Influenza Virus Mashup

Via the Hong Kong government website: Flu jabs prevent outbreaks: York Chow. Excerpt:

Inoculation has been proven to be useful in preventing flu outbreaks, Secretary for Food & Health Dr York Chow says, adding patients in all fatal and severe human swine flu cases were not vaccinated.
  

Dr Chow today told reporters the Government stockpiles human swine flu vaccines because it wants to ensure it has sufficient supply for all who may need it.
  

“Obviously we have sufficient supply for all five at-risk groups in Hong Kong, plus some extra for people who are willing to take the vaccine. I am not worried it has not [been] taken entirely because [if the influenza peak gets] worse, I am sure more people will be interested [in taking] it,” he said.

Via Ida at Bird Flu Information Corner, a report from Media Indonesia: Pekanbaru, Riau ::: Prevalence increases up to six hundred percent. Excerpt:

About 2,751 chickens had died of bird flu virus within previous month in Riau. This has folded the number of bird flu cases in chicken by 600 percent compare to number at same period of last year outbreak, 441 chickens. 

Head of Livestock Service of Riau Province, Patrianov said massive chickens deaths had been reported from six municipals/cities in Riau: Kampar 1,995 chickens; Siak 351, Indragiri Hilir 234, Indragiri Hulu 128, Rokan Hulu 22, and Pekanbaru 14. The shift of rainy season had influenced the replication of the virus. 

Several areas in Riau were still drowned by flood which had increased the rate of virus spread, added Patrianov. In the days of flood, people had trouble to diminish or bury dead chickens, so they preferred to dispose the chicken’s body to flowing water or puddle around their residences. 

According to Patrianov, most severe bird flu attack in Riau had occurred in broiler chickens in Kabupaten Kampar with total case up to 1,900. Remaining cases were reported in backyard chickens that reared by locals.

Via ReliefWeb: Situation report on influenza A H1N1 pandemic (as of 24 Jan 2010). Excerpt:

As of 24th January 2010, 9:00 AM Baghdad time, 18 governorates (All Iraq governorates) have reported 2,964 laboratory confirmed cases of Influenza A H1N1 including 42 deaths. Out of the total cases 633 are members of the multinational forces. Since 17th January, no new H1N1 cases have been reported.

The full report is available as a PDF on the ReliefWeb site.

Via the Indian government’s Press Information Bureau: Consolidated status of influenza A H1N1 as on 1st February 2010. It reports 28,861 confirmed cases and 1,235 deaths.

(Mon, 01 Feb 2010 14:15:00 +0000)

 

 

 

# 4311

 

From the British Journal of Health Psychology today we get a study on who (demographically speaking) are most likely to take precautions during a pandemic.

 

There are certain behaviors which can reduce one’s exposure to the virus, or help prevent its spread.  Among them are hand washing, wearing masks, and even self quarantine when ill.

 

This study found that there are both gender and generational differences that separate those who are more likely to take these steps, and those who aren’t.

 

Some excerpts from the press release (slightly reformatted for readability), then a link to the entire study (free access).

 

 

Study investigates who is most likely to take precautions during a pandemic

A study that looked at how people behave during pandemics has identified key demographic and psychological factors that may predict protective behaviours. The study is published online today, 30th January 2010, in the British Journal of Health Psychology.

 

<SNIP>

 

Many of the studies found significant gender differences in protective behaviours. Studies in Hong Kong and Singapore, the UK and the USA found that women were more likely than men to carry out protective behaviours such as washing their hands, wearing a mask or following quarantine restrictions.

 

Older people were also found to be more likely to carry out such protective behaviours. Dr Bish explains: “These patterns could be explained in terms of perceived risk, with women and older people feeling that they may be more susceptible to disease than men, or younger people do.”

 

In fact, greater perceived susceptibility to disease was found to be a strong predictor of protective behaviours in studies carried out in the UK, Hong Kong, Australia and the Netherlands, with those people who felt they were more at risk carrying out more protective behaviours such as good hygiene, vaccination, and disinfecting the home. In studies investigating SARS and swine flu, greater perceived susceptibility was associated with avoidant behaviour such as avoiding public places.

 

Having a high level of trust in authorities was found to be associated with compliance with preventative, avoidant and management of illness behaviours. Dr Bish explains: “As trust is a key emotion relevant to risk behaviour, people who trust in authorities are more likely to follow their advice. The issue of trust becomes weightier in uncertain situations, making this an important factor in whether people follow government advice during pandemics.”

 

 

The entire study is available as a PDF file at the link below.

 

 Demographic and attitudinal determinants of protective behaviours during a pandemic: A review

Author: Alison Bish and Susan Michie

Source: British Journal of Health Psychology

Publisher: British Psychological Society

DOI: 10.1348/135910710X485826

Via Bikya Masr: Egypt H1N1 death toll rises to 258. Excerpt:

The Egyptian Health Ministry reported on Sunday that the H1N1 influenza death toll has risen to 258. 

The statement said that one person was reported to have died from the virus, commonly known as swine flu, on Sunday. According to the ministry, the 53-year-old man from Assiut succumbed to his illness, but the statement gave no further details on the death. 

Since the virus first appeared in early June last year, the ministry has confirmed 15,800 cases of the virus, putting Egypt well to the top of the worst countries affected by the virus.

Via Antara: Bird flu kills 5,500 chickens. Excerpt:

Bird flu killed around 5,500 chickens in Purbalingga district, Central Java, during January 2010, a local official said. 

Some 5,000 dead chickens were found at Tumanggal village and 500 at Pasunggingan village, both in Pengadegan sub district, Purbalingga, Hartono, head of the Purbalingga animal husbandry office, said here on Monday. 

The local authorities have conducted measures such as insecticide spraying, rapid test and vaccination to prevent the bird flu or H5N1 virus from spreading to wider areas.

(Mon, 01 Feb 2010 13:09:00 +0000)

 

 

 

 

# 4310

 

I’ve no doubt that, given time, scientists and researchers will conduct a thorough post mortem on the pandemic of 2009.  

 

Over the next few years they should be able to come up with a reasonable estimate (probably a range) of the number of pandemic related deaths, and should be able to analyze and quantify the effectiveness of various mitigation efforts undertaken around the world.

 

That work is going on right now, of course.  But so is the pandemic.  It will take some time before we get really good answers.

 

So I take articles, like the one below that appears eager to reach a conclusion based on early data, with a sizable grain of salt. 

 

First the report, from the Daily Record, then some additional comments.

 

 

Revealed: Swine flu death rate in Scotland third worst in world..it’s even worse than Mexico

Feb 1 2010 By Derek Alexander

 

SCOTLAND’S swine flu death rate is the third worst in the world - beating Mexico where the virus was first discovered.

 

Only Argentina and Latvia have worse death rates.

 

Last night, ministers were being urged to investigate as medical experts blamed Scotland’s poor health record for the shocking findings.

 

Stefan Chmelik, of New Medicine Group, said: “There is something of a general health crisis in Scotland.

 

“It stands to reason that if you’re fit and healthy then you’re more able to fight off disease - and if you’re unhealthy then you’re potentially more susceptible.”

 

In Scotland, the swine flu mortality rate is 13.2 per million people - more than double the 5.76 figure for the rest of the UK.

 

It’s also 45 per cent higher than Mexico and three times higher than Poland, where health bosses have refused to administer a vaccine.

 

Argentina tops the poll with 15.37 deaths per million, followed by Latvia with 14.37.

 

(Continue . . . )

 

 

Seemingly a damning indictment of the Scottish Health system, and one that apparently is becoming a bit of a political football.

 

But is it really?

 

I would submit that the evidence at this point is pretty thin.

 

Scotland has recorded 66 deaths that they have attributed to the H1N1 virus. And with a population of just over 5 million, that works out to 13.2 deaths per million.

 

This article compares Scotland’s national death rate to the rates being posted by the small number of countries that are actually counting and reporting swine flu fatalities.

 

Saying Scotland has the 3rd worst numbers in the world is a bit presumptuous when most of the world isn’t even reporting.

 

But even if you refine the declaration to `among countries reporting’, there are still problems with this analysis.

 

First and foremost, there is no standardized definition for what constitutes a `flu-related death’.  

 

Someone who gets the flu, fights it off at home for a week, then is hospitalized with pneumonia isn’t likely to test positive for the virus by the time they hit the ICU. While almost certainly `flu-related’, in most reporting countries, this case wouldn’t be counted.

 

So what may be a flu-related death in one region might not be counted in another.

 

Secondly, surveillance and reporting is patchy at best, even in those countries reporting flu fatalities.

 

The deaths being counted are those with laboratory confirmed H1N1. The WHO, the CDC, and just about every public health agency in the world openly state that those represent just the tip of the iceberg.    

 

The reported number of fatal cases is an under representation of the actual numbers as many deaths are never tested or recognized as influenza related. – World Health Organization.

 

Making comparisons with incomplete (and inconsistently gathered) information may make for an interesting news story, but it hardly qualifies as good science.

 

And when you look at the CDC’s estimate of the number of H1N1 deaths in this country you end up with a much higher number for the United States. Anywhere between 26 and  54 deaths per million.

 

Or 2 to 4 times higher than Scotland’s (or any other country’s) published rate.

 

 

 

Which number is right?

Right now, I don’t think you can point to any country’s count, or method of counting, and say they’ve got it right (although I suspect the CDC’s estimate is more realistic).

 

Ask me again in 3 to 5 years.  

 

Does Scotland really have the 3rd highest H1N1 fatality rate in the world?

 

It’s possible, I suppose. 

 

But based on what little we know, I wouldn’t put any money on it.

 

 

For more on how numbers can be used to prove just about anything, you might want to revisit:  

 

Proving Anything With Numbers

Premature Extrapolations

I spent a little time today cleaning up some resource links. You’ll find fewer links in H1N1 Resources and H5N1/H1N1 Hot Zone Sources. The deleted links are to sources that I haven’t used in weeks (or months), and to sources in countries where H1N1 has for the time being faded from the local media. If these countries see new outbreaks, I’ll restore the links at once.

This is part of the gradual revision of the site that I expect to make over the next few weeks. I plan to drop some very old H5N1 links, to put a little more emphasis on new H5N1 resources, and to scale back on H1N1…unless we do indeed get a new wave of it. 

Expect to see some brand-new links to sites dealing with public health in general and infectious diseases in particular, like dengue, malaria, TB, and chikungunya. These are genuine problems in many countries, and they seem likely to become problems in North America and Europe as well.

I may also post some links to what might be called “political” diseases: those arising from social problems like economic inequality. 

If you have suggestions for worthwhile links in these subjects, please let me know.