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FUCK

 

 

 

swine flu is in neighboring counties.

 

as soon as this rain clears up some cunt with the flu is going to go to the beach in my county and shut down the schools.

 

 

with 24 motherfucking schooldays until summer....

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Seven - not 159 - swine flu deaths in Mexico

06 May 2009

 

http://www.wddty.com/03363800372602779674/seven-not-159-swine-flu-deaths-in-mexico.html

 

How many people have died from swine flu so far? If you believe what you read in the newspapers, you might think around 159 people have died in Mexico from the H1N1 virus. They haven’t – it’s just seven.

 

 

Both the World Health Organization (WHO) and Mexico’s own health minister Jose Angel Cordova have confirmed the figure. The WHO’s Vivienne Allan, from its patient safety program, says: “Unfortunately that (150-plus deaths) is incorrect information and it does happen, but that’s not information that’s come from the World Health Organization. I repeat, the death toll is seven and they are all from Mexico.”

 

 

Since her announcement, the first American citizen has died, but it’s hardly the stuff of a pandemic. Nonetheless, the WHO has now elevated swine flu to a ‘phase five’ pandemic, where there has been human-to-human spread in at least two countries.

 

 

Despite the facts, the UK government’s health officials have predicted that up to 750,000 Britons could die in a flu pandemic, and its health minister, Alan Johnson, has told the House of Commons that there have been 89 deaths from the virus in Mexico, so he’s off by a factor of 12.

 

 

Unless you’re a drug company, you have to wonder why governments – and the media - are acting so irresponsibly.

If you’re interested in a conspiracy theory, look no further than Indonesia and its health minister Siti Faldilah Supari who says she has not ruled out the possibility that the H1N1 virus is man-made.

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Seven - not 159 - swine flu deaths in Mexico

06 May 2009

 

http://www.wddty.com/03363800372602779674/seven-not-159-swine-flu-deaths-in-mexico.html

 

How many people have died from swine flu so far? If you believe what you read in the newspapers, you might think around 159 people have died in Mexico from the H1N1 virus. They haven’t – it’s just seven.

 

 

Both the World Health Organization (WHO) and Mexico’s own health minister Jose Angel Cordova have confirmed the figure. The WHO’s Vivienne Allan, from its patient safety program, says: “Unfortunately that (150-plus deaths) is incorrect information and it does happen, but that’s not information that’s come from the World Health Organization. I repeat, the death toll is seven and they are all from Mexico.”

 

 

Since her announcement, the first American citizen has died, but it’s hardly the stuff of a pandemic. Nonetheless, the WHO has now elevated swine flu to a ‘phase five’ pandemic, where there has been human-to-human spread in at least two countries.

 

 

Despite the facts, the UK government’s health officials have predicted that up to 750,000 Britons could die in a flu pandemic, and its health minister, Alan Johnson, has told the House of Commons that there have been 89 deaths from the virus in Mexico, so he’s off by a factor of 12.

 

 

Unless you’re a drug company, you have to wonder why governments – and the media - are acting so irresponsibly.

If you’re interested in a conspiracy theory, look no further than Indonesia and its health minister Siti Faldilah Supari who says she has not ruled out the possibility that the H1N1 virus is man-made.

 

You don't understand there is an election coming up in Indonesia and they're just trying to gain support of the anti-U.S. factions.

 

The rest of that stuff is well...not nearly as irresponsible as claiming something is "man-made". Holy gosh. The thought of it through me into a panic. :rolleyes:

 

/sarcasm

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And having said that, I'm a lot more interested in watching how the media plays this out than I am in the swine flu per se.

 

I have a feeling that there's a lesson to be learned here if you pay attention to how this is being covered in the news. Not to mention all of the things that AREN'T being talked about that don't add up- the high fatality rate in Mexico and nowhere else, the train incident in Switzerland, the rush to declare this a pandemic when there's been less than a thousand reported deaths, not very much news about what's being done in Africa and Russia...something about this whole panic (not the cause, but the event) seems very contrived and orchestrated.

 

Not really orchestrated, its just the nature of the beast. The media hypes the shit out of stuff to keep a hold of your attention and then sell advertising space. I'm 100% sure you know all of that anyway, but that's all that's really happening here. You can read what's going on in other countries just by reading their news (are you aware that China has been quarantining Mexicans, Canadians, etc.?, You know that fake Tamiflu is flooding the market in Australia? You know in Pakistan there's virtually nothing said about it, they already have their hands full with other shit.)

 

The reason why it is level 5 is that it has spread very quickly to many of the world's population centers. It is not a huge danger in its present form but if a mutation occurs through maybe mixing with a drug resistant strain then there could be real trouble. You guys have to understand that a lot of this is about POTENTIAL, not what is happening right now.

 

But, fuck the media, they always act the same in every "crisis". Don't be surprised and don't read in to it any more than you have to, it's just the nature of money makers like fucking Murdoch and pals. Appeal to the lowest common denominator and you'll always get a healthy return.

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You don't understand there is an election coming up in Indonesia and they're just trying to gain support of the anti-U.S. factions.

 

The rest of that stuff is well...not nearly as irresponsible as claiming something is "man-made". Holy gosh. The thought of it through me into a panic. :rolleyes:

 

/sarcasm

 

Oh god you're fucking stupid.

 

If there is a skin rash that covers 4 continents, it's a pandemic. It doesn't have to be lethal to qualify as a pandemic, you imbecile. Swine flu is a pandemic because it has spread so widely. It is a potential danger because it can, if it mutates, kill quite easily. How the fuck can you not get that?

 

 

I may disagree with most of Casek's theories, but he still shows that he is an intelligent bloke that does a lot of reading and considers his positions carefully. But you, you've got absolutely fuck all idea about anything. you seriously just run off your mouth about shit you obviously have no clue about. Here, let me give you two simple quotes to illustrate how utterly scattered you are (keeping in mind that you have displayed no knowledge whatsoever that you understand the mechanics of how the WHO works, how flu viruses work or how planning is done at national and global levels to react to bio-threats. Yet, you seem to be able to make a decision, very early on in the game to bring you to a 100% conclusion..., but then caveat it it with "at this point", which implies that you cannot be 100%. Christ, you're dull):

 

 

However if this disease WAS man made, which I 100% believe at this point it was

I'm never grounded into a position

 

 

Yep, good on you mate, you really got your shit squared away, huh?

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Can ask you what isn't a conspiracy?

 

 

look, man. why would they tout this as a pandemic or near pandemic if it's only killed one person in the u.s. who wasn't even a citizen?

 

in fact, that kid was premature with existing heart and lung problems.

 

they are making this out to be the new aids. it's not. it's just the flu.

 

 

same company who claims to have the vaccine ready (wtf?)

http://www.torontosun.com/news/canada/2009/02/27/8560781.html

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Pandemic just indicates how far the virus has spread, not its lethality. That means this is a pandemic.

 

Would be the same result if it was pink eye.

 

 

they keep talking about raising it to level 6.

if i'm not mistaken, right now, at level 5, they can

call marshall law (under our laws)

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YEs, there is talk about it but no movement as of yet. You have to understand that a lot of what is done with these things are designed to be preventative measures. This is a flu that has the potential to mutate and become fast and lethal, more so than normal human flus, which you have likened this flu to in previous posts. That's one of the root causes for the massive focus on this particular virus, there is strong historical precedent that warrants heightened alert.

 

As for you laws concerning freedom of movement etc., I don't know, not my kettle of fish. However, I will bet both my massive rock hard testicles that there will be no marshal law implemented in the US over the outbreak.

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YEs, there is talk about it but no movement as of yet. You have to understand that a lot of what is done with these things are designed to be preventative measures. This is a flu that has the potential to mutate and become fast and lethal, more so than normal human flus, which you have likened this flu to in previous posts. That's one of the root causes for the massive focus on this particular virus, there is strong historical precedent that warrants heightened alert.

 

As for you laws concerning freedom of movement etc., I don't know, not my kettle of fish. However, I will bet both my massive rock hard testicles that there will be no marshal law implemented in the US over the outbreak.

 

 

obviously not going to be any marshall law. but they have been trying to scare the shit out of us.

 

combine that with obamas air force one flyover of manhattan (for a photo op) and you've got some panic going on.

 

 

 

napolitano also told us that "the next one is going to be worse"

 

p.s.: i posted a buttload of links. check them out.

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I feel like the press in the US is doing its level best right now to maintain a certain level of anxiety and uncertainty. The swine flu story is just another drop in the bucket, along with the economy and terrorism and what have you...I've been trying to read international news more lately, since I want to know what's going on in the world without being subjected to the usual gloom and doom that sells papers here.

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I feel like the press in the US is doing its level best right now to maintain a certain level of anxiety and uncertainty. The swine flu story is just another drop in the bucket, along with the economy and terrorism and what have you...I've been trying to read international news more lately, since I want to know what's going on in the world without being subjected to the usual gloom and doom that sells papers here.

 

Yeah, of course that's what they do. The more you are worried about something, the more information you seek on it (unless you're ILOTSMYBRAIN, then you just assume stuff 100%). Also, the more spectacular something is, the more you want to se of it. Add humanity's morbid curiosity of stuff and there you have an unbeatable hook!

 

Get your ratings up, sell advertising space for big $$$ and buy a new fucking yacht!

 

What you want is straight reporting, such as AFP, AP. Reuters, basic news wire stuff, not shit like BBC, CNN, NYT. That will let you know what is happening, to a lesser extent WSJ, FT and Bloombergs are ok as well.

 

Then you want to read analytical stuff like International Crisis Group, SIPRI, Asia Times (you'd be amazed at who ghost writes here), CFR, Stratfor, Lowy institute, FAS, Christian Science Monitor, IISS, etc. These are the people that either advise governments or are at least read by people who make decisions. Lots of the people who work in these private institutions are experts in their field, non-partisan, educated and have usually spent time working in advisory positions on either side of the political divide.

 

Unfortunately being properly informed means fucking hours upon hours of reading. Make sure you keep your fridge and cupboards sparsely stocked otherwise you will get fat, like I am right now!

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christo-f

 

http://edocket.access.gpo.gov/2005/pdf/05-6907.pdf

 

 

executive order 13375

 

That's an amendment to the exec order to include a flu pandemic. So now you must ask what the order is.

 

Here it is here as found on the FAS and CDC sites.

 

 

Executive Order 13295 of April 4, 2003

 

Revised List of Quarantinable Communicable Diseases

By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 361(b) of the Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as follows:

 

Section 1. Based upon the recommendation of the Secretary of Health and Human Services (the ``Secretary''), in consultation with the Surgeon General, and for the purpose of specifying certain communicable diseases for regulations providing for the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases, the following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act:

 

(a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named).

 

(b) Severe Acute Respiratory Syndrome (SARS), which is a disease associated with fever and signs and symptoms of pneumonia or other respiratory illness, is transmitted from person to person predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences.

 

Sec. 2. The Secretary, in the Secretary's discretion, shall determine whether a particular condition constitutes a communicable disease of the type specified in section 1 of this order.

 

Sec. 3. The functions of the President under sections 362 and 364(a) of the Public Health Service Act (42 U.S.C. 265 and 267(a)) are assigned to the Secretary.

 

Sec. 4. This order is not intended to, and does not, create any right or benefit enforceable at law or equity by any party against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.

 

Sec. 5. Executive Order 12452 of December 22, 1983, is hereby revoked.

 

[signed:] George W. Bush

THE WHITE HOUSE,

April 4, 2003.

 

 

 

 

It's not martial law, it's the quarantining of infected people to control the spread of viruses. Totally normal, every developed country has contingency laws like this. Because lethal pandemics do happen, SARS being the perfect example of a bio-threat that if not controlled can be quite devastating. This is routine stuff. Sure, it can be abused, but so can any law or position of power, that's the nature of power.

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That's an amendment to the exec order to include a flu pandemic. So now you must ask what the order is.

 

Here it is here as found on the FAS and CDC sites.

 

 

Executive Order 13295 of April 4, 2003

 

Revised List of Quarantinable Communicable Diseases

By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 361(b) of the Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as follows:

 

Section 1. Based upon the recommendation of the Secretary of Health and Human Services (the ``Secretary''), in consultation with the Surgeon General, and for the purpose of specifying certain communicable diseases for regulations providing for the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases, the following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act:

 

(a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named).

 

(b) Severe Acute Respiratory Syndrome (SARS), which is a disease associated with fever and signs and symptoms of pneumonia or other respiratory illness, is transmitted from person to person predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences.

 

Sec. 2. The Secretary, in the Secretary's discretion, shall determine whether a particular condition constitutes a communicable disease of the type specified in section 1 of this order.

 

Sec. 3. The functions of the President under sections 362 and 364(a) of the Public Health Service Act (42 U.S.C. 265 and 267(a)) are assigned to the Secretary.

 

Sec. 4. This order is not intended to, and does not, create any right or benefit enforceable at law or equity by any party against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.

 

Sec. 5. Executive Order 12452 of December 22, 1983, is hereby revoked.

 

[signed:] George W. Bush

THE WHITE HOUSE,

April 4, 2003.

 

 

 

 

It's not martial law, it's the quarantining of infected people to control the spread of viruses. Totally normal, every developed country has contingency laws like this. Because lethal pandemics do happen, SARS being the perfect example of a bio-threat that if not controlled can be quite devastating. This is routine stuff. Sure, it can be abused, but so can any law or position of power, that's the nature of power.

 

 

 

you left out forced inoculation.

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Oh god you're fucking stupid.

 

If there is a skin rash that covers 4 continents, it's a pandemic. It doesn't have to be lethal to qualify as a pandemic, you imbecile. Swine flu is a pandemic because it has spread so widely. It is a potential danger because it can, if it mutates, kill quite easily. How the fuck can you not get that?

 

 

I may disagree with most of Casek's theories, but he still shows that he is an intelligent bloke that does a lot of reading and considers his positions carefully. But you, you've got absolutely fuck all idea about anything. you seriously just run off your mouth about shit you obviously have no clue about. Here, let me give you two simple quotes to illustrate how utterly scattered you are (keeping in mind that you have displayed no knowledge whatsoever that you understand the mechanics of how the WHO works, how flu viruses work or how planning is done at national and global levels to react to bio-threats. Yet, you seem to be able to make a decision, very early on in the game to bring you to a 100% conclusion..., but then caveat it it with "at this point", which implies that you cannot be 100%. Christ, you're dull):

 

 

However if this disease WAS man made, which I 100% believe at this point it was

I'm never grounded into a position

 

 

Yep, good on you mate, you really got your shit squared away, huh?

 

 

Dude, go fuck yourself. You don't know shit about me or what I know. Only about what I happen to post on a message board. Not to mention I would bet I am at least half of your age. Which I will admit, I have a lot to learn ^__^.

 

I already said how I may have rushed to judgment on the whole 100% man made comment.

 

However I wasn't that far off. It seems perhaps the strain of flu itself may not have been man made, but the panic because of it, was. It was done so purposely to get everyone scared and riled up. Oh well.

 

Which is WAYYYYYYYYYYY more irresponsible than a foreign leader talking about how something could have been "man made".

 

How you don't see this, is beyond me, and I could careless to debate it. You have your perspective I have mine. I doubt either of us is 100% right on anything.

 

:cool:

 

Let's be serious too, I'm sure you've said things to people like "I'm going to KILL YOU!". Without actually meaning it, or things of the like. It happens. The 100% comment was stupid. Can't go back in time and change it though.

 

:scrambled:

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Aaaand, to show there's no hard feelings:

 

 

 

WHO considers flu alert overhaul

By Andrew Jack in London

http://www.ft.com/cms/s/0/e89de9ea-3b11-11de-ba91-00144feabdc0.html

 

Published: May 7 2009 15:42 | Last updated: May 7 2009 21:41

The World Health Organisation is considering an overhaul of its pandemic ratings system amid growing criticism that it provoked unnecessary alarm by rapidly escalating its warnings over swine flu.

 

Officials at the agency’s headquarters in Geneva said they were discussing changes to the six-point scale to make clear in the future the gravity of the threat posed by a new virus.

 

EDITOR’S CHOICE

US anti-terror controls delayed flu response - May-06

 

In depth: Swine flu - Apr-28

 

Slideshow: Swine flu global reaction - May-01

 

Table: Swine flu cases around the world - May-06

 

The move comes against a backdrop of intensifying attacks on the WHO, which has been accused of “crying wolf” over its decisions to raise its pandemic alert from level three to an unprecedented five. This comes amid indications it may even go to the maximum level six.

 

Media organisations initially seized on the raising of the alerts in front page headlines around the world, but as it has emerged that the death toll has stayed relatively low, so the criticism has mounted. As of Thursday morning the WHO had confirmed 2,099 cases in 23 countries, including 44 deaths.

 

While designed to identify and classify the spread of a new flu virus between humans around the world, the WHO’s system of pandemic alerts provides no indication of the danger of the virus.

 

Even if the A (H1N1) virus in Mexico proves no more lethal than a typical seasonal flu, it could still soon trigger the highest level six WHO pandemic alert once it has been identified as spreading widely between humans in different parts of the world.

 

Margaret Chan, WHO director general, has stressed that an increase to level six is a technical change which does not mean that people around the world are at serious threat.

 

In an interview with the FT earlier this week Ms Chan defended the organisation’s public statements. “I am not predicting the pandemic will blow up but if I miss it and we don’t prepare, I fail. I’d rather over-prepare than not prepare,” she said.

 

But her reassurances clash with a widely-held public understanding of a pandemic as a serious infectious disease.

 

Only two weeks after the Mexican virus was first decoded, health officials are still struggling to understand which age groups and what overall proportion of a population are infected by the flu, and how many are at risk of dying or becoming seriously ill as a result.

 

With such limited data, they still want to be able to alert health authorities around the world to the potential risks so that they can step up their response while gathering more information.

 

Scientists also warn that even if outside Mexico the virus has so far proved relatively mild, there is a significant danger that it could mutate on mixing with some of the seasonal flu viruses now starting to circulate in the southern hemisphere. These are widely resistant to antiviral treatments such as Tamiflu.

 

The ”Armageddon” scenario is that it might mix with the H5N1 bird flu virus, which is highly lethal in humans but so far has not proved to be easily transmitted between humans.

 

The WHO had already sparked concerns from a number of health authorities for changing its pandemic alert scale last month, just after the Mexican virus was identified. This had the effect of speeding up the escalation from level 3 and was out of step with many national pandemic plans.

 

Anthony Kessel, from the UK’s Health Protection Agency, said the current arrangements were “a necessary alert system” but added: “It will be important for the WHO’s member states and advisory bodies to determine whether in the future a link with the severity of the infection is feasible, and whether it would add value to our current system.”

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INFLUENZA A (H1N1) - WORLDWIDE (17)

***********************************

A ProMED-mail post

<http://www.promedmail.org>

ProMED-mail is a program of the

International Society for Infectious Diseases <http://www.isid.org>

 

Date: Fri 8 May 2009

From: Marcel Jonges

<Marcel.Jonges@RIVM.NL>

 

 

Travel-associated influenza A (H1N1) with a virus containing a mutation in PB2

------------------------------------------------------------------------------

In the Netherlands, the 2nd laboratory confirmed human case of

influenza A (H1N1) virus infection was reported on 7 May 2009. A

53-year-old woman returned on the 30 Apr 2009 from Cancun, Mexico.

During the flight she developed an unproductive cough. Then, 2 days

later on 2 May 2009, she had a temperature of 38.6C and a sore throat

and consulted a general practitioner. Samples were submitted for

diagnostic evaluation and both the patient and her husband were

treated with oseltamivir. The patient recovered completely and

uneventfully, and samples collected 4 days later tested negative. The

virus was analyzed for presence of antiviral resistance markers in

the neuraminidase and for human adaptation markers in the PB2 protein

by direct sequencing.

 

The sequence data suggested that the virus was susceptible to both

oseltamivir and zanamivir. The amino acid 627 in PB2 (glutamicacid)

was not human-host-adapted, similar to recent swine influenza A

(H1N1) viruses. However, a glutamic acid to glycine amino acid

substitution was detected at position 677 in PB2. This mutation was

not observed in any of the A (H1N1) sequences submitted since 27 Apr

2009. Lam et al. (2008) postulated that this substitution could

reflect adaptation to mammalian hosts of highly pathogenic avian

influenza A (H5N1) viruses (1), as it was found to be under positive

selection based on phylogenetics of Indonesian viruses. Based on the

position of the mutation it might contribute to more efficient

human-to-human transmission by enhanced replicative efficiency of the

polymerase of the influenza A (H1N1) virus in humans [PB2 is a

polymerase component. - Mod.CP]. Experiments are underway to test the

relevance of this finding.

 

Marcel.Jonges

National Institute for Public Health and the Environment

Centre for Infectious Disease Control

P.O. Box 1

3720 BA, Bilthoven

The Netherlands

<Marcel.Jonges@RIVM.NL>

 

[The identification of a single mutation in the PB2 gene (encoding

the major component of the viral polymerase) of this Netherlands

isolate of the novel 2009 strain of influenza A (H1N1) virus is an

interesting finding only previously reported in the case of avian

influenza A (H5N1) virus. It is conceivable that such a mutation

might influence the transmissibility and the host range of the virus.

However, it would be premature to draw such a conclusion since there

appears to have been no onward transmission of the virus to any other

person. Nonetheless this is clearly a site which should be kept under

surveillance in future studies. - Mod.CP]

 

[The Netherlands can be located on the HealthMap/ProMED-mail

interactive map at:

<http://healthmap.org/r/00by>

-CopyEd.EJP]

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Just an update`

 

INFLUENZA A (H1N1) - WORLDWIDE (18): CASE COUNTS

************************************************

A ProMED-mail post

<http://www.promedmail.org>

ProMED-mail is a program of the

International Society for Infectious Diseases <http://www.isid.org>

 

[Please note that there may be discrepancies

between the various sources of information due to

different times of "closure" of daily figures

reported. Times of daily report closures where

known are listed in the table of contents below.

Oftentimes a newswire will mention a confirmed

case in a location that has not been on the

official reporting entity list as the

confirmation arrived after closure of the day's report. - Mod.MPP]

 

In this update:

[1] WHO - global update (16:00 GMT)

[2] PAHO - Americas regional update (13:00 GMT-4)

[3] CDC - USA update (11:00 GMT -4)

[4] Mexico - MOH update (08:30 GMT -5)

[5] Canada - Health Protection Agency (15:00 GMT -4)

[6] News briefs

 

******

[1] WHO - global update (16:00 GMT)

Date: 8 May 2009

Source: WHO Epidemic and Pandemic Alert and Response (EPR) [edited] <http://www.who.int/csr/en/>

 

 

a. Influenza A(H1N1) - update 21 -- 8 May 2009 <http://www.who.int/csr/don/2009_05_08/en/index.html>

 

As of 06:00 GMT, 8 May 2009, 24 countries have

officially reported 2384 cases of influenza A (H1N1) infection.

 

Mexico has reported 1112 laboratory confirmed

human cases of infection, including 42 deaths.

The United States has reported 896 laboratory

confirmed human cases, including 2 deaths.

 

The following countries have reported laboratory

confirmed cases with no deaths - Austria (1),

Canada (214), China, Hong Kong Special

Administrative Region (1), Colombia (1), Costa

Rica (1), Denmark (1), El Salvador (2), France

(5), Germany (10), Guatemala (1), Ireland (1),

Israel (6), Italy (5), Netherlands (2), New

Zealand (5), Poland (1), Portugal (1), Republic

of Korea (3), Spain (81), Sweden (1), Switzerland

(1) and the United Kingdom (32).

 

******

b. Influenza A(H1N1) - update 22 -- 8 May 2009 <http://www.who.int/csr/don/2009_05_08a/en/index.html>

 

As of 16:00 GMT, 8 May 2009, 25 countries have

officially reported 2500 cases of influenza A (H1N1) infection.

 

Mexico has reported 1204 laboratory confirmed

human cases of infection, including 44 deaths.

The United States has reported 896 laboratory

confirmed human cases, including 2 deaths.

 

The following countries have reported laboratory

confirmed cases with no deaths - Austria (1),

Brazil (4), Canada (214), China, Hong Kong

Special Administrative Region (1), Colombia (1),

Costa Rica (1), Denmark (1), El Salvador (2),

France (12), Germany (11), Guatemala (1), Ireland

(1), Israel (7), Italy (6), Netherlands (3), New

Zealand (5), Poland (1), Portugal (1), Republic

of Korea (3), Spain (88), Sweden (1), Switzerland

(1) and the United Kingdom (34).

 

******

Summary table of cases reported to WHO 30 Apr

2009 / 1 May / 2 May / 3 May / 4 May / 5 May / 6 May / 7 May / 8 May

----------------

Country: No. cases (deaths) 30 Apr 2009 / 1 May /

No. cases (deaths) 2 May / 3 May / 4 May / 5 May / 6 May / 7 May / 8 May

 

Austria: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1

Brazil: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 4

Canada: 19 / 34 / 51 / 85 / 101 / 140 / 165 / 201 / 214

China, Hong Kong, SAR: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1

Colombia: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1

Costa Rica: 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1

Denmark: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1

El Salvador: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2 / 2

France: 0 / 0 / 2 / 2 / 4 / 4 / 5 / 5 / 12

Germany: 3 / 4 / 6 / 8 / 8 / 9 / 9 / 10 / 11

Guatemala: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1

Ireland: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1

Israel: 2 / 2 / 3 / 3 / 4 / 4 / 4 / 6 / 7

Italy: 0 / 0 / 0 / 1 / 2 / 5 / 5 / 5 / 6

Mexico: 97(7) / 156 (9) / 397 (16) / 506 (19) /

590 (25) / 822 (29) / 942 (29) / 1112 (42) / 1204 (44)

Netherlands: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 2 / 3

New Zealand: 3 / 4 / 4 / 4 / 6 / 6 / 5 / 5 / 5

Poland: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1

Portugal: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1

Republic of Korea: 0 / 0 / 1 / 1 / 1 / 2 / 2 / 3 / 3

Spain: 13 / 13 / 13 / 40 / 54 / 57 / 73 / 81 / 88

Sweden: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 1

Switzerland: 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1

United Kingdom: 8 / 8 / 15 / 15 / 18 / 27 / 28 / 32 / 34

United States: 109 (1) / 141 (1) / 160 (1) / 226

(1) / 286 (1) / 403 (1) / 642 (2) / 896 (2)

 

Total No. countries reporting cases: 11 / 13 / 16 / 18 / 21 / 21 / 23 / 24 / 25 Total cases reported: 257 (8) / 367 (10) / 658

(17) / 898 (20) / 1085 (26) / 1490 (30) / 1893 (31) / 2371 (44) / 2500 (46)

 

--

Communicated by:

ProMED-mail Rapporteur Marianne Hopp

 

******

[2] PAHO - Americas regional update (13:00 GMT-4)

Date: 8 May 2009

Source: PAHO H1N1 flu website [edited] <http://new.paho.org/hq/index.php?option=com_content&task=view&id=1329&Itemid=569>

 

 

Update. Influenza A (H1N1) Regional Report (8 May 2009 1 PM) Epidemiological Alerts Vol. 6, No. 24

-------------------------------------

Two new countries have confirmed cases of

Influenza A/H1N1. Yesterday [7 May 2009], Brazil

reported 4 confirmed cases of Influenza A/H1N1

and today, Argentina reported one case. As of 8

May 2009, the total number of confirmed cases of

Influenza A (H1N1) recorded is 3067, including 46

deaths, in 9 countries of the Americas

(Argentina, Brazil, Canada, Colombia, Costa Rica,

El Salvador, Guatemala, Mexico and the United

States). The increase in the number of cases in

the United States since yesterday is due to the

recent laboratory-confirmation of samples that

were collected in previous weeks.

 

To date, the United States has confirmed a total

of 1639 cases of Influenza A (H1N1), including 2

deaths in Texas, in 43 states (including the

District of Columbia): 4 in Alabama, 131 in

Arizona, 107 in California, 25 in Colorado, 4 in

Connecticut, 39 in Delaware, 6 in Florida, 3 in

Georgia, 5 in Hawaii, 1 in Idaho, 392 in

Illinois, 29 in Indiana, 5 in Iowa, 12 in Kansas,

3 in Kentucky, 7 in Louisiana, 4 in Maine, 4 in

Maryland, 83 in Massachusetts, 49 in Michigan, 1

in Minnesota, 9 in Missouri, 4 in Nebraska, 8 in

Nevada, 3 in New Hampshire, 7 in New Jersey, 8 in

New Mexico, 174 in New York, 7 in North Carolina,

6 in Ohio, 4 in Oklahoma, 15 in Oregon, 2 in

Pennsylvania, 7 in Rhode Island, 29 in South

Carolina, 1 in South Dakota, 36 in Tennessee, 93

in Texas, 24 in Utah, 14 in Virginia, 33 in

Washington, 1 in Washington D.C. and 240 in

Wisconsin. Other suspected cases are being investigated.

 

From [1 Mar 2009 to 6 May 2009], Mexico has

reported 1204 confirmed cases of Influenza A

(H1N1), including 44 deaths, in 29 of 32 states.

The states with the highest number of confirmed

cases are the Federal District (Mexico City),

Mexico State, San Luis Potosi and Hidalgo. The

majority of these cases have occurred in previously healthy young adults.

 

In Canada, to date 214 human cases of Influenza A

(H1N1) have been confirmed in 9 of 13 provinces:

(33 in Alberta, 54 in British Columbia, 2 in New

Brunswick, 53 in Nova Scotia, 11 in Quebec, 1 in

Manitoba, 56 in Ontario, 2 in Prince Edward

Island and 2 in Saskatchewan). Some of the cases

had recent travel history to Mexico. All of the

cases developed a mild form of influenza-like

illness. Some of the cases also presented

gastrointestinal symptoms. Indigenous

transmission is not discarded since not all of

the confirmed cases have recent travel history to Mexico.

 

On [2 May 2009], Costa Rica notified 1 confirmed

case of Influenza A (H1N1). On [3 May 2009],

Colombia reported 1 confirmed case of Influenza A

(H1N1), while El Salvador reported 2 confirmed

cases of Influenza A (H1N1). On [5 May 2009],

Guatemala notified 1 confirmed case of Influenza

A (H1N1) in a person that had travelled to

Mexico. On [7 May 2009] Brazil reported 4

confirmed cases of Influenza A (H1N1), all of

them with recent travel history to affected

areas. Today, Argentina reported the confirmation

of 1 confirmed case of Influenza A (H1N1) with travel history to Mexico.

 

Various countries of the Region are reporting

suspected and probable cases. This indicates that

surveillance enhancement is producing results.

 

--

Communicated by:

ProMED-mail

<promed@promedmail.org>

 

******

[3] CDC - USA update (11:00 GMT -4)

Date: 8 May 2009

Source: CDC H1N1 flu website [edited] <http://www.cdc.gov/h1n1flu/>

 

 

H1N1 Flu (Swine Flu)

--------------------

States: Cumulative no. of lab. confirmed cases

(Deaths) 30 Apr 2009 / 1 May / 2 May / 3 May / 4

May / 5 May / 6 May / 7 May / 8 May

Alabama 0 / 0 / 0 / 1 / 4 / 5 / 4 / 4 / 4

Arizona: 1 / 4 / 4 /18 / 17 / 17 / 48 / 48 / 131

California: 14 / 13 / 24 / 26 / 30 / 49 / 67 / 106 / 107

Colorado: 0 / 2 / 2 / 4 / 7 / 6 / 17 / 17 / 25

Connecticut: 0 / 0 / 1 / 2 / 2 / 2 / 4 / 4 / 4

Delaware: 0 / 4 / 4 / 10 / 20 / 20 / 33 / 28 / 39

Florida: 0 / 0 / 2 / 3 / 5 / 5 / 5 / 5 / 6

Georgia: 0 / 0 / 0 / 0 / 0 / 1 / 3 / 3 / 3

Hawaii: 0 / 0 / 0 / 0 / 0 / 0 / 3 / 3 / 5

Idaho: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1

Illinois: 0 / 3 / 3 / 3 / 8 / 82 / 122 / 204 / 392

Indiana: 1 / 3 / 3 / 3 / 3 / 3 / 15 / 15 / 29

Iowa: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 5 / 5

Kansas: 2 / 2 / 2 / 2 / 2 / 2 / 2 / 7 / 12

Kentucky*: 0 / 1 / 1 / 1 / 1 / 1 / 2 / 2 / 3

Louisiana: 0 / 0 / 0 / 0 / 7 / 7 / 7 / 7 / 7

Maine: 0 / 0 / 0 / 0 / 0 / 1 / 1 / 4 / 4

Maryland: 0 / 0 / 0 / 0 / 4 / 4 / 4 / 4 / 4

Massachusetts: 2 / 2 / 8 / 7 / 6 / 6 / 45 / 71 / 83

Michigan: 1 / 2 / 2 / 2 / 2 / 2 / 8 / 9 / 49

Minnesota: 0 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1

Missouri: 0 / 0 / 1 / 1 / 1 / 1 / 2 / 4 / 9

Nebraska: 0 / 1 / 0 / 1 / 1 / 1 / 4 / 4 / 4

Nevada: 1 / 1 / 1 / 1 / 1 / 1 / 5 / 5 / 8

New Hampshire: 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2 / 3

New Jersey: 0 / 5 / 7 / 7 / 7 / 6 / 7 / 7 / 7

New Mexico: 0 / 0 / 0 / 1 / 1 / 1 / 3 / 8 / 8

New York: 50 / 50 / 50 / 63 / 73 / 90 / 97 / 98 / 174

North Carolina: 0 / 0 / 0 / 0 / 1 / 1 / 7 / 7 / 7

Ohio: 1 / 1 / 1 / 3 / 3 / 3 / 5 / 5 / 6

Oklahoma: 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 4

Oregon: 0 / 0 / 0 / 0 / 3 / 15 / 15 / 15 / 15

Pennsylvania: 0 / 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2

Rhode Island: 0 / 0 / 0 / 1 / 1 / 1 / 2 / 2 / 7

South Carolina: 10 / 16 / 13 / 15 / 15 / 16 / 16 / 17 / 29 South Dakota: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1

Tennessee: 0 / 0 / 0 / 1 / 1 / 2 / 2 / 2 / 36

Texas: 26 (1) / 28 (1) / 28 (1) / 40 (1) / 41 (1)

/ 41 (1) / 61 (2) / 91 (2) / 93 (2)

Utah: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 8 / 24

Virginia: 0 / 2 / 2 / 3 / 3 / 3 / 3 / 11 / 14

Washington: 0 / 0 / 0 / 0 / 0 / 0 / 9 / 23 / 33

Washington, DC: Washington: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1

Wisconsin: 0 / 0 / 0 / 3 / 3 / 3 / 6 / 26 / 240

 

Total number of states: 11 / 19 / 21 / 30 / 36 / 38 / 41 / 41 / 43

 

Total counts, cases (deaths): 109 (1) / 141 (1) /

160 (1) / 226 (1) / 279 (1) / 403 (1) / 642 (2) / 896 (2) / 1639 (2)

 

*Case is resident of KY but currently hospitalized in GA.

 

[For a map of number of cases by state, see <http://www.cdc.gov/h1n1flu/update.htm> - Mod.MPP]

 

--

Communicated by:

ProMED-mail

<promed@promedmail.org>

 

******

[4] Mexico - MOH update (08:30 GMT -5)

Date: 8 May 2009

Source: Secretaria de Salud website (MOH) [Trans. by Mod.MPP, edited] <http://portal.salud.gob.mx/contenidos/noticias/influenza/estadisticas.html>

 

 

Case counts: 29 Apr 2009 / 1 May / 2 May / 3 May

/ 4 May / 5 May / 6 May / 7 May / 8 May

Number of confirmed cases: 99 / 397 / 443 / 506 /

727 / 866 / 1112 / 1204 / 1364

Number of deaths: 8 / 16 / 16 / 19 / 26 / 26 / 42 / 44 / 45

 

Date: 7 May 2009

Source: Secretaria de Salud website (MOH) [edited] <http://portal.salud.gob.mx/>

 

 

[in yesterday's posting (7 May 2009), the case

fatality rates calculated for the 0-9 year old

and 10-19 year old age groups were erroneous and

off by 2 decimal points. The corrected CFRs are

presented below. ProMED-mail would like to thank

Dr. Carl N Mayers <CNMAYERS@mail.dstl.gov.uk> and

Kristin Choo <kchoo@aol.com> for pointing this

out. We regret any confusions this may have caused. - Mod.MPP]

 

Age distribution: No. cases (percent) / deaths

(percent) / case-fatality rate (CFR)

0-9 years: 316 (26.2) / 2 (4.8) / 0.6

10-19 years: 303 (25.2) / 2 (4.8) / 0.7

20-29 years: 243 (20.2) / 16 (38.1) / 4.1

30-39 years: 130 (10.8) 9 (21.4) / 6.9

40-49 years: 105 (8.7) / 5 (11.9) / 4.8

50-59 years: 76 (6.3) / 4 (9.5) / 5.3

60 and older: 26 (2.2) / 4 (9.5) / 15.4

ND (not determined) 5 (0.4)

 

Total: 1204 (42)

 

[To download the 8 May 2009 graphics on the

status of the epidemic, click on the link

08/Mayo/2009 <Situacion actual de la Epidemia>.

There is an epidemic curve, age distribution

data, and number of cases by state, with current

map available at this link. - Mod.MPP]

 

According to data presented in today's update,

84.1 percent of the fatalities occurred in the 20

- 54 year old age group. A breakdown of the

deaths by educational level showed 41 percent of

fatal cases had either no schooling, or had

completed primary school. Information on the

clinical symptoms of the 45 fatal cases shows

that 93.3 percent had fever, 86.7 percent had

cough, 80 percent had dyspnea (shortness of

breath), 33.3 percent had hemoptysis (coughing up

blood) and 28.9 percent were cyanotic (bluish

discoloration due to low oxygenation). Only 2 of

the fatal cases had date of onset of symptoms after 23 Apr 2009.

 

Predisposing illnesses/conditions among fatalities included:

Neoplasia: 2.2 percent

Autoimmune disorders: 2.2 percent

Smoking: 8.9 percent

Cardiovascular disease: 11.1 percent

Metabolic diseases (diabetes and obesity): 24.4 percent

 

--

Communicated by:

ProMED-mail

<promed@promedmail.org>

 

******

[5] Canada - Health Protection Agency (15:00 GMT -4)

Date: 8 May 2009

Source: Health Protection Agency [edited] <http://www.phac-aspc.gc.ca/alert-alerte/swine-porcine/surveillance-eng.php>

 

 

Province: Cumulative confirmed cases (deaths) of

human swine influenza as of 30 Apr / 1 May / 2

May / 3 May / 4 May / 5 May / 6 May / 7 May / 8 May

 

Alberta: 6 / 8 / 15 / 18 / 24 / 26 / 30 / 33 / 42 (1)

British Columbia: 11 / 15 / 22 / 29 / 39 / 46 / 54 / 54 / 60

Manitoba: 0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1

Nova Scotia: 8 / 14 / 16 / 33 / 38 / 48 / 53 / 53 / 56

New Brunswick: 0 / 1 / 1 / 1 / 2 / 2 / 2 / 2 / 2

Ontario: 8 / 12 / 14 / 16 / 31 / 36 / 49 / 56 / 61

Prince Edward Island: 0 / 0 / 0 / 0 / 2 / 2 / 2 / 2 / 3

Quebec: 1 / 1 / 2 / 3 / 3 / 4 / 10 / 11 / 15

Saskatchewan: 0 / 0 / 0 / 0 / 0 / 0 / 0 / 2 / 2

 

Total no. Provinces with cases: 5 / 6 / 6 / 7 / 8 / 8 / 8 / 9 / 9

Total: 34 / 51 / 70 / 101 / 140 / 165 / 201 / 214 / 242 (1)

 

As of [6 May 2009], half the cases are 22 years

of age or younger (median: 22 years; range: 2 ***

66 years). To date, 3 cases have been

hospitalized and one death has been reported. The

most recent date of onset of illness is [3 May 2009].

 

[There is an epidemic curve available at the

above URL link. The graph illustrates the course

of the current H1N1 Flu Virus (Human Swine Flu)

outbreak in Canada. It shows the date when

symptoms of H1N1 Flu Virus (Human Swine Flu)

began for each of the laboratory-confirmed cases. - Mod.MPP]

 

--

Communicated by:

ProMED-mail

<promed@promedmail.org>

 

******

[6] News briefs

Date: 8 May 2009

 

 

[below are links to newswires with information on

confirmed cases in countries not included in

official updates from 6 May 2009, and other

events of potential interest. The newswires are

full of reports of suspected cases in many

countries. Reports have been filtered and

discarded as more information becomes available during the day. - Mod.MPP]

 

Americas:

Brazil: 1st person to person transmission in Brazil <http://newsinfo.inquirer.net/breakingnews/world/view/20090509-204045/Domestically-transmitted-flu-case-in-Brazil>

Panama: 1st confirmed case, history of travel to the USA

Mexico: fatalities due to late health care seeking behavior <http://news.sky.com/skynews/Home/World-News/Australia-Sees-First-Swine-Flu-Case-H1N1-Virus-Infects-People-In-27-Nations/Article/200905215278467>

 

Asia:

Japan: 1st confirmed cases (3), all with history of travel to Canada and USA <http://news.yahoo.com/s/afp/20090508/wl_asia_afp/healthflujapan>

 

Oceana:

Australia: 1st confirmed case, history of travel to the USA <http://news.sky.com/skynews/Home/World-News/Australia-Sees-First-Swine-Flu-Case-H1N1-Virus-Infects-People-In-27-Nations/Article/200905215278467>

 

--

Communicated by:

ProMED-mail rapporteur Mary Marshall

 

[To summarize the current situation, as of 8 May

2009 there have been a total of 2500 cases and 46

deaths of influenza A (H1N1) infection officially

reported to WHO/PAHO coming from 25 countries, up

from 2371 confirmed cases and 44 deaths from 24

countries yesterday (7 May 2009). The newly added

country is Brazil. (According to the PAHO update,

Argentina has officially confirmed a case.

According to the newswires, there have been

confirmed cases in Japan, Australia and Panama as

well, and Brazil has confirmed person to person

spread in Brazil, but official reports are still pending.)

 

The USA has officially reported 1639 laboratory

confirmed cases coming from 44 states (compared

with 896 cases from 43 states on 7 May 2009), and

2 deaths (one in a Mexican child with

pre-existing illness visiting in the USA and a

2nd in a resident of Texas with known

pre-existing illness). Canada has reported 242

cases from 9 provinces with 1 death in an

individual with pre-existing illness, up from 214

cases and no deaths reported from 9 provinces on

7 May 2009. Mexico has reported 1364 confirmed

cases with 45 deaths (compared with 1204 cases and 44 deaths on 7 May 2009.

 

For a map of reported confirmed cases, worldwide,

as of 18:00 GMT 8 May 2009, see <http://www.who.int/csr/don/GlobalSubnationalMaster_20090508_1815.jpg>.

For an interactive map of reported confirmed

cases in the Americas, as of 13:00 GMT -4,

showing burden of disease by state/province, see <http://ais.paho.org/flu/sm/en/atlas.html>. For a

static map of reported cases in the Americas, as of 13:00 GMT -4 see <http://new.paho.org/hq/swine_files/mapeng.htm> - Mod.MPP]

 

[see also:

Influenza A (H1N1) - worldwide (17) 20090508.1722

Influenza A (H1N1) - worldwide (16): case counts 20090507.1715 Influenza A (H1N1) - worldwide (15) 20090507.1709 Influenza A (H1N1) - worldwide (14): case counts 20090507.1702 Influenza A (H1N1) - worldwide (13) 20090506.1695 Influenza A (H1N1) - worldwide (12): case counts 20090505.1681 Influenza A (H1N1) - worldwide (11): coincident H3N2 variation 20090505.1679 Influenza A (H1N1) - worldwide (10): case counts 20090504.1675 Influenza A (H1N1) - worldwide (09) 20090504.1673 Influenza A (H1N1) - worldwide (08): case counts 20090503.1660 Influenza A (H1N1) - worldwide (07) 20090503.1658 Influenza A (H1N1) - worldwide (06): case counts 20090502.1654 Influenza A (H1N1) - worldwide (05) 20090503.1657 Influenza A (H1N1) - worldwide (04): case counts 20090501.1648 Influenza A (H1N1) - worldwide (03) 20090501.1646 Influenza A (H1N1) - worldwide (02): case counts 20090430.1638 Influenza A (H1N1) - worldwide 20090430.1636 Influenza A (H1N1) "swine flu": worldwide

(07), update, pandemic 5 20090429.1622

Influenza A (H1N1) "swine flu": worldwide (06) 20090429.1614 Influenza A (H1N1) "swine flu": worldwide (05) 20090428.1609 Influenza A (H1N1) "swine flu": worldwide (04) 20090428.1601 Influenza A (H1N1) "swine flu": worldwide (03) 20090428.1600 Influenza A (H1N1) "swine flu": Worldwide (02) 20090427.1586 Influenza A (H1N1) "swine flu": Worldwide 20090427.1583 Influenza A (H1N1) virus, human: worldwide 20090426.1577 Influenza A (H1N1) virus, human - New Zealand, susp 20090426.1574 Influenza A (H1N1) virus, human - N America (04) 20090426.1569 Influenza A (H1N1) virus, human - N America (03) 20090426.1566 Influenza A (H1N1) virus, human - N America (02) 20090425.1557 Influenza A (H1N1) virus, human - N America 20090425.1552 Acute respiratory disease - Mexico, swine virus susp 20090424.1546 Influenza A (H1N1) virus, swine, human - USA (02): (CA, TX) 20090424.1541 Influenza A (H1N1) virus, swine, human - USA: (CA) 20090422.1516 Influenza A (H1N1) virus, swine, human - Spain 20090220.0715 2008

----

Influenza A (H1N1) virus, swine, human - USA (TX) 20081125.3715 2007

----

Influenza A (H2N3) virus, swine - USA 20071219.4079

Influenza, swine, human - USA (IA): November 2006 20070108.0077] ......................mpp/ejp/dk

 

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INFLUENZA A (H1N1) - WORLDWIDE (19)

***********************************

A ProMED-mail post

<http://www.promedmail.org>

ProMED-mail is a program of the

International Society for Infectious Diseases <http://www.isid.org>

 

In this update:

[1] Triple-reassortant swine flu (ex NEJM)

[2] Emergence of novel strain (ex NEJM)

 

******

[1] Triple-reassortant swine flu

Date: Thu 7 May 2009

Source: The New England Journal of Medicine [edited] <http://content.nejm.org/cgi/content/full/NEJMoa0903812>

 

 

Triple-Reassortant Swine Influenza A (H1) in

Humans in the United States, 2005***2009

-----------------------------------------------------------------------------------

Introduction

------------

Pigs have been hypothesized to act as a mixing

vessel for the reassortment of avian, swine, and

human influenza viruses and might play an

important role in the emergence of novel

influenza viruses capable of causing a human

pandemic. Recent reports of widespread

transmission of swine-origin influenza A (H1N1)

viruses in humans in Mexico, the United States,

and elsewhere highlight this ever-present threat

to global public health. Between the 1930s and

the 1990s, the most commonly circulating swine

influenza virus among pigs -- classic swine

influenza A (H1N1) -- underwent little change.

However, by the late 1990s, multiple strains and

subtypes (H1N1, H3N2, and H1N2) of

triple-reassortant swine influenza A (H1) viruses

-- whose genomes included combinations of avian,

human, and swine influenza virus gene segments --

had emerged and became predominant among North American pig herds.

 

Influenza virus infection was identified as a

cause of febrile respiratory illness in pigs as

early as 1931, 3 years before influenza viruses

were identified as a cause of illness in people.

Classic swine influenza viruses are enzootic

among pigs in North America. Cases and clusters

of human infections with swine influenza viruses

have been reported sporadically in the United

States since the 1970s. Worldwide, more than 50

cases of swine influenza virus infection in

humans, most due to classic swine influenza

virus, have been documented in the past 35 years,

and serologic studies suggest that people with

occupational swine exposure are at highest risk for infection.

 

Before the current epidemic of swine-origin

influenza A (H1N1) viruses, illness from classic

swine influenza viruses, including 7 deaths, had

been reported in both previously healthy persons

and those with preexisting medical conditions

(including pregnancy). Signs and symptoms of

infection with classic swine influenza virus in

humans are often indistinguishable from those of

infection with human influenza viruses. Until

April 2009, only limited, nonsustained

human-to-human transmission of swine influenza virus had been reported.

 

Outside the United States, there have been 2

published case reports of human infection with

triple-reassortant swine influenza A (H1) viruses

(both subtype H3N2). Before 2005, the Centers for

Disease Control and Prevention (CDC) had been

receiving approximately one or 2 case reports of

human infection with classic swine influenza

viruses per year. The CDC identified the 1st

human infection with triple-reassortant swine

influenza A (H1) viruses in the United States in

December 2005. In June 2007, human infection with

a novel influenza A virus (including influenza

viruses of animal origin) was classified as a

nationally notifiable infectious disease in the

United States. From December 2005 through

February 2009, the CDC received 11 notifications

of human infection with triple-reassortant swine

influenza A(H1) viruses, 8 of which occurred

after June 2007. In this article, we characterize

the epidemiologic and clinical features of the

1st 11 cases in humans reported in the United

States between December 2005 and February 2009.

An additional human case of infection with

triple-reassortant swine influenza A (H1) viruses

was detected in South Dakota in January 2009 but

is not described here, because serologic studies

for the patient and the patient's contacts are

pending finalization of the serologic assay for

infection with triple-reassortant swine influenza A (H1) viruses.

 

Abstract

--------

Background: Triple-reassortant swine influenza A

(H1) viruses -- containing genes from avian,

human, and swine influenza viruses -- emerged and

became enzootic among pig herds in North America during the late 1990s.

 

Methods: We report the clinical features of the

1st 11 sporadiccases of infection of humans with

triple-reassortant swine influenza A (H1)

viruses, occurring from December 2005 through

February 2009, until just before the current

epidemic of swine-origin influenza A (H1N1) among

humans. These data were obtained from routine

national influenza surveillance reports and from

joint case investigations by public and animal health agencies.

 

Results: The median age of the 11 patients was 10

years (range, 16 months to 48 years), and 4 had

underlying health conditions. 9 of the patients

had had exposure to pigs, 5 through direct

contact and 4 through visits to a location where

pigs were present but without contact. In another

patient, human-to-human transmission was

suspected. The range of the incubation period,

from the last known exposure to the onset of

symptoms, was 3 to 9 days. Among the 10 patients

with known clinical symptoms, symptoms included

fever (in 90 percent), cough (in 100 percent),

headache (in 60 percent), and diarrhea (in 30

percent). Complete blood counts were available

for 4 patients, revealing leukopenia in 2,

lymphopenia in one, and thrombocytopenia in

another. 4 patients were hospitalized, 2 of whom

underwent invasive mechanical ventilation. 4

patients received oseltamivir, and all 11 recovered from their illness.

 

Conclusions: From December 2005 until just

before the current human epidemic of swine-origin

influenza viruses, there was sporadic infection

with triple-reassortant swine influenza A (H1)

viruses in persons with exposure to pigs in the

United States. Although all the patients

recovered, severe illness of the lower

respiratory tract and unusual influenza signs

such as diarrhea were observed in some patients,

including those who had been previously healthy.

 

[byline: Vivek Shinde, M.D., M.P.H., Carolyn B.

Bridges, M.D., Timothy M. Uyeki, M.D., M.P.H,

M.P.P., Bo Shu, B.S., Amanda Balish, B.S., Xiyan

Xu, M.D., Stephen Lindstrom, Ph.D., Larisa V.

Gubareva, M.D., Ph.D., Varough Deyde, Ph.D.,

Rebecca J. Garten, Ph.D., Meghan Harris, M.P.H.,

Susan Gerber, M.D., Susan Vagoski, D.V.M.,

Forrest Smith, M.D., Neal Pascoe, R.N., Karen

Martin, M.P.H., Deborah Dufficy, D.V.M., M.P.H.,

Kathy Ritger, M.D., M.P.H., Craig Conover, M.D.,

Patricia Quinlisk, M.D., M.P.H., Alexander

Klimov, Ph.D., Joseph S. Bresee, M.D., and Lyn Finelli, Dr.P.H.]

 

--

Communicated by:

ProMED-mail

<promed@promedmail.org>

 

******

[2] Emergence of novel strain

Date: Thu 7 May 2009

Source: The New England Journal of Medicine [edited] <http://content.nejm.org/cgi/content/full/NEJMoa0903810>

 

 

Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans

--------------------------------------------------------------------

Introduction

------------

Triple-reassortant swine influenza viruses, which

contain genes from human, swine, and avian

influenza A viruses, have been identified in

swine in the United States since 1998, and 12

cases of human infection with such viruses were

identified in the United States from 2005 through

2009. On 15 Apr 2009 and 17 Apr 2009, the Centers

for Disease Control and Prevention(CDC)

identified 2 cases of human infection with a

swine-origin influenza A (H1N1) virus (S-OIV)

characterized by a unique combination of gene

segments that had not been identified among human

or swine influenza A viruses. As of 5 May 2009,

cases of human infection with the same novel

virus have also been identified in Mexico,

Canada, and elsewhere. We report the 1st 643

confirmed cases of human infection with this virus in the United States.

 

Abstract

--------

Background: Triple-reassortant swine influenza

viruses, which contain genes from human, swine,

and avian influenza A viruses, have been

identified in swine in the United States since

1998, and 12 cases of human infection with such

viruses were identified in the United States from

2005 through 2009. On 15 Apr 2009 and 17 Apr

2009, the Centers for Disease Control and

Prevention (CDC) identified 2 cases of human

infection with a swine-origin influenza A (H1N1)

virus (S-OIV) characterized by a unique

combination of gene segments that had not been

identified among human or swine influenza A

viruses. As of 5 May 2009, cases of human

infection with the same novel virus have also

been identified in Mexico, Canada, and elsewhere.

We report the 1st 643 confirmed cases of human

infection with this virus in the United States.

 

Methods: Enhanced surveillance was implemented in

the United States for human infection with

influenza A viruses that could not be subtyped.

Specimens were sent to the Centers for Disease

Control and Prevention for real-time

reverse-transcriptase***polymerase-chain-reaction confirmatory testing for S-OIV.

 

Results: From 15 Apr 2009 through 5 May 2009, a

total of 642 confirmed cases of S-OIV infection

were identified in 41 states. The ages of

patients ranged from 3 months to 81 years; 60

percent of patients were 18 years of age or

younger. Of patients with available data, 18

percent had recently traveled to Mexico, and 16

percent were identified from school outbreaks of

S-OIV infection. The most common presenting

symptoms were fever (94 percent of patients),

cough (92 percent), and sore throat (66 percent);

25 percent of patients had diarrhea, and 25

percent had vomiting. Of the 399 patients for

whom hospitalization status was known, 36 (9

percent) required hospitalization. Of 22

hospitalized patients with available data, 12 had

characteristics that conferred an increased risk

of severe seasonal influenza, 11 had pneumonia, 8

required admission to an intensive care unit, 4

had respiratory failure, and 2 died. The S-OIV

was determined to have a unique genome

composition that had not been identified previously.

 

Conclusions: A novel swine-origin influenza A

virus was identified as the cause of outbreaks of

febrile respiratory infection ranging from

self-limited to severe illness. It is likely that

the number of confirmed cases underestimates the

number of cases that have occurred.

 

--

Communicated by:

ProMED-mail

<promed@promedmail.org>

 

[These 2 papers provide well-documented accounts

of the nature of the viruses circulating prior to

and subsequent to the appearance of the novel

2009 strain of influenza A (H1N1) virus.

Interested readers should consult these papers in conjunction. - Mod.CP]

 

[see also:

Influenza A (H1N1) - worldwide (18): case counts 20090509.1728 Influenza A (H1N1) - worldwide (17) 20090508.1722 Influenza A (H1N1) - worldwide (16): case counts 20090507.1715 Influenza A (H1N1) - worldwide (15) 20090507.1709 Influenza A (H1N1) - worldwide (14): case counts 20090507.1702 Influenza A (H1N1) - worldwide (13) 20090506.1695 Influenza A (H1N1) - worldwide (12): case counts 20090505.1681 Influenza A (H1N1) - worldwide (11): coincident H3N2 variation 20090505.1679 Influenza A (H1N1) - worldwide (10): case counts 20090504.1675 Influenza A (H1N1) - worldwide (09) 20090504.1673 Influenza A (H1N1) - worldwide (08): case counts 20090503.1660 Influenza A (H1N1) - worldwide (07) 20090503.1658 Influenza A (H1N1) - worldwide (06): case counts 20090502.1654 Influenza A (H1N1) - worldwide (05) 20090503.1657 Influenza A (H1N1) - worldwide (04): case counts 20090501.1648 Influenza A (H1N1) - worldwide (03) 20090501.1646 Influenza A (H1N1) - worldwide (02): case counts 20090430.1638 Influenza A (H1N1) - worldwide 20090430.1636]

....................cp/ejp/dk

 

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humm let me see this so called swine flu thing. one word comes to mind when i hear this. umm. govt control. Why do you think this shit is being milked so much and being showed to us as the worst thing for us since umm govt. This is the precursor see right now they setting it up where we will all be used to the fact of the govt taking control locking us up and inoculating us with lethal vaccines then they hit us with another disease and we all go along and follow there orders right into the fema camps were the real depopulation comes. But i think this wont happen for a minute there will be smaller events like this but get bigger and bigger then there will be a world war then the killer virus then the death camps. And thats all folks.

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humm let me see this so called swine flu thing. one word comes to mind when i hear this. umm. govt control. Why do you think this shit is being milked so much and being showed to us as the worst thing for us since umm govt. This is the precursor see right now they setting it up where we will all be used to the fact of the govt taking control locking us up and inoculating us with lethal vaccines then they hit us with another disease and we all go along and follow there orders right into the fema camps were the real depopulation comes. But i think this wont happen for a minute there will be smaller events like this but get bigger and bigger then there will be a world war then the killer virus then the death camps. And thats all folks.

 

You had me up until you mentioned death camps- I completely agree that whatever is “really going on” regarding “H1N1 or any of the other H1, H7, H2, H5- avian, bird, swine or human -yada yada yada- flu was absolutely created in a lab by our own government and I also agree it is going in a very strange direction- either to control the population- or forced vaccinations- but death camps? Perhaps that thought is just something- I don’t want to think about yet.

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