revere | June 2, 2009Ten days ago Secretary of Health and Human Services Kathleen Sebelius announced that the US government was allocating $1 billion to help companies with production costs for a swine flu vaccine. Among the beneficiaries was French vaccine giant, Sanofi-Aventis, whose Sanofi Pasteur unit got a $190 million order. It was likely only the first in a series of expected orders for the company. Sanofi knows how to make vaccines. So what could go wrong?
Drugmaker Sanofi-Aventis has agreed to pay nearly $100 million to settle allegations it cheated Medicaid on the cost of nasal sprays.
The Justice…
revere | June 1, 2009Since I talk a lot about flu in my real life as well as on the blog, I get questions from moms and care givers who wonder when they should start to get worried about a sick child or relative. It's context dependent, of course. The same symptoms that would be shrugged off at any other time take on a different meaning during a flu outbreak, especially when everyone seems uncertain about what is happening or what might happen. There's nothing irrational about this. Infection with influenza virus is always potentially serious and when the young and healthy are in the cross-hairs even more so.…
revere | May 31, 2009We've had occasion to write about the endocrine noise-maker bisphenol-A (BPA) quote a few times (see here, here, here, here, here, here, here, here for starters). The word about BPA has gotten to consumers and they have fled BPA-containing products like they are swine flu carriers. Meanwhile the scientific evidence is piling up and what the market hasn't done will likely bring BPA into the cross-hairs of food safety regulations, if not via the FDA then by state and local governments, some of which have already acted.
So it looks like the writing is on the wall for BPA unless the food…
revere | May 31, 2009In the view of New Scientist journalist Amanda Gefter, The Discovery Institute, high priests of Creationism as an allegedly rational enterprise, aren't really worried about Richard Dawkins. Presumably he's just a great fund raising device for them. The one who really scares the BeJesus out of them is biologist Francis Collins, the evangelical Christian rumored to be Obama's choice as next Director of NIH:
The Discovery Institute - the Seattle-based headquarters of the intelligent design movement - has just launched a new website, Faith and Evolution, which asks, can one be a Christian and…
revere | May 30, 2009The natural reservoir for most influenza viruses is birds, especially aquatic birds, but some versions of the virus have also become adapted to the host cells of other species, among them sea mammals, horses, dogs and of course pigs and humans (among others). How long is the list? We really don't know, as there has been little systematic inquiry into influenza hosts in the natural world. While human influenza is seasonal in the northern and southern hemispheres, where it goes in the "off season" is a matter of debate. Most flu experts think it remains at low levels in the community, spiking…
revere | May 29, 2009As flu season ramps up in the southern hemisphere, the US, Europe and Asia are keeping an eye on it to see what will happen as swine flu finds new pieces of meat to sate its appetite for human flesh. Sorry about the overheated image. I've been reading what's going on in Australia. Because another lesson the southern hemisphere can teach us is how not to react to a pandemic virus.
Consider the Carnival Cruise Line ship, Pacific Dawn. It docked three days ago in Sydney onroute to the Great Barrier Reef to take on new passengers and let off others. But then, according to news reports (but see…
revere | May 28, 2009Influenza surveillance in the US has at least five component parts (depending on how you count it is as many as seven). We discussed the virologic surveillance system in another post. CDC has two surveillance sub-systems that look at hospitalized cases with laboratory confirmed influenza, the New Vaccine Surveillance Network (NVSN) and the Emerging Infections Program (EIP). The NVSN is confined to cases in children less than five years old, while the EIP covers all ages. Let's take a look at the most recent EIP data.
EIP doesn't cover the entire country. Instead it collects data from 60…
revere | May 27, 2009Yesterday New York reported two more swine flu deaths (a 41-year-old woman from Queens and a 34-year-old man from Brooklyn). CDC and just about everyone else who knows anything about influenza have been telling people to expect this. The influenza virus kills people all the time. We don't know exactly how many but we know that many people die of various immediate and underlying causes that wouldn't have died at that time if they hadn't become infected with the influenza virus in the period prior to their demise. Influenza is like heart disease or diabetes or cigarette smoking: a major cause…
revere | May 27, 2009We don't usually think of power outages as an important cause of poisoning but it is. Electrical power has become such a necessary part of basic needs -- think of light at night and refrigeration -- that if it is interrupted for more than a few hours people will turn to gasoline powered generators to provide it. Apparently, though, the fridge and the light bulb are not the only necessities. Experience with recent disasters is revealing that people have new kinds of imperatives:
Hours after Hurricane Ike roared ashore in Texas, more than two million homes were without power, which left some…
revere | May 26, 2009Last week another expedited-review paper appeared in the high profile journal Science, this one summarizing the genetics of the novel H1N1 influenza A virus causing the current outbreak cum pandemic. This time there is quite a bit of interesting material in this paper for non-virologist scientists with a strong interest in knowing what we are dealing with. And the first conclusion is that we are indeed dealing with swine influenza, whatever else you want to call it. Here is a short summary of the paper, which can be found here.
Influenza was identified as a viral disease in 1930 when it was…
revere | May 25, 2009We are now in the seventh Memorial Day of the Iraq War and the eighth of the Afghanistan War. This Priscilla Herdman version of Eric Bogle's "And the Band Played Waltzing Mathilda" appeared here last Memorial Day. Then, we were deeply dismayed by our government's actions. We remain so today. So here it is again, and for the same reasons:
On behalf of all the Reveres, Memorial Day 2009
revere | May 25, 2009The World Health Organization (WHO) is not the world's health department or the world's doctor. It is an intergovernmental agency that is part of the United Nations (UN). The UN, despite what hard right wingnuts might think, is not a world government. The international system is technically anarchic, meaning that there is no governing body above nationally sovereign states. For the most part, WHO has no powers beyond those granted it by its member nations (for more background, see our five part series over at the old site here, here, here, here, here). It is only within the last few years…
revere | May 24, 2009On Friday Department of Health and Human Services Secretary Kathleen Sebelius announced that the US was asking vaccine manufacturers to get ready to make an vaccine against this year's swine flu. Before a vaccine can be made there is a substantial amount of preparation that needs to be done, so this just gets the process started. And the first thing that is needed is a vaccine seed strain. We've been hearing from CDC that a seed strain was in preparation. So what's a vaccine seed strain? Two good news articles, one in Nature by Declan Butler, and one in ScienceInsider by Jon Cohen have some…
revere | May 24, 2009I'm not a paleontologist, but my children consider me an authentic fossil. This week PLoS ONE published an important paper featuring a fossil find (lots of good coverage here at Scienceblogs; Brian at Laelaps has a characteristically thorough run down). The discovery of this primate skeleton has implications for the human evolutionary tree, something that hasn't escaped the attention of the inimitable Edward Current:
revere | May 23, 2009Queens, a borough of the city of New York, seems to be a hotspot for swine flu and a New York Times reporter on the city beat, Anemona Hartocollis, has been writing very astute and perceptive pieces from there. Yesterday she had one on the problem posed by the "worried well" who are flooding Emergency Rooms in quest of reassurance. Articles about worried parents who bring relatively well kids to the Emergency Room (ER) are not uncommon. They usually include interviews with harassed and overburdened emergency room doctors and nurses dismayed at the unnecessary demand and its consequences for…
revere | May 22, 2009There is as yet no vaccine for the novel H1N1 (swine flu) pandemic strain of influenza now causing widespread illness in North America and what appears to be the start of growing outbreaks in Japan and parts of Europe (but check out this excellent piece over at ScienceInsider). WHO says most developing nations are not able to track influenza, so what is happening in Africa and parts of Asia is not known with any confidence. While the clinical illness from this virus doesn't seem very different than seasonal flu, the fact that most of the world's population has no immunity to it means there is…
revere | May 21, 2009Military planners are fond of saying that no battle plan survives the first contact with the enemy. The same can be said for the military's pandemic flu plans, although they aren't telling us exactly what those plans are. Some good reporting by Associated Press's Lolita Baldor has uncovered some of it:
The rapid spread of swine flu from Mexico surprised Pentagon officials, who had been focused on a possible Asian-borne pandemic in a response plan that would give the military a last-resort role in helping to impose quarantines and border restrictions.
Drafted and overhauled several times in…
revere | May 20, 2009We've talked a lot here over the years about preparing for a pandemic on a community level, not an individual level. Both are important, of course, but our interests here have always been on how neighbors can help neighbors and building strong communities to withstand all sorts of shocks, from recessions to pandemics. Our examples tended to focus on what we called the public health and social service infrastructure, but of course the principle went deeper. Unfortunately it was a message that fell on fallow ground during the Bush years.
There have been a lot of dismaying things about American…
revere | May 20, 2009A kind reader directed my attention late yesterday to an article on the Boston Globe's web site about three schools closing in Boston because of absenteeism from flu-like illnesses. I was struck by a comment made by a freshman at Boston Latin that seemed to get it exactly right:
The closing surprised freshman Wilhelmina Moen, who noted it was nice that authorities were concerned about the student's health.
"I'm not that worried," said Moen, who lives in Brighton. "It's the same thing as the other kind of flu. That flu kills too." (Stephen Smith, Andrew Ryan, Elizabeth Cooneym Boston.com)
So…
revere | May 19, 2009Is it a pandemic or is it not a pandemic? Since the world has never had a chance to make a call like this at the outset of a pandemic, nobody is quite sure how to handle it. The usual definition -- an epidemic (an increase in cases beyond what is expected) of global dimension -- has a lot of wiggle room and WHO and everyone else is busy wiggling. One reason is not whether this meets the definition or not but what the consequences might be of calling this "a pandemic":
Britain, Japan, China and other nations urged the World Health Organization on Monday to change the way it decides to declare…