The Health Protection Agency has a link on its Swine Influenza page to a survey of the pandemic so far in England:
The HPA has produced a report on its response to the first wave of pandemic H1N1 2009 in England, summarising key findings about the pandemic and assessing the implications for the second wave. Pandemic H1N1 2009 in England: an overview of initial epidemiological findings and implications for the second wave.
I’ve had a link to peterosborn.com - Pandemic preparedness for months, but I should have been paying more attention to it. Osborn maintains some very up-to-date statistics and does useful analysis of them.
For example, today he tells us we’ve seen a total of 9,849 H1N1 deaths around the world, a 19% increase in the past ten days. And he warns: “The aim is to understand the flow of the trends, not to attempt to document individual data or calculate totals from the chaotic reporting that is taking place.” (Judging from his charts, the trends in most parts of the world are still going up.)
Chaotic or not, a few sources would be helpful. Even so, Osborn provides more data, from the national to the global scale, than most flu sites.
By all means explore the site, including the graphs and tables for the history of the pandemic and the country analysis.
Via the Jerusalem Post: Two more people who were infected with H1N1 die in Beersheba. Excerpt:
Two more people infected who were infected with H1N1 influenza died Thursday at Beersheba’s Soroka Hospital.
The fatalities, a 70-year-old woman and a 71-year-old man, both suffered from other chronic illnesses.
They were listed by the Health Ministry as the flu strain’s 49th and 50th victims in Israel since early spring, even though it could not be proven that his death resulted from the infection.
Via Swisster.ch: Swine flu claims fourth victim. Excerpt:
Authorities on Thursday identified a fourth person who has fallen victim to swine flu in Switzerland.
A 45-year-old man from the canton of Obwald died on the weekend for reasons not initially made public. An autopsy uncovered evidence that the man was carrying the H1N1 virus.
He was suffering from other illnesses and was considered a person “at risk” by medical authorities, the ATS news service reported.
(Thu, 26 Nov 2009 13:53:00 +0000)
# 4083
Last Friday we learned of two hospitals – one in North Carolina,and one in Cardiff, Wales – that reported small clusters of Tamiflu resistant H1N1 infections among their patients.
Further investigation has turned up a 6th case in the Wales hospital, and there may yet be another.
While these reports are concerning, and of scientific interest, it is import to remember that for now Tamiflu remains effective in the overwhelming number of cases. And Relenza, another antiviral, is still effective when Tamiflu is not.
The number of resistant cases that have been reported is still very small. Given the heavy usage of Tamiflu, it would not be unexpected to see more resistant cases develop over time.
In just over a year seasonal H1N1 went from being more than 90% sensitive to oseltamivir (Tamiflu) to nearly 100% resistant. So we know the potential is there for seeing something like that happen with novel H1N1.
Which is why we watch developments such as these with interest, particularly when it involves the transmission of a resistant strain.
Antivirals were always viewed as a stop-gap measure during a pandemic. The best defense against a novel influenza strain is vaccination.
This report from the BBC.
New drug-resistant swine flu case
Page last updated at 11:55 GMT, Thursday, 26 November 2009
A sixth person has tested positive for a Tamiflu-resistant strain of swine flu, public health officials say.
The patient is linked to five people who last week became the world’s first confirmed cases of person-to-person transmission of such as a strain.
Another person in direct contact with the group at University Hospital of Wales, Cardiff, has been tested.
Three patients remain in hospital, with one in critical care and the other two treated in isolation.
Public health officials said vaccinations remain the most effective way of combating swine flu.
Dr Roland Salmon, director of the National Public Health Service for Wales’ Communicable Disease Surveillance Centre, said it was “not unexpected” that more patients on a unit treating people with severe underlying health conditions would test positive for the Tamiflu-resistant strain.
He said: “In this case, the resistant strain of swine flu does not appear to be any more severe than the swine flu virus that has been circulating since April.
Via Today’s Zaman: Death toll from swine flu rises to 161 in Turkey. Excerpt:
Turkish health officials reported 39 more people have died after contracting pandemic H1N1 virus, also known as swine flu, over the past three days, and death toll reached 161 in the country.
The Ministry of Health said Thursday that 243 people were under treatment in hospitals, 70 of them were in intensive care rooms. 32 of these patients were put on breathing devices, the ministry said.
(Thu, 26 Nov 2009 12:53:00 +0000)
# 4082
As I spent yesterday afternoon in the dentist’s chair, and last night in a vicodin induced haze, I missed the fact that yesterday was Effect Measure’s 5th blogiversary.
Since most of what I know about the science of influenza I gleaned from their terrific blog, it would be churlish on my part not to offer my heartfelt congratulations, and thanks, for their combined hard work.
If Effect Measure isn’t already a daily stop on your Internet rounds, you are missing the best public health blog on the web.
If you read the comments to their blogiversary blog, you’ll find I’m not alone in this appraisal. So go join in the celebration and read:
Fifth blogiversary
(Xinhua)
Updated: 2009-11-26 02:47
BEIJING: Genetic mutation had been detected in eight A/H1N1 flu cases on the Chinese mainland, an official with the Chinese National Influenza Center said here Wednesday.
Shu Yuelong, director of the center, which is affiliated with the Ministry of Health, said in an interview that the mutated virus was not resistant to drugs and could be prevented by vaccines.
According to Shu, the first mutated strain of the A/H1N1 flu was discovered in June this year in an imported case from Britain. Similar strain was detected three months later in Zhejiang Province.
The health department of Hong Kong Special Administrative Region (SAR) announced one human swine influenza (HSI) virus which had the same mutation as the one detected in Norway recently.
According to the World Health Organization (WHO), same mutation had been found in other countries including Brazil, Japan, Mexico, Ukraine and the United States.
“Mutations were almost inevitable in influenza viruses,” Shu said.
full story
http://www.chinadaily.com.cn/china/2009-11/26/content_9051932.htm
China: Zhong Nanshan On Viral Reassortment
In early 2003, at a time when SARS was burning its way through parts of China and the Chinese government actively hid that information from its people, its doctors, and the rest of the world, one man boldly went before the TV cameras and told the truth.
That man was Zhong Nanshan, director ofGuangzhou’s Institute of Respiratory Diseases and a member of China’s Academy of Sciences.
Zhong did something that isn’t normally conducive to good health and long life in China . . . he publicly challenged official government statements.
In doing so, Zhong Nanshan became a much respected and revered household name in China. And since that time, he has repeatedly voiced his opinions, even when they contradict the `official line’ of the Chinese government.
Last week Zhong publicly questioned the official death toll from the H1N1 virus (see Zhong Nanshan On China’s Death Toll), which brought a response 24 hours later from the Health Ministry, promising to punish anyone caught hiding fatalities.
Today, Reuters has a long and very informative article regarding his concerns over the possible reassortment of the pandemic H1N1 virus with H5N1 bird flu.
Reassortment occurs when two compatible viruses infect the same host (human, pig, bird, etc.) at the same time, and swap genetic material. This can produce a hybrid virus, with parts of both viral donors.
While we know reassortments happen, and they have caused pandemics in the past, we really don’t know how likely it is that the H5N1 virus will mix with H1N1 and produce a biologically `fit’ hybrid; one that replicates well and is easily transmissible.
Obviously biologically fit reassortments don’t happenvery often, else we’d be hip deep in new viruses all the time.
But while speculative, when Zhong Nanshan is worried, one would be wise not to dismiss the idea.
He isn’t alone, by the way. Other scientists have publicly worried over the possibility. You may recall a recent blog regarding Alan Sipress’s column in the Washington Post Alan Sipress: Playing chicken with a nightmare flu .
Follow the link to read the entire article
China expert warns of pandemic flu mutation
Wed Nov 25, 2009 3:29pm IST
By Stefanie McIntyre
HONG KONG (Reuters) – China must be alert to any mutation or changes in the behavior of the H1N1 swine flu virus because the far deadlier H5N1 bird flu virus is endemic in the country, a leading Chinese disease expert said.
Zhong Nanshan, director of the Guangzhou Institute of Respiratory Diseases in China’s southern Guangdong province, said the presence of both viruses in China meant they could mix and become a monstrous hybrid — a bug packed with strong killing power that can transmit efficiently among people.
“China, as you know, is different from other countries. Inside China, H5N1 has been existing for some time, so if there is really a reassortment between H1N1 and H5N1, it will be a disaster,” Zhong said in an interview with Reuters Television.
“This is something we need to monitor, the change, the mutation of the virus. This is why reporting of the death rate must be really transparent.”
The World Health Organization warned on Tuesday that H5N1 had erupted in poultry in Egypt, Indonesia, Thailand and Vietnam, posing once again a threat to humans.
“First, it places those in direct contact with birds — usually rural folk and farm workers — at risk of catching the often-fatal disease. Second, the virus could undergo a process of “reassortment” with another influenza virus and produce a completely new strain,” it said.
“The most obvious risk is of H5N1 combining with the pandemic … (H1N1) virus, producing a flu virus that is as deadly as the former and as contagious as the latter.”
(thanks to my flu buddy and newshound Bev for sending that.-cottontop)
China
• 8 cases of swine flu mutation (Link)
• Chinese expert warns of H1N1 and H5N1 pandemic mutation (Link)
• Detected H1N1 mutations ‘not dangerous’ (Link)
Canada
• Helen Branswell – GSK says still no answer on whether H1N1 vaccine batch triggers more reaction (Link)
Japan
• Japan to send experts to Canada over flu vaccine reactions (Link)
Latvia
• Baltic states swine flu death toll rises (Link)
Saudi Arabia
• Swine flu fears for hajj pilgrims (Link)
Slovakia
• Ill Man with A(H1N1) Flu Virus Dies in Prievidza Hospital (Link)
South Korea
• South Korea Unlikely to Buy Problematic H1N1 Vaccine from GSK (Link)
• 22 new deaths recorded last week, total now 104 (Link)
Taiwan
• Confirmation of death of 4 yr old girl from H1N1 (Link)
United Kingdom
• Scotland has 3 more deaths, 43 total now (Link)
United States
• US: CDC says that the rates of ‘invasive pneumonia’ tripled in Oct vs 5 yr averages in Denver metro (log in required) (Link)
• Decoding the turkey’s genetic gobbledygook (Link)
• FL: New mom in coma w/ H1N1, newborn survived 5 days (Link)
• IL: 2000 hospitalizations from H1N1 and 389 new hospitalized (Link)
• IN: 33 of 35 deaths from flu so far are confirmed H1N1 (Link)
• MN: Minnesota news reports seem inconsistent now (Link)
• MN: Six Duluth deaths associated with H1N1 (Link)
• NM: Two Deaths In Eastern New Mexico Linked To H1N1 (Link)
• OR: only 17 more hospitalizations since yesterday, no new deaths (Link)
• OR: Oregon Hospitalizations up 22 in four days and 4 new deaths (Link)
• PA: (7) New Deaths on PA DOH Website for 11.25.09 (Link)
• TX: 2 more deaths confirmed in El Paso (Link)
• UT: Utah confirmed another death and 72 more hospitalizations last week (Link)
General
• WHO: Possible Tamiflu resistance (translated) (Link)
• Biological H1N1 Vaccines: Too Little, Too Late (Link)
• Drug-resistant swine flu probed (Link)
• The Hajj: A perfect storm for swine flu? (Link)
Commentary
• Recombinomics: D225G Ukraine Norway Link and China Spread (Link)
I’m packing it in for the night. For a good overview of flu news, tonight or anytime, drop in on Chen Qi. It’s based in the Netherlands, so it’s always a few hours ahead of us North Americans (and being here on the west coast, I’m always the last to catch up on the news). It’s also one of the most readable blogs I know, on any subject.
Via Angus Reid, a Canadian polling organization: Canadians More Satisfied with Government on H1N1. Excerpt:
People in Canada are now less critical of the government’s handling of the H1N1 pandemic, according to a poll by Angus Reid Public Opinion.
45 per cent of respondents are content with the federal government’s preparedness for the Swine Flu outbreak, up 13 points since early November. Additionally, 44 per cent of Canadians are satisfied with the performance of their provincial government regarding the flu pandemic, up eight points since early November.
In April, Mexico was greatly affected by an outbreak of H1N1 influenza, also referred to as Swine Flu. In early June, as the virus spread throughout the globe, the World Health Organization (WHO) classified the outbreak as a pandemic, while also noting that most illnesses reported were of “moderate severity.”
So far, at least 250 people have died in Canada as a result of the H1N1 outbreak.