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Swine Flu

 
 
xris
 
  1  
Reply Sat 2 May, 2009 03:55 am
@Caroline,
It does require another's independent view of this strain of flue,to confirm or deny the possibility of it mutating naturally.It does hinge on how it mutated.
0 Replies
 
Aedes
 
  1  
Reply Sat 2 May, 2009 07:32 am
@Alan McDougall,
Alan McDougall;60263 wrote:
Hi, I am not a medical expert, could this influenza get as bad as the Spanish flu of the last century?
Unlikely -- it lacks some of the virulence factors that the 1918 flu had, our medical system is better, and we have a generally healthier population.

Alan McDougall;60263 wrote:
Is there any real agent that could halt it in its track?
Nope, just our collective immune systems.

Alan McDougall;60263 wrote:
I know there are a few antiviral drugs, but could the AIDS drugs be used for the general population if this outbreak became a global pandemic?
There are a lot of antivirals that are active against HIV, and a few of them have activity against the Hepatitis B virus, but they have no activity against influenza. There are only two classes of drugs active against influenza, the neuraminidase inhibitors (oseltamavir (Tamiflu) and zanamivir (Relenza)), and the adamantanes (to which this H1N1 virus is resistant).

Alan McDougall;60263 wrote:
How much of a difference would modern medical intervention be when compared to the Spanish flu?

Could millions die if this got out of control?
Modern medical interventions could make an enormous difference. Many if not most people who die from flu die because of a superimposed bacterial pneumonia. We did not have systemic antibiotics in 1918. As to whether millions could die, millions already die every year from the normal seasonal circulating flu strains -- as many as 30,000 every year in the USA alone.

Alan McDougall;60263 wrote:
How would it affect air traffic between continents?

What would the effect be on sports events with crowds of spectators
A single person in a crowd of 80,000 people at a huge stadium might infect a handful of people around him. They would not be able to spread it to others until after a minimum incubation period (days). It wouldn't spread like wildfire through that crowd unless you had a lot of contagious people from the start, and if you get 3-4 secondary cases for every primary case then even 100 contagious people could lead to a very large community spread. As for airplanes, there is definitely transmission of respiratory viruses on planes, but it's pretty uncommon for things other than tuberculosis to spread to distant parts of the airplane. Air traffic just depends on how draconian the national public health folks want to be. It makes sense for Mexico to restrict flights, because they have a comparatively high number of cases, but it doesn't make sense for other nations to do so.

Alan McDougall;60263 wrote:
How fast could a vaccine be be created by the medical teams?
This epidemic will probably have burned out by the time a vaccine is available 4-6 months from now.

Alan McDougall;60263 wrote:
The virus could mutate and become weak or it could mutate into different deadly viruses for which humans have no protection?
It already is one for which we have no protection. The issue is whether it can genetically recombine with other human influenza viruses that are either more virulent or more transmissible.

Alan McDougall;60263 wrote:
Must we stop eating pork?
It has nothing to do with pork.

Alan McDougall;60263 wrote:
I think the masks presently used by people are useless against a tiny virus, it would have no problem getting through into the body
They're not useless at all -- the viruses are within droplets of liquid that cannot penetrate the mask. The problem is that the droplets only travel 3-5 feet, so you're not cutting out very much exposure by wearing masks, and you're not protecting your eyes. Keeping your hands clean is the best measure.

Tuberculosis is one example where the respiratory droplets are much smaller and stay aerosolized for longer, so you do need special masks (we have to be fit tested for these once a year).

Alan McDougall;60263 wrote:
This outbreak could advance and spread in biblical proportions or we might wake up and hear the whole thing was now under control

Would the authorities hold back the truth from the population if they knew for sure this was an outbreak of deadly biblical apocalyptic pandemic proportions?
The "authorities" wouldn't have control over that information. If hospitals suddenly begin filling up with sick flu patients, and people start dying at unexpectedly high rates, and intensive care units need to close because they're full, then we'll know. There are news teams crowding around my hospital and probably every other, and they get their news from hospital spokespeople, not "authorities".

Alan McDougall;60263 wrote:
If the truth was the worst possible will the authorities tell us or just keep quite because telling us will not alter the outcome?
Public health epidemiologists have been modeling flu control scenarios for decades. Keeping it a secret does no one any good. The key to a major epidemic is to close schools, public transit, i.e. things where tons of people come into close contact, and keep a required minimum number of essential services operating.
Didymos Thomas
 
  1  
Reply Sat 2 May, 2009 11:41 am
@Aedes,
Without asking you, Aedes, to cross any boundaries about dispensing medical advice, could you elaborate on keeping our hands clean?
Specifically, what typically looks like over-kill, what could be counter-productive, the variety of products (anti-bacterial, ect.).

Sorry, I know this is very much like the workplace invading your recreational time, but, well, you are the local Medicine Man.
0 Replies
 
Aedes
 
  1  
Reply Sat 2 May, 2009 11:49 am
@Icon,
With respect to most germs that people give to one another out in the community, contamination of one's hands is a critical step in transmission. You shake someone's hand or open a door, then pick up your food or pick your nose or rub your eyes or something.

So very frequent and vigilant hand hygiene is a well-proven way to limit transmission, both from other people to you and from you to other people. Antibacterial soaps are no better than any other soap for influenza -- the important part is that you wash at all (and an effective handwash requires 15 seconds of vigorous scrubbing before you rinse). This is going to work for all the flu viruses, cold viruses, stomach viruses, and bacterial diseases like MRSA.

Alcohol-based hand sanitizers like Purell are great too and they're easy. They need to have a 60-70% alcohol concentration to be most effective -- no more, no less -- and they ideally should have a good emollient so that your hands don't break down from them (that's why I like Purell and Alcare). Purell will knock out influenza, but it's not active against a few nasties like enteroviruses (many of which circulate during summer months).

Counterproductive would be washing to the point where your skin is breaking down, because you can become colonized with staph (including MRSA) with skin breakdown.
xris
 
  1  
Reply Sat 2 May, 2009 12:10 pm
@Aedes,
Aedes wrote:
With respect to most germs that people give to one another out in the community, contamination of one's hands is a critical step in transmission. You shake someone's hand or open a door, then pick up your food or pick your nose or rub your eyes or something.

So very frequent and vigilant hand hygiene is a well-proven way to limit transmission, both from other people to you and from you to other people. Antibacterial soaps are no better than any other soap for influenza -- the important part is that you wash at all (and an effective handwash requires 15 seconds of vigorous scrubbing before you rinse). This is going to work for all the flu viruses, cold viruses, stomach viruses, and bacterial diseases like MRSA.

Alcohol-based hand sanitizers like Purell are great too and they're easy. They need to have a 60-70% alcohol concentration to be most effective -- no more, no less -- and they ideally should have a good emollient so that your hands don't break down from them (that's why I like Purell and Alcare). Purell will knock out influenza, but it's not active against a few nasties like enteroviruses (many of which circulate during summer months).

Counterproductive would be washing to the point where your skin is breaking down, because you can become colonized with staph (including MRSA) with skin breakdown.
Aedes what about this doctors claims that Justin brought to our attention, whats your opinion?
0 Replies
 
Aedes
 
  1  
Reply Sat 2 May, 2009 06:57 pm
@Icon,
No idea, xris, sounds far fetched and conspiratorial, and in truth it hardly matters -- but the fact that this virus has a different hemagluttinin (H type) and lacks certain virulence factors of the avian H5N1 makes me doubt it. Avian influenza is also FAR less contagious than this one -- there are only one or two convincing cases of human-human transmission of avian H5N1.

They can easily sequence the viruses to figure stuff like that out.
Holiday20310401
 
  1  
Reply Sat 2 May, 2009 09:28 pm
@Aedes,
Aedes, why is the H5N1 not a problem, what makes it incapable of harming humans as of yet?

Is it just a matter of a strain mutating into a certain way? And then what characteristics must the strain have in order for humans to be threatened by it?

What are the influences which cause high mutation rates of these viruses anyways? (sorry for all the questions, this stuff is fascinating)
Aedes
 
  1  
Reply Sun 3 May, 2009 10:40 am
@Holiday20310401,
Holiday20310401;61066 wrote:
Aedes, why is the H5N1 not a problem, what makes it incapable of harming humans as of yet?
First of all, H5N1 and H3N1 etc are each categories, they're not specific viruses.

The "avian flu" is H5N1, it's hurt plenty of humans.

Its cell tropism is more for the lower respiratory tract than the typical human flu viruses. This make it more likely to cause severe lower respiratory tract disease, but it's also less contagious. The fear is that it will pick up genes from a different, more contagious flu virus that will increase its transmissibility without reducing its virulence. Many people think, however, that in the case of avian H5N1 the increased transmissibility will come at the expense of virulence.

Holiday20310401;61066 wrote:
Is it just a matter of a strain mutating into a certain way? And then what characteristics must the strain have in order for humans to be threatened by it?
The main mitigating factor on clinical virulence is host immunity. Slight changes can alter viruses in a way called "antigenic drift" which makes them different enough from past viruses we've seen that they cause clinical illness. However, since there is antigenic overlap our immune system still can limit the duration and extent of disease. Occasionally, however, there is "antigenic shift" in which the new strain is so different antigenically that our immune systems are completely naive. That happened in 1918 (and several subsequent times in the 20th century).

Holiday20310401;61066 wrote:
What are the influences which cause high mutation rates of these viruses anyways?
Viruses have a very short generation time and not very much genetic material, so they're prone to mutation. More concerning is recombination, i.e. a new virus is assembled in a host cell that has been infected by two different types.
0 Replies
 
deadcolor
 
  1  
Reply Sun 3 May, 2009 12:43 pm
@Icon,
Currently, these are stuff to stall until a world health plan comes up.
0 Replies
 
kidzi
 
  1  
Reply Sun 3 May, 2009 01:11 pm
@Icon,
Even though a responsible, reasonable handling of the virus surely is absolutely necessary, I strongly dislike how the media jumps at every little news and dramatizes it to an extent that is hardly bearable.
I myself am not afraid at all atm, maybe this will turn out to have been stupid, but right now we cannot know and when I open the news paper I feel like vomitting while reading all these terribly lurid headlines. Just way too much shockvertising.

Edit lol I must have been a bit absent-minded and somehow did not see that this topic has three pages.. sry for repeating stuff.
0 Replies
 
Alan McDougall
 
  1  
Reply Sun 3 May, 2009 01:37 pm
@Icon,
I am perplexed the media at first told us there were some 180 deaths due to the virus no it has been reduced to 19 ? Still to many, but bad reporting
0 Replies
 
Aedes
 
  1  
Reply Sun 3 May, 2009 05:26 pm
@Icon,
It was never 180, the initial panic was because Mexico reported something around 12 deaths in 50 cases.

Edit -- I should add that 36,000 people die every year in the United States from influenza, and worldwide there are 250,000 to 500,000 deaths every year.

So 19 or 180, whichever, pales in comparison to the toll that the normal annual flu strains take.
Alan McDougall
 
  1  
Reply Sun 3 May, 2009 11:40 pm
@Aedes,
Aedes wrote:
It was never 180, the initial panic was because Mexico reported something around 12 deaths in 50 cases.

Edit -- I should add that 36,000 people die every year in the United States from influenza, and worldwide there are 250,000 to 500,000 deaths every year.

So 19 or 180, whichever, pales in comparison to the toll that the normal annual flu strains take.


That is precisely my point, why ring the alarm and wake up the whole world before making absolutely sure this was a major emergency of global proportions

Bad news Armageddon type is very very good news to those who spew it out for us to try and digest and we get psychologically ill because we are unable to do deal with it

So we rush around to find a cure for a phantom complaint, money in the making
0 Replies
 
Aedes
 
  1  
Reply Mon 4 May, 2009 05:47 am
@Icon,
That's quite a cynical viewpoint -- not entirely without merit, but I'd offer you a different point of view on the matter:

1) The mortality rate in the initial Mexican reports was so high that if this held true around the world there could be millions or tens of millions of deaths.

2) Flu is extremely contagious, and it's contagious early on when people are asymptomatic, so control measures need to be implemented very promptly.

3) After SARS and after avian flu, the media is very savvy about these global epidemics of respiratory viruses, they've gotten enough expertise to know when a story is "exceptional" enough to jump on it.
Alan McDougall
 
  1  
Reply Mon 4 May, 2009 06:05 am
@Aedes,
Aedes wrote:
That's quite a cynical viewpoint -- not entirely without merit, but I'd offer you a different point of view on the matter:

1) The mortality rate in the initial Mexican reports was so high that if this held true around the world there could be millions or tens of millions of deaths.

2) Flu is extremely contagious, and it's contagious early on when people are asymptomatic, so control measures need to be implemented very promptly.

3) After SARS and after avian flu, the media is very savvy about these global epidemics of respiratory viruses, they've gotten enough expertise to know when a story is "exceptional" enough to jump on it.


Noted I was referring to the media and not the authorities, it is the medias responsibility to supply us with the truth

They should have used someone like you to get a sane perceptive on the matter, like your post on the normal expected death rate of the flu virus every year
Aedes
 
  1  
Reply Mon 4 May, 2009 06:49 am
@Icon,
The media are all trying to compete against one another, so their inclination is always to overstate the importance of their stories. I agree that something like this needs to be handled calmly, and with as much visible input from public health authorities as possible (as opposed to medical correspondants... even Sanjay Gupta on CNN is a neurosurgeon, not an infectious disease specialist).
0 Replies
 
xris
 
  1  
Reply Mon 4 May, 2009 07:12 am
@Alan McDougall,
Alan McDougall wrote:
Noted I was referring to the media and not the authorities, it is the medias responsibility to supply us with the truth

They should have used someone like you to get a sane perceptive on the matter, like your post on the normal expected death rate of the flu virus every year
So you dont think its a good idea ,as i have a cold ,to go as a Mexican bandit to tonight's fancy dress party?
Alan McDougall
 
  1  
Reply Mon 4 May, 2009 07:32 am
@xris,
xris wrote:
So you dont think its a good idea ,as i have a cold ,to go as a Mexican bandit to tonight's fancy dress party?


At your extreme advanced age , the younger folk will patronize you gently and send you home quickly , they will be terrified "of you" I think ?

We of the ancient epoch of human evolution simply cant keep up can we?

Maybe I am speaking about myself!
xris
 
  1  
Reply Mon 4 May, 2009 09:38 am
@Alan McDougall,
Alan McDougall wrote:
At your extreme advanced age , the younger folk will patronize you gently and send you home quickly , they will be terrified of I think ?

We of the ancient epoch of human evolution simply cant keep up can we?

Maybe I am speaking about myself!
I have young Greek god syndrome Alan , my doctor tells me its incurable.
0 Replies
 
sarathustrah
 
  1  
Reply Sun 24 May, 2009 11:40 pm
@Icon,
well the media acted like swine flu was incurable...

but i bet the ratings soared Razz

just wait til they announce stds evolved so they can go airborne... so if a hooker breaths in your eyes you get some mutant herpes strain :detective:
0 Replies
 
 

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