Lets talk about the Swine flu...

[macms]

Copied this from another board. Interesting reading and requires some investigating (for me anyway) to understand the implications. Put on your tinfoil hat just in case.

----------------

In a discussion this morning with a cell biologist and medical doctor working at Johns Hopkins, my friend thought this 4-part flu combination is highly unusual and looks like it could be man-made. Especially because it has an avian strain. My doctor friend (he's Taiwanese) explained that in Asia, it's common for a avian-swine-human flu to happen naturally, but this virus first showed up in Mexico, where pigs and ducks are not usually raised together. Also, recombination of more than 2-different flu viruses is extremely rare. I'm just repeating what he said as an expert in the field. He says the CDC needs to explain if there is a possibility that we are under a bio-weapon attack.

From CDC via Wikipedia: 

Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, said that the American cases were found to be made up of genetic elements from four different flu viruses -- North American swine influenza, North American avian influenza, human influenza A virus subtype H1N1, and swine influenza virus typically found in Asia and Europe. 



For two cases a complete genome sequence had been obtained. She said that the virus was resistant to amantadine and rimantadine, but susceptible to oseltamivir (Tamiflu) and zanamivir (Relenza).[22][23][24] Preliminary genetic characterization found that the hemagglutinin (HA) gene was similar to that of swine flu viruses present in U.S. pigs since 1999, but the neuraminidase (NA) and matrix protein (M) genes resembled versions present in European swine flu isolates. Viruses with this genetic makeup had not previously been found to be circulating in humans or pigs, but there is no formal national surveillance system to determine what viruses are circulating in pigs in the U.S.[25] 



The seasonal influenza strain H1N1 vaccine is thought to be unlikely to provide protection.[26]



Here's more from AP via Seattle Post Intelligencer: The worrisome new virus - which combines genetic material from pigs, birds and humans in a way researchers have not seen before - also sickened at least eight people in Texas and California, though there have been no deaths in the U.S.



"We are very, very concerned," World Health Organization spokesman Thomas Abraham said. "We have what appears to be a novel virus and it has spread from human to human ... It's all hands on deck at the moment."



Update: doctor friend also says that what is also unusual is that this type/combination virus is the based on the same strain as in the 1918 Spanish flu virus (H1N1) outbreak (extremely deadly, 25 million dead in 25 weeks; total dead 50-100 million dead; 2.5%-5% of the world population). This makes the virus extremely deadly. The likelihood that this combination with the most deadly strain would happen naturally is very, very low.



From Reuters via Los Angeles Times: 
http://www.latimes.com/news/nationwo...pr25,0,5114253 .story



The CDC has analyzed samples of the H1N1 virus from some of the U.S. patients, all of whom have recovered, and said it is a never-before-seen mixture of viruses from swine, birds and humans.


Not really, the creators may be betting that this highly deadly strain further mutates. According to my Doctor source from JHU, it is not necessary to do it in the lab, when nature gets hold of it the virus evolves on its own, it can become very deadly. According to, the natural mutation rate of Influenza virus is 1.5 *10^(-5) per nucleotide per infectious cycle (each individual replication within the cell). That means each of the millions of cells in one body that becomes infected will be mutated at a rate of 1.5 *10^(-5) (10^(-5) = 1.5/10,000) 



From the Journal of Virology: 
http://jvi.asm.org/cgi/content/abstract/59/2/377

More from Reuters: (CDC acting director Dr. Richard Besser) Besser said the CDC is being "very aggressive" said it was time for people in the United States to think about what to do if this does turn out to be a pandemic."

http://www.reuters.com/article/newsO...53O0MW20090425 
More info also from Wikipedia, but certified by my doctor (JHU) friend: 



"H1N1 is a subtype of the species Influenza A virus. H1N1 has mutated into various strains including the Spanish Flu strain (now extinct in the wild), mild human flu strains, endemic pig strains, and various strains found in birds.



A variant of H1N1 was responsible for the Spanish flu pandemic that killed some 50 million to 100 million people worldwide over about a year in 1918 and 1919.[1] A different variant exists in pig populations. 



Controversy arose in October 2005, after the H1N1 genome was published in the journal Science. Many[who?] fear that this information could be used for bioterrorism. [citation needed] 



"When he compared the 1918 virus with today's human flu viruses, Dr. Taubenberger noticed that it had alterations in just 25 to 30 of the virus's 4,400 amino acids. Those few changes turned a bird virus into a killer that could spread from person to person."[2] 



Low pathogenic H1N1 strains still exist in the wild today, causing roughly half of all flu infections in 2006.[3] 



Since mid-March 2009, over 500 cases, including at least 68 deaths, have been reported in Mexico from an outbreak a new strain of H1N1.[4][5][6] 



At least some of these cases result from the same strain of H1N1 that was isolated in 9 US patients in California and Texas.[7]"



General influenza mortality rate is 0.1%, that means this is 20 times more deadly (2.0%), that's really bad. If the virus mutates in the general population, the mortality rate will likely increase. (It can mutate to become less deadly, but nobody would notice, we can hope, but that's not a strategy to combat infectious diseases.) The 1918 influenza virus mortality rate was 2%-20%.) 



If one million people get the virus, 20,000 dead, at current rates.



Mutation is neutral, that means that 50% will be more deadly and 50% less deadly, but at a mutation rate of 1.5/10,000 per per nucleotide per infectious cycle, 50% of these mutation will be more deadly. And, since this virus has already mutated to become extremely deadly (i.e., 1918), the possibility of this super, possibly human-engineered, 4-virus combination (strain) to become extremely deadly again is greater than 0. How much greater, we don't know with current information.

[icehog3]

Ever read "The Demon in the Freezer" by Richard Preston, Fred?

[macms]

Originally Posted by icehog3

Ever read "The Demon in the Freezer" by Richard Preston, Fred?

I will now.

[icehog3]

Originally Posted by macms

I will now.

I think you will find it interesting...let me know if you can't find a copy, I think mine is in my desk at work somewhere.

[macms]

I found it on Amazon in paperback.

Here are a couple of reviews for others.

Editorial Reviews

Amazon.com Review

On December 9, 1979, smallpox, the most deadly human virus, ceased to exist in nature. After eradication, it was confined to freezers located in just two places on earth: the Center for Disease Control in Atlanta and the Maximum Containment Laboratory in Siberia. But these final samples were not destroyed at that time, and now secret stockpiles of smallpox surely exist. For example, since the fall of the Soviet Union in 1991, and the subsequent end of its biological weapons program, a sizeable amount of the former Soviet Union's smallpox stockpile remains unaccounted for, leading to fears that the virus has fallen into the hands of nations or terrorist groups willing to use it as a weapon. Scarier yet, some may even be trying to develop a strain that is resistant to vaccines. This disturbing reality is the focus of this fascinating, terrifying, and important book.

A longtime contributor to The New Yorker and author of the bestseller The Hot Zone, Preston is a skillful journalist whose work flows like a science fiction thriller. Based on extensive interviews with smallpox experts, health workers, and members of the U.S. intelligence community, The Demon in the Freezer details the history and behavior of the virus and how it was eventually isolated and eradicated by the heroic individuals of the World Health Organization. Preston also explains why a battle still rages between those who want to destroy all known stocks of the virus and those who want to keep some samples alive until a cure is found. This is a bitterly contentious point between scientists. Some worry that further testing will trigger a biological arms race, while others argue that more research is necessary since there are currently too few available doses of the vaccine to deal with a major outbreak. The anthrax scare of October, 2001, which Preston also writes about in this book, has served to reinforce the present dangers of biological warfare.

As Preston eloquently states in this powerful book, this scourge, once contained, was let loose again due to human weakness: "The virus's last strategy for survival was to bewitch its host and become a source of power. We could eradicate smallpox from nature, but we could not uproot the virus from the human heart." --Shawn Carkonen --This text refers to an out of print or unavailable edition of this title.

From Publishers Weekly

Never mind Ebola, the hemorrhagic disease that was the main subject of Preston's 1994 #1 bestseller, The Hot Zone. What we really should be worrying about, explains Preston in this terrifying, cautionary new title, is smallpox, or variola. But wasn't that eradicated? many might ask, particularly older Americans who remember painful vaccinations and the resultant scars. Officially, yes, nods Preston, who devotes the first half of the book to the valorous attempt by an army of volunteers to wipe out the virus (an attempt initially sparked by '60s icon Ram Dass and his Indian guru) via strategic vaccination; in 1977 the last case of naturally occurring smallpox was documented in Somalia, and today the variola virus exists officially in only two storage depots, in Russia and at the Centers for Disease Control in Atlanta (in the freezer of the title). To believe that variola is not held elsewhere, however, is nonsense, argues Preston, who delves into the possibility that several nations, including Iraq and Russia, have recently worked or are currently working with smallpox as a biological weapon.

The author devotes much space to the anthrax attacks of last fall, mostly to demonstrate how easily a devastating assault with smallpox could occur here. He includes an interview with Steven Hatfill, who has received much press coverage for the FBI's investigation of him regarding those attacks; his description of meeting Hatfill, hallmarked by a quick character sketch ("He was a vital, engaging man, with a sharp mind and a sense of humor.... He was heavy-set but looked fit, and he had dark blue eyes") is emblematic of what makes this New Yorker regular's writing so gripping. Preston humanizes his science reportage by focusing on individuals-scientists, patients, physicians, government figures. That, and a flair for teasing out without overstatement the drama in his inherently compelling topics, plus a prose style that's simple and forceful, make this book as exciting as the best thrillers, yet scarier by far, for Preston's pages deal with clear, present and very real dangers.

Copyright 2002 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

[pnoon]

Originally Posted by icehog3

Ever read "The Demon in the Freezer" by Richard Preston, Fred?

Scary book, that one.

[icehog3]

Originally Posted by pnoon

Scary book, that one.

Mostly because it seem plausible.

[pnoon]

Originally Posted by icehog3

Mostly because it seem plausible.

yep.

[M1903A1]

The original article makes reference to the 1918 Spanish flu virus...my understanding is that, until recently, there were literally no remaining samples of the virus in the world--through the decades, nobody thought to save any.

Even a concerted effort by scientists to recover a sample from the graves of known flu victims turned up nothing until a few years ago, when a mass grave of 1918 flu victims in Alaskan permafrost finally yielded samples for researchers.

[icehog3]

That's the one, Fred.

[Sauer Grapes]

The thing scary about the swine flu is that a lot of the dead are healthy young adults 20-40 years old. Those people are supposed to be the most likely to survive.

Also scary is the fact the wife is flying to AZ right now via TX.

[floydpink]

I was watching Anderson Cooper 360 last night and they were in the Congo with a leading epidemiologist (sp?) who was showing how the diseases, like AIDS, that jump from animals to humans can really become resistant to vaccines and really spread globally in very little time with the ease of air travel.

Granted, not many here are hacking monkeys and getting in contact with their blood, but it's still scary.

Heck, not far from me, in Lake county, I think they still eat armadillos.

The doctor was saying there are signs of very strong and scary diseases emerging and he seems to think it is a question of "when" and not "if" we are faced with a very large global pandemic.

I went to bed kind of scared.

[lightning9191]

Originally Posted by floydpink

The doctor was saying there are signs of very strong and scary diseases emerging and he seems to think it is a question of "when" and not "if" we are faced with a very large global pandemic.

I have to agree with your doctor on this one. Humans have been plagued by epidemics for probably all of known history. The questions are when is the next one going to spread like wildfire and what will it be.

[floydpink]

Originally Posted by lightning9191

I have to agree with your doctor on this one. Humans have been plagued by epidemics for probably all of known history. The questions are when is the next one going to spread like wildfire and what will it be.

It wasn't actually MY doctor. It was the doctor trudging through the Congo jungle with Sanjay Gupta examining the bush kill.

Now my doctor, he said my prostate is in fine condition just a couple weeks ago.......

[lightning9191]

Originally Posted by floydpink

Now my doctor, he said my prostate is in fine condition just a couple weeks ago.......

Man am I glad to hear that....to think I was sitting here worried about your prostate.

[lightning9191]

It's just been declared an emergency

Here's the email from my work yesterday. I sure hope I don' have to wear a surgical mask on the train this week, it's too hot out for that...

Dear Colleagues,

On April 23, a high school in Queens was noted to have an outbreak of mild febrile respiratory illness that was confirmed last night to be caused by influenza A. Specimens were sent to the NYC Public Health Laboratory and were untypeable for human H1 or H3 strains, meeting the CDC case definition for probable swine influenza. These specimens are being forwarded to CDC today for further testing to determine if these infections are due to swine influenza. Results should be available tomorrow. The high school has approximately 2,700 students, and as of yesterday, 200 children were reported to be ill, mostly with mild influenza-like symptoms (fever, cough, and/or sore throat). None of the cases were severe or required hospitalization.

In the United States, there are currently 6 California residents and 2 Texas residents who have been diagnosed with swine influenza A (H1N1) virus infection; all of these patients had mild illness (only one hospitalization) and all have recovered. Isolates from California and Texas have been found to be susceptible to the neuraminidase inhibitors (oseltamivir and zanamavir) but resistant to the adamantanes (amantadine and rimantadine). In addition, there has been an outbreak of respiratory illness in Mexico, which has been confirmed as at least partly due to swine influenza; clinical and epidemiologic details of this outbreak are still pending, but preliminary reports are of thousands of cases and approximately 70 deaths.

Surveillance for Swine Influenza in Hospitalized Cases Citywide:
The NYC Health Department is now prioritizing its surveillance efforts for swine influenza on identifying potential cases of febrile, respiratory illness in hospitalized patients, in order to rapidly identify and confirm potential cases with more severe illness. Therefore, DOHMH requests that providers seeing patients with acute febrile respiratory illness only test those patients who are either currently hospi talized or are being admitted to the hospital with unexplained febrile respiratory illness. These patients should be tested for influenza using either a commercial rapid test, or direct or indirect immunofluorescence. Patients who test positive for influenza A should be reported to DOHMH and have specimens referred to DOHMH for further testing to determine whether the influenza A can be subtyped. See contact information below. DOHMH will arrange for transportation of clinical specimens to the Public Health Laboratory. See attached instructions for collecting and submitting laboratory diagnostic specimens for swine influenza testing. Nasopharyngeal swabs are the preferred specimens for influenza testing in the current swine influenza context.

Management of Persons with Milder Influenza-like Illness
At this time, providers assessing patients with mild febrile respiratory illness in clinical settings, including emergency departments, should not test for influenza and should not administer antiviral medications for presumptive therapy, unless patients meet the usual criteria for empiric influenza treatment based on underlying illnesses (listed below) that put them at higher risk for complications of any type of influenza. These patients may be sent home with instructions to stay at home until 24-48 hours after their symptoms resolve and instructed on the importance of hand and respiratory hygiene. Instructions should be given to seek medical care with worsening of symptoms.

Infection Control
For current recommendations on infection control in medical care facilities, see http://www.cdc.gov/swineflu/guidelin...on_control.htm.

Antiviral Treatment and Prophylaxis Guidelines
Swine influenza viruses identified in this outbreak to date have been susceptible to both oseltamivir and zanamivir. Antiviral therapy with one of these agents should be initiated empirically for patients currently hospitalized with sever e unexplained febrile respiratory illness, pending testing for swine influenza. See http://www.cdc.gov/swineflu/recommendations.htm for specific guidelines. This document also includes detailed guidance on antiviral prophylaxis.

The Health Department requests that providers also immediately report any clusters of influenza-like illness in medical facilities, congregate settings such as long-term care facilities, or schools.

To contact the Health Department, including to report suspected cases of swine influenza in hospitalized patients and arrange for specimen testing, please call the Provider Access Line at 1- 917-438-9766. This number is also available for questions or consultations by providers.

As always, we appreciate the cooperation of the medical community in New York City and will update you with further information when it becomes available.


Sincerely,

Scott A. Harper, MD, MPH, MSc
Medical Epidemiologist
Zoonotic, I nfluenza, & Vectorborne Diseases Unit
Bureau of Communicable Disease

Annie Fine, MD
Medical Director
Zoonotic, Influenza, & Vectorborne Diseases Unit
Bureau of Communicable Disease

Definitions of Respiratory Illness
1. Acute respiratory illness
Recent onset of at least two of the following:
1. rhinorrhea or nasal congestion
2. sore throat
3. cough
4. fever or feverishness
2. Influenza-like illness: fever >37.8°C (100°F) plus cough or sore throat
Case Definitions for Infection with Swine Influenza A (H1N1) Virus
1. A Confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an acute respiratory illness with laboratory confirmed swine influenza A (H1N1) virus infection at CDC by one or more of the following tests:
1. real-time RT-PCR
2. viral culture
3. four-fold rise in swine influenza A (H1N1) virus specific neutralizing antibodies
2. A Pr obable case of swine influenza A (H1N1) virus infection is defined as a person with an acute respiratory illness with an influenza test that is positive for influenza A, but H1 and H3 negative.
3. A Suspected case of swine influenza A (H1N1) virus infection is defined as:
1. A person with an acute respiratory illness who was a close contact to a confirmed case of swine influenza A (H1N1) virus infection while the case was ill OR
2. A person with an acute respiratory illness with a recent history of contact with an animal with confirmed or suspected swine influenza A (H1N1) virus infection OR
3. A person with an acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza A (H1N1)

Conditions which increase the risk of severe influenza infection
• chronic pulmonary, cardiovascular, renal, hepatic, hematological, or metabolic disorders,
• immunosuppression,
• compromised respiratory function , including conditions which increase the risk for aspiration,
• long-term aspirin therapy
• pregnancy
• age > 65 years
• age < 2 years

[macms]

Here's a link you may find informative.

http://www.newfluwiki2.com/recentActive.do

[smokeyandthebandit05]

Great! Just effin great! Im goin to LA for a week on Friday! No I dont want to go and I'll be honest Im kinda scared

3 news crews were stalking the employee entrance to my work today. We activated the Incident Command Center over the weekend to address the Queens outbreak. As of this morning, no additional cases have been confirmed.

All I can say is that I'm living in hand sanitizer right now.