swine flu

We've talked aplenty about how much we still need to understand about influenza. Not just its basic biology but its dynamics. How does it spread over space and time and how existing infection rates affect future infection rates and how each are related to the number of susceptibles in the population. It's even more than that. There are other viruses perhaps competing for or perhaps cooperating with the flu virus in its sole job, to make copies of itself, using the host's (i.e., our own) biological machinery. You can imagine a scenario whereby once a lot of cells are infected by one virus,…
We're writing this at an altitude of 20,000 feet, being on the road again and except for a few minutes here or there, without access to the internet most of the day. This means a lot of comments will probably go unanswered, so we'll say what we usually do in circumstances like this: talk amongst yourselves. Lots of smart people read this blog. Help each other. A quick look at today's flu news tells me that CDC has updated its estimates, using the methodology we discussed in a previous post. And a survey at Arizona State University (ASU) released Monday shows the expected: that opting to…
I don't know if the rest of the world laughs at the US, but I feel quite sure they at least shake their collective heads when they hear how we lack one of the most important non-pharmaceutical measures against pandemic flu: paid sick leave. Of course only those countries with a policy of paid sick leave would be shaking their heads. It turns out, though, that's just about everybody: The United States is one of only five countries in the world without a national policy on paid sick leave, Dodd said. "We're in the company - and I say this respectfully of these countries - of Lesotho, Liberia,…
My friend and former ScienceBlogs colleague, Afarensis, is in the hospital with pneumonia, a complication of a probable case of "swine" flu; H1N1 Influenza. His youngest daughter posted a message to his blog yesterday, so let's all head over there to leave our best wishes for his speedy and uneventful recovery! I know from experience that it's all of you, your kind words and your funny comments, who can really make a difference!
Nursing homes (Long Term Care Facilities, LTCFs) are a favorite hunting ground for respiratory viruses, including flu. They are open to the general community, where visitors and employees mingle freely with the residents. The residents are usually of an advanced age, have other sicknesses that make them vulnerable and often have less active immune defenses. So when the swine flu pandemic began at the end of April, the Public Health Laboratory at Ontario's Agency for Health Protection and Promotion ramped up their respiratory infection outbreak registration system with the prospect that LCTFs…
We only just got to the surgical/N95 mask article in the Journal of the American Medical Association (JAMA). We've been traveling and haven't been able to keep up with what others were saying, but we're sure it's been well covered by the usual suspects. So we'll just add our take here, for what it's worth. As most readers here know, what kind of mask (if any) will best protect a health care worker or anyone else at high risk of exposure to people infected with influenza virus is a difficult question. We still remain unsure whether flu is transmitted mainly by large or small droplets. If most…
I first read Barbara Ehrenreich in 1971 when she wrote The American Health Empire: Power, Profits, and Politics with her (then) husband John Ehrenreich (Health PAC, 1971). She was by then a PhD in cell biology (Rockefeller University) and anti-war activist. We traveled in the same circles and I knew her slightly at the time. Her next book, Witches, Midwives, and Nurses: A History of Women Healers (with Deirdre English) was a new reading of women in medical history. It was an influential text in the emerging women's health movement. Since then she has published many books, several making the…
Helen Branswell, the Canadian Press's extraordinary flu reporter, is one of the few reporters who could have written the article, "Flu dogma being rewritten by a strange virus no one pegged to trigger a pandemic". She's been following flu for years and has watched as one thing after another we thought we knew about flu has been shown wrong -- by the flu virus. It's a theme we have been sounding as well for almost as long. As scientists we've seen one alleged flu truism after another was stood on its head. A couple of years ago we began to assume anything said about flu was provisional. Some…
Pardon my light posting lately. Flat out with big projects, travel, and the stacking of the wood for the winter. This, however, is what has jumped out at me from the intertubez of late: Meet the New Health Care Reform, Same as the Old Health Care Reform At Top Schools, More Than Half the Profs Have Industry Ties US: Shortage of flu vaccines leaves healthcare workers vulnerable Our lack of readyness for this thing is sobering -- as is the complacency about same. In my own town, our much-delayed swine flu vaccines for kids is finally being administered this coming Monday. How'd I hear this? It…
For somebody so out to lunch on so many issues there is something undeniably likable about Ron Paul. As congressthings, he and Dennis Kucinich (there's an odd couple) had the clearest and best positions on the Iraq debacle. And as a principled libertarian (there seem to be some big chinks in Paul's libertarian armor -- like reproductive choice -- but his passion is undeniable), there is something admirable about him. It almost makes you forget his principles are self-centered, wrong-headed and inhumane. Little gnome-like figures aren't supposed to be that unfeeling toward others. Anti-science…
It's being described as a "dramatic settlement" that will set a pattern for the nation. Let's hope so, because the agreement reached yesterday by the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) and hospital player Catholic Healthcare West (CHW) sounds like just what the doctor ordered. It covers 32 CHW facilities in California and Nevada, where CNA/NNOC represents 13,000 registered nurses. Some details: A centerpiece of the agreement is the creation of a new system-wide emergency task force, comprised of CNA/NNOC RNs and hospital representatives following…
We have an interesting conundrum. Our offspring (______) is due on November 20th. This places the likely date of birth just prior to Thanksgiving. This causes many people to get very excited because they get to see and play with the new baby. I wonder how mad at me all those people are going to get when they find out I might not let that happen? I'm not entirely sure what we are going to do postpartum. I'm quite interested in advice, so please do make your suggestions below. I'd especially like the advice of the MD's and Public Health Scientists in the vicinity. Or anyone with relevant…
A reader asked an offline question that is general enough to post about (NB: I try to respond to as many questions as I can, but I'm traveling and can't keep up, so in most cases I won't be able to respond. I also don't hand out personal medical advice over the internet, something I consider bad practice). CDC says on the basis of clinical trials with the unadjuvanted vaccine used in the US that two shots, 21 days apart, are needed for children under 10. WHO, on the other hand, is telling its member nations that one will suffice. Why the confusion? We may be comparing apples and oranges. Many…
When swine flu began there was a hue and cry in some quarters to shut the border to prevent the virus from taking root in the US. It seems fairly clear, now, that by the time we detected the virus, in late April, it had already situated itself in the US -- assuming that it didn't start here in the first place. We don't really know where the jump from pigs to humans occurred, although the best guess is Mexico. Closing the borders would have done no good and would have stranded thousands of students and other tourists in Mexico. Since the US has more world travelers than Mexico, it was in fact…
We are otherwise occupied, but fortunately DemFromCT has a great status report on swine flu up at DailyKos. I suggest you also follow the first link to his piece at The Arena, although reading after his astute observations is not for the faint-of-heart. The politicization of this issue by Republicans is to be expected and typically unfair (not to mention uninformed). As Dem points out, the Bush Administration did a lot of the heavy lifting that made dealing with this much easier and deserves credit for that. We took them to task here for not shoring up a badly deteriorated public health and…
I spent about 45 minutes yesterday in the local HMO clinic. They had turned the main waiting room into a Pandemic Novel A/H1N1 Swine (nee Mexican) Influenza quarantine area, and I could feel the flu viruses poking at my skin looking for a way in the whole time I was there. Amanda, who is 8.3 months pregnant, started getting symptoms of the flu two days ago. As a high school teacher in a school being affected in a state being affected (as most are) she is at high risk for this. She was one of the first people around here to get the vaccine, just a couple of days ago, but it takes about 10…
One frequently hears claims that the current swine flu pandemic has been exaggerated because there are "only" 1000 or so deaths, while seasonal flu is estimated to contribute to tens of thousands of deaths a year. There are two reasons why this is not an apt comparison. We've discussed both here fairly often. The first is that the epidemiology of a pandemic and seasonal flu are very different. Epidemiology studies the patterns of disease in the population and swine flu is hitting -- and killing -- a very different demographic from seasonal flu. Its victims are young and many are vigorous and…
A bit early yet, but as I'm traveling the rest of the month, here's my top 5 over the last month. 1. The Weird History of Adjuvants, in which we ponder the inclusion of eye of newt and such in vaccines, and the strangeness of the fact that dirty is good. 2. Why is the swine flu vaccine so late? Who are you to ask such a question? was a close runner-up despite appearing only yesterday. Includes bonus trash-talk from a Canadian. 3. Embargo? Embargo? The case of the missing swine flu paper In which rumor runs not just amok, but quite a bit of policy as well. A particularly interesting…
On Saturday we posted our take on The Atlantic magazine article by Shannon Brownlee and Jeanne Lenzer. It's a major story in the November issue, a banner across the top of the cover page reading: Swine flu: Does the vaccine really work? We tried to ignore it. People kept asking us to comment on it, but we didn't want to get entangled in vaccine controversies. As Orac warned me, it's a game of Whac-A-Mole. But we got fed up and posted our global response, not a point by point refutation, since that wasn't what the issue was. Our main point was that it was a straw man argument built around the…
In a disturbing post at ScienceInsider, Jon Cohen and Martin Enserink explain why the swine flu vaccine is running so late. Or at least they try to explain why it's so late. For while all the suppliers are running into problems, we're not allowed to know what they are. The delays are substantial and critical. They leave us naked as the flu spreads through the country. The flu has now killed 1000 people, over 100 of them children. Even as this happens, the delivery dates keep moving back and the delivery amounts keep shrinking. As recently as a month ago, the CDC was telling us that we'd…