Swine Flu

@Icon,

The baby they said died from it in Texas was from other causes. In my opinion they're making the virus too much of a ordeal. Look at every case on the news, it isn't that bad but people perceive it in such way so people will take action. If they see it isn't a potential big deal, they'll ignore it.

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@Icon,

The problem is that this might have been a big catastrophe. SARS very nearly was, but it was controlled very effectively. Avian influenza was never transmissible enough, etc.

So fine, these mini-pandemics never turned out to be catastrophes. But someday one will, and if the media creates too much hype each time something comes along, then people are going to tune out when they actually need to be prepared. But if the media under-reports, then people will never have the chance to prepare themselves. It's a lose-lose situation from a media point of view -- only public health can really solve this problem.

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@Icon,

The swine flu was declared a global pandemic today, meaning that it is spreading easily from human to human throughout the world. It will be interesting to see how the first pandemic goes in the Information age. I guess medical experts are worried about what will happen with a swine flu outbreak in the southern hemisphere where it is winter.

BBC NEWS | Health | WHO 'declares swine flu pandemic'

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@Icon,

i have a question as to why people are dying from swine flu. the toll is 18 now in india but mounting up fast. i have no way of knowing how many deaths resulted in other kinds of flu in india either-people dont seem to get flu here like they do in america, maybe they dont have a good defense system against it.

the people who are dying is what surprises me. i expected it would be mainly poor people who were already malnourished and hadnt gone to the doctor, living in substandard conditions. but it is possibly a majority of nris who picked it up in america, now spreading here to others including even doctors. two or three doctors are among those who have died and it is spreading among the middle class-obviously they knew enough to look for it, so what happened? and the age of the dead people is mainly under 60, from a three year old, one 14 year old, but mostly adults 30-50.

in the beginning anyone with a cough or sniffles was not allowed to go anywhere from incoming planes, they were taken for testing and quarantined if positive results came back. now the numbers are probably too high to do that. i was just reading it was more likely a person would die from ordinary flu than swine flu. here they are buying up huge quantities or surgical masks, and i dont know if that would even help, i would guess not.

so what's up with this in the rest of the world?

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@salima,

In the UK I believe thousands have contracted it but under a hundred have died, mostly the young or those with underlying health problems.It is also extremely dangerous for pregnant women.It is expected to peek in the winter months and at the moment it is no worse than any other outbreak.Xris

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@xris,

xris;82986 wrote:

In the UK I believe thousands have contracted it but under a hundred have died, mostly the young or those with underlying health problems.It is also extremely dangerous for pregnant women.It is expected to peek in the winter months and at the moment it is no worse than any other outbreak.Xris

thanks xris-i just saw an article that 436 have died in the us now, but of course due to their geographical position they are the most vulnerable i guess. our count in india is now up to 20. in bombay and pune which are the hardest hit, everything is closed in efforts to contain it-all schools, bazaars, etc. no easy task with the number of people here.

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@salima,

salima;82908 wrote:

i have a question as to why people are dying from swine flu. the toll is 18 now in india but mounting up fast.

Salima, lots of people (LOTS) die from regular seasonal flu. The swine flu is not particularly lethal compared with other circulating flu viruses (it's a hell of a lot less lethal than H5N1 avian flu). The H1N1 swine flu is circulating in summer, and this may explain why there's been a comparative predominance of cases in young, healthy people.

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@Aedes,

Aedes;83011 wrote:

Salima, lots of people (LOTS) die from regular seasonal flu. The swine flu is not particularly lethal compared with other circulating flu viruses (it's a hell of a lot less lethal than H5N1 avian flu). The H1N1 swine flu is circulating in summer, and this may explain why there's been a comparative predominance of cases in young, healthy people.

thanks-i was wondering what the count was for the number of people who have died from ordinary flu in comparison, but i dont run across any articles about that. i havent heard people in india here even mentioning avian flu except in connection with birds! i can remember when everyone was terrorized by chickungunya too, and yet i dont recall reading any reports that anyone died from that.

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@Icon,

Funny, I was just reading a research article and accompanying review on Chikungunya just an hour ago.

Chik is very seldom lethal, but it causes a great deal of morbidity (illness, pain, lost productivity). And in the Indian Ocean epidemic that started in 2004 (and has affected your country), there have been runs of thousands of cases in some of the Indian Ocean islands like Reunion, Mauritius, and Seychelles. It's an extraordinarily painful illness, kind of like dengue, and people can have lingering pain long after the illness has subsided.

The editorial I just read (in the current issue of Journal of Infectious Diseases) mentions that the strain of Chik virus circulating in the Indian Ocean is genetically different than the ones elsewhere in the world, and it's now associated with a new mosquito vector, Aedes albopictus. This mosquito is a VERY aggresive one that has spread all around the world via an illegal trade in used tires. It's in the USA now, though it has not been associated with any diseases.

So this is an interesting development. The traditional, better known mosquito vector for Chik has been Aedes aegypti, which is the one that is best known for dengue and yellow fever.

You raise an interesting point about mortality. A lot of people have asserted that too much attention is paid to diseases that are lethal compared to ones that are seldom lethal but cause great suffering and illness. Many major tropical diseases, like intestinal parasitoses, leprosy, leishmaniasis, etc, etc, are not lethal but cause great loss of productivity and make people susceptible to death from other causes.

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@Aedes,

Aedes;83132 wrote:

Funny, I was just reading a research article and accompanying review on Chikungunya just an hour ago.

Chik is very seldom lethal, but it causes a great deal of morbidity (illness, pain, lost productivity). And in the Indian Ocean epidemic that started in 2004 (and has affected your country), there have been runs of thousands of cases in some of the Indian Ocean islands like Reunion, Mauritius, and Seychelles. It's an extraordinarily painful illness, kind of like dengue, and people can have lingering pain long after the illness has subsided.

The editorial I just read (in the current issue of Journal of Infectious Diseases) mentions that the strain of Chik virus circulating in the Indian Ocean is genetically different than the ones elsewhere in the world, and it's now associated with a new mosquito vector, Aedes albopictus. This mosquito is a VERY aggresive one that has spread all around the world via an illegal trade in used tires. It's in the USA now, though it has not been associated with any diseases.

So this is an interesting development. The traditional, better known mosquito vector for Chik has been Aedes aegypti, which is the one that is best known for dengue and yellow fever.

You raise an interesting point about mortality. A lot of people have asserted that too much attention is paid to diseases that are lethal compared to ones that are seldom lethal but cause great suffering and illness. Many major tropical diseases, like intestinal parasitoses, leprosy, leishmaniasis, etc, etc, are not lethal but cause great loss of productivity and make people susceptible to death from other causes.

i know-i had that miserable chickun flu. i have seen leprosy now and polio, neither have been eradicated yet. and many people dont realize the number of infants that die of simple diarrhea here yearly. malaria is another common disease that has major effects on us, so far i have escaped. it is unbelievable how the climate affects our ills-how fast one can succumb to dehydration here whereas it is so seldom encountered in the west.

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@Icon,

Malaria in India is an interesting problem. I think around 2/3 of it is P. vivax, which is very rarely lethal, but is awfully disabling. Around 1/3 is P. falciparum, which is the one that kills nearly everyone who dies of malaria. Still, the transmission of malaria in India is lower than in Africa and the amount of death not even close (there are a few hundred million more people in India than in the entire continent of Africa, but around 95% of the malaria deaths in the world are in sub-Saharan Africa). It probably has to do with the mosquitos in India, which are less competent vectors, and also that India has many areas of low malaria transmission (desert areas like Rajastan and of course the Himalayas).

I've never worked in Asia, but I've done a lot of clinical work in Africa and South America and I've certainly seen the difference in pediatric emergencies between there and here. I've seen a LOT of life-threatening diarrhea in pediatric patients in the US, but the rate is plummeting with the new rotavirus vaccine. And also medical care is so easily accessible here that almost no one gets to the point of death -- they make it to the ER, get IV fluids, maybe stay a couple days in the hospital, and it's all gone. Far different than what I saw in Ghana during the rainy season.

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@Icon,

a little update on the numbers. deaths in india due to swine flu (documented that is, which is not really representative of the truth in india) are now at 54. doesnt sound very serious to me. more people may die from the vaccines they are racing to develop here and use without testing them!

from the WHO:
Some 1,799 people have died since the A(H1N1) was uncovered in Mexico and the United States nearly six months ago, according to the WHO.
By comparison, an estimated 250,000 to 500,000 people die around the world every year from seasonal flu, and overall the symptoms of the new pandemic virus have proved to be mild in the great majority of known cases.
Swine flu has spread swiftly into 177 countries, proving to be more infectious than seasonal flu and more durable through warmer months. Some 182,000 people worldwide are known to have caught swine flu based on laboratory confirmed cases, but the WHO has long advised countries to give up counting; the true number may in the millions, according to some experts. (ANI)

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@Icon,

South Africa, has 8 recorded confirmed cases of swine flu deaths up to now, and about 5 thousand confirmed cases of people who recovered with only mild symptoms

This is believed to be only the tip of a iceburg, South Africa is by far the most impacted African country at time of writing.

There is a fear that this flu is only the first wave of a potentially more deadly strain that might mutate from the present swine flu pandemic? This happened with the 1918 influenza

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@Icon,

hi alan-
we're up to 72 deaths confirmed as swine flu, up by 12 since i last posted.. how many deaths in south africa? we have a guest in the house who flew into mumbai and said everyone there is wearing masks-in the airport anyway. but we now have dengue and malaria on our backs. look how many little germs there are and yet they havent managed to wipe us out yet.

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@Icon,

Re: Swine flu.
You'll be fine as long as you don't do this:
http://cdn.ccomrcdn.com/image/446/410/CDN-IP/cc-common/mlib/11573/05/11573_12414681601.jpg

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@Icon,

I just recovered from H1N1 a couple weeks ago. I was hit with the seasonal flu, and then a week later my cousin's two year old brought home the swine flu from daycare and I was sick for a little over a week. It was nice to get a couple weeks off from work and school, but feeling like I was run over by a bus for a week wasn't. I find it funny, though, that even after I have recovered, many people think that I am going to give them some terminal disease that will kill them by the end of the week.

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@Icon,

Why aren't the MSM reporting on the flu pandemic in the Ukraine? Over 1,000,000 have been infected and over 50,000 hospitalized and 174 are dead. The flu appears to be more virulent than H1N1 swine flu. Some reports indicate that airplanes were sprayinga strange sustance over several Ukranian cities, prior to this outbreak.

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@Icon,

That doesn't sound particularly different than in the United States.

Between August 6 and November 6 there have been more than 17,000 hospitalizations and 672 deaths attributed to H1N1 influenza in the United States.

Total cases is difficult to estimate because uncomplicated flu is not reportable (and I've taken care of several cases of it without needing to report it), but 5-10% of all medical visits right now in the United States are for influenza like illnessess, and 99% of all flu in the US right now is H1N1.

CDC 2009 H1N1 Flu | 2009 H1N1 U.S. Situation Update
CDC - Seasonal Influenza (Flu) - Weekly Report: Influenza Summary Update

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@Icon,

Swine flue seems to be flying under the medical radar

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@Alan McDougall,

Alan McDougall;103092 wrote:

Swine flue seems to be flying under the medical radar

LOL.

I haven't seen something this high on the medical radar since the SARS epidemic.

We have clinical committees including infection control, staff quarantine policies, constant updates, and we have s hospital operating above capacity because of the excess early flu cases. The medical journals are overflowing with articles about H1N1. The Journal of the American Medical Association (JAMA) just last week had an issue devoted solely to H1N1.

The media is burnt out on epidemics, perhaps, but even though this is not a very deadly infection overall the number of cases will be enormous, like hundreds of millions worldwide.

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