Influenza Virus Mashup

Via the Hong Kong edition of China Daily: Flu victims warned not to count on immunity. Excerpt:

People who have contracted A (H1N1) flu should not be misled into believing that the virus confers immunity to future episodes, Under Secretary for Health Gabriel Leung said Friday. 

The secretary urged everyone, including those who have already had swine flu, to be vaccinated in preparation for the coming peak flu season. 

“Even for seasonal flu, not 100 percent of them get immunity to the virus,” Leung said. 

He continued, saying that about one quarter to 75 percent of patients infected with seasonal flu will not be immune to a recurrence of the virus. Immunity, he said, is very much an individual matter and may be affected by the physical condition of patients. 

He encourages people, even those who have recovered from swine flu, to receive the vaccinations which will be available in mid December. Those who belonged to any of the five high-risk groups are also urged to receive the vaccine. 

The five groups considered to be at highest risk are healthcare workers; chronically ill patients and pregnant women; children aged from six months to under six years; the elderly aged 65 and above; and pig farmers and slaughterhouse workers.

via ubAlert.com: Iraq Reports Another Fatal Case of A/H1N1 Flu. Excerpt:

A medical source in Kirkuk reported on Sunday that a man from the city died of the A/H1N1 flu. 

Dr. Siddeeq Omar Rasoul, head assistant of Kirkuk Health Office said that the victim was a man in his thirties who died at the main hospital of the town of al-Hawija, approximately 70 km southwest of Kirkuk. 

Rasoul added that the man who was the first fatality from the novel flu in Kirkuk even received treatment at an isolated room designated for A/H1N1patients in the hospital; however doctors failed to save his life. 

This latest death case raised Iraq’s death toll of the A/H1N1 flu to 13.

Via Hurriyet: Swine flu does not exist, says Bahçeli. Excerpt:

The leader of the opposition National Movement Party, or MHP, has introduced existential doubt into the swine flu debate. 

“I do not believe in the swine flu,” said MHP leader Devlet Bahçeli on Saturday. 

“We have not taken any measures (against the H1N1 virus commonly known as swine flu). Everything is up to God’s will,” said Bahçeli, Anatolia news agency reported. 

According to the Health Ministry’s Web site, however, as of Thursday at least 161 people have died of swine flu and 243 people were receiving treatment in Turkish hospitals as of Thursday. 

Ninety-two of those patients were also suffering from a chronic disease, which puts them in the high-risk category, said the web site. 

During the celebration of Kurban Bayram, or Feast of the Sacrifice, some politicians including Health Minister Recep Akdağ avoid kissing people, but Bahçeli’s statement on swine flu was unique.

Via elEconomista.es: Gripe a. la pandemia multiplica por cinco los días de trabajo perdidos por gripe. [The pandemic quintuples the days lost to flu] Excerpt, with my translation:

La pandemia de Gripe A ha provocado que las jornadas laborales perdidas por gripe se hayan multiplicado por 5,5 veces en octubre, en comparación con el mismo mes de 2008, según datos del Ministerio de Trabajo e Inmigración a los que tuvo acceso Servimedia. 

The H1N1 pandemic has caused workdays lost to flu to multiply by 5.5 times in October, compared to the same month in 2008, according to data from the Ministry of Labour and Immigration.

En concreto, en el pasado mes de octubre se perdieron un total de 108.842 días de trabajo por gripe, frente a las 19.615 del mismo periodo de 2008. Este incremento en las jornadas laborales perdidas por esta enfermedad se produce a pesar de que la duración de las bajas por Gripe A son inferiores a las del tipo estacional.

Specifically, this October saw the loss of a total of 108,842 workdays from flu, compared to 19,615 days in the same period in 2008. This increase in workdays lost to the illness is despite the fact that the length of absences due to H1N1 is less than that for seasonal flu.

(Sun, 29 Nov 2009 15:37:00 +0000)

# 4096

I’ve just spent the last 4 hours combing the Internet for something blogable or at least newsworthy regarding the H1N1 virus.

It is a relatively quiet Sunday Morning – the end of a long holiday weekend in the US – and the pickings this am are pretty slim.

 

Unless, of course, you’re interests lean towards crazy conspiracy theories, wild speculation, or outright pandemic paranoia.  Those types of stories are always plentiful, regardless of vagaries of the news cycle.  

As a `reality-based’ blogger, however, these types of stories don’t do me much good (although they can be useful for killing off weaker brain cells).  Unfortunately, much of what is being reported (or perhaps more accurately, `spewed forth’) on the Internet is of dubious value at best. 

Not all of it is dreck, of course.

While you can find a lot more mentions in my blog Reliable Sources In Flublogia, some of the real standouts include:

My `go to’ science bloggers,  like Vincent Racaniello on Virology Blog, the Reveres on Effect Measure, and Tara Smith on Aetiology. 

 

And `take it to the bank’ reporting by the likes of Helen Branswell of the Canadian Press, Maggie Fox of Reuters, Jason Gale of Bloomberg, and Maryn McKenna, Robert Roos, and Lisa Schnirring of CIDRAP. 

But sometimes I’m called upon to do research on my own, and knowing where to go, and what sources I can trust, isn’t easy. 

No source can be 100% reliable, of course, and there are admittedly many things we don’t know about influenza (and many others we think we know, but are wrong about).

But there are some resources that I’ve learned to trust, and that I go to again and again. So I thought I’d share them with you on this quiet Sunday Morning.

First are the CIDRAP overviews.    When it comes to easy to read and understand historical and scientific overviews, these are hard to beat.  I refer to them often.

Novel H1N1 Influenza (Swine Flu)

Last updated November 20, 2009

 

Avian Influenza (Bird Flu): Agricultural and Wildlife Considerations
Last updated September 28, 2009

 

Avian Influenza (Bird Flu): Implications for Human Disease

Last updated September 28, 2009

While not something I use every day, another resource I’ve found useful is the Thomson Reuters Daily News Briefing on the H1N1 virus.   

This is a (currently) 55 page PDF file, updated daily, with background scientific information about the H1N1 virus, with special emphasis on the pharmacology (vaccines, antivirals, diagnostic tests, etc.) and biology of the virus.

While much of this information is specific to the Pharmacology Industry, it provides a good deal of scientific data.

Buried in the websites for the CDC, HHS, FDA, NIOSH, FEMA, Ready.gov, Flu.gov  and other governmental agencies are tremendous resources as well. 

And finally, two Flu Forum resources that I use often.  

The `wiki side’ of the Flu Wiki  is a reference site filled with flu information, and maintained by the members of the Flu Wiki.  They describe it this way:

The purpose of the Flu Wiki is to help local communities prepare for and perhaps cope with a possible influenza pandemic. This is a task previously ceded to local, state and national governmental public health agencies. Our goal is to be:

• a reliable source of information, as neutral as possible, about important facts useful for a public health approach to pandemic influenza
• a venue for anticipating the vast range of problems that may arise if a pandemic does occur
• a venue for thinking about implementable solutions to foreseeable problems

You’ll also find discussion threads, some written by doctors, on the conversation side of the Flu Wiki, that delve (often quite deeply) into the science of influenza.

And then there’s FluTrackers which has become one of the largest, and most organized repositories of flu information on the Internet.  Due to its size and scope, navigating FluTrackers can be a bit of a challenge until you get used to it, but it is worth the effort. 

Both FluTrackers and the Flu Wiki have hard working and talented newshounds (see Newshounds: They Cover The Pandemic Front) and have collected years worth of news and journal articles, and analysis, on influenza and other emerging infectious diseases.

In many ways, these forums have become living reference libraries.  Sure, you’ll find some speculation on them.  But most of it is either reasonable, or quickly refuted by other forum members.  

Like anywhere else, Caveat Lector.

On a morning where I’m seeing a discouraging number of conspiracy theories, paranoid rantings, and tabloid stories take center stage, it is worth reminding myself that there are good, solid, and reality-based resources out there.

You just have to know where to look.

Via El Sol de México: Mueren 4 portadores de VIH por A-H1N1. [Four HIV carriers die of H1N1] Excerpt, with my translation:

Según datos del Centro Nacional para la Prevención y Control del VIH-SIDA (Censida), ya hay confirmadas cuatro muertes por influenza A-H1N1 entre portadores del virus del Sida. 

According to data from the Nation Center for the Prevention and Control of HIV/AIDS, four deaths from H1N1 have been confirmed in carriers of the AIDS virus.

“Hemos encontrado en el estado de Oaxaca, que es el estado donde más sistemáticamente se realizan búsquedas, que cuatro personas que no sabían que vivían con VIH tuvieron el virus A-H1N1 y fallecieron”, indicó José Antonio Izazola, director del Censida, en el marco del XI Congreso Nacional sobre Sida, que se realiza en Chiapas.

“We have found in Oaxaca, the state that has the most systematic monitoring, that four persons who didn’t know they were living with HIV caught the H1N1 virus and died,” said José Antonia Izazola, director of the Center, at the XI National AIDS Congress, being held in Chiapas.

(Sun, 29 Nov 2009 14:12:00 +0000)

# 4095

One of the groups I tend to hear from via email and/or comments are HCW’s (Health Care Workers), since much of this blog is geared in their direction.  My interest in their welfare runs deep because I have friends who work in that sector, and of course, I used to be a HCW myself.

With a largely private Health Care Industry here in the United States, government agencies are somewhat limited in what demands they can place on hospitals, clinics, and doctor’s offices.  

Sometimes the best they can do is issue guidelines and make strongly worded recommendations.

NIOSH, the National Institute for Occupational Safety & Health, has released Health Care Worker guidelines while it attempts to gather information on HCWs who have been infected with the H1N1 virus on the job.

Although this statement was issued more than a month ago (it was updated again earlier this month), it is a good reminder than Hospitals need to follow the CDC recommendations for infection control, they need to inform HCWs about underlying conditions that might make them more prone to serious illness, and they should have flexible and non-punitive sick leave policies.

NIOSH Safety and Health Topic:

Occupational Health Issues Associated with H1N1 Influenza Virus (Swine Flu)

Risk of Serious Illness Among Healthcare Personnel Associated With 2009 H1N1 Influenza:  What Is NIOSH Learning?

October 16, 2009

Reports in the news media have associated the deaths of at least four nurses with 2009 H1N1 influenza. Efforts to gain a fuller understanding of the prevalence of serious H1N1 illness and fatalities among nurses, as well as other healthcare personnel, have been limited due to a lack of occupational data in existing healthcare surveillance systems. More efforts are needed in order to fully appreciate the prevalence of severe H1N1 illness among healthcare workers.

 

NIOSH is working with its partners to gather more information about deaths and serious illness among healthcare personnel associated with 2009 H1N1 influenza. These surveillance activities are aimed at better understanding the factors that may heighten the risk of severe work-related 2009 H1N1 infection among healthcare personnel, as well as identifying the factors which affect risk of transmission of 2009 H1N1 influenza to healthcare personnel.

 

Healthcare personnel are at increased risk of occupational exposure to the 2009 H1N1 virus based on their likelihood for encountering patients with 2009 H1N1 illness. In contrast to seasonal influenza virus, 2009 H1N1 influenza virus has caused a greater relative burden of disease in younger people, which includes those in the age range of most healthcare personnel. For some healthcare personnel, this higher risk of exposure and illness may be compounded by the presence of underlying illness which places them at higher risk of serious flu complications, such as asthma, diabetes, or neuromuscular disease. Of particular concern to the healthcare workforce, which is largely female, is the fact that pregnant women are among those groups considered to be at higher risk of severe infection from 2009 H1N1.

 

As NIOSH gathers further information about the prevalence of serious illness among healthcare personnel, it recommends the following precautions, based on known risks of exposure for healthcare personnel and known risk factors for complications from influenza:

• Healthcare facilities should follow U.S. Centers for Disease Control and Prevention (CDC) interim guidance for 2009 H1N1 influenza infection control for healthcare personnel.
• Healthcare personnel should be encouraged to receive both the seasonal influenza vaccine and the 2009 H1N1 vaccine when available.
• Healthcare personnel should be informed about and aware of the types of underlying conditions that may put them at higher risk of complications. In addition to pregnant women, those at higher risk for complications of 2009 H1N1 influenza include the following: those with a variety of chronic medical conditions (examples include asthma, sickle cell disease, and diabetes mellitus); people with immunosuppression caused by medications or disease; those with disorders such as neuromuscular disease that compromise respiratory function or handling of respiratory secretions or increase the risk of aspiration; those younger than 19 years of age who are on chronic aspirin therapy; and those 65 years of age or older.
• Healthcare personnel should be informed about and aware of the symptoms of influenza or influenza-like illness, the emergency warning signs to seek urgent care, including but not limited to difficulty breathing, shortness of breath, or pain or pressure in the chest or abdomen, and the need to seek care aggressively if they have conditions that put them at higher risk of complications of influenza or if they have any concerns about their symptoms.
• Healthcare employers should have flexible, non-punitive, and well-communicated leave policies. They should allow personnel who have the flu to stay home and away from co-workers.

Via Anchorage Daily News: H1N1 follows ethnic pattern: Swine flu (H1N1). Excerpt:

State and federal health officials wanted to know what kind of people were hospitalized with swine flu, so they studied Anchorage residents who tested positive and were admitted at four area hospitals over several weeks — 59 people. 

The biggest surprise, according to state epidemiologist Dr. Joe McLaughlin: People from two ethnic groups — Alaska Natives and American Indians, and Asians and Pacific Islanders — were hospitalized at higher rates than those in any other ethnic groups. 

The rate for Alaska Natives was 4 1/2 times greater than for white people, at 50 per 100,000, said McLaughlin. Asians and Pacific Islanders weren’t far behind Alaska Natives, at a rate of 41 hospitalizations per 100,000. 

As expected, most people of all races who were hospitalized — 71 percent — had another medical condition that put them at higher risk of complications from the flu. The most common pre-existing health problem was asthma, which affected 17 of those admitted, said Dr. Jay Wenger, an epidemiologist with the Arctic Investigation Program of the federal Centers for Disease Control and Prevention. Wenger was one of the report’s authors. 

Heart disease was next with 10 people, and other lung diseases were next with six people. People might have had more than one underlying condition. 

Nine of the 59 people were so seriously ill they were treated in intensive care units. One of the 59 died.

Via Syrian News Station: Tunisia’s President catches H1N1virus. Excerpt:

Tunisian President Zein al -Abedin Bin Ali catches the H1N1 virus (swine flu) which transferred to him from his granddaughter. 

Ben Ali’s personal physician advised him to take “a period of five days’ rest after an acute inflammation of the pharynx,” Tunisian presidency spokesman said yesterday. Two Spanish newspapers quoted diplomatic sources as saying that the Spanish King Juan Carlos’ planned visit to Tunisia was cancelled for this reason. 

On the other hand, Tunisia officially cancelled the Haj season this year in order to control the spread of the  H1N1 virus. 

Bin Ali, 73, has been leading the country since 1987, and won the fifth term of office last month with 89.62 percent of the vote.

Zeinobia at Egyptian Chronicles is less concerned about the condition of the president, or his percentage of the vote, than with the fact that Tunisia has no vice-president.