Swine flu link roundup

Revere on quarantine versus isolation. This is a topic I’ve covered previously (here) as well, and an important distinction (though the two are often muddled together in the press).

Christine Gorman talks about getting the facts straight on swine flu, and offers up many additional resources to keep you updated.

Skepchick provides “Things More Likely to Save You From Swine Flu Than Homeopathy”. Colon cleanse and chiropractic are noticeably absent…

1976 swine flu Public Service Announcements. They don’t make ‘em like that anymore… (h/t http://twitter.com/tomburket)

Finally, my colleague, Dan Diekema, a hospital epidemiologist extraordinaire here at the University of Iowa, has started a new blog: Controversies in Hospital Infection Prevention. Obviously, swine flu has been the big discussion in this area over the last few days, and Dan and his co-blogger, Michael Edmond, have several posts on swine flu and infection control. Stop by and check it out…

Comments

#1 GK
April 28, 2009

It took 31 days to sequence the SARS virus in 2003. But now, swine flu just takes 1-5 days (depending on what you include in the process, as I learned here earlier).

Soon, it will take only hours. Moore’s Law makes our tools faster and faster each year, making us more resistant to new viruses.

If the viruses also adapt faster, however, the arms race will accelerate on both fronts.
#2 Samer
April 28, 2009

Do we know what the mortality rate for this virus?
#3 mthrndr
April 28, 2009

I think the mortality rate for this virus is no more than 1%. If it were 7%, we’d certainly see a few deaths in the US by now. I think it is a mild flu variant that has the ability to produce cytokine storms in healthy adults. This would not bode well for a 2nd wave, but by fall there should be a vaccine available.

Everyone calm down, go out and get some sun (vitamin D works wonders), and wash your hands. You’re not gonna get the plague.
#4 Crafty Hunter
April 29, 2009

There’s an interesting story about patient zero possibly having been identified in Mexico, as well as a possible breeding ground for the original “swine flu”. It looks as if filthy pigs may after be responsible, although the final blame doubtless will belong (as usual) with human greed.

http://www.dailymail.co.uk/news/worldnews/article-1174270/Pictured-The-year-old-Mexican-boy-living-near-ground-zero-pig-farm-hold-key-swine-flu-outbreak.html?ITO=1490
#5 hundry
April 29, 2009

Good article thank you!

Has anyone been tracking the spread of swine flu on this website http://www.swine-flu-tracker.com/? It seems every time I check it the swine flu spreads.
#6 sara
April 29, 2009

My mother, being a child of the 40s and the daughter of a public health worker, lined us up for Swine Flu vaccines in 1976.

I suppose the upside of the anti-vax crowd with their “I’ll use enemas and homeopathy” arguments is that there will be more vaccine for those of us who want it when they finally roll one out?
#7 chuck
April 29, 2009

If this thing takes off, we’ll all probably be on our own. So in the interests of home-made expedients, can somebody tell me:

Can you make a serviceable mask by cutting up a t-shirt or pillowcase and spritzing it with a disinfectant like bleach?

Can you make hand sanitizer by mixing liquid laundary detergent (10%) and rubbing alcohol (90%)?

Can you break a fever with hot baths?

Can you use apirin or tylenol or whatever not so much to break a fever, since a little is a good thing, but to put a ceiling on how high it will go?

Can you help clear out the lung gunk by keeping a tea kettle steaming? What about throwing in some garlic cloves?

Lastly–and I am very proud of this one, so don’t rain on my parade, OK?– to prevent turning blue could you rig a ventilator from an aquarium airpump?

Hope these aren’t too stupid questions, but I won’t be the only one who will be needing to know this stuff.
#8 Stephen
April 29, 2009

Face masks are available at the dollar store. I have a couple in stock for crawling around my attic (dusty and with fiberglass insulation – it itches your skin, what does it do to your lungs?).

You can break a fever with a bigger-than-recommended does of Motrin or Tylenol. I’m no doctor, and don’t play one on TV. But that’s what they do at the hospital, and it seems to work. There doesn’t appear to be any advantage to hanging onto a high fever. I wish i’d known this before enduring a 105 fever for a week. Apparently, my doctor didn’t know it either. Astonishingly unhelpful. I’m still here, but for no apparent reason.

I’ve never been able to break or reduce a fever with a hot or cold bath or shower.

Modern aquarium air pumps have been optimized (cheapened) to the point where they’re not much good for anything else. In the 70′s i was able to inflate a balloon using one. Not quickly, but it did inflate. I don’t see how the volume would be enough.

Moist, warm air treats respiratory symptoms, a good thing. Moist air seems to kill influenza viruses, a good thing.

I’ve not tried garlic. Things i’ve tried that have helped on various diseases are: lots of sleep, bed rest, keep your ears and neck warm (i wear a hooded sweatshirt while sleeping), good dental hygiene, gargling with: salt, aspirin, mouthwash (if there’s a sore throat, do them all, as not all are effective for all sore throats), drink lots of water, avoid sugar, eat what you can (feed a fever, feed a cold), and eat pink grapefruit (but without sugar). No amount of vitamin C pills has any effect on me.

Note: this is not peer reviewed or double blind tested. And YMMV.
#9 Darin
April 29, 2009

In the US we are hearing that experts expect this flu strain to die out during the summer, but reappear in the winter months (normal flu season). But how about the countries that are about to enter winter? Will Africa, Australia, and South America experience a really bad flu season as this flu is emerging just as they entered their fall season? What do the experts say about traveling to countries that are about to enter their traditional flu season?

Also, any reason this has popped up after the normal northern hemisphere flu season?
#10 ScepticsBane
April 30, 2009

Oh how nice!!! Tara Smith has provided us with a link “explaining” about things more likely to “save” us from Swine Flu than Homeopathy.

And… what’s this!? Tara is a professor of Epidemiology!!

Then she must have read a recent issue of the Journal of Clinical Epidemiology, in which an article analyzed a 2005 Lancet meta-analyis supposedly showing that Homeopathy performed no better than placebo. The Journal of Clinical Epidemiology concluded that the 2005 meta-analysis was not tremendously useful in its conclusion (citation at end of this remonstrance). And of course, other articles in Lancet, in other meta-analyses, had shown the exact opposite.

Then there’s those “preposterous” high dilutions that Homeopathy uses – you know, dilutions so high that no molecules of the curative substance remain.
And yet… there are a number of scientists, pharmacology researchers, who report to us that such solutions do indeed stimulate biological effects, as though some molecules of the stimulant were still present (M. Ennis, Inflammation Research, vol 53, p181).

Ennis, correctly remains a skeptic of Homeopathy but still published her unexpected positive results and asked others to verify. They did. Curiously, media attention has not always been so open minded. A 2001 BBC documentary purported to “repeat” her experiment but instead, their researcher quietly changed the test protocol, forgetting to mention the introduction of Aluminum Chloride, a chemical which kills the cells under test which therefore rendered their experiment worthless. A weak-ii-pedia article about Ennis, still wrongly reports this.

Now, let’s be clear that all the reports about Homeopathy saving lives in the 1918 Influenza epidemic are just hearsay – reports, nothing more…. preposterous nonsense that the Homeopaths with their treatments were getting absurdly low mortality rates in the area of 1% while the standard medical treatments of the era (one can imagine what they were!)
experienced mortality rates of 20-40%.
Really… please disregard any of that as impossible and not proven, the Homeopathic doctors reporting those figures were obviously delusional or else perhaps hooked on homeopathic opium…
Weren’t they?

Homeopathy is most certainly unproven at a scientific level. But, like aspirin used for decades before its mechanism of action was understood, it has its uses and people find out them fast. This may cause dismay in some, but of course neither the patient to be cured, nor the virus really care.

References:

Lüdtke R, Rutten ALB. The conclusion on the effectiveness of homeopathy highly depend on the set of analysed trials. Journal of Clinical Epidemiology, 2008. doi: 10.1016/j.jclinepi.2008.06.015

Lorenz I, Schneider EM, Stolz P, Brack A, Strube J. Influence of the diluent on the effect of highly diluted histamine
on basophil activation.
Homeopathy. 2003 Jan;92(1):11-8.
PMID: 12587990 [PubMed - indexed for MEDLINE]

Sainte-Laudy J, Belon P.
Use of four different flow cytometric protocols for the analysis of
human basophil activation. Application to the study of the biological activity of high dilutions of histamine.
Inflamm Res. 2006 Apr;55 Suppl 1:S23-4.
PMID: 16705375 [PubMed - indexed for MEDLINE]

Sainte-Laudy J, Boujenaini N, Belon P.
Confirmation of biological effects of high dilutions. Effects of submolecular
concentrations of histamine and 1-, 3- and 4-methylhistamines on human
basophil activation.
Inflamm Res. 2008;57 Suppl 1:S27-8. No abstract available.
PMID: 18345504 [PubMed - indexed for MEDLINE]

Sainte-Laudy J, Belon P.
Improvement of flow cytometric analysis of basophil activation inhibition by high
histamine dilutions. A novel basophil specific marker: CD 203c.
Homeopathy. 2006 Jan;95(1):3-8.
PMID: 16399248 [PubMed - indexed for MEDLINE]

This is just a sampling, there is more, much more – perhaps we should forward it to SkepChick!

Thanks!
SB
#11 H1N1 Flu Map
May 1, 2009

Thanks for sharing. Such a mix of great information and sketchy information out there… we need to do everything we can to make sure the credible sources are the ones that people get to spend their time on!
#12 PanFLuWatch
May 3, 2009

@ Samer:

To date, there have been 19 deaths out of 898 laboratory-confirmed cases, for a preliminary cafe fatality rate (CFR) of 2.12%. (http://www.who.int/csr/don/2009_05_03a/en/index.html)

As of yesterday, however, there was a backlog of 35,000 samples in Mexico, 35,000, 600 in the UK, and a 4-day wait due to the backlog in the US… so even if the reality of the virus’s virulence doesn’t change at all, our understanding of it may change significantly over time.

And as many have mentioned around the blogosphere, the virus will continue to evolve. The 1918 pandemic actually started with a mild first wave in the spring before becoming hyper-virulent in the fall… so we shouldn’t become complacent if the early numbers seem less than shocking.

We need to prepare for the worst and hope for the best.
#13 seksi
May 3, 2009

And as many have mentioned around the blogosphere, the virus will continue to evolve. The 1918 pandemic actually started with a mild first wave in the spring before becoming hyper-virulent in the fall… so we shouldn’t become complacent if the early numbers seem less than shocking.
#14 Scott
May 4, 2009

If the viruses also adapt faster, however, the arms race will accelerate on both fronts.

So, perhaps this is an exceedingly naive question: but it seems to me that the rate of evolution in the virus is at some kind of equilibrium – that is, it’s limited by some set of related-rate factors, and it’s already at steady-state max. For example, unless something causes it to mutate faster, why would it evolve faster?

Is it that case that viruses, unchecked by human vaccines, are stable and do not evolve? How much of that is a response (ala anti-biotic resistance in bacteria) to our vaccine regimes (ie, the non-resistant ordinarily crowd out the resistant strains in the population)?

Seems to me the only difference is in the time it takes to develop a resistance response in the population naturally (as a reaction to exposure), and that vaccination reduced responses aren’t any quicker (you still have to wait for the mutation to appear and then sequence it…so your limiting step is still the currently existant rate of mutation.

That is: even if the rate at which you sequence and synthesize a vaccine catches up with the normal immune response, you’re still only at parity with the present in terms of the arms race.