Pandemic - novel H1N1 influenza: world awaits announcement of Level 6 alert.

June 11

Agonist Exclusive - After years of international concern about an avian flu H5N1 pandemic; the world is awaiting the 6pm Geneva time WHO press conference, at the WHO boardroom where it is expected that the Director-General Dr. Margaret Chan will announce that the world is officially dealing with the novel H1N1 influenza (swine flu) at pandemic level. Scotland's Health Secretary Nicola Sturgeon told Scottish lawmakers "A move to level 6 is not a verdict on the severity of the virus," she said. "It simply means that the extent of global spread now fulfills the definition of a pandemic." WHO considers a disease pandemic when transmission between humans becomes widespread in at least two regions of the world.

Emerging in Mexico and California in March 2009, the novel H1N1 influenza, commonly known as swine flu, has achieved what many feared Avian Flu would do since November 2003, spread rapidly 'around the world in 80 days', with sustained transmission on several continents, especially in Australia.

...And we have a pandemic! ~ h/t raja

Surprisingly, it has not yet apparently spread to the African continent, but from its beginnings in California and Mexico the virus has penetrated Canada, Australia, Japan, the UK and 74 other countries. Hundreds of thousands of people with the disease is likely as mild cases may not have been detected.

The death toll remains low, and statistically infection levels remain commensurate with seasonal flu outbreaks. Concern of mutation and a second wave of infections in late 2009 with the onset of winter in the northern hemisphere may indicate that the virus may prove as deadly as the three previous pandemics in the past 100 years. (The "Spanish flu", a H1N1 virus was identified early in March 1918 in Kansas and spread by October 1918 to become a world-wide pandemic on all continents infecting one third of the world's population. Especially deadly and virulent it killed over 50 million. The "Asian Flu", an H2N2 virus, was first identified in China in late February 1957, caused about 2 million deaths globally. The "Hong Kong Flu" a H3N2 virus was first detected in Hong Kong in early 1968 and killed over one million people worldwide in the next two years.) However the raising of the alert level by WHO to level 6, BBC - does not mean the world is going to see the spread of the disease on the scale as deadly as that of the 1918 Spanish Flu.

In developing nations health facilities will be overwhelmed, whilst in the developed world drugmakers will increase production of a vaccine for the novel H1N1 influenza strain, whilst at the same time providing vaccines for older H1N1, H3N2 and type B viruses which are still in circulation. It appears that a vaccine may not be ready until October. Governments will be forced to budget more money to curb the spread of the virus, by increasing vigilance at seaports and airports, and providing increased medical resources including anti-viral medications and masks. Quarantine of school children, sporting teams, and travellers will increase.

With its propensity to attack the young and the elderly and those already ill with chronic illness; the schooling systems, aged care providers and medical and nursing resources will need to adapt to meet the challenge of the virus, especially if it mutates into a more virulent and deadly strain.

REUTERS - David Heymann, a former top WHO official now chairing Britain's Health Protection Agency, said that countries had tried to contain the virus through measures including school closures during the current phase 5. This has extended the precious time needed to prepare for a full-blown pandemic. "During phase 5, the government and people in the U.K. have had the time to prepare for a pandemic -- this has hopefully decreased any surprise and concern that might be associated with a WHO announcement of phase 6, if one is made," he told Reuters. As it spreads in humans, science cannot predict what course the virus will take, the disease it causes and the age groups infected, Heymann said. "The severity of that disease, the effectiveness of antiviral drugs and the stability of the virus must all be watched closely," he added. A pandemic could cause enormous disruption to business as workers stay home because they are sick or to look after family members and authorities restrict gatherings of large numbers of people or movement of people or goods.

WHO patient care checklist for medical professionals.


graham June 11, 2009 - 6:59am

WHO: Swine flu pandemic has begun, 1st in 41 years

GENEVA — The World Health Organization has told its member nations it is declaring a swine flu pandemic — the first global flu epidemic in 41 years.

The move came Thursday as infections climbed in the United States, Europe, Australia, South America and elsewhere.

In a statement sent to member countries, WHO says it decided to raise the pandemic alert level from phase 5 to 6, meaning that a global outbreak of swine flu has begun. The decision was made after the U.N. health agency held an emergency meeting on swine flu with its experts.


W.H.O. Raises Alert Level as Flu Spreads to 74 Countries

New York Times, By Nick Cumming-Bruce & Andrew Jacobs, June 11

GENEVA — The World Health Organization has told its member nations it is declaring a swine flu pandemic — the first global flu epidemic in 41 years, news services reported.

The move came after an emergency meeting with flu experts here that was convened after a sharp rise in cases in Australia, which reported 1,224 cases on Wednesday, and rising numbers in Britain, Japan and elsewhere.

In a statement sent to member countries, the W.H.O. said it decided to raise the pandemic alert level from phase 5 to 6, indicating a global pandemic outbreak, The Associated Press said, attributing the information to health officials from Scotland, Indonesia and Thailand. An official announcement of the change was due at 6 p.m. Geneva time on Thursday (noon in New York).

In an effort to avoid triggering panic with such an announcement, W.H.O. officials are expected to include a caveat that the flu, which has resulted in mostly mild cases, is not more deadly now that it has been declared a pandemic. Rather, the announcement reflects the global spread of the disease, not an increase in its severity.


They sicken of the calm, who knew the storm.

Raja June 11, 2009 - 10:21am

Flu-stricken native community 'in a war with no artillery'

roll over and click each of the four tabs for graphics

graham June 12, 2009 - 6:21am

How do Australian aboriginals usually react to flu?


--Sell Texas to China!

Singular June 13, 2009 - 6:11am

endure less than optimal living conditions.

Due to overcrowding, poor nutrition, chronic illness and remote settlements, the possibility of death and rapid spread is more likely.

However, so far the swine flu appears to be only proving to be a mild virus.

btw: Back 200 years ago, the original inhabitants were decimated by influenza and other whiteman illnesses as well as deliberately spread infections.

graham June 13, 2009 - 6:32am

There were 1565 cumulative cases yesterday, mostly in the UK and Spain. NO DEATHS, which means that the virus is milder than it used to be.

I wonder what's the mixture of normal flu and new A(H1N1) in Australia. This is the sum of all flu viruses etc.: http://www.google.org/flutrends/intl/en_au/

In the USA the new A(H1N1) is behind a higher proportion of flu cases than a normal influenza virus during a winter.

Note that the news are very vague in which countries there are official epidemics outside Americas. Scotland is not a country.

The low number of cases in Russia and Africa seem to be impossible. It probably reflects the lack of testing.


--Sell Texas to China!

Singular June 13, 2009 - 6:53am

lets face it, most first world countries are not doing comprehensive investigations.

triage is culling out the seriously ill influenza victims and testing them. the rest are being told, "you have the flu, go home and get well, if you get worse come back and see us, heres some tamiflu just in case"

Back in 2007 we had nasty h3n1 and h1n1 viruses doing the rounds in late winter (August), deaths doubled and tripled that year, giving the flu forums a bit of excitement. A tamiflu blanket was used back then, spring came and all was well.

This week the local school that had a child in the kindergarten with a positive swine influenza diagnosis shut down the kindegarten, but parents of older children descended en masse with their children to the dedicated flu clinic, causing chaos with too little staff on hand. Many adults who had been in contact with earlier confirmed cases left before being seen...

It's spreading, it's a flu: most people will survive and life will go on.

graham June 13, 2009 - 7:49am

has just posted on the USA school closing problem

graham June 13, 2009 - 8:08am
Xinhuanet roundup Taiwan's A/H1N1 flu cases reach 44 ( 2009-06-13 )
# Egypt reports three more cases of A/H1N1 ( 2009-06-13 )
# A/H1N1 flu continues to spread, in some places rapidly ( 2009-06-13 )
# NZ reports 2 non-imported Influenza A/H1N1 case ( 2009-06-13 )
# Death toll of A/H1N1 flu reaches 17 in New York ( 2009-06-13 )
# Honduras suspends school activities due to A/H1N1 flu ( 2009-06-13 )
# Colombia reports five new cases of A/H1N1 flu ( 2009-06-13 )
# Second death, 3,008 confirmed cases reported in U.S. State of Wisconsin ( 2009-06-13 )
# Canada: confirmed A/H1N1 flu cases surge to 3,515 ( 2009-06-13 )
# El Salvador's A/H1N1 flu cases reach 95 ( 2009-06-13 )
# Costa Rica confirms 6 new cases of A/H1N1 flu ( 2009-06-13 )
# Brazil confirms two new cases of A/H1N1 flu ( 2009-06-13 )
# Nicaragua confirms 21 new cases of A/H1N1 flu ( 2009-06-13 )
# A/H1N1 flu situation closely monitored in Asia as WHO raises alert level ( 2009-06-13 )
# Community transmission of A/H1N1 flu appears to decline in New York City ( 2009-06-13 )
# U.S. A/H1N1 flu death toll rises to 45 ( 2009-06-13 )
# HK confirms 10 new cases of A/H1N1 flu, passengers tracing practice adjusted ( 2009-06-13 )
# Chinese mainland confirms 17 new A/H1N1 cases, total reaches 143 ( 2009-06-13 )
# Saudi reports three new A/H1N1 cases ( 2009-06-13 )
# Singapore confirms 6 more cases of A/H1N1 flu ( 2009-06-13 )
# Germany confirms more A/H1N1 flu infections ( 2009-06-13 )
# Thailand reports 43 new cases of Influenza A/H1N1 in one day ( 2009-06-12 )
# Hong Kong confirms 8 new cases of A/H1N1 flu ( 2009-06-12 )
# Egypt reports three more A/H1N1 cases ( 2009-06-12 )
# Thailand confirms 2 more A/H1N1 flu patients ( 2009-06-12 )
# Confirmed cases of A/H1N1 flu rise to 114 in Oklahoma ( 2009-06-12 )
# Vietnam's A/H1N1 flu cases rise to 25 ( 2009-06-12 )
# Morocco reports first A/H1N1 case ( 2009-06-12 )
# Massachusetts reports 1153 confirmed cases of A/H1N1 flu ( 2009-06-12 )
# Second death, 637 cases of A/H1N1 flu confirmed in U.S. state of Connecticut ( 2009-06-12 )
# New Zealand's influenza A/H1N1 confirmed cases rise to 34 ( 2009-06-12 )
# Confirmed cases of A/H1N1 flu rise to 2,050 in Texas ( 2009-06-12 )
# A/H1N1 flu infection toll rises to 71 in Ecuador ( 2009-06-12 )
# WHO's pandemic declaration not to change Mexico's response to A/H1N1 flu: minister ( 2009-06-12 )
# Influenza A/H1N1 alert upgraded in Fiji ( 2009-06-12 )
graham June 13, 2009 - 8:50am

1st death after 2096 confirmed cases. The flu is less lethal than earlier. BBC.

237 new cases during the last 24 hours -> epidemic is spreading efficiently in the UK despite summer. I assume they export this first to the Netherlands.


--Sell Texas to China!

Singular June 14, 2009 - 3:39pm

Suddenly there were now 18 new deaths in the USA in a week even if the virus is not especially common because of summer.

The focus will move from counting sick people to counting deaths.


--Sell Texas to China!

Singular June 14, 2009 - 3:54pm

stuff.co.nz- The number of confirmed cases of swine flu has risen to 86, an increase of 15 from yesterday, Health Minister Tony Ryall said today.

The number was expected to rise and the Ministry of Health was going to step up its public information campaign about flu prevention, Mr Ryall said at a press conference.

"What we're seeing around the world is that there's a rapid transfer in young people," he said.

"The strategy remains containment. We want to delay the major impact of swine flu beyond the normal winter cycle."

graham June 15, 2009 - 4:51am

abc.net.au - Western Australian doctors are being told they don't need to test patients with flu-like symptoms for swine flu. Doctors are also being advised against prescribing the influenza medication Tamiflu for patients who are not at high risk of becoming seriously ill from the virus.

The Health Department's Paul Effler says because the virus is mild in the vast majority of cases, there is no need for medication.
_______________________
The number of West Australians infected with swine flu continues to rise. The Health Department says there are now 75 confirmed cases of the virus in WA, and 19 probable cases. In total, 27 children have the flu, and 48 adults.

graham June 15, 2009 - 5:16am


abc.net.au - Many sick passengers who flew to Ho Chi Minh City in southern Vietnam have taken fever reducers to cheat temperature scanners at the airport, leading to the discovery of several infected cases later.

Nguyen Van Chau, head of Ho Chi Minh City's health department, has been quoted in state-run Tien Phong daily as saying "a series of passengers" took fever reducers three hours before arrival.

"That's why when they passed through the airport, the body temperature scanners skipped them," he said.

Vietnam has confirmed 26 people infected with H1N1 flu, 23 of whom came by air after travelling in the United States or Australia. Three others fell sick after coming into contact with the infected travellers.

The country requires inbound passengers found with fever to be isolated for seven days.

Clinical investigations of the infected cases revealed they had taken fever reducers, Mr Chau said.
ate, including 144 deaths, according to the WHO's latest figures.

Vietnam has so far had no deaths from swine flu.

graham June 15, 2009 - 6:41am

CNN, June 12

LONDON, England -- A person with swine flu died in Scotland on Sunday, the government announced, marking the first known death of a swine flu patient outside of the Americas, according to the latest World Health Organization information.

The patient who died in Scotland had "underlying health conditions," the Scottish government statement said. No information was released about the patient.

"We are now waiting for the results of the death certificate to determine the cause of death," the statement said.

A total of 145 people had died from the H1N1 virus, as swine flu is officially known, as of Friday, according to the WHO. More than two-thirds of the deaths were in Mexico, where the outbreak was first detected. There have also been 27 deaths in the United States, four in Canada, two in Chile, and one each in Colombia, Costa Rica, the Dominican Republic and Guatemala.


They sicken of the calm, who knew the storm.

Raja June 15, 2009 - 7:08am

BelfastTelegraph- A new mother who gave birth prematurely has become the first person in Europe to die while suffering from swine flu. The 38-year-old woman died over the weekend at a hospital in Paisley, Scotland. Doctors say she had underlying health problems. She gave birth almost three months early around a fortnight ago and had been critically ill in intensive care.

______________________
A number of news sites are still posting that it was a male.

graham June 15, 2009 - 7:18am

Reuters, By Maggie Fox, June 18

*Up to 7 percent of population sick in heavily hit areas
*Flu season could last all year this year in US

WASHINGTON - The new strain of H1N1 flu is causing "something different" to happen in the United States this year -- perhaps an extended year-round flu season that disproportionately hits young people, health officials said on Thursday.

An unusually cool late spring [and rainy *cough* global warming *cough*] may be helping keep the infection going in the U.S. Northeast, especially densely populated areas in New York and Massachusetts, the officials at the U.S. Centers for Disease Control and Prevention said.

And infections among healthcare workers suggest that people are showing up at work sick -- meaning that workplace policies may be contributing to its spread, the CDC officials said.

[...]

The United States has been hardest hit, with upward of 100,000 likely cases and probably far more, with 44 deaths and 1,600 hospitalized.

"The fact that we are seeing ongoing transmission now indicates that we are seeing something different," the CDC's Dr. Daniel Jernigan told a news briefing.

"And we believe that that may have to do with the complete lack of immunity to this particular virus among those that are most likely affected. And those are children," Jernigan added.

"The areas of the country that are most affected, some of them have very high population densities, like Boston and New York. So that may be a contributor as well. Plus the temperature in that part of the country is cooler, and we know that influenza appears to like the cooler times of the year for making transmission for effective."

Jernigan said in areas that are the most affected up to 7 percent of the population has influenza-like illness.


They sicken of the calm, who knew the storm.

Raja June 18, 2009 - 11:06pm

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