Influenza Virus Mashup

Via The Japan Times: At least 28 swine flu variants infected Japan. Excerpt:

At least 28 genetically different types of the H1N1 swine flu virus have entered Japan since the time of the outbreak last spring to late September, researchers at the Infectious Disease Surveillance Center said Wednesday. 

The first types of the “new” virus, which spread through Kobe and Osaka in the initial phase of Japan’s outbreak last May and eventually became a pandemic, are believed to have been eradicated because of widespread school closures and other measures quickly taken to halt its spread, the results of an analysis indicate. 

A team led by Teiichiro Shiino, the institute’s chief researcher, analyzed the genetic base sequence of 238 specimens, including 75 samples of the flu collected between May 8 and Sept. 20 in Japan and 163 collected worldwide. 

Locally, the flu is called “shingata infuruenza,” or new-type flu. 

According to Shiino’s results, the virus can roughly be divided into four major types, including the one detected in Mexico and the southern United States, where the outbreak likely originated, one found in New York and other places, and two other types formed by the crossing of the other two types.

(Thu, 27 May 2010 14:33:00 +0000)

 

 

# 4601

 

 

Today NOAA (National Oceanic and Atmospheric Administration) issued their updated `forecast’ (an outlook, really) for this year’s Atlantic Hurricane season.

 

Yesterday, if you will recall, two hurricane researchers from the University of Colorado (Dr. William Grey & Dr. Phil Klozbach) stated they expected `a hell of a year’. 

 

Apparently NOAA experts agree.  They are anticipating 14 to 23 Named Storms, 8 to 14 Hurricanes of which 3 to 7 could be Major Hurricanes

 

Along with this seasonal outlook , NOAA Administrator Dr. Jane Lubchenco  discussed with FEMA Administrator Craig Fugate the critical need for storm preparedness.

 

 

 

NOAA Expects Busy Atlantic Hurricane Season

May 27, 2010

Hurricane Ike, 2008.

 

An “active to extremely active” hurricane season is expected for the Atlantic Basin this year according to the seasonal outlook issued today by NOAA’s Climate Prediction Center – a division of the National Weather Service. As with every hurricane season, this outlook underscores the importance of having a hurricane preparedness plan in place.

Across the entire Atlantic Basin for the six-month season, which begins June 1, NOAA is projecting a 70 percent probability of the following ranges:

• 14 to 23 Named Storms (top winds of 39 mph or higher), including:
• 8 to 14 Hurricanes (top winds of 74 mph or higher), of which:
• 3 to 7 could be Major Hurricanes (Category 3, 4 or 5; winds of at least 111 mph)

“If this outlook holds true, this season could be one of the more active on record,” said Jane Lubchenco, Ph.D., under secretary of commerce for oceans and atmosphere and NOAA administrator. “The greater likelihood of storms brings an increased risk of a landfall. In short, we urge everyone to be prepared.”

The outlook ranges exceed the seasonal average of 11 named storms, six hurricanes and two major hurricanes. Expected factors supporting this outlook are:

• Upper atmospheric winds conducive for storms. Wind shear, which can tear apart storms, will be weaker since El Niño in the eastern Pacific has dissipated. Strong wind shear helped suppress storm development during the 2009 hurricane season.
• Warm Atlantic Ocean water. Sea surface temperatures are expected to remain above average where storms often develop and move across the Atlantic. Record warm temperatures – up to four degrees Fahrenheit above average – are now present in this region.
• High activity era continues. Since 1995, the tropical multi-decadal signal has brought favorable ocean and atmospheric conditions in sync, leading to more active hurricane seasons. Eight of the last 15 seasons rank in the top ten for the most named storms with 2005 in first place with 28 named storms.

(Continue . . . )

 

 

Today is day five of  National Hurricane Preparedness Week, and the focus today is on Forecasting.

 

 

WATCH vs. WARNING - KNOW THE DIFFERENCE

• TROPICAL STORM WATCH: An announcement that tropical storm conditions (sustained winds of 39 to 73 mph) are possible within the specified coastal area within 48 hours.
• TROPICAL STORM WARNING: An announcement that tropical storm conditions (sustained winds of 39 to 73 mph) are expected somewhere within the specified coastal area within 36 hours.
• HURRICANE WATCH: An announcement that hurricane conditions (sustained winds of 74 mph or higher) are possible within the specified coastal area. Because hurricane preparedness activities become difficult once winds reach tropical storm force, the hurricane watch is issued 48 hours in advance of the anticipated onset of tropical-storm-force winds.
• HURRICANE WARNING: An announcement that hurricane conditions (sustained winds of 74 mph or higher) are expected somewhere within the specified coastal area. Because hurricane preparedness activities become difficult once winds reach tropical storm force, the hurricane warning is issued 36 hours in advance of the anticipated onset of tropical-storm-force winds.

Via ABC News: Swine flu put ICUs on verge of collapse.

Australia’s intensive care system was on the verge of collapse for the first time during last year’s swine flu epidemic, according to an intensive care physician. 

Associate Professor Steve Webb from the Royal Perth Hospital hopes lessons learnt in 2009, together with vaccination, will help prevent a repeat scenario this year. 

The Australasian Society for Infectious Diseases is holding its annual scientific conference this week and Professor Webb will tell the gathering early diagnosis and treatment with antivirals is vital, as is expanding the intensive care unit (ICU) system to cope with admissions. 

His team recently investigated swine flu admissions to all 187 ICUs in Australia and New Zealand last year. 

“ICUs were on the point of collapse, which was unprecedented,” he said. “The ICU system in every region in Australia came close to collapse and we’ve learnt a great deal from that and will be better prepared to manage ICU [surges] this year. 

“One Sydney doctor said that in one week during last year’s flu season, his ICU saw more people with severe acute respiratory distress than in any other week of his 30-year career in intensive care … there was a massive wave of very sick people.” 

The study, published recently in the New England Journal of Medicine, found one in seven infected people admitted to hospital died.

Via CIDRAP, Lisa Schnirring reports: Legal expert shares lessons from pandemic vaccine campaign. Excerpt:

Legal issues that came into play during the H1N1 flu pandemic provided a useful look at how laws can help ease the availability of the vaccine, but in some instances can work against immunization efforts, according to a legal expert who has analyzed events that unfolded over the past year. 

Encouraging the production of the vaccine while addressing public fears about immunization requires a delicate balance, Wendy E. Parmet, JD, wrote today in the New England Journal of Medicine. Parmet is a professor at Northeastern University School of Law in Boston. 

Acknowledging the fragile market for vaccines, since the 1976 swine flu vaccine program Congress has connected liability protection for vaccine makers with a compensation system for patients, she wrote, referring to the National Childhood Vaccine Injury Act, which set up a special vaccine court to streamline claims and quickly compensate injured patients. 

When the H5N1 avian influenza threat focused efforts on pandemic preparedness, Congress, with the 2005 passage of the Public Readiness and Emergency Preparedness (PREP) Act, combined tort immunity with no-fault compensation for injured patients, she added. The provisions take effect when federal officials declare a public health emergency. 

While the PREP Act, along with Food and Drug Administration (FDA) emergency provisions, removed legal obstacles to the rapid production and distribution of the pandemic vaccine, “the effect of these laws on the public’s willingness to be vaccinated, however, is uncertain,” Parmet maintained.

(Thu, 27 May 2010 12:02:00 +0000)

 

 

# 4600

 

 

As a (former) paramedic, I’m used to thinking about and preparing for the `worst case scenario’.  Hurricanes, plane crashes, chemical spills . . . you name it.  It is part of the job description.

 

Thankfully, they don’t happen very often.

 

In fact, most of the extreme situations we trained for simply didn’t happen on my watch.  But over the years, just about all of them have happened on somebody’s watch.  

 

A few recent examples include:

 

Haitian Earthquake (2010)

Sichuan earthquake (2008)

Katrina (2005)

Indonesian Tsunami (2004)

World Trade Center (2001)

As disconcerting as it may be to think about, emergency planners and response agencies don’t have the luxury to ignore `worst-case scenarios’.  It is their job to prepare for them.

 

Later today we’ll be getting the revised 2010 Atlantic Hurricane Outlook from NOAA, and most experts are anticipating that we’ll see a busy year.

 

While no one can predict months in advance where hurricanes will hit, or how strong they will be when they do, emergency planners do have their `worry list’; Heavily populated areas of the coastline that are at particularly high risk from major hurricanes.

 

The damage expected from a Category 4 or 5 storm is 100 times greater than that from a Category 1 Hurricane.

 

Since most people have never experienced a CAT 5 storm, or its aftermath, it might be useful to look at how NOAA describes its impact.  This from the newly revised Saffir-Simpson Scale  (emphasis mine):

 

Category 5

Winds (1 min sustained winds in mph and km/hr) 155MPH

Catastrophic damage will occur

People, livestock, and pets are at very high risk of injury or death from flying or falling debris, even if indoors in mobile homes or framed homes.

Almost complete destruction of all mobile homes will occur, regardless of age or construction.

A high percentage of frame homes will be destroyed, with total roof failure and wall collapse. Extensive damage to roof covers, windows, and doors will occur. Large amounts of windborne debris will be lofted into the air. Windborne debris damage will occur to nearly all unprotected windows and many protected windows.

Significant damage to wood roof commercial buildings will occur due to loss of roof sheathing. Complete collapse of many older metal buildings can occur. Most unreinforced masonry walls will fail which can lead to the collapse of the buildings. A high percentage of industrial buildings and low-rise apartment buildings will be destroyed.

Nearly all windows will be blown out of high-rise buildings resulting in falling glass, which will pose a threat for days to weeks after the storm.

Nearly all commercial signage, fences, and canopies will be destroyed.

Nearly all trees will be snapped or uprooted and power poles downed.

Fallen trees and power poles will isolate residential areas.

Power outages will last for weeks to possibly months. Long-term water shortages will increase human suffering. Most of the area will be uninhabitable for weeks or months.

 

If this sounds extreme, it is. 

 

But it is exactly what happened to Homestead, Florida in 1992 with Hurricane Andrew, and to the Mississippi Gulf coast in 1969 in the wake of Hurricane Camille.

 

And it doesn’t take an (admittedly) rare land falling CAT 5 storm to do incredible damage.  Katrina was barely a CAT 3 when it devastated New Orleans.

 

From an insured loss standpoint, the 10 worst places for an extreme hurricane to strike are:

 

 

 

What you see below is a SLOSH Model (Sea, Lake, Overland, Surge, from Hurricanes) depicting a CAT 4 storm coming in just north of St Petersburg (Tarpon Springs), driving a wall of water up into Tampa Bay.  

 

 

Some areas of St. Pete and Tampa would have 15-18 feet of water on top of them.   And at the point where I snapped this image, the storm would be sitting just about on top of what ever is left of my home.

 

You can view the entire animation HERE.

 

 

Houston, Texas is another highly vulnerable area.  Here is a 10 second SLOSH model for that community.

 

 

 

A couple of years ago the State of Florida held an exercise on a `worst-case’ imaginary hurricane; Hurricane Ono  ( Think: “Oh No!”). 

 

A CAT 5 storm that would come in at Miami, cross the state and exit around Tampa, re-intensify in the Gulf, and then strike Pensacola as a CAT 4.

 

You can read more about this scenario here.

 

This path is remarkably similar to the path of the Great Miami Hurricane of 1926, which killed hundreds in South Florida.

 

 

Hopefully, won’t see a `worst-case scenario’ this year.

 

But it will happen again.  If not this year, perhaps next year, or the year after.  

 

The Saffir-Simpson Scale description of a CAT 5’s damage is admittedly the worst-case scenario, but is worth remembering as you think about and prepare for this hurricane season. :

 

Power outages will last for weeks to possibly months. Long-term water shortages will increase human suffering. Most of the area will be uninhabitable for weeks or months. 

 

Which is why it is imperative that people living in vulnerable areas heed evacuation warnings, that they prepare to weather the storm and it’s aftermath . . .  and that they take all of this very, very seriously.

(Thu, 27 May 2010 10:12:00 +0000)

 

 

#  4599

 

 

 

Despite years of planning and preparing for a much worse pandemic (which may yet come), hospitals – particularly ICUs – in many regions around the world found themselves severely tested during the peak of the 2009 pandemic.

 

The vast majority of people who contracted this virus recovered without incident, but for something less than 1% of those infected, swine flu proved far more serious.  

 

Today, a detailed overview of how ICU’s in Australia coped with the influx of patients last year – and hopefully, some lessons learned – from ABC (Australia) News.

 

 

 

 

Swine flu put hospitals ‘on edge’ last year › News in Science (ABC Science)

Thursday, 27 May 2010 Helen Carter
ABC

---

Australia’s intensive care system was on the verge of collapse for the first time ever during last year’s swine flu epidemic, according to one intensive care physician.

 

Associate Professor Steve Webb from the Royal Perth Hospital hopes lessons learnt in 2009, together with vaccination, and the fact many now have some immunity to swine flu, will help prevent a repeat scenario this year.

 

Webb will tell the Australasian Society for Infectious Diseases annual scientific conference in Darwin this week that early diagnosis and treatment with antivirals is vital, as is expanding the ICU system, to cope with admissions.

 

Webb and colleagues recently investigated influenza H1N1 (swine flu) admissions to all 187 intensive care units (ICUs) in Australia and New Zealand in 2009.

 

“ICUs were on the point of collapse which was unprecedented. The ICU system in every region in Australia came close to collapse and we’ve learnt a great deal from that and will be better prepared to manage ICU surge capacity this year,” says Webb.

 

“One Sydney doctor said that in one week during last year’s flu season, his intensive care unit saw more people with severe acute respiratory distress than in any other week of his 30 year career in intensive care…There was a massive wave of very sick people.”

 

(Continue . . . )

 

 

The sobering lesson here, of course, is that we remain woefully unprepared to deal with a truly severe pandemic. 

 

A repeat of 1918 could be 100 times worse than what we saw in 2009.   While that may never happen, history suggests that we shouldn’t take that for granted.

 

Obviously, no health care system can prepared adequately for a `worst-case’ pandemic.   

 

But when a `mild-to-moderate’ pandemic tests our health care capacity the way H1N1 did, it demonstrates just how vulnerable we are to even a moderately severe public health crisis.

(Wed, 26 May 2010 19:08:00 +0000)

 

 

# 4598

 

 

Every Spring scientists look at variables like Atlantic SST’s (Sea Surface Temperatures), whether the Pacific is in an El Nino – neutral – or in a La Nina pattern, and a host of other climatological indicators in an attempt to divine what kind of hurricane season we might expect.

 

Some years, they get it right.  Some years, they don’t.

 

Tomorrow, May 27th,  at 10:00AM ET NOAA will release their 2010 hurricane season forecast via a conference call.  But today, a pair of well known hurricane experts gave their own assessment.

 

‘Hell of a year’ for hurricanes, experts warn

Record warm seas for May; storms could complicate Gulf oil disaster

 

These ships are among the hundreds working in the Gulf of Mexico to cap and cleanup the BP oil spill. That work could see delays if storms develop this hurricane season, which runs from June to November.

FORT LAUDERDALE, Fla. - The threat of an above-average 2010 Atlantic hurricane season has increased over the last month and it now promises to be “very active,” two leading forecasters said Wednesday. The warning comes as the season also sees an unusual factor added to the mix: the Gulf oil disaster.

 

William Gray and Phil Klozbach, who head the respected Colorado State University hurricane forecast team, said they would ramp up their prediction for the 2010 season in a report due out on June 2.

 

“The numbers are going to go up quite high,” Gray said. “This looks like a hell of a year.”

(Continue . . . )

 

 

While predictions of active seasons are interesting, and potentially useful for emergency planners, the reality is it only takes one major land falling hurricane to make for a very bad year for a whole lot of people.

 

It does appear that El Nino is weakening in the Pacific, and in about half the time when that happens the Pacific slips into a La Nina – which reduces wind shear in the Atlantic which is considered conducive for hurricane formation.   

 

Water temps in the Atlantic and the Gulf of Mexico are also running above normal, and warm waters feed the `engine’ of a hurricane.

 

So the ingredients that many experts believe contribute to an active season are in place.   There are other factors we understand less well, and so these forecasts are subject to considerable error.

 

Will it be `a hell of a year’?

Stay tuned.

In any event, I’ll have the NOAA forecast from the National Hurricane Center in a blog late tomorrow morning.

 

NOAA to Issue 2010 Atlantic Hurricane Season Outlook

NOAA will release its initial seasonal outlook for the 2010 Atlantic hurricane season during a press conference on May 27 in Washington, D.C. NOAA Administrator Dr. Jane Lubchenco will discuss the outlook with FEMA Administrator Craig Fugate highlighting the critical need for storm preparedness.

WHAT:

Press conference announcing NOAA’s 2010 Atlantic hurricane season outlook.

WHEN:

Thursday, May 27, 2010; 10am ET

(Wed, 26 May 2010 18:11:00 +0000)

 

# 4597

 

 

Note: I’m having intermittent Internet problems (the tech is on his way for the 2nd visit in 2 days), so I’ll make this a short post.

 

 

Today is day four of  National Hurricane Preparedness Week, and the focus today is on inland flooding.

 

 

On Saturday, I listed some of the major inland flooding events caused by hurricanes in You Don’t Have To Live On The Coast.

 

This is from NOAA’s Hurricane Preparedness page.

 

“In the 1970s, ’80s, and ’90s, inland flooding was responsible for more than half of the deaths associated with tropical cyclones in the United States.”

Ed Rappaport

National Hurricane CenterWhen it comes to hurricanes, wind speeds do not tell the whole story. Hurricanes produce storm surges, tornadoes, and often the most deadly of all - inland flooding.

 

While storm surge is always a potential threat, more people have died from inland flooding from 1970 up to 2000. Intense rainfall is not directly related to the wind speed of tropical cyclones. In fact, some of the greatest rainfall amounts occur from weaker storms that drift slowly or stall over an area.

 

Inland flooding can be a major threat to communities hundreds of miles from the coast as intense rain falls from these huge tropical air masses.

(Continue. . . )

 

 

 

Other AFD blogs for this year’s National Hurricane Preparedness Week series include:

Why I’ll Be Gone With The Wind

Storm Surge Monday

The Crossroads Of The Atlantic Storm Season

You Don’t Have To Live On The Coast

Via New Scientist, an excellent article: Swine flu hoax? Get real. Excerpt:

Once upon a time, a village asked its nerds to warn it when wolves threatened the chickens. One day the nerds saw wolf tracks - but how many wolves were there, and how hungry? The forest was big and there was not enough time to find out before sunset, so the nerds advised the panicked villagers to buy rifles. 

But before the rifles were even loaded, one small and skinny wolf slunk out of the woods, killed two chickens and ran away. The nerds tried to explain that there were probably more wolves out there, but the angry villagers took the rifles back to the store and lynched the nerds. 

This is the parable of swine flu. Governments had asked the World Health Organization to coordinate their response to flu pandemics, and when one broke in April 2009 the WHO did exactly that, triggering expensive government health measures and vaccine purchases. 

Critics now allege the flu was less deadly than normal flu, meaning vast sums of public money were wasted on nothing more than a scare. Some even claim that it was a conspiracy to boost vaccine company profits. 

So were the WHO and governments right to respond as they did? Or was it all an expensive overreaction, or a hoax? This week an independent inquiry by a WHO committee delivers its preliminary answers to these questions. Similar inquiries are under way in the UK, the US and elsewhere. 

Here’s the answer I hear from scientists: declaring a pandemic and making vaccine were overwhelmingly the right things to do given the science and technology at our disposal.

Via UKMedix Health News: Google Flu Trends Useful But Not Perfect Say Researchers. Excerpt:

The search engine Google proved to be extremely useful when the swine flu pandemic broke out in different parts of the world. By monitoring the number of times that certain flu related queries were put into the Google search engine it was possible to work out with some degree of accuracy exactly where the flu outbreak clusters were located. 

Google who made the information public using an application called Google Flu Trends were commended for their initiative in helping health officials around the world prepare for large numbers of sick people and also to know where to move stocks of medications. 

A study done by the University of Washington did say however that while Google Flu Trends was still a useful monitoring tool for influenza outbreak patterns it was not 100 percent accurate. In fact when compared to the United States national surveillance done by the Centers for Disease Control which used data from laboratory confirmed influenza infections it was seen to be is 25% less accurate. 

The value of Google Flu Trends is that it gives up to date and immediate information about likely flu outbreaks without having to undergo the laborious process of getting results confirmed by laboratories. Google Flu Trends should be seen as a rough but immediate guide to influenza rates which could prove invaluable especially when speed is of the essence.