaneously develop influenza. He discovered that influenza epidemics in Great Britain in the 17th and 18th century occurred simultaneously in widely separated communities, before modern transportation could possibly explain its rapid dissemination. Hope-Simpson concluded a "seasonal factor" was triggering these epidemics. Whatever it was, he was certain that the deadly "crop" of influenza that sprouts around the winter solstice was intimately involved with solar radiation. Hope-Simpson predicted that, once discovered, the "seasonal factor" would "provide the key to understanding most of the influenza problems confronting us."

Hope-Simpson had no way of knowing that vitamin D has profound effects on human immunity, no way of knowing that it increases production of broad-spectrum antimicrobial peptides, peptides that quickly destroy the influenza virus. We have only recently learned how vitamin D increases production of antimicrobial peptides while simultaneously preventing the immune system from releasing too many inflammatory cells, called chemokines and cytokines, into infected lung tissue. ...

Worth reading whole article

http://www.medicalnewstoday.com/articles/51913.php

 

[TheBloods]

Worth reading whole article

Twice?

 

[Dry Rot]

Twice?

Fixed - thanks.

 

[BomberGal]

Good luck with lotto but it's already started to mutate.

Northern hemisphere health officials are expecting a much nastier version for their next winter.

Viruses are constantly mutating. All organisms are. This virus AROSE by mutating. I wouldn't be so alarmist.

BTW, someone said 'which medicos'? I can assure you that ones I work with are laughing at the way the media are handling this.

In fact I could give you stories that the media are trying to sell, and the hospitals are telling them to bugger off because it's not as bad as the media are trying to make out. The media have literally been waiting for people to die from rare complications so they can tie it in with swine flu - despite the fact that these complications may arise from any viral infection and have nothing to do with the nature of the virus itself. Needless to say, this is not impressing doctors.

I've had a virologist (who has been working in a swine flu clinic) tell me that she's had to calm down parents who aren't even willing to believe the facts from the doctors, because of the "WHAT IF IT MUTATES OR CAUSES COMPLICATIONS OMG" pushed by the media.

The facts: all viruses mutate, and may mutate in a way that could be lethal or cause a pandemic. And all viruses have the potential to cause the complications seen with swine flu - every single virus, just by virtue of BEING a virus (yes, your cells know what's infecting them - and sometimes viral responses go haywire). Even your regular flu. The problem with swine flu is the combination of elements from both swine and birds means it COULD "mutate" to a form that is more transmissible in humans. This is due to its potential to recombine with elements from other swine flus that share common receptor paths with humans. But this is going to require people carrying multiple strains at the same time, if we want them to mix up. So stay away from pigs and wash your hands, kids.

Another possibility for mutation is the mutation of an avian element to a human element at a particular amino acid (odds are low, it's not more likely to mutate to this amino acid than any other), creating a virus that would more closely resemble a human influenza - again, making it more virulent.

I've seen no scientific evidence yet that mutations would create a worse form of the flu - just one that is more easily transmitted due to the peculiar origins of swine flus (as pigs act as the perfect vector between birds and humans - if birds have molecular path A and humans path B, pigs in this case have paths A and B). Any flu could mutate to become worse. Any flu. This one just might affect more people. **And generally, when the phrase 'worse form' is employed, it is referring to its virulence, not its pathology.**

Just to point out what virulence (and pathogenicity) mean: the spread and likelihood of infection. We're all exposed to tons of stuff every day that could make us sick - think about all the people with colds and flus around you, that you don't catch. The potential mutations that are being discussed are simply ones that mean it spreads more easily, or alternatively, once it is in a host, produces a response more quickly, thus meaning people who might not have got the flu before, now get sick because their immune response wasn't quick enough. It doesn't mean your immune response can't handle it.

Please keep in mind where it originated: Mexico, where the standard of health care is poor, and that it's spreading in the US, where health care isn't exactly great. Also keep in mind that former pandemics have been at a time where population health, and health care, are below what we would consider decent now, resulting in more deaths.

The reason people over 50 aren't generally getting sick is because they already have antibodies to the virus. Consider it a good thing that we are getting such high exposure to something so mild now - if it DID mutate, there will be higher resistance in the population.

The facts are also that people who are dying from this are already sick or have stupidly high BMIs. Generally over 40 points.

For all those reading (and buying into) those statements like "it will get worse in the Northern hemisphere winter!!!" - please stop and think about it. It already is winter here. It's not getting worse. Calm down.

If you ignore all the sciencey stuff if you don't understand it, this journal article may provide you with a few rational answers: http://ajws.elsevier.com/ajws_archive/200971087A6406.pdf

Alternatively, go here and search for H1N1, and enjoy the non-alarmist information about swine flu.

 

[Dry Rot]

I've seen no scientific evidence yet that mutations would create a worse form of the flu - just one that is more easily transmitted due to the peculiar origins of swine flus (as pigs act as the perfect vector between birds and humans - if birds have molecular path A and humans path B, pigs in this case have paths A and B). Any flu could mutate to become worse. Any flu. This one just might affect more people. **And generally, when the phrase 'worse form' is employed, it is referring to its virulence, not its pathology.**

Just to point out what virulence (and pathogenicity) mean: the spread and likelihood of infection. We're all exposed to tons of stuff every day that could make us sick - think about all the people with colds and flus around you, that you don't catch. The potential mutations that are being discussed are simply ones that mean it spreads more easily, or alternatively, once it is in a host, produces a response more quickly, thus meaning people who might not have got the flu before, now get sick because their immune response wasn't quick enough. It doesn't mean your immune response can't handle it.

What happened in the second waves of pandemic flu in 1918, 1957 and 1968?

 

[BomberGal]

What happened in the second waves of pandemic flu in 1918, 1957 and 1968?

Do you enjoy being scared? Do you suppose I am lying to you?

Or is there just something wrong with your own ability to look it up? I'm telling you about the current virus and what they think might happen with THIS virus. What's that got to do with other viruses? They're not the same virus. Why don't we compare it to Ebola?

For your convenience:

http://en.wikipedia.org/wiki/1918_flu_pandemic#Deadly_second_wave - start a world war with trench conditions and maybe we'll worry about it...

http://en.wikipedia.org/wiki/Asian_Flu#Asian_flu - is this what you're referring to with the 1957/1968? Because it quotes: The Asian Flu strain later evolved via antigenic shift into H3N2 which caused a milder pandemic from 1968 to 1969.

And in 1968: The pandemic infected an estimated 500,000 Hong Kong residents, 15% of the population, with a low death rate.

Milder. Low death rate.

Not to mention this is what happens when you read about the strains of Asian flu, and the second wave:

Accumulated antibodies to the neuraminidase or internal proteins may have resulted in much fewer casualties than most pandemics.

Interesting. Isn't that what I just said in my last post? Getting immunity now?

Oh and this little snippet:

"While the pandemic human influenza viruses of 1957 (H2N2) and 1968 (H3N2) clearly arose through reassortment between human and avian viruses, the influenza virus causing the 'Spanish flu' in 1918 appears to be entirely derived from an avian source (Belshe 2005).

Again. This flu already is not entirely avian, so why compare to 1918 at all? It's like comparing this to the bird flu from a couple of years ago.

 

[Dry Rot]

Do you enjoy being scared? Do you suppose I am lying to you?

Or is there just something wrong with your own ability to look it up? I'm telling you about the current virus and what they think might happen with THIS virus. What's that got to do with other viruses? They're not the same virus. Why don't we compare it to Ebola?

For your convenience:

http://en.wikipedia.org/wiki/1918_flu_pandemic#Deadly_second_wave - start a world war with trench conditions and maybe we'll worry about it...

http://en.wikipedia.org/wiki/Asian_Flu#Asian_flu - is this what you're referring to with the 1957/1968? Because it quotes: The Asian Flu strain later evolved via antigenic shift into H3N2 which caused a milder pandemic from 1968 to 1969.

And in 1968: The pandemic infected an estimated 500,000 Hong Kong residents, 15% of the population, with a low death rate.

Milder. Low death rate.

Not to mention this is what happens when you read about the strains of Asian flu, and the second wave:

Accumulated antibodies to the neuraminidase or internal proteins may have resulted in much fewer casualties than most pandemics.

Interesting. Isn't that what I just said in my last post? Getting immunity now?

Oh and this little snippet:

"While the pandemic human influenza viruses of 1957 (H2N2) and 1968 (H3N2) clearly arose through reassortment between human and avian viruses, the influenza virus causing the 'Spanish flu' in 1918 appears to be entirely derived from an avian source (Belshe 2005).

Again. This flu already is not entirely avian, so why compare to 1918 at all? It's like comparing this to the bird flu from a couple of years ago.

I'm not afraid, just interested in the subject.

The Wiki authors may not have done their homework?

...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....

http://content.nejm.org/cgi/content/full/NEJMp0903906

 

[medusala]

http://www.smh.com.au/national/swine-flu-warning-as-deaths-increase-20090713-diti.html

HEALTH experts fear the state's swine flu death toll could soar with six young, healthy people in Sydney fighting for their lives on last-resort cardiac bypass machines because their lungs are too damaged or diseased for regular mechanical ventilation.

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

It seems healthy people in the UK have now started to die. It is summer here so the winter promises chaos.

http://news.bbc.co.uk/1/hi/uk/8148162.stm

 

[Geelong_Sicko]

http://www.smh.com.au/national/swine-flu-warning-as-deaths-increase-20090713-diti.html

HEALTH experts fear the state's swine flu death toll could soar with six young, healthy people in Sydney fighting for their lives on last-resort cardiac bypass machines because their lungs are too damaged or diseased for regular mechanical ventilation.

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

It seems healthy people in the UK have now started to die. It is summer here so the winter promises chaos.

http://news.bbc.co.uk/1/hi/uk/8148162.stm

In the face of this would you bother getting flu jabs, meds? I mean, even ones specifically designed to combat the swine flu aren't 100% guaranteed anyway yet folk still talk it up.

 

[campbell]

http://www.news.com.au/heraldsun/story/0,21985,25778285-662,00.html
How swine flu felled our young


An otherwise healthy man, 24, was admitted to a regional hospital after a week of dry coughing, fever, headache, abdominal pain and vomiting.

Less than 36 hours later he was taken to Melbourne and placed on mechanical ventilator. He stayed in intensive care for 15

 

[medusala]

In the face of this would you bother getting flu jabs, meds? I mean, even ones specifically designed to combat the swine flu aren't 100% guaranteed anyway yet folk still talk it up.

Never had one, never been convinced, though could well be mistaken. Had very bad cough for just a day about a week ago. Pointless going to a doctor and the NHS healthline is a waste of time. I suspect there are tens of thousands of people who like me have no idea if they got it or not and local health services in many cases are too overloaded to test.

The trains here are so crowded and well used though I would imagine it would be spread exceptionally easily.

 

[TheBloods]

For all those reading (and buying into) those statements like "it will get worse in the Northern hemisphere winter!!!" - please stop and think about it. It already is winter here. It's not getting worse. Calm down.

If you ignore all the sciencey stuff if you don't understand it, this journal article may provide you with a few rational answers: http://ajws.elsevier.com/ajws_archive/200971087A6406.pdf

Alternatively, go here and search for H1N1, and enjoy the non-alarmist information about swine flu.

And yet the WHO says the swine flu is unstoppable and the death toll will rise.

 

[Eagle87]

http://www.news.com.au/heraldsun/story/0,21985,25778285-662,00.html
How swine flu felled our young


An otherwise healthy man, 24, was admitted to a regional hospital after a week of dry coughing, fever, headache, abdominal pain and vomiting.

Less than 36 hours later he was taken to Melbourne and placed on mechanical ventilator. He stayed in intensive care for 15

So, in line with what Bomber Gal suggested earlier, the media are taking every chance to stir the pot.

I would love to hear your thoughts on Bomber Gal's comments campbell?

I mean both of you being "experts" and all and "in the industry". Of course one of you comes across as a dribbling, low level, fool whereas the other seems rational, calm and informed.

I think a cursory glance at both sets of posts will allow readers to form their views.

 

[Eagle87]

And yet the WHO says the swine flu is unstoppable and the death toll will rise.

Yes, exactly the same as "normal" flu is unstoppable and the death toll from that will also rise.

Why are these concepts so hard for otherwise intelligent people to grasp?

 

[Dry Rot]

And a local warning - the rise of bad cases in young healthy people is an unusual and concerning development.

Swine flu warning as deaths increase
Kate Benson and Andrew Clennell
July 14, 2009
HEALTH experts fear the state's swine flu death toll could soar with six young, healthy people in Sydney fighting for their lives on last resort cardiac bypass machines because their lungs are too damaged or diseased for regular mechanical ventilation.

The surge in the number of people with swine flu needing life-saving treatment has forced NSW Health to consider closing elective surgery at some big hospitals to allow staff to redirect resources.

Four people have now died in NSW since the pandemic hit on May 9, a woman, 61, being the latest victim. Her death on Saturday at Lismore Base Hospital was followed by two more suspected swine flu deaths, of men aged between 30 and 50, at Royal North Shore Hospital. Their deaths have been referred to the coroner.

More than 350 people have been admitted to hospital with swine flu since the pandemic began. Fifty have been treated in intensive care, but doctors say the surge in patients needing cardiac bypass treatment is putting a huge strain on intensive care units and on staff and resources across the state.

All six of the victims on cardiac bypass are at Royal Prince Alfred Hospital, where staff have been forced to borrow three machines to treat 10 patients in the past two weeks. The hospital usually treated about five patients a year using the machines, the head of intensive care services, Robert Herkes, said yesterday.

"This is not an ordinary winter. Swine flu is hitting young, otherwise healthy people … they start with a sore throat, develop shortness of breath and within 12 to 24 hours have rapidly developed respiratory failure and are being ventilated."

Dr Herkes said extracorporeal membrane oxygenation, or ECMO, was considered a last resort treatment, but staff were "throwing everything" at the patients because they were young and relatively healthy.

Patients in respiratory distress are administered anticoagulants by machine, and their blood is drained through tubing in their femoral or jugular veins. It is oxygenated outside the body, allowing the lungs to recover....

http://www.smh.com.au/national/swine-flu-warning-as-deaths-increase-20090713-diti.html

 

[Dry Rot]

Yes, exactly the same as "normal" flu is unstoppable and the death toll from that will also rise.

Why are these concepts so hard for otherwise intelligent people to grasp?

Good question - you fail to grasp that unusual and unlikely groups are being badly hit - see report above.

 

[TheBloods]

Yes, exactly the same as "normal" flu is unstoppable and the death toll from that will also rise.

Why are these concepts so hard for otherwise intelligent people to grasp?

So the WHO is panicking unnecessarily?

 

[Dry Rot]

Interesting echoe from the past

New flu resembles feared 1918 virus, study finds
13 Jul 2009 14:28:11 GMT

By Maggie Fox, Health and Science Editor
WASHINGTON, July 13 (Reuters) - The new H1N1 influenza virus bears a disturbing resemblance to the virus strain that caused the 1918 flu pandemic, with a greater ability to infect the lungs than common seasonal flu viruses, researchers reported on Monday.
Tests in several animals confirmed other studies that have shown the new swine flu strain can spread beyond the upper respiratory tract to go deep into the lungs -- making it more likely to cause pneumonia, the international team said.

In addition, they found that people who survived the 1918 pandemic seem to have extra immune protection against the virus, again confirming the work of other researchers.
"When we conducted the experiments in ferrets and monkeys, the seasonal virus did not replicate in the lungs," said Yoshihiro Kawaoka of the University of Wisconsin, who led the study.
The H1N1 virus replicates significantly better in the lungs."
The new swine flu virus has caused the first pandemic of the 21st century, infecting more than a million people, according to estimates, and killing at least 500. The World Health Organization says it is causing mostly moderate disease but Kawaoka said that does not mean it is like seasonal flu.
"There is a misunderstanding about this virus," he said in a statement. "There is clear evidence the virus is different than seasonal influenza."
Writing in the journal Nature, Kawaoka and colleagues noted that the ability to infect the lungs is a characteristic of other pandemic viruses, especially the 1918 virus, which is estimated to have killed between 40 million and 100 million people....

http://www.alertnet.org/thenews/newsdesk/N13166187.htm

 

[Eagle87]

So the WHO is panicking unnecessarily?

Huh?

The WHO isn't panicking at all.

Advising that the virus is unstoppable is a simple statement of fact. Are they panicking when they say "normal" flu is unstoppable?

Flu kills people, always has. So saying the death toll will rise is a statement of fact.

Don't they teach critical thinking anymore?

 

[Eagle87]

And a local warning - the rise of bad cases in young healthy people is an unusual and concerning development.



http://www.smh.com.au/national/swine-flu-warning-as-deaths-increase-20090713-diti.html

More alarmism.

Nice use of tabloid language in the report "soar" "surge" etc....

So 6 people in a city of 3+ million have severe breathing/lung problems some 2 months after the virus arrived.

None have died.

The 4 in NSW who have died may have had underlying health issues. I.e normal flu could have killed them.

Yep, let's call in the army.