Killer swine flu outbreak in Mexico, government alarmed

[Broomstick]

Chicago elementary school shut down due to possible swine flu outbreak.

Confirmed cases in US in California, Texas, Kansas, Indiana, Ohio, and New York City.

Confirmed Canadian cases reported in Nova Scotia, Ontario, Alberta, and British Columbia.

Europe: Scotland, England (London), Germany, Spain, Austria, Suspected cases in France, Greece, Sweden, Denmark, Czech Republic, Italy, Ireland, Russia (traveler from Mexico)

Middle East: Israel. Suspected case in Egypt

Asia: New Zealand, Australia, Hong Kong

Africa: two suspected cases in South Africa

Deaths reported in US and Mexico

Source: compiled from New York Times, BBC, and Le Monde. Yes, it's spreading. However, flu always spreads like that. The question is whether or not this is a worse than usual flu, which is still not conclusively determined yet.

Again - wash your hands. Avoid large crowds. If there are outbreaks near you, you may consider limiting social contacts. Still not at a point for panic, but definitely something to keep an eye on.

[erik_t]

CBC confirms the Spiegel report on the pervious page.

...
The World Health Organization said Wednesday that laboratory tests have confirmed 114 cases in seven countries, including:

13 cases in Canada.
91 cases in U.S. with one reported death.
26 cases in Mexico with seven reported deaths.
Two cases in Israel.
Four cases in Spain.
Two cases in the United Kingdom.
Two cases in New Zealand.
...

Of course, the one non-Mexico death was less than two years old, an age that is susceptible to death from any strain of flu.

I mean, I don't want to quench anybody's breathless look-at-how-prepared-I-am look-how-seriously-I'm-taking-this Chicken-Little-esque disaster-porn panic, but I'm not too worried. I expect this post will be ignored just like salm's.

[Alyrium Denryle]

CBC confirms the Spiegel report on the pervious page.

...
The World Health Organization said Wednesday that laboratory tests have confirmed 114 cases in seven countries, including:

13 cases in Canada.
91 cases in U.S. with one reported death.
26 cases in Mexico with seven reported deaths.
Two cases in Israel.
Four cases in Spain.
Two cases in the United Kingdom.
Two cases in New Zealand.
...

Of course, the one non-Mexico death was less than two years old, an age that is susceptible to death from any strain of flu.

I mean, I don't want to quench anybody's breathless look-at-how-prepared-I-am look-how-seriously-I'm-taking-this Chicken-Little-esque disaster-porn panic, but I'm not too worried. I expect this post will be ignored just like salm's.

It shouldn't be ignored. If you look at the cases thus far, it has a mortality rate of <1% in first world countries, around 1/4th in a third world shit-hole with no healthcare, and a water supply that compromises the immune system of the locals because they must continually fight off giardia infection. Granted, Mexico is a developing nation, not quite like Somalia or anything, but it is bad enough that it qualifies. Particularly because drug cartels control how much of the country's northern land mass?

The disease responds well to Tamiflu.

To the extent that people are panicking, they shouldnt. This is not 1918. To be perfectly blunt, most of our flu strains originate in domestic swine and fowl.

Calm the fuck down.

[Count Chocula]

91 cases in U.S. with one reported death.

That US death was a 23-month old Mexican toddler, who was brought to Houston for treatment and unfortunately died. So no US deaths so far.

In the same article that revealed the origin country of the toddler who died in Texas, the CDC's Dr. Besser noted that influenza kills around 36,000 Americans every year. This strain is unusual, yes, in that it affects healthy age groups, but with a 0% US mortality rate its danger is far below "regular" influenza.

[Dartzap]

We have a confirmed case in the bay now, a 12 year old girl at one of the community colleges. It was pretty paniced at first there, apperently, but things have calmed down a fair amount. General grumblings about not being informed sooner, of course, but thats always the case.

[Cairber]

WHO raises level to 5

GENEVA, Switzerland (CNN) -- The World Health Organization raised its pandemic alert to 5, its second-highest level Wednesday, indicating the outbreak of swine flu that originated in Mexico is nearing widespread human infection.
Patients wait at a hospital Wednesday in Mexico City. The swine flu outbreak began in Mexico.

Dr. Margaret Chan, the U.N. agency's director-general, said the decision mean to raise the alert to 5 on its 6-point scale indicated that all countries should "immediately" activate pandemic preparedness plans.

"This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharm industry and the business community that certain actions now should be taken with increased urgency and at an accelerated pace," Chan said.

The annoucement came as the number of people infected with swine flu increased rapidly across the world, and health officials scrambled to get more information about the virus -- which has no vaccine.

Germany and Austria became the latest European countries to report swine flu on Wednesday, while the number of cases increased in the United Kingdom and Spain.

The WHO and national governments have confirmed 148 cases of swine flu in 11 countries. Most of those are in the United States, where the Centers for Disease Control and Prevention has confirmed 91 cases.

The figures include seven deaths in Mexico and one in the United States. More than 2,700 other patients worldwide are believed to be suffering from the virus, known scientifically as H1N1.

The WHO's "Phases of Pandemic Alert," which has been in existence for five years, characterizes phase 5 as a human-to-human spread of the virus into at least two countries in one WHO region, which signals that a pandemic is imminent.

The highest level, phase 6, is defined by community-level outbreaks in at least one other country in a different WHO region, according to the agency.

"The question now is how severe will the pandemic be, especially now at the start," Chan said. "It is important for us to take this very seriously and take vigilance as the virus evolves."

The Pentagon is planning for a task force that would help with transportation, logistics and distributing medical supplies in the event of a pandemic, a spokesman said.

The U.S. government is distributing 25 percent of its stockpile of antiviral medications Tamiflu and Relenza to all states, Homeland Security Secretary Janet Napolitano said Wednesday. Health officials stress that the medications are effective only if taken in the early stages of the infection.

In the meantime, the government is working on developing a vaccine and hopes to have a pilot version ready for testing in a few months, Fauci said.

The number of people infected with the 2009 H1N1 influenza strain includes the first U.S. swine flu fatality: a 22-month-old child from Mexico who died of the illness Monday at a Houston, Texas, hospital.

A U.S. Marine in California is the military's first suspected case of swine flu, and three military family members in San Diego have confirmed cases, the Defense Department said.

As a precaution, the military is banning travel to Mexico for nonessential personnel.

The first cases of the virus were detected in Mexico, where health officials suspect swine flu in more than 150 other deaths and roughly 2,500 illnesses. Only 26 cases have so far been confirmed, including the seven fatal cases.

The deadly outbreak has prompted authorities to order about 35,000 public venues in Mexico City to shut down or serve only takeout meals as health officials tried to contain spreading of the virus. iReport.com: "Regular life" in Mexico with masks

Mexican officials also said they believe they may have found "patient zero" -- the first case of the global outbreak -- in the small mountain village of La Gloria.

Edgar Hernandez, 5, survived the earliest documented case of swine flu. He lives near a pig farm, though experts have not established a connection between that and his illness.

Edgar has managed to bounce back from his symptoms and playfully credits ice cream for helping him feel better.

President Obama called on schools with confirmed or possible swine flu cases to "consider temporarily closing so that we can be as safe as possible."

At least 74 elementary, junior high and high schools have closed across the country due to confirmed or probable cases of swine flu, the Department of Education said Wednesday.

Another 30 schools have closed as a precautionary measure, Department of Education spokesman Massie Ritsch said.

Researchers do not know how the virus is jumping relatively easily from person to person, or why it's affecting what should be society's healthiest demographic. Many of the victims who have died in Mexico have been young and otherwise healthy.

Governments around the world are scrambling to prevent further outbreak.

Some countries, such as China and Russia, have banned pork imports from the United States and Mexico, though the WHO said the disease is not transmitted through eating or preparing pig meat. Several other countries, such as Japan and Indonesia, are using thermographic devices to test the temperature of passengers arriving from Mexico.

Egypt reportedly is considering culling all pigs although there have been no reported cases of swine flu there.

Swine influenza, or flu, is a contagious respiratory disease that affects pigs.

When the flu spreads person to person, instead of from animals to humans, it can continue to mutate, making it harder to treat or fight, because people have no natural immunity. Learn more about swine flu and how to treat it »
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Symptoms include fever, runny nose, sore throat, nausea, vomiting and diarrhea.

Common seasonal flu kills 250,000 to 500,000 people every year worldwide, far more than the current outbreak of swine flu. But there is a vaccine for seasonal flu

CNN article

[Narkis]

WHO has increased the warning level from 4 to 5. That's not good, is it?

Incidentally, the suspect cases in Greece were just common flu. No need to worry, yet.

edit: Damn, ninja'd. That'll teach me search for sources faster.

[Knife]

Honestly this whole thing is being over reported and add a pinch of hysteria. We have an unknown sample size in Mexico with limited death rates with an extremely limited spread in other countries. Fucking calm the fuck down.

Why the fuck WHO is going Def Con 6 is beyond me unless they are precautionary measures people are interpreting as reactionary measurese .

The only deaths so far are at the epi center of the 'pandemic' and even those are few confirmed cases of the disease and even then we can not rule out secondary causes and just jump to 'OMG the flu is killing us' bullshit. Outside of Mexico, the only confirmed death is an infant from Mexico that came to the US for medical treatment.

I'm sorry but holy shit take your tinfoil hats and hysterical tampons out and fucking calm down. Yeesh. I hope Snowe or another GOPer turns Democrat to take the sensationalism off this story for another day or two.

[Broomstick]

It shouldn't be ignored. If you look at the cases thus far, it has a mortality rate of <1% in first world countries, around 1/4th in a third world shit-hole with no healthcare, and a water supply that compromises the immune system of the locals because they must continually fight off giardia infection. Granted, Mexico is a developing nation, not quite like Somalia or anything, but it is bad enough that it qualifies.

Mexico has more deaths because it has had more cases. It is also misleading to say 1/4 of infected die in Mexico because the mildest cases have slipped through the net. It is known that there are mild cases both within Mexico City and in outlying regions, but how many is impossible to quantify. In other words, the official Mexican mortality rate reflects that among serious cases, not among all cases.

The disease responds well to Tamiflu.

For now, yes.

To the extent that people are panicking, they shouldnt. This is not 1918. To be perfectly blunt, most of our flu strains originate in domestic swine and fowl.

Calm the fuck down.

The 1918 strain is believed to have originated in domestic animals as well. While I would advice against panic this certainly does bear watching.

91 cases in U.S. with one reported death.

That US death was a 23-month old Mexican toddler, who was brought to Houston for treatment and unfortunately died. So no US deaths so far.

Sorry - even if the kid was from Mexico he died in Houston. That counts as the US. While he was in Houston there was certainly the potential for him to infect others in the US.

the CDC's Dr. Besser noted that influenza kills around 36,000 Americans every year. This strain is unusual, yes, in that it affects healthy age groups, but with a 0% US mortality rate its danger is far below "regular" influenza.

Actually, no - the fact that it "affect healthy age groups" is what is alarming to public health people. That is the signature of a particularly nasty pandemic flu, that it has significant mortality among the young healthy adults. That is the characteristic that made the 1918 flu so deadly. At present it does not seem to be that bad but it really should be watched carefully.

WHO has increased the warning level from 4 to 5. That's not good, is it?

No, it's not good. On the other hand, ordinary seaonal flu can hit that level of spread with nary a blip on the media radar. Flu spreads. That's a major characteristic of the group of viruses. The problem isn't so much that is spreads, but how virulent the particular strain is. A strain that kills healthy adults in their prime is of much more concern than one that kills only the already ill and frail. Either form of flu will spread rapidly, but one is of much more concern than the other.

Incidentally, the suspect cases in Greece were just common flu. No need to worry, yet.

That is good news. I expect we'll continue to turn up cases of ordinary flu as this progresses.

[Akkleptos]

According to an article from Der Spiegel - (Article in German therefore not quoted) the Mexican health minister has corrected the deaths and suspected infection numbers. They were corrected from 2500 suspected infected and 159 deaths to 26 Infected and seven deaths.
A microbiologist from the Uni halle explains that the discrepancy might have been generated as follows: It´s hard to diagnose the A/H1N1 Virus under Mexican conditions. The Mexican results of the investigations had to be confirmed by a Canadian Lab. After this confirmation the number was a lot smaller.

...[snip]

If you have 2500 suspected infections that would be 25 000 infected. If you have 7 deaths per 25 000 infected it means that the swine flu is less lethal than normal flu.
Furthermore he says that it´s not proven yet that the Swine flu virus favours healthy adults.

As I explained yesterday, thus:

We shouldn't forget that, of the 159 dead in Mexico, only 7 so far have been confirmed as being A/H1N1 infections (testing takes time, and there are only a handful of facilities that can do the virology involved), while 26 other confirmed cases survived, got better and have returned home.

The way it's done here is that someone gets to a hospital with a fever over 39°K, or an acute respiratory infection, as well as the general flu symptoms, they assume it to be Swine Flu and ask questions later. So you get numbers like 2,498 cases, of which 1,311 are still hospitalised (so, the rest are already better and walked out), and 159 have died. Within these numbers you find the 7 confirmed H1N1 deaths and the 26 confirmed H1N1 recoveries.

Come to think of it, let's just call the 26 "non-lethal infections", as I can't be sure if they all effectively recovered.

What? WHO just decided to raise the alert level to 5? What were they waiting for?

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

It's sad that it took a little child's life.

[weemadando]

Honestly this whole thing is being over reported and add a pinch of hysteria. We have an unknown sample size in Mexico with limited death rates with an extremely limited spread in other countries. Fucking calm the fuck down.

Why the fuck WHO is going Def Con 6 is beyond me unless they are precautionary measures people are interpreting as reactionary measurese .

The only deaths so far are at the epi center of the 'pandemic' and even those are few confirmed cases of the disease and even then we can not rule out secondary causes and just jump to 'OMG the flu is killing us' bullshit. Outside of Mexico, the only confirmed death is an infant from Mexico that came to the US for medical treatment.

I'm sorry but holy shit take your tinfoil hats and hysterical tampons out and fucking calm down. Yeesh. I hope Snowe or another GOPer turns Democrat to take the sensationalism off this story for another day or two.

I imagine that the move to level 5 is a bureaucratic step, to unlock more funds, resources and possibly even some legislated/mandated powers to let them try and lock this shit down. I know that before a case had even been reported in Australia the gov't declared it a "quarantine emergency" or somesuch which allowed them to access stockpiles of anti-virals for use, set up quarantine procedures at airports etc.

I doubt that it's meant to cause panic/raise alarm, but the reporting slant is doing just that. It seems that it is more of a preparatory step, possibly one where there hands are tied and they have to escalate it according to their guidelines at certain events - especially if there are now cases on more continents/in more countries.

[Broomstick]

Honestly this whole thing is being over reported and add a pinch of hysteria. We have an unknown sample size in Mexico with limited death rates with an extremely limited spread in other countries. Fucking calm the fuck down.

It's the media that really fanning the flames. However, like hurricanes and volcanic eruptions, this bears watching. Hey, I still went out to work today, without a mask.

Why the fuck WHO is going Def Con 6 is beyond me unless they are precautionary measures people are interpreting as reactionary measurese .

Precautionary measures. Flu spreads. It goes to a 5 or 6 at some point most years, it's just not hyped in the media to this degree.

[aerius]

Toronto just got hit, and they came through my airport. 4 confirmed cases, another dozen or so probables under observation. We've been asked to help with some of the screening of people coming off planes, my job is suddenly a lot less fun.

[Knife]

I imagine that the move to level 5 is a bureaucratic step, to unlock more funds, resources and possibly even some legislated/mandated powers to let them try and lock this shit down. I know that before a case had even been reported in Australia the gov't declared it a "quarantine emergency" or somesuch which allowed them to access stockpiles of anti-virals for use, set up quarantine procedures at airports etc.

That might well be so, which is why I said precautionary measure. I hope so, that said, seems a lot of people are interpreting it the wrong way.

I doubt that it's meant to cause panic/raise alarm, but the reporting slant is doing just that.

I agree whole heatedly on this point.

It seems that it is more of a preparatory step, possibly one where there hands are tied and they have to escalate it according to their guidelines at certain events - especially if there are now cases on more continents/in more countries.

Indeed, but the media seems not to either care about that or inturperate them in a sensational way.

snip

I realize it takes precautionary measures. My biff with the situation is; one should always have some sort of common sense about communicable disease about them, this is no different. For fucks sake, more people have died in the US from car accidents the last week than have died from the Swine Flu in the last week. God forbid we freak out over cars, hell even illegal immigrants drive cars!!!!!

[Alyrium Denryle]

The 1918 strain is believed to have originated in domestic animals as well. While I would advice against panic this certainly does bear watching.

I will give you a hint. Birds are the major reservoirs for most influenza strains, followed by pigs. That this is a recent host-shift is nothing special, or of particular concern.

Sorry - even if the kid was from Mexico he died in Houston. That counts as the US. While he was in Houston there was certainly the potential for him to infect others in the US.

You missed the point. The point was that he was brought to the US for treatment, probably already on death's door, and suffering from all the other problems one would associate with mexican nutrition and prior bacterial/viral/fungal loads.

Mexico has more deaths because it has had more cases. It is also misleading to say 1/4 of infected die in Mexico because the mildest cases have slipped through the net. It is known that there are mild cases both within Mexico City and in outlying regions, but how many is impossible to quantify. In other words, the official Mexican mortality rate reflects that among serious cases, not among all cases.

That means the mortality rate is even lower, as the most severe cases lead to hospitalization.

I am going with the official number of confirmed cases, and confirmed deaths. IE. of those cases severe enough to be brought to hospital, approximate 1/4th die. There have been more cases in the US and other western countries that have been severe enough to go to hospital. Of those, less than 1% have died and that person was a mexican national who was brought in when already terminally infected.

Watched should this flu be? Sure. But stocking up on gloves and getting ready for the End Times.... no

[Broomstick]

The 1918 strain is believed to have originated in domestic animals as well. While I would advice against panic this certainly does bear watching.

I will give you a hint. Birds are the major reservoirs for most influenza strains, followed by pigs. That this is a recent host-shift is nothing special, or of particular concern.

What triggered concern was a report that in Mexico healthy adults in their prime were dying. THAT is a flu trait that could get serious. Haven't heard much about it in recent day, though - was that just a statistical glitch, are there not enough cases elsewhere, or what?

Sorry - even if the kid was from Mexico he died in Houston. That counts as the US. While he was in Houston there was certainly the potential for him to infect others in the US.

You missed the point. The point was that he was brought to the US for treatment, probably already on death's door, and suffering from all the other problems one would associate with mexican nutrition and prior bacterial/viral/fungal loads.

We don't know, do we? There's a bucket-load of assumptions there - you could just as easily assume the toddler who died in Houston was from an upper-class family with all the luxuries available to the very rich, including good food, clean water, and what not. After all, they could afford to get him to Houston, couldn't they? We just don't know, and likely never will given privacy regulations.

Mexico has more deaths because it has had more cases. It is also misleading to say 1/4 of infected die in Mexico because the mildest cases have slipped through the net. It is known that there are mild cases both within Mexico City and in outlying regions, but how many is impossible to quantify. In other words, the official Mexican mortality rate reflects that among serious cases, not among all cases.

That means the mortality rate is even lower, as the most severe cases lead to hospitalization.

Yes, that was my point.

Watched should this flu be? Sure. But stocking up on gloves and getting ready for the End Times.... no

I simply happen to have plastic gloves and face masks, as I use them for tasks other than infection control. Meanwhile, as I said, I continue to go out in public to work at my job without any special precautions. I can be interested and observant without being panicked.

[Akkleptos]

You missed the point. The point was that he was brought to the US for treatment, probably already on death's door, and suffering from all the other problems one would associate with mexican nutrition and prior bacterial/viral/fungal loads.

They went all the way from Matamoros to Houston, specifically for treatment. I sincerely doubt that they were a poor family with a malnourished child, since that's what affluent-enough Mexicans typically do if they think the illness warrants it: go to Houston for treatment.

I guess we'll have to wait and see if they disclose more information later.

And then you have the hate-flinging wankers saying they were illegal immigrants or something (article, see comments at the bottom).

[Knife]

What triggered concern was a report that in Mexico healthy adults in their prime were dying. THAT is a flu trait that could get serious. Haven't heard much about it in recent day, though - was that just a statistical glitch, are there not enough cases elsewhere, or what?

I brought this up earlier and no one engaged it, minus Akkleptos in an odd ball way. No telling if it was a death of primary or secondary causes.

We don't know, do we?

We don't and not knowing isn't equal to worse case scenario.

There's a bucket-load of assumptions there

I'm stopping here for a reason and letting it speak for itself.

[Knife]

You missed the point. The point was that he was brought to the US for treatment, probably already on death's door, and suffering from all the other problems one would associate with mexican nutrition and prior bacterial/viral/fungal loads.

They went all the way from Matamoros to Houston, specifically for treatment. I sincerely doubt that they were a poor family with a malnourished child, since that's what affluent-enough Mexicans typically do if they think the illness warrants it: go to Houston for treatment.

I guess we'll have to wait and see if they disclose more information later.

And then you have the hate-flinging wankers saying they were illegal immigrants or something (article, see comments at the bottom).

The parents might not be, but a 2 yo child might or might not fit that description. Plenty of 'rich' American kids with manlnutrition problems and other secondary problems.

[Cairber]

The story I read was that the child came to southern Texas via airplane from Mexico to visit relatives and became ill there. THEN he was transferred to Houston.

http://uk.reuters.com/article/UKNews1/i ... EY20090429

Following is a chronology of key dates in the case, as provided by Texas state health officials:

April 4 - A 22-month-old boy travels with his family to Matamoros, Mexico, from Mexico City on a commercial flight, to visit relatives in Brownsville, Texas, just across the border.

April 8 - boy develops fever and influenza-like symptoms.

April 13 - boy admitted to Brownsville area hospital.

April 14 - medical transport service transfers boy to Texas Children's Hospital in Houston, which has a world-class medical centre.

April 27 - boy dies of underlying problems associated with pneumonia.

April 29 - U.S. Centers for Disease Control and Prevention confirm that boy had swine flu, making him the first confirmed U.S. death of the disease.

[Knife]

The story I read was that the child came to southern Texas via airplane from Mexico to visit relatives and became ill there. THEN he was transferred to Houston.

Which means shit for incubation periods.

[Cairber]

Well it does counter the point that his family brought him all the way to Houston specifically for treatment, which I think would point to them being more upper class to fly so far just for treatment, but that wasn't the case.

[Akkleptos]

The parents might not be, but a 2 yo child might or might not fit that description. Plenty of 'rich' American kids with manlnutrition problems and other secondary problems.

True. Many people still think a chubby kid is a healthy kid, even though they eat all kinds of junk food, and they can be fat and suffer malnutrition.

The story I read was that the child came to southern Texas via airplane from Mexico to visit relatives and became ill there. THEN he was transferred to Houston.

So, it wasn't all the way from Matamoros. Still, that doesn't necessarily make them poor people. But really rich people go to the private hospitals. I don't think that place in Brownsville was such a facility. So, I guess just normal people.

...
April 8 - boy develops fever and influenza-like symptoms.
...
April 27 - boy dies of underlying problems associated with pneumonia.

So it was almost 20 days. I wonder how diferent that is in the case of adults.

Also, there's still the issue of -as Knife so eloquently put it-:

Which means shit for incubation periods.

[The Duchess of Zeon]

Bluntly, 20 days is completely out of sorts with any kind of pure influenza. That child died of pneumonia which was an opportunitistic secondary infection, probably long after the influenza itself was gone.

[Akkleptos]

Bluntly, 20 days is completely out of sorts with any kind of pure influenza. That child died of pneumonia which was an opportunitistic secondary infection, probably long after the influenza itself was gone.

My thoughts, exactly. Many other cases must have gone similarly, with the patient getting worse from an opportunistic infection rather than H1N1.

It would still be interesting to know just why makes the infection different in the case of a child from when it hits adults, since it's official that most of the deadly casualties have been between the ages 25-45 (I know, it's over a week old but, latest I heard, it hasn't changed).

Also, the fact that there were confirmed cases long before today, in many cases people who hadn't even been to Mexico, or been in contact with anyone who had, means that the virus had been running around there long before now. So, the incubation time is still somewhat of a mystery.