revere | July 4, 2009I don't know what's going to happen with swine flu. I do know that if there is a nasty flu season we'll all get through it better if we help each other, not run from each other. It's national independence day in the US, so I thought this clip of the crowd singing the National Anthem (hat tip, Paul Rosenberg at Open Left) at Boston's Fenway Park (home field of the Boston Red Sox baseball team) was appropriate. It was Disability Awareness Day and to recognize it the anthem was being sung by a handicapped youngster. When he got nervous, the entire ball park came to his rescue:
revere | July 4, 2009The number of people who die from seasonal flu every year varies greatly from year to year. No one really knows what it is. The most frequently (mis)quoted figure is 36,000 deaths directly or indirectly, although this figure is a long term seasonal average of excess mortality correlated with flu season. We discussed this in more detail in an earlier post and for the purposes of this one, only the rough order of magnitude is pertinent. Let's just say it's in the tens of thousands -- roughly. Let's also agree on the several hundred thousand hospitalizations from flu or flu related illness -- on…
revere | July 3, 2009It's not even three months since the first H1N1 swine flu cases were diagnosed in San Diego, but already there is a significant amount of science published on the subject. Lots of genetic sequences from various isolates, clinical descriptions of hospitalized and fatal cases and now animal experiments. Two teams, one in The Netherlands and one in the US, have infected ferrets and mice with pandemic H1N1 isolates from Europe, the US and Mexico and compared transmissibility, virulence and pathology with seasonal H1N1 strains. The two papers were published yesterday in the journal, Science (…
revere | July 2, 2009The first cases of swine flu were diagnosed in the US in San Diego in mid-April. The discovery was serendipitous, the result of out-of-season US-Mexican border surveillance and use of a new diagnostic test at the Naval Health Research Center. When the new test protocol showed infection with influenza A with undeterminable subtype, follow-up testing showed it to be an previously unknown swine flu virus. Detection of a second, apparently unlinked swine flu infection in San Diego got the outbreak (now pandemic) investigation rolling.
That was just over 2 months ago, but it established the…
revere | July 1, 2009For reasons not revealed to anyone I know, WHO is saying the Tamiflu resistance in a Danish swine flu isolate is "isolated case." Could be, but I'd sure like to know why they think so, other than they don't have any other examples. Meanwhile WHO and CDC continue to advise prompt use of Tamiflu (oral oseltamivir) for treatment of swine flu in high risk patients. Which brings up the question of side effects.
The most common Tamiflu side effect is nausea and vomiting. When my daughter was seen at the local hospital ER for swine flu symptoms and a positive rapid test for influenza A at a time…
revere | June 30, 2009Currently the only antiviral drugs effective against the swine flu (novel H1N1) virus are the two neuriminidase inhibitors, oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza). Relenza is in active form at the outset and cannot be absorbed orally. It must be inhaled, leading to asthmatic reactions in some, ineffective dosage in those with breathing difficulties, and no drug at sites beyond the respiratory tract. Despite these drawbacks, it has so far produced little or no viral resistance. Tamiflu is absorbed orally and converted by the liver into the active form, so it gets…
revere | June 29, 2009Crafting a message on swine flu is not easy, and it's easy to make missteps. I think CDC has gotten it pretty much right over the last two months, but not everyone has. We've written here since the beginning (some examples here and here) that describing any flu outbreak as "mild" is inapt. Flu always has the potential to be a serious disease and kill people, even in flu seasons termed "mild" by comparing them to flu seasons that are "bad." Even with virulent flu viruses many people have minimal illness -- in comparison to those who don't. But flu, even in its most common form of a self-…
revere | June 28, 2009A few days ago we posted about hedge funds getting ready for a swine flu pandemic. At the time we wondered what other industries and businesses were getting ready. We don't know the answer, but we are seeing more signs the message has gotten through. Yesterday we saw this story about a regional airport in Arizona:
The Valley's Mesa-based reliever airport is gearing up to operate with a surprisingly lean staff should the Swine Flu pandemic decimate the airfield's workforce.
Keeping Phoenix-Mesa Gateway Airport flightworthy with a skeleton crew was added earlier this month to mandatory…
revere | June 28, 2009There is a misconception that because I am an atheist and poke fun at religion in this space every Sunday that I must have contempt for religion for its own sake. It's true I find many of the pious contemptible, but not because they are pious. You can be stupid in all sorts of ways and that's just one of them. Nor do I go after religion and the religious because they believe in one of the many gods people have made up. There are a lot of ways to be irrational. Look at Wall Street. No, I go after religion because it represents a particularly nasty form of tribalism, a set of beliefs that…
revere | June 27, 2009Early returns on what is happening in the southern hemisphere suggest that novel H1N1 is crowding out the expected seasonal strains, something that pandemic strains have usually done. In 1918 there was a pandemic with the H1N1 subtype that settled down as the dominant seasonal flu virus until the "Asian flu" pandemic of 1957 when it was bumped by H2N2. That subtype ruled the seasonal flu roost for only 9 years when a new subtype, H3N2 took its place in the Hong Kong flu pandemic of 1968. Both pandemics were much less severe than 1918 but still resulted in millions of excess deaths globally.…
revere | June 26, 2009Science may know no borders but scientists have nationalities. Many live within the countries where they have citizenship, while many travel to where they can do more and better science. In the 21st century no nation can afford to squander its scientific talent. But some do it, anyway, either in small ways (failing to support science) or in Big Ways (oppressing free inquiry and free expression). No country is perfect, but some excel in this kind of stupidity. Even before the recent national uprising Iran's government was distinguishing itself in the irrationality and anti-science department (…
revere | June 25, 2009A story in yesterday's New York Times was headlined: In New Theory, Swine Flu Started in Asia, Not Mexico. That sounded pretty interesting. What's the new evidence? The answer? None. Just speculation. So what's going on?
Contrary to the popular assumption that the new swine flu pandemic arose on factory farms in Mexico, federal agriculture officials now believe that it most likely emerged in pigs in Asia, but then traveled to North America in a human.
But they emphasized that there was no way to prove their theory and only sketchy data underpinning it.
There is no evidence that this new virus…
revere | June 24, 2009For years those concerned about the consequences of an influenza pandemic from an exceptionally virulent flu virus, like A/H5N1 ("bird flu") have despaired about motivating business, government and neighbors to take it seriously enough to make serious preparations. It's understandable. There's are a lot of potential catastrophes competing for our attention and while each can be made plausible if we can get someone to listen long enough, it's rare we can do this. As I said, too much competition. Now that a real life influenza pandemic has arrived, the concern of some is that the public isn't…
revere | June 23, 2009CDC has another snapshot of what the flu surveillance system is seeing up through week 23 (ending June 13). It shows flu still circulating in many communities at a time when most seasonal flu is normally at a very low level. Indeed of the 2765 specimens tested in CDC's network of 150 laboratories, virtually all of the roughly 40% were influenza A (seasonal influenza B has all but disappeared; the others were not influenza). Not all the flu A viruses were or could be subtyped, but of those that were or could be, 98% were novel H1N1. IN other words, there's lots of flu around, but essentially…
revere | June 22, 2009If you don't want to smell, the FDA has a recommendation: use an over-the-counter cold remedy that contains an intranasal zinc solution. You won't smell. Possibly ever again:
The U.S. Food and Drug Administration today advised consumers to stop using three products marketed over-the-counter as cold remedies because they are associated with the loss of sense of smell (anosmia). Anosmia may be long-lasting or permanent. (FDA Press Release)
Losing your sense of smell is no joke. It is intimately involved with your sense of taste and is a warning sense for dangerous gases. The role of zinc in…
revere | June 21, 2009All eyes are on Iran as young people struggle for basic freedoms: to assemble, to speak freely, to participate in civil society regardless of gender. It's a struggle not special to Iran. For some Americans, winning those rights is within recent memory. And when I was a young man, I had contemporaries who didn't live to see it. In the historic Freedom Summer of 1964, 45 five years ago today, three of them -- James Chaney, a 21-year-old black man from Meridian, Mississippi, Andrew Goodman, a 20-year-old white anthropology student from New York, and Michael Schwerner, a 24-year-old white social…
revere | June 21, 2009Blood on the streets in Teheran. Religion is not the only cause of this. But it's one of them Not Islam, particularly. Religion, itself. All religions have done this. Enough is enough.
revere | June 20, 2009Two elite flu reporters, Helen Branswell (Canadian Press) and Declan Butler (Nature), both noted yesterday the dearth of clinic information on the serious and fatal swine flu cases. First Butler:
Clinical researchers have been slow to respond to the 2009 flu pandemic, lament researchers writing in today's Lancet. "Public health officials, virologists, epidemiologists, and policy makers have done well in responding to a rapidly emerging and complex problem. By contrast, the clinical research community's response has been delayed and modest, " writes Jeremy Farrar, a researcher in Ho Chi Minh…
revere | June 19, 2009Swine flu infection of health care workers (or as CDC refers to them, health care personnel or HCP) was of interest early in the pre-pandemic phase for at last two reasons. One was the obvious goal of estimating the risk to front line workers and devising best practices for their protection. Another was the belief, reinforced by the SARS outbreak in 2003, that spread to HCP was an early warning that the virus was easily transmissible from person to person. SARS is a disease where patients are most infectious in the later stages when they are extremely ill, and HCP were among the hardest hit…
revere | June 18, 2009We were among the first to bring you the full text of the leaked minutes of the secret meeting of the bisphenol-A (BPA) cabal at a posh private club in Washington, DC on May 28. It turns out those minutes may be almost as toxic to the cabal as their endocrine disrupting chemical is to humans. I guess I am exaggerating. It would have to pretty toxic for that. But it is at least producing some unpleasant fall out (see also here). You may remember one element (besides describing as the "holy grail" finding a “pregnant young mother who would be willing to speak around the country about the…