Tag Archives: swine flu

We may have a pig problem

There is a novel strain of swine flu of the H3N2 type with a lot of infections in humans over a short period of time but over a large geographic area.

The CDC reports 12 cases this week, 1 in Hawaii, 10 in Ohio, and one in Indiana. Seventeen more cases were reported since about one year ago. Most of the cases are found in individuals who had direct contact with swine, but some cases appear to be person to person transmission.

A large number of the recent cases seem to have been in individuals who had contact with swine at a fair. This is fair season across much of the US, and apparently petting the pigs is a cool thing for people, mainly kids, to do.

No one has died of this flu, and few seem to have become gravely ill. Three people with high risk factors were hospitalized in all.

The take-home message, the message the CDC is trying to get out, is to wash hour hands very carefully after you pet the pig. But health authorities are also saying to not eat or drink in the presence of swine at these state fairs. Personally, I plan to stay away from the pigs entirely. That will be hard to do because one of our favorite things to do at the State Fair is to visit the Big Pig. They have one really big pig at the fair every year. It is the pig that won the prize for being really really big. Nobody pets it, though. But a lot of people stand around looking at it while they eat their Food on a Stick. This year, I may glance at the pig from a distance, but I will not be eating my corn dog at that particular time.

You can’t get this flu from eating a swine who is infected. So, I can eat the corn dog, just not while petting an influenza infected swine.

Normally, even though swine do get the flu pretty routinely, it does not transmit to humans. While it is possible that there is just a lot more swine flu among the swine and we are seeing unlikely events happening, it is thought that this flu is a variant that is more transmittable to humans than is usual. In prior years, an average of about one person per year in the US gets swine flu from swine. Over the last few years, this number has gone up and the present situation is seemingly unprecedented. However, there have also been significant changes in surveillance and reporting which almost certainly account for some of this apparent increase. The CDC is not sure if there is a real increase in swine flu occurrence, transmission, or mainly reporting. They say:

The increased detection and reporting of these cases could be occurring for a number of reasons, including one or more of the following factors: First, pandemic preparedness efforts have improved state level surveillance and laboratory capacity to detect novel viruses in the United States. Second, in 2007, novel influenza virus infections were made domestically and internationally reportable. And three, it’s also possible that there is a true increase in the number of these cases, possibly occurring from exposure to infected swine or through subsequent, limited human-to-human transmission.

Just don’t pet the pig.

The CDC report is here and additional information is here and in links therein.

How many people does it take to make a baby really sick?

We have an interesting conundrum. Our offspring (______) is due on November 20th. This places the likely date of birth just prior to Thanksgiving. This causes many people to get very excited because they get to see and play with the new baby. I wonder how mad at me all those people are going to get when they find out I might not let that happen?
Continue reading How many people does it take to make a baby really sick?

How do we know how bad the Swine Flu is so far?

I spent about 45 minutes yesterday in the local HMO clinic. They had turned the main waiting room into a Pandemic Novel A/H1N1 Swine (nee Mexican) Influenza quarantine area, and I could feel the flu viruses poking at my skin looking for a way in the whole time I was there.

Continue reading How do we know how bad the Swine Flu is so far?

Is obesity a risk factor for H1N1 Novel Swine Flu infection?

… or is obesity simply Yet Another Risk Factor in severity of this illness?

Probably the latter, but health officials seem interested in the developing data.

From CTV:

… in a report released Friday, health officials detailed the cases of 10 Michigan patients who were very sick from swine flu in late May and early June and ended up at a specialized hospital in Ann Arbor. Three of them died.

Nine of the 10 were either obese or extremely obese. Only three of the 10 had other health problems. Two of the three that died had no other health conditions.

This hardly settles the question of whether obesity is its own risk factor for swine flu. It’s possible the patients had undiagnosed heart problems or other unidentified conditions.

The report is called Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection — Michigan, June 2009 and is published in MMWR, the CDC’s rapid turnaround publication for disease. The report warns:

This report describes the clinical findings of a limited series of patients with novel influenza A (H1N1) virus infection and refractory ARDS …. This patient group represents the most severely ill subset of persons with novel influenza A (H1N1) virus infection and is notable for the predominance of males, the high prevalence of obesity (especially extreme obesity), and the frequency of clinically significant pulmonary emboli and MODS. All required advanced mechanical ventilator support, reflecting severe pulmonary damage. The pulmonary compromise described in this report suggests that severe pulmonary damage occurred as a result of primary viral pneumonia. Although data are not available, this damage also might be attributable to secondary host immune responses (e.g., through cytokine dysregulation triggered by high viral replication). However, bacterial coinfection in the lung not identified by blood culture or bronchoalveolar lavage cannot be excluded.

The high prevalence of obesity in this case series is striking. Whether obesity is an independent risk factor for severe complications of novel influenza A (H1N1) virus infection is unknown. Obesity has not been identified previously as a risk factor for severe complications of seasonal influenza. ….

Further characterization of severe cases of novel influenza A (H1N1) virus infection in the United States and worldwide is needed to determine the frequency of the findings from this limited case-series.

You can read the report here.

Clearly this is very preliminary and I suspect that this will not develop. In other words, I suspect that existing poor health related to the cardiopulmonary system is a serious risk factor with any flu. But we shall see.

The new swine flu: don’t panic, but there is a very bad WCS

I have a handful of comments, mostly about how what you are seeing on the news is unimportant, and one comment about why you actually should worry. Within reason.

The new Swine Flu has now been verified in nineteen US states, with 141 cases. Technically there is 1 death, but since the young girl who died actually caught the flu in Mexico (and came to Texas for treatment) it is hard to say how that should be counted.

WHO characterizes the global spread of the flu as a “rapidly evolving” situation. As of an early morning update from WHO, the swine flu has been confirmed in Mexico (156 confirmed cases) as well as Austria, Canada, Germany, Israel, Netherlands, New Zealand, Spain, Switzerland and the UK. Each of these countries has between 1 and about a dozen cases, except Canada which has 34.

My comments:

Continue reading The new swine flu: don’t panic, but there is a very bad WCS

1970s Swine Flu Training Video

The swine flu maneno in the 1970s was actually a key moment in the history of epidemiology politics. It also relates to the history of anti-vaccine activism in important and interesting ways. I should probably write a whole post about it. For now, suffice it to say that the government reaction to the sudden appearance of swine flu on the scene was somewhat bungled, it is probably true that the wrong people got screwed, and the swine flu itself turned out to be a false start. But please also note that the epidemiology of the present swine flu is very different from what we had then. And, we have a Democrat in the White House so the government won’t screw it up as badly.

How do you know when to start worrying about the new Swine Flu threat?

Well, at some level, you should be worrying now. This is serious. But there are a lot of other things you should be worried about as well, such as the nuclear threat and, if you live in tornado alley, tornadoes. But when do you have to start paying attention to current information, bulletins, and so on, and to perhaps start planning to alter your behavior (like, not going to Mexico, or wearing around a mask and staying in the house, or perhaps something in between)?

Continue reading How do you know when to start worrying about the new Swine Flu threat?