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Old 09-25-2009, 10:01 AM   #21
Jared Buffie
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Re: Swine Flu

Regular flu actually kills less than 2000 per year in America, and over 90% of those who die are >65 years old:

http://apps.who.int/whosis/database/mort/table1.cfm (wfs)

Pick a country and year and find out the REAL number of flu deaths.

The WHO numbers for H1N1 incidence are terribly inaccurate. For example, they are "confirming" cases in England via online survey of symptoms. Some places in USA are actually no longer testing people with FLI - if the symptoms are there, they are considered an H1N1 case even if there was no lab test to confirm. If we went by laboratory confirmed cases, the number would be much lower.

And remember - most people have been exposed to the H1N1 virus by now, so most will have antibodies in their blood to the virus. In those people who fall ill, they may just have a cold but there are antibodies in their system from a previous H1N1 exposure they fought off asymptomatically, but are considered a positive test because of the antibodies from a previous exposure. So even lab-confirmed tests can be false positives.

So if anyone feels the need to freak out over this, go right ahead. But please don't create pandemonium in the rest of the sheep....
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Old 09-25-2009, 05:18 PM   #22
Frank E Morel
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Re: Swine Flu

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Originally Posted by Mark Markley View Post
Do you have a source for this? I haven't heard this, but admittedly I haven't been following the literature as closely as I used to.

Annually, about 36,000 (US) people die each year from REGULAR influenza. According to recent numbers I've found, H1N1 has killed about 500.

Is there potential for a more serious scenario? Sure, but we could be killed by a giant asteroid, too. IF the virus acquires characteristics more like the 1918-1919 pandemic, then there is justifiable concern (this pandemic killed somewhere between 60-100 million worldwide). SOME subgroups are at higher risk than others. Does H1N1 suck for those who catch it? Sure, but so does "normal" flu.

Fear sells. Pandemic is a scary word (I think it is because people (either consciously or subconsciously) associate it with "epidemic pandemonium"). Stay fit, eat well, and wash your hands.
this just arrived in email this afternoon as the canadian government is issuing warning to citizens abroad.

H1N1 Message

Consulate General of Canada San Francisco / Silicon Valley
580 California Street, 14th floor, San Francisco, CA 94104

September 25th, 2009

This message provides Canadians with information regarding human cases of the 2009 H1N1 Flu Virus. The flu virus has currently spread to 198 countries in the world, and continues to spread. While in many cases the effects are relatively mild, it is still to be taken seriously. As of September 22, 2009 about 394,000 confirmed cases and 4,300 deaths have been recorded globally. Reliable statistics are no longer being maintained, due to the widespread nature of the virus. The total number of cases and deaths is probably far higher than official reports.
The Consulate encourages all Canadians to be vigilant with regards to their personal hygiene and sanitation practices. You should wash your hands frequently and thoroughly with soap and warm water for at least 20 seconds to eradicate viruses and bacteria. When soap and water are not available, apply a hand sanitizer with a minimum of 60 percent alcohol content. Remember to practice good respiratory etiquette by coughing and sneezing into your sleeve or a tissue and get vaccinated against flu, as recommended by your health care provider. Also, ask your employer, organization or school about pandemic contingency plans, and make a pandemic contingency plan for your family.
Any questions or concerns about influenza or other illnesses should be directed to a medical professional. Although the Consulate cannot provide medical advice or provide medical services, including antivirals and vaccine, to the public, a list of hospitals and doctors can be found in your local area phone book.
At this time, the Consulate advises Canadians to review the guidance provided by the Public Health Agency of Canada (www.fightflu.ca) and the World Health Organization (www.who.org). Canadians planning on travelling outside their country of current residence should determine if any form of entry screening is in effect in the destination country. You should not travel if you are displaying flu-like symptoms. Consult our travel reports and warnings page at http://www.voyage.gc.ca/countries_pays/menu-eng.asp
Canadian citizens or their families should inform the Consulate if they have been detained or quarantined by local authorities. Canadian citizens should be aware that if they have been detained or quarantined in accordance with local public health regulations, the Consulate is limited in its ability to intervene.
Canadians living or traveling abroad are encouraged to register with the nearest Canadian Consulate, through the Department of Foreign Affairs and International Trade website (www.voyage.gc.ca). Canadians without Internet access may register directly with the nearest Canadian Consulate. By registering, Canadian citizens make it easier for the Consulate to contact them in the event of an emergency.
The Consulate General of Canada is located at 580 California Street, 14th floor, San Francisco. The phone number for consular services is (415)834-3180 and our fax number is (415)834-3139. In the case of an emergency, you may contact us after-hours, on weekends and on holidays at +1(888)949-9993.


Consulate General of Canada
San Francisco | Silicon Valley
580 California Street, 14th floor,
San Francisco, CA 94104
Telephone: (415) 834-3180
www.sanfrancisco.gc.ca
\


tamaflu resistance is due to mutation...

CDC media update raised issues for all three seasonal flu serotypes. 93% of influenza B isolates was B/Yamagata/26/88, which doesn’t match the vaccine strain (B/Victoria02/87). 87% of the H3N2 was A/Brisbane/10/2007, which doesn’t match the vaccine strain (A/Wisconsin/67/2005). H1N1 did match the vaccine strain (Solomon Island/3/2006), but 8.1% was Tamiflu resistant in the United States. Moreover the incidence of flu positives was above the epidemic threshold for the four week in a row. Last week it rose dramatically above the threshold.

The increase in Tamiflu resistance paralleled increases elsewhere, including Europe.
The cause of the increase does not appear to be treatment of human seasonal flu with oseltamivir (Tamiflu), because the first 71 cases tested in Japan were negative for the resistance H294Y.

The timing of the rise is curious, since Tamiflu treatment for seasonal flu has not risen, and no cases have been identified in Japan, where oseltamivir use is highest.

However, the rise does follow increased use of Tamiflu blankets to treat H5N1, and H274Y is the dominant change in H5N1 treated patients.

1919 flu was considered to be a soldier's flu as they WERE THE FIRST TO BE INFECTED. Once returned home, the infection rate spread to non soldier populous

Now what is scary about swine vs regular... is the regular flu strains tend to die off on their own in time, and occur in different regions. Regular flu vaccines are generated because the top three flu viruses are tracked and then its decided that one is going to be more aggressive and that one is cloned and vaccine is made. Swine, has not died off, its not limited in a region and vaccine creation has been iffy.
Yes hygiene and sanitation plays a role.. as both are contributing factors in a cities or country's state of health care.. poorer the country.. the less the garbage collection, poorer water quality... the higher the illness rates and the higher death rates. First world life expectency compared to third world. Couple this with High density living ... the term breeding ground is fact.
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Old 09-25-2009, 06:48 PM   #23
Mark Markley
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Re: Swine Flu

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Originally Posted by Frank E Morel View Post
t

However, the rise does follow increased use of Tamiflu blankets to treat H5N1, and H274Y is the dominant change in H5N1 treated patients.

1919 flu was considered to be a soldier's flu as they WERE THE FIRST TO BE INFECTED. Once returned home, the infection rate spread to non soldier populous

Now what is scary about swine vs regular... is the regular flu strains tend to die off on their own in time, and occur in different regions. Regular flu vaccines are generated because the top three flu viruses are tracked and then its decided that one is going to be more aggressive and that one is cloned and vaccine is made. Swine, has not died off, its not limited in a region and vaccine creation has been iffy.
Yes hygiene and sanitation plays a role.. as both are contributing factors in a cities or country's state of health care.. poorer the country.. the less the garbage collection, poorer water quality... the higher the illness rates and the higher death rates. First world life expectency compared to third world. Couple this with High density living ... the term breeding ground is fact.
Many current experts believe that the 1918 pandemic first started in US military camps in Kansas/central US (read "The Great Influenza," John Barry).

"Swine" is a misnomer. Flu is characterized by the hemaglutinin and neuraminidase types (the "H" and "N" in the "H1N1" subtype. One thing that differentiated the "Spanish" flu from traditional ones was the characteristics of those who died... Traditional flu tends to claim the old and the young. The 1918 pandemic (suspected to be H1N1) had a "W"-shaped curve... It tended to kill those in early adulthood and late middle-age. This was theorized to be due to a hyperactive immune response which was the cause of death. Influenza is an RNa virus which easily infects humans, birds, and pigs. Because of the lack of error-checking mechanisms in RNA, and because more than one strain of virus can infect a single individual, influenza can "mix" genes/chromosomes from different strains, leading to transmission of different pathogenicity factors.

I don't take issue with "breeding ground" as a concept. High-density areas encourage transmission (look at the incidence of Neisserial meningitis in college students and military barracks). I still think that the "Swine Flu" media onslaught is the current "Shark Summer" of 2001. Remember that? In summer 2001 all we heard about was the terrifying shark attacks that were plaguing the US. This occurred until September 10. Is there potential for a larger global health issue? Sure. Is it something that 99.999% of the population need to worry about? I don't think so.
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Old 09-25-2009, 09:08 PM   #24
Frank E Morel
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Re: Swine Flu

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Originally Posted by Mark Markley View Post
Many current experts believe that the 1918 pandemic first started in US military camps in Kansas/central US (read "The Great Influenza," John Barry).
I am not comparing the spanish flu of 1919 to swine. I commented on that as when it first broke out it wasnt considered to be a concern as it only affected a certain population. Yet later eskimo villages in northern canada and alaska were exposed. Just like the early break out of aids in the 80s, it was only affecting a certain population group, and was labelled that group's disease. Both of these examples had their share of "media hype" in their time. Was the end result hype?
Flu has been tracked for some time for this reason that is in front of us. Watch rapid spread and degree of impact.

Quote:
Originally Posted by Mark Markley View Post
"Swine" is a misnomer. Flu is characterized by the hemaglutinin and neuraminidase types (the "H" and "N" in the "H1N1" subtype.
Swine in not a misnomer.. swine flu origin was a flu that was typically found in north american Pigs. Not saying that people contracted it from pigs or if you have a pig flu. Just that virus has in its dna swine strands. The virus that is now present has mutated multiple times and is very very different from a pig flu
Quote:
Originally Posted by Mark Markley View Post
One thing that differentiated the "Spanish" flu from traditional ones was the characteristics of those who died... Traditional flu tends to claim the old and the young. The 1918 pandemic (suspected to be H1N1) had a "W"-shaped curve... It tended to kill those in early adulthood and late middle-age.
Ahem... this is normal patho physiology at work. Children and the old tend to die from regular flu is due to dehydration of prolonged fever, or poor fluid replacement due to loses via vomiting or diarrhoea. Coupled with immature immune systems ( children) to chronic exposure of the old. Both groups bodies have difficulty in producing the necessary cell toxins aka cytokines to combat the virus. An infant has a high fever in a short period time will have a seizure to reset body thermostat in efforts to combat the problem. The elder will have prolonged low grade fevers for a few days before developing other problems that will be their downfalls. But the middle age or the fit/young... our bodies are in tip top shape and have no problems dumping massive amounts of that cell toxins to kill off the problem.. if that doesnt work, then body thermostat will fire up and will crank that core temperatures are not life enhancing in a rapid fashion for a sustained time frame.
cliff's notes.. infants get fevers fast and correct themselves.. only to repeat the process. Elder people have a 100 degree fever for days before going to into sepsis and die. Middle aged are capable of developing a fever of 106 and keep it there.. after a few hours, you die. ( I know this is a super simple explaination and hope one of the Md's chime in to help clear this further.) But the flu does take the super young and super old equally.
Quote:
Originally Posted by Mark Markley View Post
This was theorized to be due to a hyperactive immune response which was the cause of death. Influenza is an RNa virus which easily infects humans, birds, and pigs. Because of the lack of error-checking mechanisms in RNA, and because more than one strain of virus can infect a single individual, influenza can "mix" genes/chromosomes from different strains, leading to transmission of different pathogenicity factors.
Not sure what your trying to say here. Flu is a virus and virus are animal like. Because virus are capable of injecting itself into genetic material of the cells, this gives them the ability to mutate and over time if allowed, will jump species. Hence the "hoopla " of avian flu.. a bird specific flu was being watched to see if it was jumping species.

Quote:
Originally Posted by Mark Markley View Post
I don't take issue with "breeding ground" as a concept. High-density areas encourage transmission (look at the incidence of Neisserial meningitis in college students and military barracks).
Saudi arabia deals with meningitis and influenza outbreaks yearly. Why? Haj when the country population swells by several million people from all parts of the planet. Accommodations for some could be the marriot, a tent, or a lean to made from a plastic tarp. This comment was directed to jason's comment about sanitation. Basically it was due to numbers, too sick people too fast, and couldnt cope with the dead. History proves this time and time again when outbreaks occur.

Quote:
Originally Posted by Mark Markley View Post
I still think that the "Swine Flu" media onslaught is the current "Shark Summer" of 2001. Remember that? In summer 2001 all we heard about was the terrifying shark attacks that were plaguing the US. This occurred until September 10.
nope.. 2001 i was living in tucson. Not many sharks there.

Quote:
Originally Posted by Mark Markley View Post
Is there potential for a larger global health issue? Sure. Is it something that 99.999% of the population need to worry about?
I don't think so..
Kinda like in the 80s... the whole condom lecture.
I am not predicting doomsday, but it could be a very difficult winter.

yet, the UN, multiple countries, cities, hospitals have created position papers and response protocols
Kinda like these people
wfs
http://www.co.yavapai.az.us/WorkArea....aspx?id=45060
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Old 09-25-2009, 09:36 PM   #25
Jason Ashman
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Re: Swine Flu

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yet, the UN, multiple countries, cities, hospitals have created position papers and response protocols
I do seem to recall them doing this before, a few years back..... Ahh, now I remember- SARS. And every major city in the US now has an entire department called "Emergency Planning" or some such. The big cities have ad them for years, and just about every city has had them since 9/11.

All of the establishments you mentioned do this EVERY time something different comes about (or someone thinks of it) that they figure may cause chaos; SARS, Swine Flu, terrorist threats, train derailments, air crash, gas explosions, flooding, etc etc etc.

Its a pretty big list- and it's standard operating procedure.

This is what they do, and its what they're supposed to be doing. It's designed simply to ensure they're not caught with their pants down if it hits the fan. If you think back to the New Orleans flood, you'll recall the city was chastised for not having an effective disaster evacuation plan in place if the levies broke during a hurricane. I guarantee you they have one now, for obvious reasons. I can also guarantee you that any city within 50 miles of a major body of water also has plans detailing evacuation in the face of major flooding.

As an example: If you pick a city, and go grab their Flu pandemic quarantine plan, in the file right in front of it you'll also find plans for city evacuation, co-ordination plans for mass fires, flooding, earthquake response, etc.

Emergency planning; Prepare for the worst, and have lots of contingency strategies.

Hospitals have emergency evacuation plans and high-volume overload (also known in some circles as "The Battlefield Triage Plan") plans, internal and external threat lockdown procedures, contagious disease quarantine plans, etc etc etc.

They exist, but there's nothing new or shocking about them, and the swine flu thing certainly isn't the first time they've been referenced.

The difference is that now the media jumps all over anything they figure will up the ratings, which sucks because eventually something serious will crop up, and by then we'll all be de-sensitized to the media's blithering, and just ignore it at our peril.
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Old 09-25-2009, 10:12 PM   #26
Frank E Morel
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Re: Swine Flu

[quote=Jason Ashman;670171]I do seem to recall them doing this before, a few years back..... Ahh, now I remember- SARS. And every major city in the US now has an entire department called "Emergency Planning" or some such. The big cities have ad them for years, and just about every city has had them since 9/11.
All of the establishments you mentioned do this EVERY time something different comes about (or someone thinks of it) that they figure may cause chaos; SARS, Swine Flu, terrorist threats, train derailments, air crash, gas explosions, flooding, etc etc etc.
Its a pretty big list- and it's standard operating procedure.
This is what they do, and its what they're supposed to be doing. It's designed simply to ensure they're not caught with their pants down if it hits the fan. If you think back to the New Orleans flood, you'll recall the city was chastised for not having an effective disaster evacuation plan in place if the levies broke during a hurricane. I guarantee you they have one now, for obvious reasons. I can also guarantee you that any city within 50 miles of a major body of water also has plans detailing evacuation in the face of major flooding.
As an example: If you pick a city, and go grab their Flu pandemic quarantine plan, in the file right in front of it you'll also find plans for city evacuation, co-ordination plans for mass fires, flooding, earthquake response, etc.
Emergency planning; Prepare for the worst, and have lots of contingency strategies.
Hospitals have emergency evacuation plans and high-volume overload (also known in some circles as "The Battlefield Triage Plan") plans, internal and external threat lockdown procedures, contagious disease quarantine plans, etc etc etc.
They exist, but there's nothing new or shocking about them, and the swine flu thing certainly isn't the first time they've been referenced.
The difference is that now the media jumps all over anything they figure will up the ratings, which sucks because eventually something serious will crop up, and by then we'll all be de-sensitized to the media's blithering, and just ignore it at our peril.[/1quote]

Of course have plans existing, they simply morph them to the need. Its a generic disaster plan. I will say In my 20 years of healthcare experience I have yet to see a hospital policy and procedure that is labelled quarantine plan. Isolation procedure yes but those tend to address individual cases of a problem. Not a Mass quarantine. I am certain some facilities that are designated hazmat response center will. But the average size town with a single medical centre doesn't Regarding things changing because of SARS. I have worked several emergency Rooms that did not have a Sar policy in place. One ER solution to SARS was the installation of a glass pane at the triage desk that separated the patient from your desk. Now, some hospitals have a flu tent, out in the parking lot.. or are requesting all ems crews to place a mask on all fever and cough presentations. This is all recent. Some have yet to create a FLU plan. And my employer has generated a position paper, in essence. Funny thing is, it hasnt made its way to the rank and file. We are told to follow existing procedure. Which was signed off back in 2001.

jason dont expect that all systems are to par. Example San Francisco general hospital which is major trauma/trauma hospital is un able to meet compliance on retrofitting the 1950s vintage buildings on its campus to current earthquake standards. Its due to be closed because of this non compliance.. as too costly to revamp verses build a new hospital. Problem.. there is no money to build a new one.. so the old thing still stands providing services. Yet, they have they have one of the biggest stock piles of mark 2 auto injectors for nerve agents in the US. In 2000 when I was in vancouver BC working, st paul's hospitals a 50s built hospital was in the same problem.. too old and not to code. In fact.. it wasnt even on the Provincial response plan as it wasnt expected to be around. Its still there functioning.

We can go around and around on this, all i am saying that, its not hype, its real. If you choose to heed to the warning or not thats fine. I originally said, I just didnt find the oinkment comment funny.
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Old 09-25-2009, 11:34 PM   #27
Christopher Delgado
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Re: Swine Flu

Frank,

What is your background in healthcare if you dont mind my asking?
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Old 09-26-2009, 12:16 AM   #28
Frank E Morel
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Re: Swine Flu

Registered Nurse
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Old 09-26-2009, 01:05 AM   #29
Christopher Delgado
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Re: Swine Flu

Thanks. Did you start off in the military ?
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Old 09-26-2009, 05:41 PM   #30
Frank E Morel
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Re: Swine Flu

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Thanks. Did you start off in the military ?
I was in the military, but in a completely different trade.
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