Not much change. The increase in cases continues at the same rate. 2254 cases in the US today. 100 or so in the hospital. One real US death. And this is just the tip of the iceberg, folks. These are CDC confirmed cases only. they are still catching up from last week and at this rate of increase in cases they are falling farther and farther behind. The Flu is out and we are in a national epidemic whether or not the WHO is willing to acknowledge it is a pandemic yet.
And IT'S NOT THAT BAD> This bug is on the level of any other flu. It is not 1918 killer flu. It is last winters pain in the butt flu. It is the fever and aches and stay home from work flu. If however you have chronic lung disease or immune deficiencies or other such chronic illness, you should take precautions just as you would in normal cold and flu season. Elderly patients and infants should be protected as well. Otherwise, take reasonable infectious disease precautions, and go about your daily lives.
I will update on the flu only periodically from now on unless things change.
The one thing about illness is it creates work for me. This is my usual slow time of the year and I'm seeing as many if not more patients than I usually do in the real cold and flu season.
Saturday, May 9, 2009
Tuesday, May 5, 2009
I am working myself to death with this outbreak and cannot find time to get a good update with research. What I can say with certainty is there are 400 confirmed US cases now and 700 probable cases. There are many many more under investigation. The rate of spread seems to have slowed a little but it is still spreading at a fairly rapid rate. Yet there is only ONE death.
A 33 year-old American in a border town with chronic diseases apparently and who was pregnant died of the disease. This is horribly tragic. But from an epidemiological perspective does not increase the perceived threat level from this virus. I cannot imagine the grief her family must feel. I am glad the baby survived. But this is the kind of person the flu kills every year. It is tragic but expected.
I have also seen the Swine flu fatigue set in. I hear constant jokes and criticism of the handling of this disease. I am reminded of living in hurricane country before Katrina with all the cavalier attitudes people had after surviving storms that did not pay off as they had threatened. I fear for this country's ability to handle a killer flu if one arises.
My advice, relax. This virus is still just as likely to keep spreading as it is to fizzle out, but it is not currently dangerous. If you are in a high risk group (young children, elderly, pregnant, chronic disease) or if you are around people in high risk categories, continue to protect yourself. But stay wary. Don't completely let down your guard. This virus can still mutate as flu does. It is still a novel virus and we are not immune to it. And it can become a severe one.
A 33 year-old American in a border town with chronic diseases apparently and who was pregnant died of the disease. This is horribly tragic. But from an epidemiological perspective does not increase the perceived threat level from this virus. I cannot imagine the grief her family must feel. I am glad the baby survived. But this is the kind of person the flu kills every year. It is tragic but expected.
I have also seen the Swine flu fatigue set in. I hear constant jokes and criticism of the handling of this disease. I am reminded of living in hurricane country before Katrina with all the cavalier attitudes people had after surviving storms that did not pay off as they had threatened. I fear for this country's ability to handle a killer flu if one arises.
My advice, relax. This virus is still just as likely to keep spreading as it is to fizzle out, but it is not currently dangerous. If you are in a high risk group (young children, elderly, pregnant, chronic disease) or if you are around people in high risk categories, continue to protect yourself. But stay wary. Don't completely let down your guard. This virus can still mutate as flu does. It is still a novel virus and we are not immune to it. And it can become a severe one.
Saturday, May 2, 2009
Hiney flu fears
People have been stockpiling tamiflu and relenza, the 2 drugs that treat Swine Flu. Pharmacies that fill one tamiflu script every week are now filling 25 a day. The problem is there is a growing shortage of these meds and nobody is sick yet. People have them sitting on their shelves to protect every member of their family. Now if we have outbreaks especially in poorer communities with out easy medical access and funds, there will be no medicine to treat them. This can worsen an epidemic as disease spreads much more quickly in this type environment. Those privileged people who have bought up the meds also can cause additional harm by taking it unnecessarily and breeding resistance.
Why does this matter? Hiney flu is going out with a whimper not a bang. But the flu is a squirrelly bug. It may have shifted to something harmless as a kitten, but can mutate into a tiger and hit the world again next winter. This time we may have nothing to treat it.
Who's to blame. I hold my colleagues largely responsible. Those who are unable to or refuse to say "no" to unreasonable requests by their patients. It is a sad commentary on our professional ethics.
Why does this matter? Hiney flu is going out with a whimper not a bang. But the flu is a squirrelly bug. It may have shifted to something harmless as a kitten, but can mutate into a tiger and hit the world again next winter. This time we may have nothing to treat it.
Who's to blame. I hold my colleagues largely responsible. Those who are unable to or refuse to say "no" to unreasonable requests by their patients. It is a sad commentary on our professional ethics.
Thursday, April 30, 2009
Hiney Flu
Interesting news today, much of it is very encouraging. First Mexico is backing down on its claims of over a hundred dead. They now only claim 12 confirmed cases. They will not comment on how many suspected cases. The initial reports of this virus effecting young adults primarily is no longer being reported. This was the most alarming factor of the news to me and now seems much more remote and less threatening.
Second, genetic analysis of the virus has been reported and apparently although it is very similar to the 1918 Spanish flu, it lacks many markers for genes that seem to signify increased virulence in flu viruses. To put this more plainly, it doesn’t look like a killer. It looks far weaker than initially reported and possibly even weaker than normal seasonal flu.
However, this is still a novel virus and we have no innate immunity to it. So although initial fears of its potential mortality or lethality may have been in error, fears of its morbidity or ability to cause disease are still quite valid. It is currently classified as a level 5 pandemic threat. I believe it will almost certainly become a level 6 pandemic. US cases went up more than 40% again over the last 24 hours to140 and new cases have been reported in several countries including Austria, Switzerland, and Germany.
I have seen the beast in the office. At least I suspect I have. A family in our practice tested positive for Influenza A and the state lab is testing to see if it is Swine Flu. We have not seen flu in our area for over a month now so although it could be sporadic seasonal Flu A, it is very likely the current strain of concern. These patients are not very sick, however. One child had already recovered on her own, and the 6 month old baby only had a fever and runny nose and cough. I know of several other doctors with cases like this, none of whom are very sick, but I expect the number of confirmed cases to continue to rise as these tests are completed.
Precautions are being taken to stop viral spread and even though my personal impressions are that they are probably going to wind up being overkill, I still fully support them. Schools nearby have closed for a week. Large group events are being postponed. This is the right decision. We still have an evolving picture of this virus and when you deal with people’s lives you do not gamble.
On the waste of government effort front, the effort to rename this virus continues. Although it is made up of porcine flu virus with small components of avian and human flu virus that has been found in pigs for decades, it is no longer PC to call in Swine flu. We are now to refer to it as the H1N1 Influenza A virus. I’m now going to call it the Hiney Flu for short.
And our great and powerful Vice President put his foot in his mouth again today saying to avoid travel in planes or subways. His staff, used to this by now quickly tried to temper his words to stay on message with the rest of the White House’s message. The travel industry is very upset. But I don’t think he’s all that wrong. I would avoid large crowds or unnecessary travel for the next week or so and see what happens.
Second, genetic analysis of the virus has been reported and apparently although it is very similar to the 1918 Spanish flu, it lacks many markers for genes that seem to signify increased virulence in flu viruses. To put this more plainly, it doesn’t look like a killer. It looks far weaker than initially reported and possibly even weaker than normal seasonal flu.
However, this is still a novel virus and we have no innate immunity to it. So although initial fears of its potential mortality or lethality may have been in error, fears of its morbidity or ability to cause disease are still quite valid. It is currently classified as a level 5 pandemic threat. I believe it will almost certainly become a level 6 pandemic. US cases went up more than 40% again over the last 24 hours to140 and new cases have been reported in several countries including Austria, Switzerland, and Germany.
I have seen the beast in the office. At least I suspect I have. A family in our practice tested positive for Influenza A and the state lab is testing to see if it is Swine Flu. We have not seen flu in our area for over a month now so although it could be sporadic seasonal Flu A, it is very likely the current strain of concern. These patients are not very sick, however. One child had already recovered on her own, and the 6 month old baby only had a fever and runny nose and cough. I know of several other doctors with cases like this, none of whom are very sick, but I expect the number of confirmed cases to continue to rise as these tests are completed.
Precautions are being taken to stop viral spread and even though my personal impressions are that they are probably going to wind up being overkill, I still fully support them. Schools nearby have closed for a week. Large group events are being postponed. This is the right decision. We still have an evolving picture of this virus and when you deal with people’s lives you do not gamble.
On the waste of government effort front, the effort to rename this virus continues. Although it is made up of porcine flu virus with small components of avian and human flu virus that has been found in pigs for decades, it is no longer PC to call in Swine flu. We are now to refer to it as the H1N1 Influenza A virus. I’m now going to call it the Hiney Flu for short.
And our great and powerful Vice President put his foot in his mouth again today saying to avoid travel in planes or subways. His staff, used to this by now quickly tried to temper his words to stay on message with the rest of the White House’s message. The travel industry is very upset. But I don’t think he’s all that wrong. I would avoid large crowds or unnecessary travel for the next week or so and see what happens.
Wednesday, April 29, 2009
Pig flu update
Our clinics are starting to get flu cases. We had 2 cases today of Influenza A. We're testing for Swine Flu, but the diagnosis is likely.
Us cases increased 50% again to 91. NO deaths. I'm sorry, I do not count a case of this disease acquired in Mexico as a US death. This poor 2 year-old's death is tragic but does not raise my concern level.
The WHO has increased the threat level to 5. I hold out little hope that we will not go to 6. I think the cat's out of the bag and we will have a flu pandemic. BUT! This flu does not appear from current observation to be any different from normal seasonal flu if you look at it's behavior outside of Mexico. I still hold out a good hope that this is just going to amount to an extra flu season in late Spring. My crystal ball (which has never been real reliable to be honest) thinks we will wind up with thousands of deaths worldwide like we do with normal flu, but not be a worldwide plague like we might fear. It could peter out and be far less. It could go the other direction.
I have added the CDC RSS feed to this blog for easy access to their updates and bulletins.
My advice, use good hygiene practices, stay home if you are sick, and avoid large crowds. I think the Hockey, and Basketball playoffs are going to suffer.
Us cases increased 50% again to 91. NO deaths. I'm sorry, I do not count a case of this disease acquired in Mexico as a US death. This poor 2 year-old's death is tragic but does not raise my concern level.
The WHO has increased the threat level to 5. I hold out little hope that we will not go to 6. I think the cat's out of the bag and we will have a flu pandemic. BUT! This flu does not appear from current observation to be any different from normal seasonal flu if you look at it's behavior outside of Mexico. I still hold out a good hope that this is just going to amount to an extra flu season in late Spring. My crystal ball (which has never been real reliable to be honest) thinks we will wind up with thousands of deaths worldwide like we do with normal flu, but not be a worldwide plague like we might fear. It could peter out and be far less. It could go the other direction.
I have added the CDC RSS feed to this blog for easy access to their updates and bulletins.
My advice, use good hygiene practices, stay home if you are sick, and avoid large crowds. I think the Hockey, and Basketball playoffs are going to suffer.
The first US casualty of the flu has been announced. This is tragic news for the family and loved ones of the 2 year -old. It is horrible when children die. This is however normal flu behavior, still. Flu deaths are much more common in those younger than 5 and older than 50. So this does not change the fact that the flu outside Mexico has not acted like the flu inside Mexico. In Mexico the deaths have been clustered in young adults. That is much more worrisome for a killer flu that kills by cytokine storm.
So stay yellow. Keep watch for a change in the mortality pattern. Do not panic.
So stay yellow. Keep watch for a change in the mortality pattern. Do not panic.
Tuesday, April 28, 2009
H1NI? flu update
There are from the best I can gather only 64 confirmed US cases today. 7 however are now hospitalized severe cases. There are also 2 unconfirmed US deaths. There is no info on any other nation having severe cases as far as I can tell.
New York officials admit to likely having many hundreds of School children sick with what is likely the Mexican flu strain at this time. It also appears to have human to human transmission in the US, another key to pandemic potential.
Pandemic does not necessarily mean catastrophe. What one needs to keep in mind is that 2 out of the 3 20th century pandemics were mild. Only the 1918 one was a disaster.
So, this is not yet a pandemic although the risk level has been raised higher than usual of it becoming one. And this is not necessarily a deadly plague if it becomes one. The key to watch is the rate of spread. So far cases are increasing by 50-100% daily. This is far too quick for comfort. Second, watch for its mortality or lethality. No confirmed deaths outside of Mexico, yet. Possibly 2 in California though. We’ll need to watch this.
On the government stupidity front, our homeland security leader spent much of the day arguing over the name of the virus. Although proper nomenclature marks this as a swine flu due to its genetic composition, she worries about the negative effect on the pork industry and wants to rename it the H1N1 flu. Whatever….
New York officials admit to likely having many hundreds of School children sick with what is likely the Mexican flu strain at this time. It also appears to have human to human transmission in the US, another key to pandemic potential.
Pandemic does not necessarily mean catastrophe. What one needs to keep in mind is that 2 out of the 3 20th century pandemics were mild. Only the 1918 one was a disaster.
So, this is not yet a pandemic although the risk level has been raised higher than usual of it becoming one. And this is not necessarily a deadly plague if it becomes one. The key to watch is the rate of spread. So far cases are increasing by 50-100% daily. This is far too quick for comfort. Second, watch for its mortality or lethality. No confirmed deaths outside of Mexico, yet. Possibly 2 in California though. We’ll need to watch this.
On the government stupidity front, our homeland security leader spent much of the day arguing over the name of the virus. Although proper nomenclature marks this as a swine flu due to its genetic composition, she worries about the negative effect on the pork industry and wants to rename it the H1N1 flu. Whatever….
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