Archive for the 'Infectious Disease' Category
June 2nd, 2009 by Nina Thompson, ARNP
The swine flu has gained a foothold in Australia and the number of cases have been doubling about every two days. This may well prompt the World Health Organization to declare the first flu pandemic in more than four decades, according to an Australian public health expert yesterday.
Experts believe the virulence of the swine flu may well reveal itself during the Southern Hemisphere’s winter months. Australia’s winter is from June 1 to Aug. 31. Swine flu infections are expected to peak in Australia in July. This is because the flu virus thrives in colder, drier weather and is transmitted easily when people stay close together indoors.
Pandemic experts will be closely monitoring the upcoming behavior of this swine flu virus in Australia where it can spread easily, possibly gain strength by mutating, and then re-enter the Northern Hemisphere in the fall, as the devastating swine flu virus did in 1918.
Image courtesy of the CIA (www.cia.gov)
Source: “Swine Flu Cases in Australia May Prompt Pandemic Call”, Bloomberg.com, June 1, 2009
Source: World Health Organization, June 2, 2009
May 15th, 2009 by Nina Thompson, ARNP
A new flareup of the swine flu virus has recently struck New York city schools, sending an assistant school principal to the hospital in critical condition. He apparently had an underlying condition that may have worsened his illness, Mayor Michael Bloomberg said. The city has closed three schools because of “unusually high levels” of flu-like illness, according to the mayor. There have been a total of 320 students reporting illness.
As of today at 11am, the CDC reports 4,714 confirmed or probable cases of swine flu in 47 states and the District of Columbia. There have been 4 deaths attributable to swine flu.
There is still “great uncertainty” about how the H1N1 flu outbreak will evolve, the director-general of the World Health Organization has recently stated.
Source: “WHO Head Says H1N1 Outbreak Not Over”, MedpageToday, May 15, 2009
Source: “H1N1″, CDC, May 15, 2009
May 10th, 2009 by Nina Thompson, ARNP
The CDC reports 2532 cases and 3 deaths, as of May 10, 2009 at 11am.
In Florida, there are now 20 probable cases of swine flu, but only five confirmed cases. Pinellas County has 1 confirmed case and Hillsborough County has six probable cases. Florida state health officials have set up a hot line where citizens can call for more information and learn about acquiring masks and antiviral medication.
Source: CDC, May 10, 2009
Source: St. Petersburg Times Online, May 10, 2009
May 7th, 2009 by Nina Thompson, ARNP
The virus that caused the widespread epidemic of 1918 is thought to be caused by a swine flu virus. It was the most devastating epidemic in recorded world history and was caused by an exceptionally virulent strain of the flu which infected 28% of all Americans and a fifth of the world’s population. During the worst of the epidemic, the virus moved quickly, killing young and healthy people within hours of the onset of symptoms. Although the current outbreak is also due to a swine flu virus, so far this particular circulating strain lacks certain features that would make it extremely virulent. However, experts are concerned that it could still mutate and change to a more virulent strain.
Another concerning feature of this swine flu outbreak is that the virus appears to not only be jumping from pigs to humans and back to pigs, but it appears to be efficiently spread in the new population of humans. This suggests that the virus is not going to fade away, according to experts. The last time a swine flu jumped to human and was efficiently spread in the new host was in 1918.
This is a virus that “no one in the population has seen before and therefore everyone is immunologically vulnerable, “ Chris Smith, a flu virologist at Cambridge University in England, recently told the Associated Press. ”Therefore it’s highly likely that once it starts to spread, people will catch it. And since the majority of the world’s population are in contact with one another, you’re going to get quite a lot of spread.” Up to 2 billion people could be infected by swine flu if the current outbreak turns into a pandemic lasting two years, the World Health Organization said today. This is one-third of the world’s population which is consistent with the historical record of flu pandemics. Independent experts agreed that the estimate was possible.
Another dangerous characteristic of this swine flu outbreak is that the median age of hospitalized individuals with swine flu is 15, which is younger than occurs with regular seasonal flu, said Dr. Richard Besser, during a news conference on May 6th. This is a concerning fact that scientists will be watching.
At this point in early May, it has already moved into the southern hemisphere. Suspect cases have been reported in Brazil, Australia, and New Zealand, where the flu season is just beginning. The virulence of the swine flu may well reveal itself during the Southern Hemisphere’s winter months, according to Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention.
Scientists will be watching this virus closely to see whether it disappears as the swine flu scare did in 1976, becomes the dominant flu strain, or mutates into a deadlier illness that returns to the Northern Hemisphere and causes a pandemic in the fall similar to that of 1918.
Source: “Swine H1N1 Transmission From Human to Swine“, Recombinomics, Commentary 07:10, May 3, 2009
Source: Journal of Virology, May 2009
Source: “Swine Flu Travels to Poland as 1,893 Confirmed Ill”, Bloomberg.com, May 7, 2009
Source: “WHO says up to 2B people might get swine flu “, Associated Press, May 7, 2009
May 7th, 2009 by Nina Thompson, ARNP
Today the CDC reports 896 confirmed cases and 2 deaths in the U.S., but this is far from the whole story.
In the U.S., state labs have been struggling with huge backlogs of untested flu samples. The Texas State Lab, for instance, currently has tested only 13 percent of the 6,677 samples received. Test kits were finally delivered May 5 to laboratories in all 50 states and Puerto rico. The test kits were shipped internationally as well. This increase in testing capacity is likely to result in a sudden increase in the number of reported confirmed cases in this country, which should provide a more accurate picture of the extent of the spread.
The virus does appear to be spreading with ease. In two weeks, swine flu jumped from isolated reports in the U.S. and Mexico to a widening circle of infections in Central America, South America, Europe, the Middle East, Asia and New Zealand. The WHO is on the verge of declaring a pandemic. In fact there is significant concern that the “swine flu may affect at least one-third of the world’s 6 billion population within the next year”, said Keiji Fukuda, the WHO’s assistant director-general of health, security and environment, in a video broadcast today.
Source: “Swine Flu Travels to Poland as 1,893 Confirmed Ill”, Bloomberg.com, May 7, 2009
Source: Source: “Reporter tries to get tested for swine flu“, Wall Street Journal, May 6, 2009
May 6th, 2009 by Nina Thompson, ARNP
The ongoing outbreak of swine flu (H1N1) continues to grow in the United States and internationally. Currently the CDC continues to report only 400 cases confirmed, with another 700 probable cases in 44 states. But does the CDC’s running tally truly represent the number of swine flu cases in existence?
Apparently not. Some state labs are ramping up testing but reports are surfacing that authorities are far from having enough resources to test everyone. In fact some labs are limited to testing as few as 2 swabs per day while the remaining specimens are put on hold, adding to the backlog of untested samples. The Federal Government is working to expand capacity for testing around the country, but at this point the full extent of the outbreak is not being reported.
The Federal Government and manufacturers have begun developing a vaccine against the H1N1 swine flu virus. Making a completely new influenza vaccine can take five to six months, according to the WHO.
Source: “Reporter tries to get tested for swine flu“, Wall Street Journal, May 6, 2009
Source: CDC Press Briefing May 5, 2009 1:30pm
May 4th, 2009 by Nina Thompson, ARNP
Yes it could, although the good news is the outbreak appears to be declining, and right now it doesn’t contain the features seen in much more severe flu strains.
The bad news is the H1N1 virus could return with a vengeance in the Fall, as the deadly Spanish flu did in 1918. It started with milder cases in the spring, seemingly disappeared over the summer, and then returned as a much more virulent and deadly strain in the fall. In the Northern hemisphere, the weather is most conducive to the usual seasonal flu virus during the winter months. Thus the virus tends to disappear by April and re-emerges in November.
The 1918 pandemic is cited as the most devastating epidemic in recorded world history. It was caused by an exceptionally virulent strain of the flu which eventually infected 28% of all Americans and a fifth of the world’s population. It claimed the lives of 20 million to 50 million people worldwide. More died of influenza in a single year than in four-years of the Bubonic Plague.
The flu of 1918 was most deadly for people ages 20 to 40, which was different than the usual pattern of morbidity for the seasonal flu which is usually a killer of the elderly and young children. The influenza virus of 1918 ”had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Taubenberger).” (virus.stanford.edu/uda/)
In 1918, “People were struck with illness on the street and died rapid deaths. One anectode shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza (Hoagg). Others told stories of people on their way to work suddenly developing the flu and dying within hours (Henig). One physician writes that patients with seemingly ordinary influenza would rapidly ‘develop the most viscious type of pneumonia that has ever been seen’ and later when cyanosis appeared in the patients, ‘it is simply a struggle for air until they suffocate,’ (Grist, 1979). Another physician recalls that the influenza patients ‘died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth,’ (Starr, 1976).” (virus.stanford.edu/uda/)
On the other hand, the past two pandemics - in 1957 and 1968 - were relatively mild. This flu could be a catastrophe as in 1918 or it could fizzle out as in 1957 and 1968. Nobody knows, but they do know preventive measures, such as getting a flu shot and frequent handwashing, make a huge difference. The CDC says that ’the genes of all of the viruses we have examined to date are 99 to 100 percent identical. This means that it will be somewhat easier for us to produce an influenza vaccine.”
Also, avoid the numerous scams that are surfacing in an attempt to take advantage of the current concern over the flu. The U. S. Food and Drug Administration and the Federal Trade Commission warned consumers Friday to avoid Internet sites and other promotions that offer products claiming to diagnose, prevent, treat or cure the swine flu virus.
Read more About Influenza and How to Prevent It
Source: CDC, May 4, 2009
Source: Stanford online, http://virus.stanford.edu/uda/
April 30th, 2009 by Nina Thompson, ARNP
“The 1918 influenza epidemic started with cases in the spring, seemingly disappeared over the summer, and then returned with a vengeance in the fall”, according to the CDC.
In the Northern hemisphere, the usual seasonal flu virus tends to disappear by April and re-emerges by November. It can, however, be caught at any time of the year.
The real concern over this most recent outbreak may well occur this coming Fall.
April 29th, 2009 by Nina Thompson, ARNP
Nobody knows whether swine influenza A (H1N1) will cause a pandemic, become endemic in humans causing continuous small outbreaks, or fizzle out and disappear, according to Dr. Klaus Stohr in an article in MedPage Today.
“If the virus were to “disappear” though, that would not necessarily eliminate the need to prepare for its re-emergence if it remained in an animal reservoir”, said Klaus Stohr, D.V.M., vice president and global head of Novartis Vaccines and Diagnostics and former head of the World Health Organization’s global influenza program. “The earliest the public would see a vaccine against the disease would be September”, a researcher said at the conference on Influenza Vaccines for the World, according to MedPage Today.
The swine flu outbreak serves as “a stark reminder of the unpredictability of the timing and of the speed by which the pandemic situation can change,” Dr. Klaus added.
Read more:
Source: MedPage Today, April 29, 2009
April 29th, 2009 by Nina Thompson, ARNP
The World Health Organization has raised the global alert level for swine flu to Phase 4, indicating that the
virus is becoming more adept at spreading among humans. The increase in the pandemic alert phase indicates that the likelihood of a pandemic has increased.
The CDC has issued a travel warning recommending that people avoid non-essential travel to Mexico. Health officials are urging people to follow important, common sense preventive measures:
- Wash your hands often with soap and water, especially after you cough or sneeze, before eating or touching your face, mouth or nose. Flu viruses can survive for two hours or longer on surfaces, such as doorknobs and countertops.
- Alcohol-based hands cleaners are also effective. Carry a small bottle with you at all times to use when a sink is not available.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Try to avoid close contact with sick people.
Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. It is not spread by eating pork because cooking to an internal temperature of 160 F (71 C) kills the virus. So eating properly cooked pork is safe. Swine flu is spread like any other respiratory disease, via droplets from sneezes and coughs. You can breathe in these droplets or become infected by touching a contaminated surface and then touching your eyes or mouth.
If you get sick, the CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. Call your doctor or health care provider for further recommendations. An important note for children, always check with your pediatrician before giving your child any cold medicines. Do Not Give Aspirin To a Child or Teenager Who Has the Flu or Flu-like symptoms.
Read more:
Source: CDC, April 28, 2009
