revere | May 6, 2009We get emails, all kinds of emails, from people thinking it would be great if we mentioned something near and dear to them on Effect Measure. We are flattered by this, of course, but we aren't journalists or a commercial site or a non-profit advocacy site (well, we are ultimately non-profit, but not intentionally). Occasionally, though, we get email that piques are interest and enthusiasm. This afternoon I got one from Jonathan Link, a writer for AboutKidsHealth, a project of the The Hospital for Sick Children at The University of Toronto.
Back in the days when Quebec was a referendum in the…
revere | May 6, 2009How fast flu spreads is related to how many susceptible people an infectious person can infect (a measure called R0) and also something called the serial interval. The serial interval is the average length of time between the start of one infection and the start of the infection of that case's infected contacts. The horter the serial interval the faster a virus can spread. So what is the serial interval for this virus and how can we determine it? The answer to the first question is the usual. We don't know yet. The answer to the second one tells us a little about why we don't know and why we…
revere | May 5, 2009If you've ever wondered how spammers got your email address, the answer might be that you gave it to them by following a link you thought had important or interesting information. We all know the kind of "interesting" information people will follow. Sex is the biggest business on the internet. But spammers have also learned that breaking news events can also be a lure, especially if there is public anxiety and uncertainty. About things like swine flu:
About five per cent of global spam volume mentions 'swine flu' to trick people into opening the e-mail message, say security experts.
As the…
revere | May 5, 2009As I write this the US has 279 confirmed cases and one death from H1N1/2009 in 36 states. WHO has tallied 1085 1124 cases in 21 countries with 25 deaths. There is a backlog of samples waiting for confirmation, so by the time you read this the counters will probably have rolled upward, especially as state laboratories become facile with the new primers and are able to do their own confirmation. And predicting an increasing case count is about all anyone can say with certainty at this point. What we said once about flu pandemics can be said just as appropriately for the flu virus: "If you've…
revere | May 4, 2009Cytokine storm is a graphic phrase that doesn't do justice to the complexity of one of the things that made the 1918 H1N1 virus so virulent and is also implicated in the frightful case fatality of H5N1 ("bird flu"). The current H1N1/2009 is not showing a propensity to cause this nasty effect, but the subject has come up several times in the comments. The post I am sending you to was written just before the current outbreak. It is about recent work that is trying to unravel the mechanism behind the serious immune system dysregulation called cytokine storm. While it's mainly about cutting edge…
revere | May 4, 2009There have been questions in the comments about where the CDC estimate of 36,000 to 40,000 influenza related deaths a year comes from. It's a figure I've used a number of times here to say generally that regular old seasonal influenza may be a mild disease for some but not for many others. Even if you don't die of flu, it can be a miserable illness and lay you low for several weeks of acute illness and months of fatigue and malaise. Now the 36,000 deaths number is taking on a life of its own, so it's time to explain exactly what it is and what it isn't. There are more things it isn't that it…
revere | May 3, 2009Newspapers and wireservices are doing a terrific job keeping a flow of information on H1N1/2009 (the virus formerly known as swine flu). And so, I am happy to say, is the blogosphere. I don't want to slight some terrific bloggers by mentioning some and not others, so I won't do a blogroll. OK. I will make one exception to the "not mentioning" by mentioning crof over at H5N1, not only for his usual splendid job of gathering the news but for his great blog roll and resource list on the sidebar.
And, yes, I am going to make another exception for an exceptional blog post by my long time blogging…
revere | May 3, 2009It's now fairly certain that humans have returned the favor and given H1N1/2009 to pigs, another example of a cozy flu swapping relationship now almost a century old. At the time of the 1918 pandemic, pigs were also suffering a serious influenza-like illness which was quickly dubbed "hog flu." The pigs got sick suddenly with fever and respiratory symptoms but recovered quickly and mortality was fairly low. The same thing occurred elsewhere (Europe, China) during and after the pandemic, so it wasn't hard to make a connection between the "Spanish flu" and "hog flu." But in 1918 it wasn't known…
revere | May 3, 2009[New readers: the Freethinker Sermonette is a weekly feature here. If atheism bothers you, you can skip it. But please don't complain it has nothing to do with science. In our view, it has everything to do with science. The rest of you, enjoy.]
PZ over at Pharyngula has the most appropriate post for this week's Freethinker Sermonette (plus it provides a nice link to scibling Nick Anthis's terrific post on the mechanism of a kind of antiviral resistance exhibited by the swine flu virus). I'll just settle for Bill Maher's little diatribe. The swine flu part starts at about 1:45 minutes:
revere | May 2, 2009CDC has posted images of the H1N1/2009 (aka swine flu) virus. This looks like it is grown in tissue culture (probably dog kidney cancer cells). It presents the ideal picture of a spherical virus studded with HA and NA protein spikes on its surface and enveloped with capsular material derived from the host cell. When flu virus infects actual organ tissue in an intact host it is pleomorphic, i.e., it has a variety of shapes, including a long threadlike one. However this is its ideal shape, often rendered in cartoon or diagram form in textbooks.
Here's a typical diagram of a flu virus:
Source…
revere | May 2, 2009Laurie Garrett of the Council on Foreign Relations and a well-known authority on emerging infectious diseases was on PBS's Newshour last night and she made a very important but little appreciated point. Mexico has made a major national sacrifice for global public health by shutting down its country and interrupting transmission of disease. The cost to Mexico has already been enormous it will continue to pay in other ways. The reputation of the government has suffered because of the way it handled this -- the lack of transparency, the initial slow footedness (which of course it denies), its…
revere | May 1, 2009[NB: I have been traveling and offline all day. No way I can even read much less respond to the many excellent comments, tips, questions. Thanks to all. Help each other. Back at home base now.]
Closing US borders with Mexico for swine flu is fruitless since the virus is already planted in a dozen or more countries. And while right wing xenophobes are trying to blame Mexican immigrants, most of the international spread has come from commercial travelers, either tourists or business people. If we had sealed the borders, would it have included all American nationals in Mexico? Somehow I don't…
revere | May 1, 2009Just a brief note to remind everyone about the case definitions CDC is using for reporting on swine flu (or whatever name we collectively settle on). In order to make sure numbers are comparable from day to day and place to place we have to decide on criteria for knowing we have something to count. Is someone with flu-like symptoms to be counted as a case? Or do we confine it to someone with laboratory proved infection with the virus? Should there be different categories of diagnostic certainty?
For the moment, CDC is using the following definitions for suspected, probable and confirmed cases…
revere | May 1, 2009One of the things we are told is not the responsibility of government but an "individual responsibility" is not working sick or sending our kids to school when they are sick. I pointed out that the ability to do this may depend on others, particularly employers. Employers also have a responsibility, not just employees.
The US has some of the worst sick leave and child care policies among industrialized nations. It is nothing short of a scandal. And now these non-policies have the potential to have major public health consequences. The US labor movement is querying its workers about this. Here…
revere | April 30, 2009There were 3 flu pandemics in the 20th century and each has gotten an unofficial name. 1918 was the Spanish flu, so named because the Spanish were the only ones honest enough to acknowledge its presence initially and thus got stuck with the blame. Like the other two pandemic viruses it probably originated in southern China (although its history is cloudy), so the nicknames of the 1957 (Asian flu) and 1968 (Hong Kong flu) are probably more apt, or at least less inapt. Now we have swine flu. Excuse me. I mean influenza A/H1N1, since that is how WHO is calling it so as not to impugn the good…
revere | April 30, 2009A reader (hat tip, sandy) has pointed me to a very interesting interview with CDC's chief virologist, Ruben Donis, in Science Magazine's blog, ScienceInsider. In it he provides further information on the confusing reports about the species origin of the current swine flu, originally said to be of swine, human and bird origin but later claimed to be only swine. It may be that both are true, depending on how you look at it.
According to Donis, who has been sequencing the isolates, the virus is all recent swine but bears the marks of human and avian ancestry in some genes. Different genes have…
revere | April 30, 2009There is a tendency to be preoccupied with the latest in fast moving events, but I want to pause for a moment to make a point that has been lost in the discussion: we are witnessing a medical science landmark. Never before have we watched a flu outbreak of global dimensions unfold in real time. Nor have we ever had the opportunity to alter the course of such an outbreak.
I have been critical of WHO for being late to the party, but they are fully on board now and by raising the pandemic threat level to phase 5 have done something very important: served notice that it's time to mobilize…
revere | April 29, 2009In June 2005 a reader over at the old site suggested we put up some of our flu related material on Wikipedia. That sounded like a great idea to me. Even better, why not start a special purpose wiki -- a flu wiki -- to harvest the vast knowledge of the hivemind? Many, if not most, of the problems that would plague us in a pandemic weren't medical or even scientific in nature. They were things like, how do you prepare your small business for the possibility that the one person who knows how to unjam the fax machine is out sick for 4 weeks? Two other bloggers were also doing flu stuff at that…
revere | April 29, 2009A student once complained that no horse was too dead for me to stop beating it. Long time readers are familiar with that here. Over the years I have said that the best way to prepare for a pandemic -- or any other grave threat to our communities -- is to strengthen its public health and social service infrastructures. While some progress along those lines have been made (the additional training and upgrading of the national laboratory system is what allows us to find swine flu cases), in the main public health and social services have continued to deteriorate and weaken. And with the day of…
revere | April 29, 2009This has been a supremely frustrating day for me since I am traveling and must attend to professional business having nothing to do with the current outbreak. I is incredibly maddening to be away from fast moving events. I'll return home Friday night. In the meantime I will do what I can late in the day and early in the morning, and if I can't sleep, in the middle of the night. Since there are plenty of other places paying attention you'll still be getting the latest news and I am hoping the enforced distancing may allow me to give a more detached view. That aside, I have a favor to ask of…