Killer swine flu outbreak in Mexico, government alarmed

[Cairber]

I don't know what to do. Panama city is reporting 3 possible cases and we are suppose to be traveling there for two weeks leaving May 7. I don't want to get sick there, and I don't want to get stuck in a complicated situation if we start having travel restrictions. It seems so mild here on one hand, but then I think that our medical care here is better than down there-- though it is not too bad in the area of Panama City that we will be staying.

But I also don't want to be alarmist; I can't really decide if I should be worried or not...

[The Duchess of Zeon]

I don't know what to do. Panama city is reporting 3 possible cases and we are suppose to be traveling there for two weeks leaving May 7. I don't want to get sick there, and I don't want to get stuck in a complicated situation if we start having travel restrictions. It seems so mild here on one hand, but then I think that our medical care here is better than down there-- though it is not too bad in the area of Panama City that we will be staying.

But I also don't want to be alarmist; I can't really decide if I should be worried or not...

Cancel the trip while you can still get some kind of refund; it's entirely possible that international air travel to Central America could be shut down by this in coming days/weeks.

[weemadando]

Heres my question... Ok, so lots of people are getting infected, and it seems its easily transmissible...but, how many people are dying? exactly how serious is this type of flu when it hits a human? I ask because depending on that is how much I really worry... I mean, the whole world could become infected and it wouldn't mater if it was a weak virus. but if people are dying from the dises easily, well thats more an issue

As previously mentioned it seems to have a mortality rate of around 5-7 percent currently, but given that it's still a fairly small sample size and being well treated, that's likely on the low-ball side of things. The concerning part was that it was taking down HYA (Healthy Young Adults), which shows that this is a mean fucker of a virus.

Healthy Young Adults in Mexico City. We have no idea if all the smog and shit they breath every day complicated matters or if poor health care complicated it, or if just that bunch had secondary infections that did them in or if it was JUST the virus.

Considering only a small sample size in Mexico let alone the itty bitty sample in the US, I'm not williing to throw my hands in the air and start screaming like a girl.

The reporting I'd seen was that it has more to do with the virus going better in HYA than in other populations (eg children and elderly). That fact alone is impressive and slightly nonsensical, which is why it does likely have some other causation. I'm not going to do the running about screaming bit yet, but I will give nature her due - this is one intriguing beastie she's cooked up.

Lets just see if it gets contained effectively. It looks like everyone's learnt a lot from SARS.

[Broomstick]

Heres my question... Ok, so lots of people are getting infected, and it seems its easily transmissible...but, how many people are dying?

Nobody knows. We have a discrete number of known fatalities, but unless we know what percentage that is of the total number of infected it means little. The truth is nobody knows how many people have this virus right now. The Indiana case at Notre Dame is actually recovered and was identified only because the student health service took a swab for culturing even before the Mexico City outbreak made the news (certain clinics swab patients as part of CDC monitoring, it was largely chance/luck the student went to one such).

You see, that's what's getting lost in the media frenzy - this flu did NOT appear this week, or last week. It's probably been around for months, gradually spreading and adapting to human hosts. It's not as new as people think it is.

exactly how serious is this type of flu when it hits a human? I ask because depending on that is how much I really worry... I mean, the whole world could become infected and it wouldn't mater if it was a weak virus. but if people are dying from the dises easily, well thats more an issue

Nobody really knows at this point.

Are the risks to die of it once you´ve caught it lower in a country with better medical standards or is there just nothing besides hoping that your body can take it?

Nobody really knows at this point. It could be that what you state is the case, or it could just be that so many more in Mexico have caught it that the there are simply greater absolute numbers of fatalities without the virus actually being more serious. Remember, a certain percentage of cases will be a MILD illness, too, and we don't have that number either.

The biggest concern is that in Mexico the fatalities have included healthy young adults. It is by no means proven that this flu induces a "cytokine storm" or immune cascade, but the 1918 flu virus did do that so it's at least a theorectical possibility. That sort of flu is the most dangerous sort, but as yet no one knows if this flu can really do that or not.

Tamiflu and Relenza have recovered even hospitalized US cases, so even the serious cases are treatable if rapidly counteracted--if you get the flu, go to the doctor immediately, immediately, immediately, even if you have to pay a huge amount to do so, those drugs work best in the first 48 hours, and there's no way to tell whether or not you have the swine flu or regular flu until that period of maximum effectiveness for anti-virals has already passed.

Except that, with our jacked-up medical "system", it's almost impossible to get medical care unless you either have insurance or can pay up front in cash. That means 15-20% of the US will not be able to get the medical care needed until they are lying in the ER with a 103 degree fever, by which time they will have already spread the virus on to others.

It is also possible for a person to pass from first sniffles to critical condition in less than 48 hours if this is a truly bad form of flu.

However, most people will recover from this even without anti-virals. There is no need to panic. There are some people at higher than normal risk of flu complications (unfortunately, I'm one of them) but unless this is an immune trigger flu the average person might get ill but they won't get dead. The vast majority of flu viruses do not trigger the immune system to go into lethal modes of operation.

The best thing to do, meanwhile, is wash your hands, avoid touching your face or body orifices unless you have just washed your hands, and limit contact with other people and crowds.

I don't know what to do. Panama city is reporting 3 possible cases and we are suppose to be traveling there for two weeks leaving May 7. I don't want to get sick there, and I don't want to get stuck in a complicated situation if we start having travel restrictions. It seems so mild here on one hand, but then I think that our medical care here is better than down there-- though it is not too bad in the area of Panama City that we will be staying.

But I also don't want to be alarmist; I can't really decide if I should be worried or not...

Call the airline and ask about refunds. At least some of them are allowing people to change their travel plans without penalty. At least find out what the current rules and policies are regarding travel to Panama. It will help you make a decision.

If this is going to go to a full pandemic and travel is restricted we'll most likely find out by the end of this week.

Remember, too, that at least some of the "new cases" aren't really new - they're like the student in my state who has already recovered. It's not that they're new, they were out there for some time it's just now we're recognizing them.

[Akkleptos]

Although the hypothesis in the article is debatable -other sources point to an Asian origin for the virus, which would have entered Mexico through the border with Texas- it is well worth looking into.

April 28, 2009

Mexico outbreak traced to 'manure lagoons' at pig farm
(Alexandre Meneghini/AP)

Chris Ayres in Mexico City
The first known case of swine flu emerged a fortnight earlier than previously thought in a village where residents have long complained about the smell and flies from a nearby pig farm, it emerged last night.

The Mexican Government said it initially thought that the victim, Edgar Hernandez, 4, was suffering from ordinary influenza but laboratory testing has since shown that he had contracted swine flu. The boy went on to make a full recovery, although it is thought that at least 148 others in Mexico have died from the disease, and the number is expected to rise.

News of the infected boy is expected to create controversy in Mexico because the boy lived in Veracruz state, home to thousands of farmers who claim that their land was stolen from them by the Mexican Government in 1992. The farmers, who call themselves Los 400 Pueblos – The 400 Towns – are famous for their naked marches through the streets of Mexico City.

The boy’s hometown, La Gloria, is also close to a pig farm that raises almost 1 million animals a year. The facility, Granjas Carroll de Mexico, is partly owned by Smithfield Foods, a Virginia-based US company and the world’s largest producer and processor of pork products. Residents of La Gloria have long complained about the clouds of flies that are drawn the so-called “manure lagoons” created by such mega-farms, known in the agriculture business as Confined Animal Feeding Operations (CAFOs).

It is now known that there was a widespread outbreak of a powerful respiratory disease in the La Gloria area earlier this month, with some of the town’s residents falling ill in February. Health workers soon intervened, sealing off the town and spraying chemicals to kill the flies that were reportedly swarming through people’s homes.

A spokeswoman for Smithfield, Keira Ullrich, said that the company had found no clinical signs or symptoms of the presence of swine influenza in its swine herd or its employees working at its joint ventures anywhere in Mexico. Meanwhile, Mexico’s National Organisation of Pig Production and Producers released its own statement, saying: “We deny completely that the influenza virus affecting Mexico originated in pigs because it has been scientifically demonstrated that this is not possible.”

According reports gathered on the website of James Wilson, a founding member of the Biosurveillance Indication and Warning Analysis Community (BIWAC), about 60 per cent of La Gloria’s 3,000-strong population have sought medical assistance since February.

“Residents claimed that three pediatric cases, all under two years of age, died from the outbreak,” wrote Mr Wilson. “However, officials stated that there was no direct link between the pediatric deaths and the outbreak; they said the three fatal cases were isolated and not related to each other.”

The case of the four-year-old boy was announced yesterday by Mexico’s Health Minister, Jose Angel Cordova, at a press conference that was briefly interrupted by an earthquake. “We are at the most critical moment of the epidemic. The number of cases will keep rising so we have to reinforce preventive measures,” he said, adding that in addition to the 149 deaths another 2,000 had been hospitalised with “grave pneumonia”, although at least half of that number had since made a full recovery.

Mr Cordova went on to say that there have been no new cases detected in La Gloria but epidemiologists want to take a closer look at pigs in Mexico as a potential source of the outbreak.

As the desease spread Greater Mexico City, usually a chaotic, traffic-snarled megatropolis of 22 million – where braised pork or carnitas, is prepared at taco stands on busy street corners – remained at a virtual standstill yesterday.

A majority of people are now wearing surgical masks and or plastic gloves in public. Airport terminals are deserted. Schools and government offices are closed and will remain so until at least early May – creating a childcare crisis for millions of working parents.

Many Mexicans are fearing the economic devastation caused by the health emergency as much as they are the prospect of swine flu. Adding to the misery, several countries including China have banned imports of live pigs and pork products from Mexico (and parts of the US) in spite of claims by farming trade groups that it is impossible to catch the virus from cooked meat.

Revolting... Manure lagoons!... Wasn't there a thread about the many ways those things are deadly, not so long ago?

The situation is looking pretty bleak for Mexico, and I mean the economy, not the stupid virus.

[The Yosemite Bear]

yeah RS did an article on them over a year ago, It seems it has resulted in the decimation of most of the Southern US Atlantic Coast fish breeding grounds, resulting in an Atlantic wide decline in fish stock because of the Manure lagoons dumping straight into the Ocean.

[hongi]

Okay, now this is beginning to scare me:

Most of the nation's confirmed cases were in New York City, where the health commissioner said "many hundreds" of schoolchildren were ill with what was "most likely swine flu." The city announced 45 confirmed cases, all affiliated with a Catholic high school.

[Broomstick]

Revolting... Manure lagoons!... Wasn't there a thread about the many ways those things are deadly, not so long ago?

Yes, we did have this thread which, oddly enough, was about Smithfield... the same producer mentioned in connection with the article you quoted....

[Knife]

Okay, now this is beginning to scare me:

Most of the nation's confirmed cases were in New York City, where the health commissioner said "many hundreds" of schoolchildren were ill with what was "most likely swine flu." The city announced 45 confirmed cases, all affiliated with a Catholic high school.

That reportedly just came back from Cabo.

[erik_t]

Oh be quiet Knife, you're ruining the panic. Next you'll mention that said school has cancelled classes in order to prevent a big scaAAAary outbreak!

[weemadando]

Oh be quiet Knife, you're ruining the panic. Next you'll mention that said school has cancelled classes in order to prevent a big scaAAAary outbreak!

Sounds like the cluster in NZ. A school trip just came back from Mexico.

[Knife]

Oh be quiet Knife, you're ruining the panic. Next you'll mention that said school has cancelled classes in order to prevent a big scaAAAary outbreak!

Meh. I hate doom and gloom people, they bug me for some reason.

[The Grim Squeaker]

FUCKING GLOBAL PANDEMICS! I have a booked flight to NY in 2 weeks and it's the only time when I can do my post army trip .
Here's hoping it quiets down (and that there aren't millions of fatalities of course). Yes, i'm being disgustingly self centered in my motives, but i'm allowed to dammit!.

[The Yosemite Bear]

is this a bad to mention that some of the squirrels in Yosemite have the Black Death?

[Akkleptos]

You see, that's what's getting lost in the media frenzy - this flu did NOT appear this week, or last week. It's probably been around for months, gradually spreading and adapting to human hosts. It's not as new as people think it is.

That would mean that little Edgar Hernández was not patient zero, or at least not the first infected human. This of course has a lot to do with incubation times. It would also mean that the spread couldn't be completely stopped by just cancelling flights or even closing borders, since many carriers would already be in a country. Not that it wouldn't still help, of course.

Healthy Young Adults in Mexico City. We have no idea if all the smog and shit they breath every day complicated matters or if poor health care complicated it, or if just that bunch had secondary infections that did them in or if it was JUST the virus.

Yes, but then how about the cases in Querétaro and San Luis Potosí (if they are confirmed to be H1N1)? Those places don't have anything like the think smog layer found in Mexico City.

yeah RS did an article on them over a year ago, It seems it has resulted in the decimation of most of the Southern US Atlantic Coast fish breeding grounds, resulting in an Atlantic wide decline in fish stock because of the Manure lagoons dumping straight into the Ocean.

Yes, we did have this threadwhich, oddly enough, was about Smithfield... the same producer mentioned in connection with the article you quoted....

Ah, thanks. Somebody'd better do something about those wankers.

Here's hoping it quiets down (and that there aren't millions of fatalities of course). Yes, i'm being disgustingly self centered in my motives, but i'm allowed to dammit!.

Yes, you are. But don't worry. Just wash your hands before touching your face, mouth eyes, &c; maybe wear a surgical mask in confined spaces with lots of people, and -most likely- you'll be juuuust fine.

"Airborne" virus contagion potential has been grossly exagerated. "Airborne" typically means the virus travels in droplets of saliva spit out when sneezing, coughing or even talking. These are dangerous because -of course- they can fall directly on your face where you can easily breath them in or they can come in through the very vulnerable eyes (why isn't anybody suggesting the use of eye glasses?). But these droplets obviously tend to fall down. Most of the time, it's just that people touch things on which these droplets were deposited and then touch their nose or their eyes.

On the numbers angle:

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.

[The Grim Squeaker]

is this a bad to mention that some of the squirrels in Yosemite have the Black Death?

I know that and don't mind that, i've been bitten by worse than squirrels.

Yes, you are. But don't worry. Just wash your hands before touching your face, mouth eyes, &c; maybe wear a surgical mask in confined spaces with lots of people, and -most likely- you'll be juuuust fine.

I'm not worried about my health, but about airports being shut down. (And well, i'm not going to go to a city if it's a ground zero of a plague outbreak). But hey, this is maybe mainly probably hysteric flavour of the year flu, and i'm sure everything will be fine within a week or two. OR at least I hope it will be.

[CaptainChewbacca]

is this a bad to mention that some of the squirrels in Yosemite have the Black Death?

Its a natural park, there's LOTS of endangered species there, just most people don't know the plague is one of them.

[Broomstick]

FUCKING GLOBAL PANDEMICS! I have a booked flight to NY in 2 weeks and it's the only time when I can do my post army trip .
Here's hoping it quiets down (and that there aren't millions of fatalities of course). Yes, i'm being disgustingly self centered in my motives, but i'm allowed to dammit!.

If they close borders, it's most likely to be Mexico first. NYC has a cluster, yes, but it also has a huge amount of international travel. In other words, don't worry too much about your trip just yet.

[salm]

I just looked at a map which shows the amount of infected and suspected infected. Most cases are in Europe and North America. Some other industrialized Nations as well. I guess this is not due to the fact that they really are only in these countries but because these countries are the only ones that have the medical infra structure to actually diagnose and report this virus.
I see a big problem with a virus like this in places like Africa. African nations are less likely to have the financial measures, nor the medical infra structure to report, let alone contain this virus. Furthermore hygine isn´t up to standards there, (people tend to eat out of the same bowl as others with their hands for example).
If the virus hits Africa it´s going to get messy. It will claim loads and loads of dead people there.

[Broomstick]

I just looked at a map which shows the amount of infected and suspected infected. Most cases are in Europe and North America. Some other industrialized Nations as well. I guess this is not due to the fact that they really are only in these countries but because these countries are the only ones that have the medical infra structure to actually diagnose and report this virus.

The fact that the average person in those countries has the means to travel internationally is also a factor here.

I see a big problem with a virus like this in places like Africa. African nations are less likely to have the financial measures, nor the medical infra structure to report, let alone contain this virus. Furthermore hygine isn´t up to standards there, (people tend to eat out of the same bowl as others with their hands for example).
If the virus hits Africa it´s going to get messy. It will claim loads and loads of dead people there.

Yes. In fact, just about every infectious disease you care to name claims more victims in Africa than anywhere else. The diminished amount of personal travel is outweigh by lack of medicine and frequently poor sanitation.

[Force Lord]

First H1N1 U.S. death reported.

Officials confront first US death from swine flu

By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer – 14 mins ago

WASHINGTON – A 23-month-old toddler died in Texas from the swine flu virus as authorities in the United States and around the world struggled to contain a growing global health menace that has also swept Germany onto the roster of afflicted nations.

"Even though we've been expecting this, it is very, very sad," said Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention. "As a pediatrician and a parent, my heart goes out to the family."

In what has become standard operating procedure in this widening health crisis, Besser went from network to network Wednesday morning to give an update on what the Obama administration is doing. He said authorities essentially are still "trying to learn more about this strain of the flu." His appearances as Germany reported its first cases of swine flu infection, with three victims.

"It's very important that people take their concern and channel it into action," Besser said, adding that "it is crucial that people understand what they need to do if symptoms appear.

"I don't think it (the reported death in Texas) indicates any change in the strain," he said. "We see with any flu virus a spectrum of disease symptoms."

Sixty-six infections had been reported in the United States before the report of the toddler's death in Texas.

The world has no vaccine to prevent infection but U.S. health officials aim to have a key ingredient for one ready in early May, the big step that vaccine manufacturers are awaiting. But even if the World Health Organization ordered up emergency vaccine supplies — and that decision hasn't been made yet — it would take at least two more months to produce the initial shots needed for human safety testing.

"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the Food and Drug Administration's swine flu work, told The Associated Press.

The U.S. is shipping to states not only enough anti-flu medication for 11 million people, but also masks, hospital supplies and flu test kits. President Barack Obama asked Congress for $1.5 billion in emergency funds to help build more drug stockpiles and monitor future cases, as well as help international efforts to avoid a full-fledged pandemic.

"It's a very serious possibility, but it is still too early to say that this is inevitable," the WHO's flu chief, Dr. Keiji Fukuda, told a telephone news conference.

Cuba and Argentina banned flights to Mexico, where swine flu is suspected of killing more than 150 people and sickening well over 2,000. In a bit of good news, Mexico's health secretary, Jose Cordova, late Tuesday called the death toll there "more or less stable."

Mexico City, one of the world's largest cities, has taken drastic steps to curb the virus' spread, starting with shutting down schools and on Tuesday expanding closures to gyms and swimming pools and even telling restaurants to limit service to takeout. People who venture out tend to wear masks in hopes of protection.

The number of confirmed swine flu cases in the United States rose to 66 in six states, with 45 in New York, 11 in California, six in Texas, two in Kansas and one each in Indiana and Ohio, but cities and states suspected more. In New York, the city's health commissioner said "many hundreds" of schoolchildren were ill at a school where some students had confirmed cases.

New Zealand, Australia, Israel, Britain, Canada and now Germany have also reported cases.

But only in Mexico so far are there confirmed deaths, and scientists remain baffled as to why.

The WHO argues against closing borders to stem the spread, and the U.S. — although checking arriving travelers for the ill who may need care — agrees it's too late for that tactic.

"Sealing a border as an approach to containment is something that has been discussed and it was our planning assumption should an outbreak of a new strain of influenza occur overseas. We had plans for trying to swoop in and knockout or quench an outbreak if it were occurring far from our borders. That's not the case here," Besser told a telephone briefing of Nevada-based health providers and reporters. "The idea of trying to limit the spread to Mexico is not realistic or at all possible."

"Border controls do not work. Travel restrictions do not work," WHO spokesman Gregory Hartl said in Geneva, recalling the SARS epidemic earlier in the decade that killed 774 people, mostly in Asia, and slowed the global economy.

Authorities sought to keep the crisis in context: Flu deaths are common around the world. In the U.S. alone, the CDC says about 36,000 people a year die of flu-related causes. Still, the CDC calls the new strain a combination of pig, bird and human viruses for which people may have limited natural immunity.

Hence the need for a vaccine. Using samples of the flu taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness. The hope is to get that ingredient — called a "reference strain" in vaccine jargon — to manufacturers around the second week of May, so they can begin their own laborious production work, said CDC's Dr. Ruben Donis, who is leading that effort.

Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against three human flu strains. The WHO wants them to stay with that course for now — it won't call for mass production of a swine flu vaccine unless the outbreak worsens globally. But sometimes new flu strains pop up briefly at the end of one flu season and go away only to re-emerge the next fall, and at the very least there should be a vaccine in time for next winter's flu season, Dr. Anthony Fauci, the National Institutes of Health's infectious diseases chief, said Tuesday.

"Right now it's moving very rapidly," he said of the vaccine development.

Besser appeared on NBC's "Meet the Press," CNN and CBS's "The Early Show."

It saddens me that the victim was a toddler.

[salm]

There´s some confusion about the death toll comming up and the swine flue might be less lethal than a normal flu:

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.

The Microbiologist continues:
The 159 deaths are due to the fact that Mexico is a Developing Country and that are normal deathrates in a developing coutry. Not everybody dying of pneumonia is a victim of an epedemy. The estimated rate of infections is usually ten times as many cases as the reported cases. 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 fovores healthy adults.

When asked if it was a wrong alarm he answers "Not necessarily." The authorities and experts acted correctly and the alarm should not be lifted because new types of Influenza viruses can be dangerous and mutate fast.

[Knife]

Not that it really matters, but apparently that baby was a Mexican national whom the parents brought up north for medical attention. Poor thing.

[Furlong]

Well, at least we have a Secretary of Health and Human Services now.

Washington -- Kathleen Sebelius won Senate confirmation Tuesday as the nation's Health and Human Services secretary, thrusting the former Kansas governor into the middle of the public health emergency involving swine flu.

The 65-31 vote came after Democrats urged quick action so that Sebelius could get to work leading the federal response to the flu outbreak.

"We find ourselves in the midst of a global crisis," Sen. Christopher J. Dodd (D-Conn.) said. "What we've been missing in all of this is the head of the Health and Human Services Department."

Sixty votes in the 100-seat Senate were necessary to avert a filibuster. Some Republicans had objected to Sebelius' stance on abortion -- she supports a woman's right to choose -- and her initial underreporting of campaign contributions from a doctor who performs late-term abortions.

Immediately after the vote, Sebelius, 60, resigned as governor in Kansas and headed to Washington. She drove directly from Andrews Air Force Base in Maryland to the White House, where she took the oath of office.

"We wanted to swear her in right away because we've got a significant public health challenge that requires her immediate attention," President Obama said, standing with his newest Cabinet secretary.

Sebelius received a briefing from Obama's Homeland Security advisor, John Brennan, and other officials dealing with the first domestic test of the administration, which turns 100 days old today.

[Fingolfin_Noldor]

Sure hope the problem doesn't flare up into the red line over the next month. I have a photonics conference to attend, and I have things to do in the US. *grumble*