Person-to-person spread of Tamiflu-resistant strain of swine flu
Health officials in Wales say a strain of Tamiflu-resistant H1N1 swine flu has passed from person to person in a Cardiff hospital. The first news of this story was broken on this blog just a couple of hours ago. The National Public Health Service for Wales says that five patients at the University Hospital of Wales in Cardiff were all diagnosed with swine flu resistant to Tamiflu. All have severe underlying health conditions. Three appear to have acquired the infection in hospital.
We know that sporadic resistance to Tamiflu has developed in individuals being treated for swine flu. But this appears to be the first definite case in the world of person-to-person transmission of a Tamiflu-resistant strain. Another case reported in the United States by the CDC in September had a number of other possible explanations.
In truth it's not easy to be absolutely certain that there has been person-to-person transmission in Wales. Chris Lines, director of communications for Public Health Wales, said "we can't find any other explanation for this, so our confirmation of person-to-person spread is based on the lack of evidence of any other means of transmission."
He gave some more detail about the patients: "Of the five, two have recovered and been discharged having recovered. Of the three in hospital, one is in critical care and two are on the wards but being isolated from other patients."
So how important is this? Hopefully this will be a viral dead-end and it won't go any further. I'm told all the patients were immunocompromised and so especially vulnerable to developing Tamiflu resistance.
Dr Roland Salmon, director of the NPHS Communicable Disease Surveillance Centre, said:
"The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment."
Finally, just to stress, there's no evidence or suggestion that a "new" Tamiflu-resistant strain of H1N1 virus is now "out there" in the community. But public health officials in Wales will be very busy this weekend tracing contacts to ensure they have contained this among this small group of patients.
~RS~q~RS~~RS~z~RS~53~RS~)
I'm 
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It was bound to happen. Surprised it didnt sooner considering how many doses we have given out.
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I was wondering about this the other day. In my un-educated mind I wondered if the flu vaccinations can be a cause of mutation as the virus has to work harder to infect people? Is that nonsense? Now that this has happened, it seems to be rather the same kind of thing. Were the patients treated with relenza and how did that work out?
What could be the consequences of this then, if it spread? Or is it really not that important in the grand scheme of things?
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Well.... I honestly dont think it will make much difference.
We are the only country in the world that gives out tamiflu like skittles. And we have a similar case fatality ratio to countries that barely even use antivirals. So if this actually spread, which i doubt it will. I really dont see it making any kind of noticeable difference.
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The infections in Wales may have passed from a person using Tamiflu to patients who haven’t taken the drug, raising the possibility that a hard-to-treat form of the disease may spread, according to the U.K. health agency.
The patients in Wales all had blood diseases that weakened their immune systems, either because of the condition itself or the chemotherapy used to treat it, according to the agency. Resistance to Tamiflu is known to occur in patients with weak immune systems, it said. All the Welsh patients remain sensitive to GlaxoSmithKline Plc’s Relenza, another antiviral treatment, the agency said.
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And about all these mutations that are being reported every other hour... Its just silly. These things have been happening since the virus was first found. Its nothing significant. Its not even something thats spreading. It wont make a damn difference to the case fatality ratio and its just another thing for theorists to stick their nose into and portray it as truth.
Again. If the WHO, the CDC, the HPA, the BBC, if you arent getting your info from these sources, odds on its not worth paying attention to. THe niche sites arent something the average blogger should bother delving into. They are hard to understand, filled with technical jargon, and are in general packed with myth and lies. Ive seen tens and tens of mutation posts in blogs. Each one as stupid as the last.
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Good post osteogenesis.
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Skyline,
No, you are not the only country giving anti-virals out like candy. Tamiflu is being widely offered in Canada as well. As of end of October, more than 1 million doses have been used, in contrast to about 300,000 total over the previous 5 flu seasons. And Norway is allowing Tamiflu and other antivirals to be bought over the counter (without prescription). The WHO official recommendation is to start anti-virals asap with suspected flu cases--waiting for lab results costs lives.
I have been wondering how much of the lower-than-expected death totals from H1N1 are due to anti-virals (my understanding is that this is the first flu pandemic for which they have been available, being a medicine that only began to be widely available in the 1980s). I have also been thinking that widespread and indiscriminate use of anti-virals will lead to anti-viral resistance in precisely the same way widespread and indiscriminate use of antibiotics led to bacterial resistance. But, on the other hand, there is clear evidence that starting anti-virals within 48 hours of onset of symptoms leads to far better outcomes than starting it later, and in the real world this often means starting folks on Tamiflu without waiting for lab results to come back, or waiting to see is symptoms turn severe. Not saving lives now to save theoretical lives in future pandemics (from anti-viral resistance) is a hard sell.
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Im sure that antivirals have saved a few lives. But im also sure that it isnt a significant amount percentage wise. The case fatality ratio is very similar worldwide. In countries where they dont give antivirals to anyone, to countries where they only give them to people with "at risk" conditions, and countries like UK where they give them to everyone who wants them, they all have the same case fatality ratio. Mercifully small i may add.
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I am not so sure, as there are a variety of reasons why death has been low in different countries, or even within a country. In Canada, we have very different rates of H1N1 death from one area to another (though, as you rightly point out, all low) as flu generally moves west-to-east here, so different regions hit peak at different times. It would be interesting to compare countries with similar rates of hospitalization from H1N1, and see what difference, if any, anti-virals are making.
I recall reading a study (which of course I now can't google easily) that found results like this: of those hospitalized but then quickly sent home, antivirals were started within 2 days of onset on symptoms; of those admitted to ICU, antivirals were generally not started til 5 days; and of those who died, antivirals were not started til 8 days. If anyone can find me a link I'd be grateful!
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I am feeling very anxious again now with news of this on top of the black lung stuff. Hard not to let my imagination trun riot.
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all I can do is sigh...
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Surely these people in hospital would have had the vaccine if they were immuno compromised. Did this happen before they had the vaccine? Or shortly after before the immunity had built up?
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Seems North Carolina in the Us has had a similar thing happen today too...
http://www.star-telegram.com/190/story/1778241.html
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Questions:
I wouldn't be too worried. Severe complications are pretty rare. And those black lungs sound to me just like pneumonia, which while horribly serious, is one of those rare complications we already know about.
But if you're in an at-risk group, just make sure you get vaccinated.
And as for your question at #12: given how many people in at-risk groups don't seem to have had the vaccine yet, I'd say it's quite likely that they hadn't been vaccinated. And it's also possible that they were vaccinated but got flu anyway. Vaccination reduces the risk of flu, but it doesn't eliminate it completely. No vaccine is 100% effective. Think of vaccination like wearing a seat belt when you get into your car. You're less likely to be killed in a car crash if you're wearing a seat belt, but you can still be killed if you're unlucky.
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Further to Disgusted in #14: I imagine that the vaccination itself might not be all that effective either. If the vaccine has a goal to provoke an immune-system response in case the flu does get to them; can it be conceivable that the trigger might be less effective or possibly not effective at all?
I must admit that I had expected the Tamiflu resistance to pop up earlier after initial reports from way back in the day, and given that the seasonal H1N1 already is resistant to it for a fairly large part. On the other hand, it needs to spread as well. As long as it stays limited to these isolated pockets, it might even be somewhat beneficial since it propels the notion that viruses can be tricky and incredibly mutable to the fore again.
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There is a simple answer to this problem. It's called Relenza. The problem ? it's more expensive and this government's priority has been to do the cheapest thing, not the best thing, at every stage of the flu pandemic.
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I am curious to know how often the relenza is being used intravenously in severe cases. I have read a couple of reports where it has been used this way in a last ditch attempt to save a life, and in some cases it has worked wonders. More recently a little girl in the UK who came out of a three day coma after having received it.
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Tinker I read that story too what amazed me about it was how and why did the doctors decide to use Relenza; it seemed as if all else had failed and what made them try as a last ditch attempt?
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Disgusted
- thanks for the reassurance, esp re the black lungs! No I'm not in an at risk group but my Hubby is & he just got the vaccine thankfully. I have 2 teenage kids also low risk too, so no vaccine for them. I think what I'm afraid of most is a strain developing that is immune to the vaccine.
Aminti
- are you saying immunocompromised people perhaps cannot develop much of an immune response to the vaccine? That would make sense. Furthermore surely anyone undergoing chemo would have their vaccination immunity wiped out just like their other immunities too?
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I'm not certain, Questions, hence I put it in the form of a question. My understanding of the human immune system is very limited as it is, and it's never been one of the topics I enjoyed most (I never much liked biology in general.). This makes sense from _my_ point of view, but whether it's true? Not sure.
Re: Relenza - One reported side-effect is that it can cause bronchospasms, which, I imagine, could be quite debilitating if that side-effect happens in someone who already has a chronic respiratory illness (asthma) as well as the flu on top of it. On the other hand, resistance to Relenza has rarely, if ever, been noted. So yeah, the money explanation would make some sense -- including a better marketing plan from Roche than from GSK. (Tamiflu and Relenza respectively.)
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Sounds like we need yet another new and improved(sic) vaccine then Fergus.
Big Pharma laughs all the way to the bank.Again.
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Aminti-interesting question re immunity. My immunologist thinks I may have a specific type of immune deficiency-the acid test for which is vaccination for Bacteria Pnemococcus (or something like that-no good with fancy medical names!). If I have this vaccination, the antibodies I produce will be significantly less than the amount needed to induce a reasonable level of immunity. However, that doesn't mean this is true for all vaccinations, nor all immuno deficiencies.
I have a problem understanding this tamiflu resistant strain of SF. It develops in immuno compromised patients - I get that....but why? Does the virus go more beserk in such cases or something? What is causing this to only to develop in immuno compromised patients, and not folk with immune systems firing cannons, not corks?
The patients involved were all immuno compromised. I've heard nothing about this resistant type of flu appearing for people without this problem. If it could spread that easily, then surely more people wouldn't find tamiflu worked?
What if there was a Typhoid Mary in the hospital-a carrier of this particular strain? If so, I'm sure more people would have caught it? Of course, many people may have, but not bothered with Tamiflu having recovered very quickly on their own. Not everyone is tested, but it stands to reason that these very poorly people are having their blood tested very frequently, so it would show up.
If this is in wider circulation then I have no doubt that many people have just not been picked up as having it.
Also, once you've had the vaccination and developed antibodies, I would imagine it would still be possible to pass SF on to people. Not to mention that as the families of at risk patients won't be anywhere near the top of the priority pile yet, it would be extremely easy to pass SF on.
I guess the question really is whether the resistant SF developed it's resistance once the first patient caught it, or did arrive already mutated? As if these terribly sick people didn't have enough to worry about!
Sorry, just thinking out loud-rambling random thoughts again-I blame the antibiotics!
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Good balanced summary of the situation round the world re Ukraine, Norway, UK!
Good news - Looks like the US is peaking too now (several sources)
http://www.nytimes.com/2009/11/21/health/21flu.html
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Tigerjayj it may start in people with immune problems but its in people like this with genetic variance in their immune systems that we are likely to see a strain that becomes drug resistant, from there with a new strain of the virus with faulty genetic makeup or variance, we could all really be in trouble.
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It is very important to note that, in the NY Times article Questions (#23) links, the D222G receptor binding is actually the D225G that Recombinomics talks about, just on a different numbering system, according to my sources. The writer does reference Recombinomics, or rather, H. Niman, the founder of it, which does use the D225G name -- leads me to suspect that someone put a spin on it.
Spin or not - the mutation has happened repeatedly and has apparently spread or is appearing simultaneously in different locations. The questions now are the same as the questions that one must ask of the Tamiflu-resistant version: Is the spread sustained and if so: what does this mean for the CFR? Norway mentions that there was no apparent spread -- just as in all the other cases that have been floating around since way back in the day. The Ukraine, on the other hand, has those reports of 'black lungs'. If that is a result of the change, then I should assume that the spread is a little more widespread than anyone would hope that it is. (And please note that I use the conditional, not the factual.)
I apologise for my rather alarmist post, but these are the risks in any pandemic - and with more and more mentions of this in the media - alongside more and more mentions that the pandemic has been increasingly mild - I would rather exercise excessive caution and be relieved than exercise ignorance and be caught off my guard completely. It could very well be that this leads to nothing, or that the change will continue to happen occasionally, never spreading much outside a few clusters.
I should point out that the WHO says that "[t]he public health significance of this finding is thus unclear." They say this because the change has only been found in some cases, not in others. And that is really what this is. Unclear.
http://www.who.int/csr/disease/swineflu/notes/briefing_20091120/en/index.html
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Here's what a blog says about the Norwegian finds:
"What are the possibilities? This change isn't likely to make this virus more transmissible. It's already transmissible as hell and doesn't need any help in that department. It isn't in the part of the viral protein that the vaccine is directed against, so I doubt it would make the vaccine unusable. The same is true for antiviral activity, even though resistance to antivirals is likely to emerge via other mutations. CDC and the UK are both reporting some instances of Tamiflu resistant virus spreading from person to person. What the virus means for virulence, however, is unknown. The Norwegians speculated it could make the virus more prone to infect the lower respiratory tract but they are speculating. That would seem to be the major concern at the moment but there isn't much to go on."
Copying more wouldn't be right, so I'll just direct you to the blog I got this from: http://scienceblogs.com/effectmeasure/2009/11/trying_to_understand_the_norwe.php
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Thanks Aminti -
It's all so confusing isn't it? The NYTimes article I posted implies some flu tracker in the US has stated that the same D225G mutation found in Norway is the same as that which is happening in the Ukraine, and the reason for the black lungs is the haemorraging from deeper lung penetration. (They are stating that this mutation is still treatable with Tamiflu.) But the WHO are saying there is no significant mutation in the Ukraine. I wish they would tell us what they believe is happening out there!
Then we have the Tamiflu resistant mutations happening in immune suppressed people periodically around the globe. Separate issue I guess. It helps to keep the two issues separate from a health anxiety angle!
Fergus - can you provide any clarification as to what is going on?
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Oh and the NY times article does imply there is a very definite expectation of a third wave (in December/ January for the US). What scares me most is that such a mutation discussed above might be the standard version of the virus by then. Horrible thought! (A health anxiety mind at its worst sees a planet full of our vaccinated 5 year olds being brought up by the worlds asthmatics, diabetics and immuno suppressed population as they were the only ones got the jabs in time! I do understand this is very unlikely but the mind works overtime. Gotta try not to go there!)
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The mutation found in Norway was said to make the virus more able to infect the lower respiratory tract,but they have said that they have found the same mutation elsewhere, where it has caused severe illness and mild illness too. Also, people who have died have been shown not to have had this mutated strain and there are some who have. So really, how can it be of such massive significance when it does not really seem to make any remarkable difference in the disease?
I have read that there have been changes in this virus but none that so far would be enough to cause a genetic shift to make it more worrisome.
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Questions, I cant get my head round how significant the 'black lungs' story is. I think if our media were to report on the state of some of the poor victims of flu in this country after their deaths were investigated, we would be worrying about a lot more. As it is they dont, which is probably for the best. Trouble is it does bring to mind stories about 1918 etc...... TB apparently is rife in the Ukraine, and I read also a Dr there has said parainfluenza is causing the problem as well as SF?? The Who have said that the Ukraine are currently experiencing the same flu activity as Russia and Poland, so keep listening to them I guess. We will know if there is ever anything new to worry about.
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All valid points Tinkerbell. The image of black lungs in relation to swine flu mutation is pretty horrifying. It could well be unrelated, but I would just like to know what caused it, and whatever it is, is it spreading. I suspect we would have reported black lungs over here too if we'd had them - there must have been quite a few autopsies.
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Wow! Some really interesting stuff here - thanks everyone! That's why I love this blog - lots of fascinating information appears from other people's conscientious research.
I'm not sure that the 'black lung' issue is anything we need to worry about - with the amount of SF around the world something as significant as this would surely have reared it's ugly head before now?
I also agree that the regular SF virus doing the rounds is so effective at onward transmission it is highly unlikely that the Tamiflu resistant strain will get a hold. Is it possible that the resistant type can only get a hold in immuno suppressed patients, where regular immune systems can fight it off? If this is the case, then most people have absolutely no need to worry about it. Not to mention the fact that Relenza is available should it be required.
For interest I'm looking at the links posted and other things on the net, but for definitive information I'm sticking with WHO and the BBC (not to mention Skyline and others with much more knowledge of such things).
I don't want to get SF, I want to be vaccinated asap, but I'm not frightened by all these weird and wonderful stories from around the world.
One other thing that I do keep in mind is how different nations are having different experiences of SF. What happens in the Ukraine, Poland, Russia, and even the US are different to the way SF is manifesting itself here. I'm sure we will hear very quickly if anything changes.
I just wish the supplies of vaccine were arriving more quickly at local surgeries. This is surely more important? Fergus, any chance of chasing this one?
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Thank you for your voice of reason there, Tiger. How are you doing now? I totally agree that the lack of vaccine and ICU beds (esp. paediatric) are the stories that should worry us the most right now. The rest may genuinely be a threat or - probably - turn out to be horrible for those involved but not a major risk. I'm glad for you that you're finding the blog interesting right now - tbh I feel more like I'm reading a Daily Mail article.
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With respect angels I think that was a bit uncalled for. I guess we all have different concerns & "worries". Yours naturally are skewed towards vaccines and care beds for young children since those areas relate to you. Mine happen to be different. Personally, I have been particularly scared recently by things people have posted and articles about the Ukraine and Norway and I have been seeking information and answers regarding these. I don't believe my worries are any less relevant. I do not WANT to worry about these things - By discussion in the blog, I am actually trying to find clarity that they are nothing to worry about.
Numbers of ICU beds are certainly something to look at for future epidemics and waves but may not actually be a problem right now if we have already peaked. Lets hope so.
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Questions - I guess if this was a new development (The black lungs) then we would have heard more about it. The WHO have stated that nothing different is happening in the Ukraine, so either the black lungs is a known reaction or something specfic to what is going on there. I didnt read that this was down just to the mutated strains, so I might be wrong. Thats how I reassure myself anyway. lol
Angel and Tiger - I took my daughter to the Drs this week just to get her chest and lungs checked over, and there were queues of elderly people there waiting to get their swine flu jabs, so I guess it is being rolled out, we are quite remote and I thought it would take ages to reach us here, so hopefully this is a good sign.
Im not sure what to do about my three year old if they call me in for her vaccination.
I agree about the ICU beds for the children esp. Donaldson did an interview a couple of weeks ago, almost moaning that they were going to run out of beds soon. I was furious. Why the hell after "Years of pandemic planning" would they have to run out of beds. Pandemic flu's are known to affect the very young, they should have been more prepared.
And what is the point of him doing an interview to warn us all about it? So we take up the vaccine, what? What is he doing about it?
Good news though that the numbers are falling in new cases. I read in Canada, they think cases may have peaked and one specialist unit was empty due to no-one needing specialist care. Thats just one area though, but still a positive thing to read.
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A great article re the Ukraine and the sensationalism there Questions.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/20/AR2009112004023.html?sid=ST2009112004284
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Thanks Tinkerdell - that is a very rational and reassuring article :) Why our own newspapers are not intelligent enough to report things in this way is beyond me. I would love them to dispel all the scary rumours that have no foundation as they crop up, but it seems that is not possible.
Interesting you say there were queues of "elderly" people getting their swine flu jab in your area. Are you sure it was the swine flu one for that age group?
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Questions, I'm not seeing any clarification of views here, because right now it is too early to clarify anything - the WHO doesn't know but are saying that at present there is no cause for concern and we will not egt any more than that until they know more. All I can see going on right now is a feeding of the anxiety that you and others have about mutation. I don't need to sit here googling foreign websites for possible fears about the lack of vaccine or the lack of ICU beds, that is a reality that we are facing - now, today, this minute. The fact is that if my son gets sf now then it is a case that could and should have been prevented. I'd love to think that the lack of ICU beds is only a worry for future pandemics but every year we get by by the skin of our teeth, it should be a cause for concern every single year for parents of young children. And whilst the figures may show there is a 'peak' we are still going to see high numbers of under-fives needing ICU treatment throughout the next month-six weeks' and there will not be enough beds - the best the Govt can come up with is that they can move children from one region to another. That is the reality, in the UK, spelled out for us by our own authorities, today, not next month or in 'the third wave' or next winter.
And you rcomment earlier on about vaccinated children being raised by those left behind after their parents have died really made my day.
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angels - I was simply seeking clarification over some concerns which others had already raised on this blog. I have every right to ask people's views on these things, just as you have on the issues which concern you most. I am certainly not out to promote the fact that these things are happening, I am searching for disproof so that I can discard them from my mind. I was not the person who reported them in the blog in the first place but once raised I need to question them to be happy that they have no importance. Please respect that.
Discussion of such issues is one of the purposes of a blog such as this. I am not asking you personally to google any websites.
Regarding your last comment - I was describing how irrational my health anxiety can be and the sort of ridiculous images it gives me that even I know would not happen. This is unfortunately a symptom of health anxiety which i have to live with. I am sorry you had a problem understanding that.
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Hang on, I suffered from health anxiety after being told on the telephone on the maternity ward they thought my daughter had meningitis the day after my son was born. Then within a week the girls got chicken pox and I was told that if my son got it he had a 1 in 5 chance of dying. That's on top of the lumbar punture my daughter had when I was 7 mo pg, and the 'we're doing all we can' incident when she was four. My son has a temp today and threw up snot this morning, probably something and nothing but it wouldn't be the first time that 'something and nothing' has led to me ringing an ambulance in the middle of the night. I'd like to think there will be a bed for my kids should we need one but I doubt it. I was so paralysed by anxiety for them that when my son was a little baby I couldn't leave our bedroom with him, my younger daughter had chicken pox after coming out of hospital and I was so terrified of getting chicken pox again and passing it on to my son I wouldn't go near her, I loved her more thanm life itself but was too scared to touch her. It took me ages to bond with her again and I feel like my son's babyhood was a film that I watched but didn't take part in.
Think I don't know what health anxiety is?
Well, I know one thing: don't feed it.
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angels -
I have had health anxiety (diagnosed) for a number of years.
I have had CBT counselling for it.
I am supposed to question my fears which is what I was taught to do at my counselling sessions.
I am seeking alternative more positive scenarios which is what I was taught to do. To do that I seek other peoples views on things which scare me.
I am not feeding it but facing it.
Perhaps we had better leave this disagreement here, I have no wish to argue and don't need to justify myself any further.
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Tinker, thanks for the Washington Post article (36). Makes you realise, although we have shortcomings in the health service in this country, it is nothing like the situation in the Ukraine. It must be so very frightening in these countries and it makes me very sad that they should be suffering so badly. We are indeed lucky that we have the luxury of debating if we want the vaccine for our loved ones and should we take Tamiflu. It has made me feel very humble; thanks for posting it.
Questions and Angel please don't fall out about this; you are obviously very caring,loving mums who are understandably very concerned about your children. You both have a lot to give to this forum and its many readers. X
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Thank you lurking - i have no wish to fall out with anyone :)
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I'm not sure how tight the beds are around here - though the pessimist within me would probably point out that despite our 'superior' (as I've seen it named by an eternal optimist) health care, we'd probably still not have enough beds in the event that the amount of hospitalisations is just a tiny bit bigger than the usual amount from flu. That's before taking paediatric beds into account, of which there probably are not a lot in the intensive care department. A quick overview leads me to suspect that even saying there are 170 (or roughly 1 per 100.000 inhabitants of the country) is a guess on the upper end (delusional end) of the spectrum.
We have had 359 hospitalisations with SF in the last week - which is quite a staggering number if you take into account that the total amount was 911 for anything prior to the 12th of November. An added 39 were on the 'likely' list of infections - what they mean by that I have no idea of. I personally doubt that 360 people admitted to hospital stresses the hospitals all too much. 38 of those (roughly 11 %) were in the Intensive Care. Still unlikely to be a problem, I should think. (Given that I can think of at least six or seven hospitals within 30 miles in north/east/west direction...) But we haven't seen a peak yet - though the graph reporting incidence does show a decreased rise this week compared to previous weeks.
The consultation rate is an odd thing. A literal translation brings me the following: "Weekly amount of consults for ILI or pneumonia at the reporting GP practices, per 10.000 inhabitants.". And it's up at 18.4 at the moment. Compared to a 35.4 per 100.000 for the UK according to your Department of Health. I'm almost tempted to say that your guidelines are a lot stricter than ours are, because this discrepancy is way too big, really, considering we're still rising. (For instance: a rather bad cold with fever also gets added on as being ILI.)
Then again, there are lies, there are damned lies and then there are statistics. I'm rather tempted to agree with that sentiment as it stands.
I have no experience with children, or even with close family/friends, in the Intensive Care. I can only hope it stays that way for at least another few years.
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Lets all look on the bright side............ Jordan has another jungle task to do soon
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Now yorkshire - she is one girl who could certainly do with some counselling! ;o)
Aminti - it's really interesting and helpful to hear another country's analysis of the situation. Just before our drop in reported cases we had a similar reduction in increase. I hope it is a good sign for you...and you are west of us so fits with the reports.
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whoops I mean east of us! LOL
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angels - can we just put this behind us? You & I both have fears about the SF - we are not so very different!
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There is (finally!) some evidence that the pandemic (at least this wave!) has peaked in Canada in some areas. But it's a darn big country, so we have some areas still heading towards peak. Hopefully the peak will cause less death in these areas: as the vaccination program began at the same time in most provinces, and was distributed per capita, then if the vaccine works we should see fewer deaths in regions that began vaccinating a few weeks before peak. This sadly was not the case in Alberta where I live, where rates of ILI and school outbreaks (showing rate of infection) skyrocketed just before the vaccinations began. And further, Alberta was the only province not to vaccinate high(er) risk folks first; it was a "we'll jab whoever shows up!" policy. Alberta now has the highest hospitalization and death rates per capita in the country (save Nunavut, which has its numbers skewed by very low population). Draw your own conclusions.
Speaking of Nunavut, the area of the country without cases (and hence no one in the specialist care that someone mentioned) is in Nunavut, and the most northerly part of Nunavut at that. Nunavut--ALL of it--has a population of less than 30,000. Canada's population is about 33 million. So good news, but a small piece. :-)
Oh, and peak is usually measured in terms of outbreaks in schools and ILI consultation rates. Those have definitely declined in some areas. But peak hospitalizations and deaths don't occur til a bit later (when the folks who got sick during the peak of infection discover they are ill enough to require medical care.) So it'll probably be another week or two til we see these rates decline significantly here.
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Questions, I totally agree about the need to face your fears. You face them by checking out the WHO, the HPA, the BBC, asking questions of people like Skyline, talking to your GP. You don't face your fears by googling unknown foreign sites and least of all the British press (or the US, from what I've seen.) That really is feeding them, because with foreign sites you can have no way of knowing their veracity, and we all know that the British media almost exclusively relies on getting its readers hooked in through fear - that and sex. It's also worth bearing in mind that on a blog such as this we have no idea if the person we are blogging with is what they appear to be or if their emotions are genuine. I used to hang out on Mumsnet and there were all sorts of weirdos trolling on there - goodness knows what they were getting off on. I am not referring to anyone in particular on this blog, and obviously quite a few of us have been around for a while and try to support each other, but I do think it wise to exercise caution on any public forum. I think it is possible that people do get excited about being the first with a piece of unsubstantiated news, and some just get a kick out of causing fear and panic.
I may not have been as lucky as you to get offered CBT (the only option I had after my son's birth was counselling with a year long waiting list) but I do know that there is a fine line between facing up to things and keeping yourself well-informed (which is 100% necessary) and living in such a way that only helps the fear and anxiety to grow. I've said before, very few things that we believe can stand up to the question, 'can I possibly know that this is true?' When looked at that way, very few things are cause for anxiety.
Ironically my Daily Mail comment initially wasn't directed at you in particular, but this blog in general. I also think it acts as a distraction from the shambles that is being made right in the here and now (and I would have to really do some work to convince myself that that isn't true!)
Anyway, it's forgotten, no worries.
Lurkingmum, thank you. xx
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questionaplenty, i have recently been told i suffer from anxiety, but even before that i believe the same thing, we have to question our fears because knowledge dipels fear, the more we learn about something, the less we fear it, thats why although i don't post often i am always here, every day, because the links and information provided in this blog are invaluable, i to share your worry over the black lungs, but there is very little information at this time, give it a couple of days and there will be loads on the subject, this is the internet after all
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Risa - that's great news about Canada too! I was very interested to read flu in general there moves West to East!
Angels - to be honest, generally I do keep my googling to positive things like "swine flu peak" and I do this because it helps me to read any positive news (whatever the source) and the US NY Times link I came across this morning I found as a result of exactly those words to be very well written, informative & balanced and I posted it because I believed it added something informative to the blog.
Re the Ukraine - just so you know where I was coming from... I had been alerted to the Ukraine scare story already by a poster on here, I ignored it for some time, but when it appeared in the UK press (and I came across this because a friend mentioned it to me, not by Googling), it did start to concern me a lot. Hence I raised the issue of the article on this board. It helped a lot to have a discussion on here about it, to discern other people's views and to realise that other people are not particularly worried about it.
Glad we have cleared things up. I do try to be positive most of the time but have to voice when things worry me as I'm sure you'll understand.
Yes the CBT was very helpful and turned things around for me tremendously. (There are some very good books on the subject if you are interested & haven't already come across them.) My course was on the NHS but I had to wait 6 months for treatment after an initial consultation. (I'm a big fan of Claire Weekes too - I'm sure you have heard of her.)
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Bit concerned about this mutated virus appearing across Norway and Ukraine. If this is spreading, it's likely it's the reason for high death tolls in Russia, Turkey and Italy.
For the first time I'm thinking of stockpiling water and food. Better before the panic starts
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Aminti,
The 359 hospitalizations in one week stat you gave--is that for all of the UK, or just a small region? By way of contrast, the week of Nov 8-14th in Canada, we had 1674 hospitalizations from SF in the country (pop. 33 million) and 413 in Alberta alone (pop. 3.5 million). There was some scrambling here--extra staffing needed, extra ICU beds and ventilators, non-essential surgeries and other procedures delayed--but the strain was coped with. I do not know how many doctors, hospitals etc. you have per capita there, but I can tell you Alberta in particular is under-served wrt health care (mainly because this is the fastest growing region in Canada, and infrastructure hasn't been able to keep up). My point is that we've coped with a horrendous week, and got through it with high deaths compared to earlier, but what are still, objectively speaking, small numbers. (84 deaths in Canada in one week, of which 22 were in Alberta. During the first wave, April to August, there were 77 deaths total for the whole country). If this truly is (near) peak, it is honestly not that bad. Tragic for those who've died, of course--I in no way want to diminish that--but we're hardly talking Spanish Flu 1918-type numbers, are we?
And Questions, I'd love a list of some good books about CBT. (Assuming this means cognitive-behavioural therapy?)
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See Questions, much as I like the NY Times article it is still bigging up the paediatric deaths, and as the mother of young ones that is what freaks me out. And will do until they've been vaccinated.
The Ukraine scare story...that was posted before very much was known, but during the summer there were similar stories (not to mention pneumonic plague) freaking everyone out and nothing came of it. Maybe it is just where I focus but I tend to look at the immediate dangers rather than possible future ones, not least because the present moment is all I have and the future doesn't actually exist. If I'm off up there living this future life, where sf has mutated or whatever, who is living my life here and now?
I have read a bit about CBT but felt that it was something best learned in person, maybe I'm wrong about that. I have studed NLP a little and have found anchors very helpful. I do like Claire Weekes and have recommended her on here. My biggest help is the Work of Byron Katie though, it's life changing. Risa, I don't know if you've come across her, she's much better known your side of the pond?
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Questions, I am on the same page as you in the HA book, Angel is nearing the end and Skyline has finished his. lol
We'll get there. Hope anything I have posted hasnt caused you to worry all the more. Some of the foreign articles are scary, but sometimes some of the more scientific posts on here are just as frightening when talking about mutation - even more so infact as it always sounds like the poster knows what he/she is talking about. lol
Yes they were elderly people in the queue for the jabs, the Dr told me. Although when I saw them a couple of them had breathing apparatus with them so they would have fallen quite neatly into the UHC category.
Lurking Mum - you are welcome. Its nice to read something a little more objective isnt it? We are very lucky to live where we do, its no wonder the people there live in fear of this virus, when they are facing it in the dark. :-(
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Delta, good to see you are still posting. Hope you and your lil girl are well.
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Risa (#54): I'm Dutch, born and bred and still living there. My data reflects the data of a country still in the upswing of a peak and even further behind on hospitalisations due to natural delays involved. Last week (12-18 nov) was the fourth week of a steep rise in incidence as measure via consults, and I suspect there may be one or two more weeks of that before we'll hit the downward swing again. I have no idea what the hospitalisation rate will be in one or two weeks time, but I will find out then. Based on a quick comparison of data, I would tentatively say that we're about 2.5 weeks behind on your Canadian timeline. (Given that this country has 16.5-17 million inhabitants, a comparison is fairly easy to make.)
Location is a bit of a moot point for me to discuss - The Netherlands is a positively tiny country compared to Canada and it's only about 250 miles from the north-east to the south-west of the country, as the bird would fly. I have seen no data on where our 28 deaths have occured, I can only find hospitalisation rates per 10.000 as it stands, which doesn't have a real relevance since it's been documented since the end of April and it doesn't show the hospitalisation rate per health sub-region for the last week. (Or two weeks or month, for that matter.)
Angel (#55): I literally shudder at the thought that one of the children I teach at chess club would die from SF (or anything else, really), and I'm about as a-parental as you can get! I can definitely understand your 'freaking out' about that!
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Aminti,
Thanks for the clarification. I have to admit having a hard time wrapping my head around a country 250 miles across. :-) I'm sure there'd be some regional variance with SF there, but not as much as here. The same week Alberta had 413 hospitalizations and 22 deaths, British Columbia (to my west) had only 154 hospitalizations and 6 deaths (they peaked a few weeks earlier, and also rolled out the vaccinations based on higher risk first), and Saskatchewan and Manitoba, the provinces to the east of me, had 9 hosp/2 deaths, and 12 hosp/0 deaths respectively (they are nowhere near peak yet). BC and AB have about the same population of 3.5 million; SK and MB about 1 million each. This is why it hard to say whether "Canada as a whole" has peaked. Further, in our media, generally when you see "Canada has X-ed" it means "Ontario has X-ed", partly for good reasons (Ontario is by far the most populous province) and partly for bad ones (our media is incredibly Ontario-, and specifically Toronto-centred). A few weeks ago after the tragic death of Evan Frustaglio from SF (healthy 13 year old boy who went from playing in an (ice) hockey tournament to dead from SF in less than 48 hours), the media here kept saying how this was the 6th child death in Ontario. Since Ontario has about 1/3 the population of Canada, this was rather alarming: we usually have 2-5 deaths from seasonal flu per year in kids for the whole country! In fact, it was the 6th child death in Canada--still concerning, but nowhere near as much.
BTW, our child death numbers while higher than with seasonal flu, are far lower, per capita, than in the US. I honestly think the lack of universal health care/insurance plays a role here; the folks who don't have health insurance in the US are disproportionately poor, and the child poverty rate in the US is high. Not seeking prompt medical attention, and not giving medicines--both of which need to be paid out-of-pocket by many Americans--until it's too late no doubt plays a role here. But data from many countries is showing SF of more concern to kids than seasonal flu; they are at higher (though still overall low) risk.
And Angels, yes I've heard of Byron Katie. She's the "accept everything; things are as they should be" lady, yes?
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Delta, I'd missed your post, good to see you and I hope that you and your family are well, I've thought about you often. I know how paralysing and demoralising anxiety is (as I said, I couldn't leave my bedroom with my baby son) so if I can help in any way please shout.
Aminti - as mch as stories about children dying upset me and would reduce me to tears, often for days, I never really thought it could happen to mine. Then my friend lost her son very suddenly to menigitis just prior to my daughter getting sick and it really came close to home. It can happen to anyone, at any time. Life is incredibly precious, and especially your childrens' childhood because every day there is always some little loss to mourn - the day they don't need their buggy, or their bottle, or they go off to a friend's for tea without you. It's good, but it's still a loss, something goes that you can never get back. Although my anxiety is under control most of the time I am still very angry that I didn't get to enjoy my son's babyhood because I won't be having any more.
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#59 Yes, Risa, what Byron Katie says is that if you try to argue with reality ('this shouldn't be happening!') then you lose, every time. I've heard her on audio and read transcripts of her 'Work' with people where she's got them to accept everything from sexual abuse to child bereavement to cancer. Absolutely amazing. If I had the time I'd really like to get to grips with her method but it does take a lot of time, in my experience, but I've certainly used it to heal my elder daughter's birth trauma and subsequently not being able to breastfeed. And if I had the money I'd fly off on one of her week-long courses like a shot. Ah well, as she says, if I'm meant to do so then one day I'll find myself on a plane. She also has this idea of just asking, 'is it true?' - so few things really are because we all believe our stories about our worlds. You can check her out at thework.org.
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Life is very fragile and precious but we as a species and generally as individuals are also incredibly tenacious. You were asking, Angel, the other day if my kids had any chronic problems and I said what they are. And then I remembered (how could I forget!) my eldest son had asthma from age 1 to 7 and I didn't tell you that and yet it absorbed me totally for 6 years. I used to sit beside him night on night breathing for him, fearing every cold, every infection, all the rest of it. And here I am, forgetting. And here he is, a great 18yr old lump of a thing and my only worries about him are that his attitude ought to improve! Just shows you!
My point is, all of you with HA, small vulnerable kids, whatever, will be alright. That's the overwhelming likelihood. This danger will pass and then the next thing will come along to absorb us. Life's like that. Don't worry.
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Are the Govt going to review the use of Tamiflu now then? If this resistant strain becomes common what will they do to treat it? If they choose to roll out the relenza rather than the Tamiflu, then dont they risk SF becoming resistant to that also?
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Seems there's quite a few of us in the same HA boat here - probably not unexpected on a blog like this! About to pop off to bed but wanted to reply quickly to you...
delta - I'm sorry you have HA too. I guess as you say we have to play wait & see with some of these articles!
risa - yes CBT = cognative behavioural therapy :). The book I was recommended to follow whilst undergoing my counselling was Manage Your Mind by Gillian Butler & Tony Hope.
angels - I wasn't on this thread in the summer, didn't have the forerunner scare stories so maybe the Ukraine stuff hit me a bit harder.
Tinker - thanks - as you say we shall all hopefully get there - I'm a lot better than I once was!
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Joan - thank you - that was a sweet post!
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Yes, Joan, you are so right - life is fragile but people are very tough, even tiny children. My eldest was oxygen deprived during her delivery, I ended up needing a crash section and when she was born her apgars were 1 and 2. She had an abnormal brain scan, her kidneys weren't working, and where she'd been resusccitated her lung had collapsed. She was in NICU for four days' and home within eight, fully recovered. A tiny baby! they monitored her for a year instead of the two they normally do because she was doing so well, and the only possible problem they told us to look for was breathing problems like asthma which she's never had. Funny, she was lietrally ten minutes' away from dying and yet she's the one I worry about least!
I can well imagine how anxious your son's asthma made you, although my boy has ENT problems rather than chest my husband has a family history of asthma and bronchitis and he's always listening for my son's betahing, which I don't in the same way. Poor boy, he's just got up to watch Tractor Ted, he's so full of snot he's throwing up. All well,gives me an excuse for a cuddle on the sofa!
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That's my son's breathing - terrible typos - getting the same cold I think.
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So so right Joan, thank you too. My HA has crept up again these last few days what with 'black lungs' 'mutation in Norway', 'Tamiflu resistance in Wales' '5 year old died in Slough', and its easy to seize upon these stories and worry away. I've been trying to look at the positives: 'probably peaked in US' 'cases down in UK last week' 'elderberry extract further proof effective against flu including H1N1'. Also kicking myself because I decided not to let my daughter take part in the vaccine trials, and now she probably won't get chance to get vaccinated, she's 5 will be 6 in February, so it's just dodging sf with sambucol, eucalyptus oil and vigilant watching every school day. I so want this to be behind us but I hope I won't be worrying about the next thing. Mind you I saw an absolutely frightening headline in the Independent on Friday "world on course for 6 degree rise in temperature by end of century" and that dwarfs anything else for me, that is the world our children will get if we don't change it now. Did not want to depress anyone or myself but wanted to try to put this sf anxiety into a bit of perspective. Sigh, also tired off to bed. LOL all.
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Universal Mum, just to ease your mind, take a sneaky look at this...
http://www.dailymail.co.uk/news/article-1229740/Hackers-expose-global-warming-Claims-leaked-emails-reveal-research-centre-massaged-temperature-data.html
I worry about everything, but not about climate change. Its all about the money... lol. X
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Angel, I missed your post re your son. Hope he is well soon X
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Skyline (or anyone else interested),
I found the study I was looking for that suggested anti-virals, particularly when used early, were reducing deaths from SF. The study is here:
http://content.nejm.org/cgi/content/full/NEJMoa0906695
It tracked 272 US patients hospitalized for at least 24 hours with lab-confirmed H1N1. There was info on anti-viral use for 268 of these patients. Of those hospitalized with non-severe illness, the median time from onset of illness until anti-virals were begun was 3 days. For those who ended up in ICU (67 patients), the median time from onset of illness til anti-virals was 6 days. For those who died (19 patients), it was 8 days. Similarly, among hospitalized patients, 62 of 139 (45%) began anti-virals within 48 hours of onset of symptoms (this the the official recommended window now for maximum anti-viral effectiveness); for ICU patients 13 of 56 (23%) began within 48 hours. None of the 19 who died began anti-viral therapy within 48 hours of onset of symptoms. All this data was found to be "statistically significant" via the complicated math method scientists have to determine these things.
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#66
It's no wonder at all that you worry about your kids given your dreadful experiences Angel. It's hardly even as if you have HA because your experience of childhood illness is so extreme. You are conditioned to get hyper-worried because experience has shown you you should be. And yet your kids are here, aren't they? I hate it when the little ones cough and cough away and finally chuck-up, it's dreadful. But better out than in, eh? I hope your son picks up this morning. And when he grows up, which he will, he won't remember the sickness, only the cuddles on the sofa, you mark my words!
#68 Universalmum, our trouble is we watch too much developing news. All those scary symptoms look like news but when they develop into nothing they'll be forgotten. Maybe everyone who has flu has virus mutations going on in their body but nobody knows because nobody checks; the virus just stops there. They just get well and we're none the wiser. When my little girl had flu last week she wasn't checked. Who knew what happened to her that didn't happen to my other kids. But she's better now so there's no need to check her blood, or the colour of her lungs or what have you.
I'm going to put money on it: this wave is nearly over, everyone will have a chance of the vaccine if they want it before the next wave, we'll all be here next year to worry about climate-change or whatever the BIG thing is in 12 months;-)
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Hi Joan, I know that you're right, I sometimes feel like we've been bombarded by stuff, yet as you say none of it turned out to be that awful and they are all still here. Amongst other incidents there was the time that my middle one's temp shot up over 40 and teh paramdeic rushed her to hospital; she threw up loads of bright yellow snot and then her temp went back down so they sent her home (so I do agree about better out than in!) Then there was the time she got faecal vomiting which resulted in another dash by ambulance, they put us on the surgical ward(it's usually caused by a a twist or blockage in the gut) but the next morning she was right as rain and the xrays showed nothing, and she was eating and drinking okay so she got sent home being told it was a 'virus'. I wasn't happy with that and spoke to our GP who said that the only explanation she could come up with was that her stomach glands had swollen in response to the cold she was fighting off (as most kids' do) and somehow it had temporarily blocked her gut. So you see why I'm always on my guard. And yet she's always got better, very quickly, and is by far and away the most independent of my three - it's just us that freak out. Oh, and I've seen first hand how pushed our hospitals are over the winter, we waited five hours for a bed last time.
Tinkerbell and Joan, thank you, my boy is on the mend, no sickness this morning although he was up late coughing. He's passed it on to me and it's gone right on my sinuses bt it's nothing out of the ordinary. Had a terrible night though.
Re global warming, it seems almost certain that we are entering a period of cooling - the experts are divided over whether it will then start heating up again or continue to cool. The science behind the idea that the polar ice cap melting could cut off the gulf stream is, as I understand it, perfectly sound and rather than getting hot we could find ourselves with a climate like Alaska.
But long before that peak oil will get us anyway. As I understand it we have less than 15 yrs reliable supply left (most of it is in the hands of people who aren't exactly our best buddies). It's not just a case of not being able to fly to Torremolinos any more, we will also lose our main source of fertiliser and plastics. Our best bet is to get some nice big grown up nuclear power stations asap.
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Hi Angel, glad you're son is OK. Sorry about your night, but I'm quite amazed that you are still putting words together - I can only groan after nights like that - lol!
See what I mean about your worries being quite understandable! And I wonder if you don't have Post-traumatic stress. It wouldn't be a surprise. But you do sound strong and resourceful. Hope things feel better and you get a little space to get over your own cold.
You talking about global warming - that's it, I'm not going to worry about anything ever again, there's too much, will just put my head in the sand and whistle:-D
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By the way I should say that I realise how lucky we are that our children do not have any chronic problems of the kind that make these dashes to hospital inevitable.
I've just been reading the Relenza leaflet on the Glaxo site. It seems that it doesn't cause nausea. I'm wondering how feasible or sensible it would be for people who are 'at risk' or who have 'at risk' household members to have some on standby until they manage to get the vaccine. It can be used as a preventative too, although it can't be taken by the under-5s.
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Joan, re PTSD, I don't get flashbacks which I understand is a feature of that. It is a cliche but time really does heal and it is putting distance between what happened and now that really helps. But when the sf story broke earlier this year I was right back there, with that paralysing fear again. It was through geting information via this website and in particular discovering this blog that I managed to get a grip again, so I do agree that facing your fears is the only way to deal with them. Thanks to Skyline and the fact that sf has turned out so far not to be so bad I've got back near enough to normal, although I still have my moments! Thank you for your concern and kind words, it does make a difference. :-)
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I don't want to worry you, but a mutated H1N1 is quite widespred. Interestingly the Ukraine have their own local problem. I have no idea though why it isn't being broadcast.. Please have a look at this. This isn't some 'kook' website. The topic is opened by a Dr Henry Niman.
http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=3206
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Did any one out there know that there are two types of Swine Flu vaccine available?
One is made by SMITH KLINE GLAXO (SKG) the other by BAXTER.
The SKG vaccine contains an adjuvant to allow the body to absorb the vaccine more readily. The BAXTER one has no adjuvant.
The adjuvant in the SKG vaccine is called SQUALENE and has a known history. It was present in the vaccines administered to Gulf War participants in 1990-91. The on set of the symptoms of Gulf War Illness have been traced to Squalene along of course with other factors. But it has been medically proved that Squalene is one of the main protagonists.
Now that the Government is offering the Swine flu vaccine to under fives there is a clear and present danger that in up to ten years time a whole generation of teenagers could have their lives affected by the effects of Squalene.
To avoid this choose the Baxter vaccine which is readily available in the UK and from GPs by consultation.
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Define, it will be broadcast once the WHO is clear about what is happening, right now it isn't, and it is true that these mutations have been around for a while. As for expert and medical opinion, well this year I've heard UK deaths from sf as predicted between 1,000 and 150,000, by experts.
All we can do is wait and see.
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Geoff, as I understand it the Baxter vaccine is only available for those with egg allergies. I don't think GPs have any option over who gets what, and neither do their patients.
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It seems very unlikely we have peaked or we have gotten off very lightly compared to other countries
http://www.flutrackers.com/forum/attachment.php?attachmentid=5081&stc=1&d=1258752062
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I don't know a lot about viruses, but am I right in thinking at some point we want sf to mutate itself out of existence? If this new strain is more difficult to pass on maybe it is doing just that.
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Questions, please don't read DefineReal's link. It has half scared me to death. Don't go there......
x
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Ryan, those graphs are interesting. I am assuming the red line is SF infections and the grey line a regular flu season? If that is the case, then I can see where you're coming from. However, it could just mean that the absence of a soaring red line for England means that we're trotting along ok. With the vaccination programme underway (albeit very slowly) and herd immunity developing, this red line may well stay as it is or even drop.
If the red line is the mortality rate then we're obviously very lucky and I can only assume this has to do with free medical care and hence early intervention.
I have never been to the Ukraine, so I cannot say what their living conditions, health care and general diet are like. However, many of the severe SF cases with pneumonia complications are in isolated (and I guess hard to reach) places. I would imagine this means that people living there would be less able to access good quality medical care, and possibly have to pay for it. The advice on the WHO website re the Ukranian situation states that the current SF vaccines are still effective against it, even if there is a slight mutation.
I have to stress again, we need faster supply of this vaccine and faster distribution of it to get the vaccination programmes around the world moving full steam ahead. There have been no announcements/press releases about the lack of supply to meet demand. I really am beginning to think that the Pharmaceutical companies had inadequate pandemic action plans in place. It's high time they were taken to task over this. The only other reason I can think of is the money these vaccines cost. I know enough for half the population was ordered, but wasn't that when 2 doses were expected to be needed? If we had that amount, then with one dose only needed for most now, nearly everyone in the country would be vaccinated. Without laboratory testing, the numbers are totally unreliable, so most people would need to be vaccinated. The longer the delay, the greater the speculation will be-I really would like to see some sort of official statement about this!
With the current weekly increases in hospitalisations and ICU patients (especially paediatric patients), the longer the vaccines take to arrive, the greater the strain on these vital, life saving resources.
IMHO, vaccine availability, ICU's and PICU's are the most pressing concerns right now. This worries me more than what is happening around the world. Governments are moaning about lack of vaccine supply, but there is a deafening silence about why this is and when this will be sorted out.
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I hope that Skyline pops by later with his take on the mutations, having re-read Define's link I must admit even I'm spooked.
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Ryan - all those graphs show is that we have a lower peak than other countries this second wave. we were hit particularly hard back in the summer and as a result many people already have immunity. That is the explanation I'm going with for now anyway. plus tigetr makes some very good points.
enlightened - thanks for the warning :)
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OK enlightened - I had to look, but am glad you forewarned me - thanks!
Actually, the worldwide mutation thing I'm OK with if the % death rate is still the same, it doesn't matter if it's mutated or not (though on a hopefully separate issue, I would still like more info about those lungs - would love to categorically have them ruled out and be told they are not related). They are saying on that forum that this mutation has been around since April, in which case it is surely nothing worse than the original.
Re the Tamiflu resitant version: I'm presuming this is a separate thing - we still have Relenza for serious cases and the virus is still of a form where most of us don't need the Tamiflu. Plus I posted last week about some other antivirals currently being developed. I don't think we are out of weapons yet!
SKYLINE - please can you come back & give us your views on all of this?
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Questions, you are welcome.
Angels, I will be looking out for Skyline, too. I really need to hear something positive. I was worried about SF to the point of it taking over, back at the beginning, but I haven't worried at all for a few months (apart from the odd, fleeting moment when I remember any one of us could have a serious SF case, but then I remind myself it's not statistically likely) Now I'm really scared again, because of so much conflicting info. For now, I'm just letting it all go, and letting what will be, be. It's a conscious decision. What helps me, is thinking none of us is alone in this, whatever happens. We are all here, today, right now, and sharing this experience. I don't know if I'm getting my meaning across very well, but it's something I find comforting.
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Yikes - i just read the second page...enlightened you are right I shouldn't have gone there!
I am trying to hope this guy is an American sensationalist!
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Oh, Questions, I hadn't seen your comment! I know what you mean - you just have to look. The only time I can resist is when it comes to horror films. I have to avoid them, as I'm okay actually watching them, but I will be terrified in the night, for months!! My DH watched Paranormal Activity recently, and I didn't even let him talk about it!
Skyline, why are they saying that the CFR for this D225 (or whatever it is) is:
4/4 Ukraine, 2/3 Norway, 2/2 Brazil????
Please don't shout at me for asking about this D225, as it is cropping up a lot now, and scaring me.
Thanks.
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Questions, our posts keep crossing!! Yes, at the point I told you not to read, I had only read two pages myself. Then I went back and read the rest.....dodn't I ever learn? This guy says he has a PHD in Biochemistry, but who knows??
I should be cooking a roast dinner/helping with homework, etc!
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It does appear if you google this guy's name with sensationalism, some interesting links come up. Apparantly he has a vested interest in flu vaccines.
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Yes, it's the D whatever stuff that freaked me, if it is the same as in 1918. Didn't get any further than pg 2, pg 1 was okay! Am not sure how plausible the idea is that the WHO are spinning this because from what I've seen they tend to be quite negative. However, so long as the vaccine and the relenza carries on working...It's the vision of panic, justfied or otherwise, that gets to me and I'm now wondering whether I should be stockpiling food etc. But as I said before, plenty of 'experts' have been wrong and plenty have contradicted themselves.
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Angel, try not to get spooked by Define's link-I've read through it a few times, and it really is just someone's point of view-nothing more. Effectively a veiled suggestion that the WHO were keeping info from us. I know their annoyncements have a time delay, I imagine this is purely because of the need to be certain of facts. Read all the info on the WHO site-they are monitoring things very closely, and I'm absolutely certain that if the situation worsens they will let the world know.
The person writing in the blog may well be a doctor, but they are also normal people with a right to their own opinion. Take it or leave it as you do the opinions of others on here.
Ultimately, we cannot keep running 'what ifs' in our heads, we can only deal with the 'what is' when it happens. I know HA is a dreadful condition but you and others are amazing in the way you cope. I'm not sure I could and admire you all greatly.
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Ah, very interesting, Questions. So he has an interest is spreading panic then.
Like I said last night, you just have no idea who these people are. Good thinking for googling him.
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It might help some of us who are freaked out by what this Niman guy says in that link to read the following post re this DR Niman on another forum this time regarding Bird Flu. He is described as the "prophet of doom on the internet" and the link includes a description of his background:
http://209.85.229.132/search?q=cache:b73N_8hMhNAJ:www.thehulltruth.com/archive/t-221024.html+dr+henry+niman+sensationalism+prophet+of+doom&cd=4&hl=en&ct=clnk&gl=uk
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Questions, Angel, Tiger, thank you! I wish I could have thought of something reassuring to say. I think I must be having a wobbly day! I'm feeling a bit better now, thanks to all of you.
Off to read Miss Pettigrew Lives For A Day (suitably cheery), before getting down to the things I should be doing!
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Not sure why the link didn't come up blue - I'll try again, else copy & paste should work!
http://209.85.229.132/search?q=cache:b73N_8hMhNAJ:www.thehulltruth.com/archive/t-221024.html+dr+henry+niman+sensationalism+prophet+of+doom&cd=4&hl=en&ct=clnk&gl=uk
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meant to add - you need to scroll down to skiman's post!
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skibum rather!
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Opinion on Niman seems divided, but certainly he's been way off the mark on avian flu. His credentials seem shakey, too, but then it appears that his detractors may have their own agenda. Incidentally Recombonomics (sp?) is his site, or was.
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According to David Mercer of the WHO the Norway mutation is much harder to pass on although it appears to attack lower in the lungs. It is also still 'sensitive' to both tamiflu and relenza. If this is the case, and it carries on respnding to the vaccine, then could this be seen as beneficial in a way because it can be treated but is less contagious? Or am I being thick? Cerainly both the guy in Norway and the WHO guy aren't worried at the moment. If they go around saying everything is tickety-boo (which they are largely at the moment) just for spin and then it isn't they risk undermining their credibility. I don't believe they are being more positive than they need to be. Oh and Niman is described as 'right wing' even by his supporters, and in the US in particular the WHO and the UN aren't exactly popular with right-wingers.
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Yes angels - he certainly seems to have his loyal band of followers but I'm glad to see he has been disproven in the past several times.
He says some very non-technical/medical stuff on define's link too (a few pages in) - like he has been personally infected twice by H1N1 and taken Tamiflu both times? How on earth would he know that it was H1N1? Has he been tested twice? I very much doubt it. Also once infected aren't we at least supposed to be partially immune to reinfection? Why would he need to have taken Tamiflu a second time?
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Yes that was my understanding - the mutated "deeper lung" version in the Ukraine and Norway is not related to the Tamiflu resistant strain. We don't have a mutant which combines both right now according to the WHO.
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I think I owe an appology re: Dr Niman. Clearly his posting of readily available data shouldn't be taken seriously, and as such disregard. It should only be taken seriously if it's on the 6 o'clock news. In the same way you shouldn't read too much into the recently hacked and posted e mails regarding East Anglia Uni.. as that hasn't been mentioned on the BBC news yet (ergo-it doesn't really matter).. and only the actual hack on the blogs.
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According to one thing I've read about him he's a Creationist. Not a belief I have a problem with but I don't see how it can be compatible with a science background.
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It's funny, I looked at Define's link and wasn't alarmed by it at all. It just seemed to me that these were people just typing their thought-processes, no big deal, and something you might get a bit embarrassed about in the cold light of day. Didn't the WHO say that these mutations had been seen in Mexico, Brazil, etc, early in the outbreak? If so, if they were mutations that we should fear, wouldn't they have gone exponential by now? Shouldn't we all be coughing up our lungs? But we're not. Latest sf news: wards set aside for flu patients returning to their pre-pandemic use - that's more like it!
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Exactly joan - even Niman says they've been around since April! :)
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Im not going to read that link. I just keep reading this on the WHO website. Till that changes, Im not worrying.
Worldwide, laboratory monitoring of influenza viruses has detected a similar mutation in viruses from several other countries, with the earliest detection occurring in April. In addition to Norway, the mutation has been observed in Brazil, China, Japan, Mexico, Ukraine, and the US.
Although information on all these cases is incomplete, several viruses showing the same mutation were detected in fatal cases, and the mutation has also been detected in some mild cases. Worldwide, viruses from numerous fatal cases have not shown the mutation. The public health significance of this finding is thus unclear.
The mutations appear to occur sporadically and spontaneously. To date, no links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread.
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Joan, I know exactly what it was that sparked off my reaction, it was the idea of mass panic. One of the things that upset me the most in the early days of the pandemic was those pictures of people in Mexico with their masks on, struggling to find shops open for essentials and basically not being able to go about their daily lives. It may sound odd but the times when my children have been sick, they have been incredibly traumatic but also you have to live in the moment and just get on with it - in fact I have very powerful memories of how close it made me and my little girl when she was unwell. The exception was when our son was born and I couldn't be with her because then I couldn't get on with looking after her, I was just stuck with my mind running riot. I would say that living with the fear of what might happen (or what might repeat itself) is traumatic in itself and really grinds you down.
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He doesnt sound too credible anyway...you were all right...
Perhaps since before recorded history began, we've been fascinated by people who tell us we're all doomed - the end of the world is nigh. Especially, perhaps, those who appear to have special insights the rest of us aren't blessed with, such as visions, abilities to supposedly see into the future.
Now, in an age that's dominated by technologies many of us can use but few of us understand (operating VCRs can seem complex to many people, let alone understanding what makes a computer work), it seems the time has come for a new Prophet of Doom, one for the Internet Era. And that Prophet is one....
Henry Niman
Armed with a Harvard Medical School (where he was an assistant surgery instructor, not a professor as he perhaps likes people to believe) background, and a vocabulary rich in jargon that clearly sets him apart from the rest of us ordinary mortals - "cleavage sites", "sequences deposited in GenBank", "a simple BLAST search" - Niman pours forth a veritable stream-of-consciousness series of commentaries, taking news tidbits from here and there and concocting some truths, and a generous helping of pure baloney, many dollops of which concern his belief that wild birds are spreading h5n1.
Not for Niman the caution of scientists who publish in learned, peer-reviewed journals, and take care with their conclusions, couching them in dull terms that might often make even fellow scientists yawn; no, instead Niman loves to speculate, to leap and jump to conclusions, and to pepper them with both jargon, and colourful terms of phrase that make them irresistible to bloggers, and a goodly number of journalists. - "viruses don't read press releases" being among Niman's ready made soundbites.
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Apparently the vaccine would protect you against a mutated strain....
http://www.digitaljournal.com/article/282524
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I'd read exactly the same thing, Tinkerbell.
Amazing how he managed to take people along with him.
Perhpas in future I'd better take my own advice about a) not clicking on any dodgy links and b) only relying on the WHO for accurate information.
Then I would have had a much betetr Sunday!
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Don't wish to be inflammatory but Creationists have a special interest in end-of time scenarios. That's all this is: a wish-fulfillment fantasy of Mr Nimen's.
I know what you mean, Angel, about the terror of chaos that accompanies sickness, small-scale or big-time. But this is not going to be a return to the 1918s. It's just not. Fair enough, those in the old Eastern bloc and the third world ought to worry, poor beggars. But we have good nutrition, a vaccine, antibiotics, warm houses, mild winters, and on and on. The Government has to prod to take the vaccination because they have the manage the thing. But, at the moment, today, here and now, there is nothing to worry about. Phew:-)
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I do agree there, Joan, our world at least is a very different place from 1918.
Not referring to Mr. Niman in particular, but I have wondered before today whether the religious right regard sf as punishment for liberalism.
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#115 Angel
Maybe they do. And perhaps I think it's to do with the Gaia-principle. I think disease is - you know; pruning. Our needs are in clear violation of the needs of the rest of the planet as a whole. And if we were just a collective it would all be fine. But we're not. We're individuals and we're programmed to defend ourselves. Maye we'll find a balance one day.
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Nearer to home. Swine flue or whatever it will be called next week isn't that dangerous as far as our government is concerned to most of the population. If it were, schools would be closed as children can carry spread viruses easily not just between themselves but back home too, and on buses, trains etc.
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Apologies if someone posted this BBC article from yesterday already but it is quite reassuring re the Tamiflu resistant cases and the fact that they are so much more unlikely in the wider community. It also states the experts believe there are biological reasons why Swine flu is unlikely to become resistant to Relenza.
http://news.bbc.co.uk/1/hi/wales/8371539.stm
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#116 joan, it is certainly true when looked at from a Gaia point of view we are not necessary and Gaia would better off without us. I'm not too sure that I believe that the Gaian principle can account for sf but it most definitely does make sense in terms of climate change, soil erosion, falling fish stocks, even insect plagues - I was reading the other day how certain insect pests thrive where deforestation has taken place. One of the things I used to struggle with was the Darwinian 'survival of the fittest', but from a Gaian perspective it is 'survival of the most co-operative' which not only fits with my sense of a just universe but actually makes a lot more sense. The fact is that Gaia would be much better off without us, 'she' was here a long while before will came along and will continue to be long after we've gone. It's sort of why I find looking at clouds so soothing, I picture them from above and feel how small I am, but also it is a reminder that the Earth had cloud formations in its sky before people ever existed, and the clouds will still be there regardless of what happens to us.
I do find a kind of irony in the fact that when Lovelock was warning up about the effect we were having on Gaia years ago his most voiciferous opponent was Richard Dawkins, and he was the one that was listened to. Now of course it is looking as though Lovelock was right. Maybe if Dawkins, the arch Darwinian, hadn't been so powerful an opponent we'd have listened and changed our ways sooner. But I doubt it.
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Joandunne,
I was going to say the exact same thing that you did in #114. The world is not as it was in 1918: there are so many ways in which medicine, access to medicine, nutrition and so on are different. Instead of asking, Can the 2009 H1N1 pandemic result in death totals like 1918?, lets turn it around: if the 1918 Spanish flu hit the world today, what would the death total be? I have no doubt many would still die--that is the sad reality--but I also have no doubt that antivirals, antibiotics for secondary infections, universal access to health care in much of the first world, ventilators, better (quicker and more accurate) testing techniques, etc.--would make a VERY large difference compared to the 50 million (estimated) who died 1918-1920 from Spanish flu.
So don't panic. Stay healthy (eat well, rest well, play well), wash your hands, take your vitamins, get vaccinated if that is your choice, and go on with your life. The Tamiflu-resistance and 'blank lungs' and genetic mutations of H1N1 are interesting, and need to be continued to be followed and investigated--these are the FACTS--but at this point saying what the significance of these facts is, whether scary or not, is SPIN. Don't lose sleep over spin or you'll drive yourself crazy--there's an almost infinite supply of it out there!
Oh, and this is not a comment about Dr. Niman per se, but I can tell you that at least three other people with "Dr." before their names who post prolifically on SF on the internet have spun facts and data in VERY misleading (outright fallacious) ways. If you want to read the details, let me know and I'll give the links to my blog. (Disclaimer: I am not a doctor, and I make no profit off my blog; I am someone trained in logic/critical thinking who gets rather worked up by bad arguments!) :-)
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Tigerjayj, yer the red lines is SF infections. What bothers me is that our death toll is the highest in Europe, yet more people are getting swine flu in other countries. Maybe other countries are covering up deaths, which seems to be happening in China, Belarus and Russia.
Questionsaplenty2, you could be right. NYC badly hit in the first wave is hardly seeing any cases. What worries me is that 144 of 216 have happened in the second wave (Sep-Nov), yet many more people were infected in the first wave. Maybe more people were worried then so they were more likely to go their GPs.
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I stare at the stars for reassurance, Angel. The immensity of the Universe is a comfort in a paradoxical way, just like your clouds.)
You're right, it is way too simplistic to blame sf or any other illness entirely on the Gaian principle although it does seem to me one mechanism at work which strives for balance on Earth. Even so, my feeling is that even if Gaia would be better off without us she won't ditch us because she's got a bit of a soft spot for the human race, flawed as we are. Hope so, anyway.
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Ryan, ths may be rubbish but it has been commented on before that we record deaths with swine flu. That is not the same thing as deaths from swine flu. In some cases it may be that the person was so unwell that they would have died if they'd caught a cold. It may be that other countries are recordng the deaths in a different way to us, I don't know. We also have pockets of areas that are as deprived as any elsewhere in Europe and we know that poverty is a big risk factor in illness and outcome. As for the reason that death rates are higher now, it is winter so there are a lot more bacterial infections around - people are more likely to develop chest infections for example. In terms of GP consultations and hospital admissions, anecdotal evidence is that a lot more 'worried well' went to hospital in July. A friend of mine works in A&E and she says that they have to get all patients seen and dealt with within a certain time (I think it is 5 hrs) - this means a surge in admissions just before the 5 hr limit to meet the Govt's figures, even if the person is then discharged almost immediately. So more 'worried well' = more admissions to hospital = a lower rate of ICU cases, than when most people turning up at hospital are genuinely poorly.
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Joan, yes the stars are amazing, I always study the moon, too, and try to keep track of the current phase. Nice to think we are made from stardust.
With regards to Gaia, I think there are enough of us who are co-operative to make it and fit in with what she needs.
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Having been lucky enougth to have sat on my own yacht in the middle of an ocean 1000 miles from any light and seen the stars in all their full glory five times now I can say it makes you feel very humble and glad of what you have and just being alive.
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Angelscomeinthrees, you could be right. Some countries report swine flu deaths very differently. In Israel a man infected with swine flu, fell from a buliding, after feeling dizzy. And they included him in their death count. However in NZ lots of people who have died after having swine flu, still aren't included, as they are still finding out how much swine flu was the role in the death. It seems in this country they include anyone who been infected with swine flu.
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I was wondering about numbers of people eligible to be being vaccinated so I looked up some stats. Thought they might interest others in working out timescales of when the next group will be eligible for vaccine and any subsequent groups:
Of our population of 61 million, 9 million are in the current high risk group (including pregnant women).
There are 3 million young children in the next group to be vaccinated, but they will require 2 doses of vaccine.
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Love the Gaia thoughts! Many years ago we performed a modern work for choir and orcestra called 'Cry Of The Earth' by a guy called Tony Biggin. This tells of the anguish of Gaia at all that is happening to her. It is an amazingly moving work-incredibly powerful stuff with both the words and music conveying the story - it made me cry more than once.
If it's your sort of thing, I highly recommend it-the composer has his own site and it may be possible to still purchase the CD. You don't have to be a music buff to appreciate it either!
Regarding an individual's qualifications-some less reputable people can create a whole history around themselves on the internet-i would urge caution in accepting qualifications at face value unless there are dissertations/theses published, quoted comments and articles in reputable journals. However, I'm sure Universities are monitoring these people carefully, and should the Uni's reputation seem to be brought into disrepute they will make sure everyone knows about it!
Btw, wonder if Granny is ok? She's dropped off the radar again.
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Hello all, phew what a fantastic group of people you all are. I read quickly, skimming all 16 pages of that link and got really bad (not to be too graphic) physical symptoms of fear doing it and since I returned here to read the rest of all your wonderful posts I feel much better now and my trembling is finally quietening down. I note that most people on that blog seem to be Americans/in America, where apocalyptic visions abound. (Apologies to any Americans on this blog)
Stars do it for me every time but we don't get too many in London, so I make do with the wonderful weather we have, even mucky old winter weather is good.
I will however, go to my GPs tomorrow to ask what our local vaccine take up has been like, see if my daughter can be considered now/yet. I know she's 5 but can GPs include 5 year olds or is it just those who are up to 5, so 4, at any point up to their 5th birthday? Seems very arbitrary to me.
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Questions-thanks everso for that.
Well, that says 15 million doses required for current high priority group and children.
That's half of what's ordered-assuming every eligible adult and child take the opportunity. I am now asking myself more questions like:
How much has been delivered so far?
How much used for health workers?
How many high priority patients have been vaccinated so far?
How many of the vaccinated health workers were also part of the first high priority group? And how many pregnant women were like the wife of that gentleman who was told being a pregnant nurse she had to get her vaccination at her GP, only to be told she wasn't able to get it yet (if I remember correctly?).
The more I unpick this topic, the more unlikely it seems that 15 million doses of vaccine will be given by Christmas!
What a fiasco! You couldn't make it up, could you!
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I'm going to look through some of Skyline's previous posts-I'm sure he did some sort of number crunching on this when he analysed why GP surgeries only had 500 doses each. I have a vague recollection of a comment from him along the lines of 'seems about right to me'.
However, if I assume there are 8,500 GP surgeries with 500 doses of vaccine, that makes 4.25 million doses across England-not quite a third of the 15 million needed. But that does assume that the high risk group does not include health workers, or people who have been vaccinated at work nor people who have declined a vaccination.
So obviously this is a worst case scenario. But even so, it's an alarming prospect that 6 million doses alone are needed for children. Like Angel and others have said, I can't see children getting vaccinated for quit some time.
As I said before, all the lists in the world are not worth the paper they're written on if there isn't enough vaccine around to fulfil them. A bit like knowing the recipe you really want to make, but not having all the ingredients you need to make it.
Forget trying to scare everyone with stories about mutations and resistant SF-this vaccination story is more than sufficient for us to worry about.
C'mon Fergus-do your stuff-get the answers to these vaccine questions as soon as you can-your bloggers need you!!!!
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Just re-read the NHS Choices leaflet and parts of these blogs.
50 million double doses of vaccine to arrive by December. Also says Pandemrix for children to be given in 2 half doses. Also says over 65's in seasonal flu at risk groups will get the vaccine in first priority group.
By that token and at this time, I would have envisaged a heck of a lot more people would have been vaccinated by now!
Couldn't find Skyline's number crunching-will look tomorrow in more detail as it may have been someone else's.
I just can't make these numbers add up. Sir Liam said a while back that 6.6 million doses had already been delivered and by the end of October all surgeries would have their initial 500. More would follow. This suggests all at risk patients in the first priority group should theoretically be vaccinated already, or at least contacted with an appointment.
Seemingly this is not the case.
Ok, rant over! Off to sleep now!
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Vaccines are good of course. But.... We are dealing with the statistically weakest flu of all time here. So any rush to the vaccine queues isn't very important. Stats from the WHO,CDC, NHS, HPA ETC.... Point to a mortality rate of 1 in 7500 cases in the UK as a worst case scenario.... Well... They are slightly wrong there. Because thats only going on the "symptomatic" cases. 50 percent of all swine flu cases are asymptomatic, i.e they dont even know they have had it. So its fair to say we can double the 1 in 7500 to 1 in 15,000 people.
Now... Lets add to that the 25 percent of all cases that wont be reported to the NHS. We are looking at 75 percent of all cases not actually being counted in the official case fatality ratio of 1 in 7500. This would but us at a worst case scenario,
Case fatality ratio, of 1 in 22,500. I really see this as the way its happening right now. Feel free to correct me, but id like some backing to it rather than "omg you have your head in the sand we are all going to die!".
Hope everyone is good.
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Skyline,
I've been wondering about case-fatality ratio and the "mildness" of SF (or any other flu). It is said that the seasonal flu kills more folks than SF has--both in raw numbers and in case-fatality ratio--and that the vast majority of these deaths occur among the elderly. (I've heard 90% or more of seasonal flu deaths among elderly in Canada, the UK and the US). It is also fairly well established that SF is not striking the elderly in numbers comparable to seasonal flu; only a very small percentage of SF cases are among the elderly, presumably due to some pre-existing immunity they have from living through previous pandemics, like in 1957. But when the elderly do get ill with SF, they are more likely to die than is a younger person, like a child, afflicted with SF. So what I am wondering is, does anyone have case-fatality data broken up by age group, for either SF or seasonal flu?
It seems to me that how "deadly" (or mild) and illness is depends on two things: the illness itself, and the immune strength of those it infects. It is generally accepted that younger folks have stronger immune systems than older folks. So I guess I am wondering, given the much higher than normal numbers of young people coming down with serious cases of SF--more hospitalizations, and at least in some countries, deaths, than we see with seasonal flu for these age groups--if SF is in fact a stronger flu than most seasonal flus have been, and the reason for the low case-fatality ratio is that it has been by and large infecting those with strong enough immune systems to fight it off. If the elderly were contracting as many cases as SF as they do with seasonal flu, we'd be seeing much higher numbers of deaths, and hence a much higher case-fatality ratio.
So that is why I am wondering about case-fatality ratios for each age strata. What is the case-ratio fatality for children (say, under 18s) from seasonal flu? Is the case-fatality ratio of SF worse for this age group, or are the high numbers of children hospitalized or dying from SF due to it simply infecting MORE children than seasonal flu does? What about for adults 18-65? Younger seniors and older seniors? (Most seasonal flu deaths occur among old seniors; in Canada the average age of death from seasonal flu is 82/83; ditto for Australia).
I guess I am trying to pick apart what Fergus called "the Swine flu paradox" (low numbers of deaths overall, but very busy medical facilities) in an earlier blogpost. I think we miss something in assessing our personal risk from SF by focusing solely on the "more people die from seasonal flu than SF" claim, as the distribution of deaths is so different with SF than seasonal. I am similarly wondering if we are missing something by focusing on case-fatality ratio overall from SF vs. seasonal flu. How much of SF's low numbers come from it being a weak illness, and how much come from it preferentially infecting those with strong enough immune systems to fight it off? And why are so many more kids and younger adults getting seriously ill from it: is it a more virulent illness, or are way more young people being infected in the first place? For any given senior contracting SF, are they more likely or less likely to die of it than if they contract seasonal flu? I really don't know.
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Just some final thoughts while im waiting for my flight.
What’s truly unprecedented about this swine flu is its incredible mildness. The CDC estimates seasonal flu annually kills 36,000 Americans, spread over four months. That compares to 4,000 swine-flu deaths in the current cycle, 6 months now. The seasonal-flu death rate therefore ranges from 0.06 percent to 0.24 percent, while the CDC estimate puts it at only 0.0182 percent for swine flu. So seasonal flu is three to twelve times deadlier per case.
We all know that the UK and the US, both initial "boom" countries (a lot of infection at the start of the outbreak) cases have peaked for now. Thats fact.
But could these indicators start to shoot up again? Not likely. According to Farr’s law, named after 19th-century epidemiologist John Farr, infectious disease patterns follow a bell curve. As the disease first plucks low-hanging fruit, infections rise rapidly, but as fruit gets harder to reach the rate of increase slows – until, finally, infections start falling off either to zero or to a low “endemic” level. Makes sense when you think about it huh?
Farr’s law applies in the southern hemisphere perfectly. Since Australia is in the southern hemisphere, its flu season has ended. Almost all cases were swine flu and there was no vaccine. And Australia’s epidemic curve indicates that, yes, once swine flu cases started going down they kept dropping. There are simply no more hosts for the virus to infect.
No, the bell wasn’t symmetrical, and we shouldn’t expect it to be here in the UK either. Expect a long “tail” extending to the end of normal flu season in April. In other words, the fact that infections have peaked doesn’t mean we’ve necessarily seen all of them yet.
And that should actually prove to be good news. Consider that even without a vaccine, Australia along with New Zealand reported significantly fewer flu deaths than in normal years. Why? As I mentioned above, the CDC estimate of infections and deaths in the U.S. indicates that seasonal flu is anywhere from three to twelve times deadlier than swine flu. Other data, including data from New York City, also indicate that swine flu is far milder. Yet swine flu spreads more easily, essentially outcompeting seasonal flu. In doing so, it’s essentially acting as a vaccine against its far deadlier cousin. (The father of vaccinations, Edward Jenner, observed something similar: Cowpox protected dairy workers from the often-deadly and horribly disfiguring smallpox.)
Swine flu, therefore, prevents more flu deaths than it causes. Unfortunately, the western media “hysteria curve,” as indicated by emergency-room visits by people worried they have the flu (and worried enough to seek medical attention) is still at a higher level than for any other flu season in the 21st century. You can probably credit, in part, Obama’s October 23 “national emergency” declaration in the US, and the NHS/HPA 65,000 deaths estimate. Nothing like an official pronouncement to send people with slight fevers — real or imagined — into fever pitch. Perhaps the administration can argue that extra work hours put in by exhausted health-care personnel, and by a sensationalist media hyping the story, are stimulating the economy....
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Thank you for explaining why sf protects against seasonal flu, Skyline. I'd understood that there was a protective effect but I didn't know what it was. Very positive!
Yes, Angel, I watch the moon phases too. They give the month a lovely rhythm I think. Sounds like there are a few of us out there sky-gazing:-)
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Skyline, I'm assuming you're not filming in the Ukraine again???
Joan, thanks for reminding me, must order next yr's Moon Diary!
Risa, I think you are right about older people and immunity. My GP says he is seeing that older people tend not to get sf, and if they do it has a tendency to be easier for them to cope with than seasonal flu. He puts this down to earlier exposure to the sf virus, which means it isn't that novel, and also down to the fact that many older people have been in the seasonal flu vaccination programme for a number of years. He's also seeing less swine flu in adults around my age (late 30's) - for example he sees it in whole families of children but very often not their parents, or the parents throw it off quicker. All this has now been born out by research. H1N1 probably has been around for a long time. The seasonal flu vaccine does give some protection. And adults in their 40s have been shown to have some immunity because in some way their body 'remembers' having sf. This would therefore account for why children and young adults get the most cases of sf and therefore the most complications. I'm hearing of very few deaths in the middle-age range where the adult that has died hasn't been 'at risk' with an underlying condition. I think that were it not for the fact that H1N1 isn't novel and for teh seasonal flu vaccine programme we would be looking at a much more serious scenario, albeit not as bad as previously predicted.
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At my GPs this morning the receptionist told me they have no guidance from the DoH yet on vaccination for healthy children but they expect to know by the end of this week. They are also confused about whether it is up to and incuding 5 year olds or not. (Lots of uncertainty among all the receptionists, and checking with the practice manager - no clarity acheived, all agree there is a lot of "media confusion"). I asked them how it's going generally, i.e. vaccinations and they said they are getting people in in groups of 10 at a time. They are, however, and they told me this unprompted, not vaccinating pregnant women.
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Universal - thanks for the update. Interesting re the pregnant women. I have heard some people describe them as group 2 to be vaccinated after the "at risk" patients whereas other doctors surgeries seem to be doing both at once.
I spoke to the pharmacist here this morning. She told me they'd had a lot fewer people in needing Tamiflu recently. :)
TIGER
- yes there doesn't seem to be a clear reason why the vaccine hasn't been out there in the volumes that Sir Liam has described. If there have been further delays, they should tell us.
That's good news about the children's vaccines being 2x half doses at least rather than full doses - so that means 12 million doses accounted for. Supposedly the government have actually ordered 60 million doses, one for everybody if needed but at this rate it will be next year before everyone is offered it, if at all. And then it will be like the Forth Bridge, starting all over again but with the SF vaccine this time incorporated into the seasonal. (I note Boots are selling seasonal flu vaccine this year - so does that mean those of us in low risk groups can just go & get the whole thing next year from the high street?)
SKYLINE
- thanks for your positive comments as usual - do you have any comments on the two types of mutations?
- also the WHO are saying 700,000 infected in this country now. Are you saying 1,400,000 is more likely adding in those who are asymtomatic? That is still quite a low figure compared to a population of 60 million. The WHO were saying about 30% (20 million) will eventually catch SF, do you think we have a long way to go still over the next few years? Thanks
- Interesting point you make about the economy. When SF hit in the summer, the economy was no longer in the news and I did feel at the time it may well have helped the turn around as the media cwere no longer concentrating on talking the situation down any further!
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We are told that SF is mild.. and having spoken to those who have had it (including members of my family) it does seem that if you're in normal good health, it's little more than a few days feeling grotty but back to normal in a week or so.. That being the case, why has the USA seemingly gone obsessed with promoting vaccination? They've done a cartoon for goodness sake, even the santas are promoting it! It's either dangerous (in which case schools should close and travel restricted) or it isn't.. and why has there been no big deal in recent years about seasonal flu the way SF seems to be grabbing the headlines?
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I dip into this blog from time to time, and am mostly a miture of alarmed and amused by the scare stories and half stories that are here.
Anyway, as someone who manages a GP Practice, re the children vaccination programme thread I copy below an extract from the letter received here today from Sir Liam Donaldson.
"The swine flu vaccination programme will be extended to offer the vaccine to all children over six months of age and under 5 years old."
For that please read children aged 6 months plus one day, and children aged up 4 years and 364 days. Further clarification will be forthcoming, and the logistics of how this will be deleivered and when have not yet been agreed nationally.
And as a way of dealing with this, and anything else that life throws at you, may I suggest the following from a poster from the 2nd world war - "Keep Calm and Carry On".
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Just been to the GP, my boy has sore ears again. This time I saw our usual family GP and he is happy to give my son his sf vaccine as soon as his current cold has cleared up. That said, he says that as a surgery they are seeing hardly any sf so in his opinion it isn't urgent. Take up so far has been over 50% of the priorty groups but he says he is getting a huge amount of political pressure over this. If I'd felt more up to it I'd have asked him why.
I have also picked up the boy's cold and have developed an ear infection and sinusitis. I had a temp over the weekend and when I tried to sleep I ended up in that weird hallucination/dream state where you aren't really asleep at all, and for some reason I imagined that I was making egg-free vaccines in the kids' playroom. I've obviously spent far too much time on this blog.
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For those Dutch posters, I'm impressed about the organised vaccination system you have going out there.... described as:
"military-like precision as the fire services are delivering vaccines, the police are directing traffic, ambulance personnel are assisting, public transport authorities have laid on buses and employers are giving people the day off as the mass innoculation campaign kicks off"
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I would also raise the fact that the classification of the pandemic was changed around may/2009.
The old text, pre-2009, that can be found in various sites of respected organizations and government agencies, including the WHO, states that:
An influenza pandemic occurs with the appearance of a new influenza virus against which none of the population has any immunity. This results in several simultaneous epidemics worldwide with enormous numbers of cases and deaths. With the increase in global transport and communications, as well as urbanization and overcrowded conditions, epidemics resulting from a new influenza virus are likely to be established quickly around the world.
In the new definition, that appeared in May/2009, states that:
A disease epidemic occurs when there are more cases of that disease than normal. A pandemic is a worldwide epidemic of a disease. An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity. With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic.
As you may have noticed, the part that says "This results in several simultaneous epidemics worldwide with enormous numbers of cases and deaths." were removed in the new text, replacing it for the fuzzy and confused statement that "Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic"
Where you can find the documents that prove this:
Old definition:
http://www.who.int/entity/csr/resources/publications/influenza/CDS_CSR_GIP_2004_1.pdf
New definition:
http://www.who.int/csr/disease/influenza/pandemic/en/
Check also the video of the epidemiologist Tom Jefferson tells a Swedish TV about this change and how it would enormously benefit pharmaceutical companies:
http://bigbrother-uk-1984.blogspot.com/2009/10/irrefutable-truth-oms-changed-pandemic.html
With the current classification, even the seasonal flu would be a pandemic. How people can be so easily fooled?
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(((angels))) I've been suffering sinusitis for 6 weeks now since a fluey virus just beforehand. I have never had sinus problems before in my life. Picked up my second dose of antibiotics today :(
That's good news what your doctor said about not too much SF in your area at the moment and also about your son's vaccine.
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143#
Hmmm, whip round then for pharmaceutical share buying then? Holland think it's dangerous then? We don't, USA does (ish).... It's looking more like a Mel Brookes film the more this goes on.
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#145 Thanks, Questions, my sinuses are my weak spot so I'm not surprised. Had a terrible night, my boy wanted to get up and play and my eldest was in tears until about 5 am, she's got a runny nose but I think she'd got to the stage where she was too wired to actually sleep. Grim for you re sinuses, try using hot steam with either some eucalyptus oil or the juice of half a lemon (you know, the towel over the head thing). I don't know about you but my brain barely functions when my sinuses are bad, I keep having very vague conversations with people who end up looking at me like I'm an idiot. Hope you feel better soon.
# 143 Echo, both definitions refer to pandemic flu as a new virus. Seasonal flu isn't new which is why some people have immunity to it. Therefore seasonal flu doesn't fit the new WHO definition. That said, it is looking like H1N1 entirely isn't new, although it probably hasn't been around for a while.
Of course the big pharamceutical companies stand to make money from this pandemic and any other. They also make money from cancer, HIV/AIDS, malaria, and all the rest of the illnesses that humanity suffers from. And to be honest I don't give a monkeys so long as there is treatment for when me and mine get sick. Nice to think that they'd do it for free, but that isn't the world we live in.
My guess is that the WHO, like everyone else, believed an avian flu pandemic was heading our way. This one broke out and they over-reacted. That is certainly the casefrom our authorities here. But even if this pandemic had never been declared there is a very nasty strain of flu going around which is penetrating deeper into the lungs for some people, kids under five are particularly vulnerable and I want to get my son protected against it. I don't really care if it is called seasonal flu, pandemic flu or anything else.
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#140, Define_real:
It's true that swine flu is a mild disease from which you make a swift and complete recovery in most cases.
However, for some unlucky folks, it can be a lot more serious. Some people have died. That is why vaccination is so important. Most people wouldn't have had any serious complications from swine flu anyway, but even if vaccination saves just a handful of lives, isn't that worth doing?
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#147 angelscomeinthrees
I meant that any (new) virus as the common influenza would fit the bill with the new criteria.
Of course labs are not suppose to do anything for free, but the WHO shouldn't work for them announcing a pandemic for a flu that isn't dangerous. That triggered people and government to start spending billions on medications and vaccines.
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Define_real,
Yes, for the vast majority of people, in any age group or with any underlying condition, SF tends to simply run its course without much difficulty: that's true of ALL flus. Even the dreaded 1918 Spanish flu with an estimated death rate of 2.5% means that 97.5% of folks who got the illness recovered.
What is odd about SF is _who_ is it making more seriously ill, or killing. The distribution of deaths and hospitalizations is very different than we see with seasonal flu, as Fergus has shown in graphs another blogpost (scroll down):
http://www.bbc.co.uk/blogs/thereporters/ferguswalsh/2009/11/swine_flu_new_advice_to_pregnant_women.html
And as for the US, I am sure that part of their "push" (or panic) to vaccinate comes from the pediatric death totals, which are already far higher than normal for seasonal flu. As of Nov 15th, there have been 171 lab-confirmed SF deaths in children (the CDC estimates the true number is far higher, but let's just stick with the lab-confirmed) since this outbreak began in April. Another 28 children have died from Type A flu, unknown subtype, but given that 90%+ of all type A flu when sent to lab is coming back as H1N1 (the numbers in Canada are coming back over 99%), very likely H1N1. The average pediatric death total from seasonal flu is 82 for an entire year in the US.
http://www.cdc.gov/h1n1flu/updates/us/
So look. 171 (or 199) is, objectively speaking, a small number of children compared to the number who die of cancer or car accidents in the US, or malaria in Africa (to pick examples I've seen used elsewhere). But it is well above normal for seasonal flu in the US, and we are talking about a so-called "vaccine-preventable disease". So on the one hand, we've got the "it's just the flu" and "seasonal flu kills more people" ideas; on the other, we've got nearly 200 US kids dead of a vaccine-preventable disease in a little over 6 months. When was the last time we had so many children die of a vaccine-preventable disease in the US? If those child deaths were from measles, or polio, or diptheria, would it strike folks as more serious, as we'd no longer be talking about "just the flu" (an illness most of us have had and survived)?
Surely there is a balanced view here to be had about SF, somewhere between panic and brushing it off?
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148:"However, for some unlucky folks, it can be a lot more serious. Some people have died. That is why vaccination is so important. Most people wouldn't have had any serious complications from swine flu anyway, but even if vaccination saves just a handful of lives, isn't that worth doing?"
It is not worth if you risk killing hundreds or even thousands of innocent lives. Without mentioning of the lifelasting suffering of the side effects.
Much cheaper, safer and healthier would be to boost people's Vitamin D3 level. It is scientifically proven that the correlation of lack of vitamin D and the immune system.
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=529704
http://preventdisease.com/news/09/111609_H1N1_linked_vit_D_deficiency.shtml
http://www.youtube.com/watch?v=HH1rB-Ya2UQ
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#151:
"It is not worth if you risk killing hundreds or even thousands of innocent lives. Without mentioning of the lifelasting suffering of the side effects."
And your evidence that flu vaccination risks killing people or having long-lasting side effects is...?
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Have you read Dr. John Cannell, the main Vit D researcher, on H1N1?
http://www.vitamindcouncil.org/newsletter/h1n1-flu-and-vitamin-d.shtml
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Oh, another thing, echofloripa:
The idea that vitamin D3 protects against flu is an interesting idea, but it's far from scientifically proven. Maybe it will turn out to be useful, but I don't think it's sensible to rely on an unproven therapy that may or may not work, when we have vaccines, which we know are effective.
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echofloripa, the new WHO definition of pandemic is more accurate as pandemic is just a term referring to the geographical of a new flu virus regardless of its severity which they quite rightly state can be mild to severe and change as the virus runs its course. They changed it as it was outdated and apologized for the fear the old definition may have caused at the beginning of the outbreak. It certainly wasn't done in some kind of clandestine conspiratorial fashion to trick us in some way.
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Thanks Skyline for the illuminating post about Swine flu acting as a 'vacination' against deadlier seasonal flu. I put up a similar argument stating Swine flu is in some ways (lower age of mortality aside) a good thing, as it has displaced seasonal flu and will continue doing so for several years, to my relatives and was met with incredulous looks.
Did anyone else hear about a potential universal flu vaccination somewhere down the pipeline? I read an article about it a while back saying that it will protect against flus new and old and will make flu pandemics a thing of the past. Sounds good to me.
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I am starting to think we are seeing natural selection at work here....
The anti-vaccine lobby prepared to believe in pure conjecture, half-truths and outright lies about the jab and the pro-vaccine lobby who believe in facts, science and common sense.
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I think we need reminding that seasonal flu is a serious illness too. The reason most of us don't particularly notice it is that it mainly kills the old and the sick - people that society regards as expendable. It doesn't shock us in the same way when someone old or with a chronic illness dies. Swine flu freaks us out because it is killing children and young healthy adults because they have no natural immunity to it. But perhaps we need to think more about the seriousness with which we take seasonal flu in the future.
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DisgustedOfMitcham2 wrote:
#151:
And your evidence that flu vaccination risks killing people or having long-lasting side effects is...?
http://www.dailymail.co.uk/news/article-1229929/Patient-dies-given-swine-flu-vaccine.html
"There have been two cases of anaphylactic shock, one child experienced arthritis and two had seizures, the Medicines and Healthcare products Regulatory Agency said. "
Although WHO is trying to play down and dismiss the deaths, they are there:
http://www.google.com/hostednews/afp/article/ALeqM5iQX5BZWUKRQdSnzKgt8guItuSk9A
And know one know the long lasting effects this unknown and untested vaccine will have, especially over pregnant and small children, which won't be known until it is too late, if ever, if we will depend on this biased media that feed us.
Tim:
"It certainly wasn't done in some kind of clandestine conspiratorial fashion to trick us in some way."
If so, why this isn't clear that this was changed and for what reasons? You need to be a detective to find this information. Different virus change every year, the common influenza virus changes every year. They will have a pretext to put the planet in a state of fear for years to come.
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It's always about what we don't know. Nature never ask our permission to change.
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Can I just say how much I appreciate this blog and all its posters.
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Echo, leaving aside the fact that it probably isn't a good idea to link anything from the Daily Mail if you want us to take it seriously (if I remember you're not in the UK) it is sadly true that a very small number of people will go into anapylactic shock after having a vaccine. I also have a friend who goes into anaphylactic shock if she eats tomatoes but I'm assuming that you wouldn't advise us all to avoid them just in case. I also have a friend who goes into anaphylactic shock if she gets stung by a wasp, but again I'm assuming that you'd not advise us all to stay inside to avoid them - we wouldn't get enough vitamin D for starters. It's about weighing up the risks and many of us are concluding that at least for certain groups the benefits of vaccination outweigh the risks. As for someone with severe underlying health issues dying after being vaccinated, some people are so ill that it really takes very little challenge to their immune system to kill them, assuming that the vaccine is connected in any way - seriously ill people do tend to die, sadly.
As for the WHO having a pretext for scaring us each year, they just don't. Seasonal flu is the same strain of flu that has mutated. It isn't new. It's like...okay, very bad non-scientifuc example coming up, but suppose one year I'm three stone overweight. The next I've lost two stone. The next my BMI is normal and I've run a marathon. The next I'm pregnant. The next I'm recovering from having had a c-section and have put on two stone and haven't excercised for months. The next I've lost half a stone and taken up trancendental meditation. In each example my body's physiological make-up will be different and will respond in different ways to the environment around it. But it won't be 'new'. Seasonal flu is the same - different, but essentially the same flu. Pandemic flu is new, a newborn, something we don't have any experience of (or haven't for a long time) It also needs to have spread itself to certain geographical areas before it can be declared a pandemic.
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Questions (#143 and #145): Thank you. I'd like to think that most of the bureaucracy, once someone lights a inferno under its ***, is perfectly capable of moving along at high speeds. I think that the main part of the story is derived from Amsterdam, where they decided to centralise the vaccination as far as location is concerned, and getting 64.000 people into a single location is a damn lot of people, even if you spread it over 5 days - that's still 13000 people a day, and rest assured that those days don't run past 17:00. (So 8.5 hours). So in that case, yes, you'll need medical help etc.
Good luck with your sinuses (same goes for Angels). I've been blessed enough in life to have avoided sinusitis for the last eleven years, and I still remember the truly annoying feeling of my head swimming in a decidedly not calm ocean and the splitting headache that came along with it. Not my idea of a good feeling.
Do the Dutch regard SF as a danger? The government apparently does, judging from the amount of infomercials they've put out. (Alternately: the amount of propaganda.) Personally, I think they're not presenting one whole, though, and at times, the entire thing just reeks of spin to keep the entire thing together after a simply disastrous start to the entire campaign, which was, simply put, not a campaign at all. This allowed the anti-vaccination camp to sink their claws into the society from some or another angle, and now the government trying to make up for lost time, it seems. We have a few leaflets (the usual tips - sneeze in your elbow, wash your hands, yada.) and a few ads in the public spaces - though I saw more ads for the new Twilight film (I'm feigning the flu if someone invites me to that!) than for the government website today - and I see quite a few ads each day.
Society as a whole is taking it in stride, almost stiff-upper-lip-ish, one could say. They're just going on with life, which is how it should be, at least at this point in time. I can't really detect an undercurrent of fear, though there was, and still is, a lot of information that doesn't make sense to everyone. (The apparent contradiction of vaccinating for a mild pandemic being one of them.) This will likely have put a few off the vaccine, but eh, that's life for you. My social radar isn't stellar, though, I'll readily admit.
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Hi, just popped by for a chat. Last week I was put in the optimum conditions to catch SF. Hot, dry conditions, poor ventilation and over 100 young people crammed into a small area. Some of the young people were coughing ominously, and the crammed-in session lasted over an hour. How long does it take to catch SF? One week? Staff sickness is at very high levels in our neck of the woods which means I get plenty of work.
To cap it all, at the doctors surgery, a young man coughed violently into his hand and then opened the surgery door to go outside. I followed, gingerly opening the same door thinking, I must remember to wash my hands as soon as possible. This SF thing is a bit of a sod because without testing, no one knows if they have already had the bug.
I hope everyone who is feeling unwell gets better soon, some of you sound pretty under the weather. Anyway, it will soon be Christmas. ;o)
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I have just been looking at a poor little bird, feathers fluffed up and hunched on the top of a flat roof, trying to keep warm. With low pathogenic H5N1 now present in Germany, poultry farmers are going to have a hard time preventing wild birds carrying the disease, from getting in to their nice warm barns.
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#159, echofloripa:
So, you have details of one person who died in the UK after receiving swine flu vaccine, and that death, according to the article you linked, was likely to be related to the patient's underlying health condition rather than the vaccine.
So in fact we probably have zero deaths attributable to the vaccine.
Now, how many people have died of swine flu?
Are you seriously saying that you think the risk of death from the vaccine is greater than the risk of death from swine flu?
And as for long-lasting side effects, am I right in thinking that what you are saying is that you have no evidence whatsoever that there are long-lasting side effects, but you personally believe that there might be?
So again, you'd rather take flu, which we know has a risk of long-lasting side effects, than the vaccine, for which there is no evidence of long-lasting side effects?
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Sensible, it might be wise to not get too worried about the H5N1 possibility..A while ago we had a swan crash land into a Scottish loch and it resulted in all the press (surprise surprise) screaming 'Dead swan has bird flu'.... Only it hadn't... but don't let fact get in the way of a good headline and extra copies sold.
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#165
" 'Low' Pathogenic H5N1 "
Huh?
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Thought this was interesting reading this morning. Wonder if it will affect how they administer the vaccine to the under 5s in the UK?:
Pandemrix one-dose effective in children
Meantime, GSK also announced new results from an ongoing trial assessing the use of its swine flu vaccine Pandemrix in children and adolescents aged 3 to 17. The study shows that after the first dose of adjuvanted H1N1 vaccine, “a strong immune response was demonstrated in all age groups [which] exceeded the immunogenicity criteria, as defined by international licensing authorities for a pandemic influenza vaccine”.
All the participants received 3.75mcg of Pandremix, equivalent to the full adult dose and GSK also noted that over 40 million doses have been distributed.
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This is interesting - it seems the DoH will now let pregnant women have the adjuvant free jab!:
http://news.sky.com/skynews/Home/UK-News/Swine-Flu-Pregnant-Women-To-Receive-The-Alternative-Celvapan-Vaccine-Say-The-Department-Of-Health/Article/200911415463384?lpos=UK_News_Third_Home_Page_Article_Teaser_Region__9&lid=ARTICLE_15463384_Swine_Flu%3A_Pregnant_Women_To_Receive_The_Alternative_Celvapan_Vaccine%2C_Say_The_Department_Of_Health_
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Lots of news coming in today:
More children have had SF than first thought...
http://news.bbc.co.uk/1/hi/health/8375922.stm
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That's sensible on the part of the DoH, I think it will increse the uptake.
Am hoping that Fergus does a report on the fact that so many children are asymptomatic, esp. looking at whether this includes younger children. My three have definitely had seasonal flu at some point. Having just made up my mind about getting my boy jabbed I'm now starting to unmake it again. I wish I could have him tested first! The fact that so many children are asymptomatic accounts for why my GP isn't seeing very much of it, we live in an area that should by rights have loads of sf (within commuting distance of two cities and close to an international airport).
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TruScotsman90,
'Huh'
Yeh, well... er...I have written it as it says. Apparently there is such a thing as low-pathogenic avian flu. High pathogenic H51N comes from Asia and low pathogenic H5N1 comes from North America, or so they say.
Have a read on a google search. The WHO are warning of a possible resurgence of H5N1 as it is popping up in several places. Anyway, I shall wear my marigold gloves and have my antibacterial spray handy when I prepare the christmas turkey..... just in case.
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173#
Are you serious? No... you're not... tell me you're not.
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Thanks for educating me about high-pathogenic and low-pathogenic variants of H5N1, sensibleoldgrannie, I hadn't realised that those two types existed. For anyone else who's interested, there's a useful article here.
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Questions,
In Canada the "official" recommendation re: number of jabs for kids has changed in light of recent studies. We started the same as you--2 jabs, about a month apart, for kids under 10 was the party line. On the basis of recent studies, the recommendation has been changed for HEALTHY (i.e., no underlying conditions like asthma) children ages 3-9: they now need only one dose (and that's the half-dose(0.25ml) compared with the adult dose). As all studies done so far have been on kids without underlying health conditions, Canada is still recommending kids 3-9 with underlying health issues get the second half-dose, and all children ages 6 months to 2 years get it as well. Just FYI. Hubby and I are wrestling with whether or not to give the second dose to our 4 year old asthmatic: there is no evidence saying he needs it, and no evidence saying he doesn't right now, as--as far as I can determine--there have been no studies looking at antibody levels to SF generated by asthmatic kids after the single half-dose. If anyone knows of such a study, please pass the info along!
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"Influenza Flux will eventually find the appropriate or optimal combination of genetics to achieve stasis, but until that stasis of PF11>Ω is achieved, these sub-species will continue to be quite dangerous, demonstrating varying levels of Cytokinic Dysregulation according the host-pathogen interplay and the viral strain's capacity for temporarily suspending early catalysts to the innate immune response, including suppression of RIG-I ubiquination as the viral NS1 protein binds TRIM25 ultimately leading to reduced intra-cellular synthesis of Type I IFN.
...
225G gets the virus situated in the lung tissue and NS1 blocks the innate response. Add back the rapid replication at a multiplier over the speed of a Seasonal Influenza strain and you find an overwhelming viral load before any cell has signalled for assistance.
When millions of viral particles erupt in a concentrated area from the lysed cells, the detritus alone drives an surging cascade of inflammatory cytokines. A slow response creates deadly risk."
The introduction of this "insignificant mutation" in the likes of Norway,Hong Kong,Ukraine etc is only the beginning. Officials are starting to panic.
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#173
No... low pathogenic avian influenza viruses have their own variables such as H5N3,H7N3,H7N2,H6N1
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Infact, apologies sensibleoldgrannie
Google comes in handy, wow i need to read up on this. Learn something everyday.
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Hey risa - thanks for that! We have a lot of smilarities with you guys in Canada with the same vaccine - good to hear what is happening over there!
Presumeably the antibody levels of children would be similar in a vaccine study whether they were asthmatic or not? I wonder if more information will come out about the study results from that link. Perhaps the extra dose is just for caution?
Did your son have just 1/2 an adult dose? I think the link above was talking about a single full dose for children.
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sorry I didn't post a link, but the quote refers to a full adult dose...
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177#
The introduction of this "insignificant mutation" in the likes of Norway,Hong Kong,Ukraine etc is only the beginning. Officials are starting to panic.
Should that be taken as meaning the stories eminating from Ukraine suggesting a far worse infection/death rate than reported here, are in fact true?
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Questions,
Yes, he had the half-dose, and the official line from Canada is that if your kid is 3-9, and healthy, and has had the half-dose, you don't need to go back for the second jab. This change in recommendation came a few weeks ago now, so I'm going to go do some digging and see if it was based on studies with the half-dose, or the full-dose, like the one you referenced. Here's the Public health Agency of Canada:
The recommendations include:
* Children between 6 months of age and under 3 years of age should receive two half-doses of adjuvanted H1N1 flu vaccine, administered at least 21 days apart. Guidance for children in this age group is unchanged.
* Children with chronic health conditions who are between 3 and 9 years of age should receive their first half-dose of the H1N1 flu vaccine as soon as possible. They should also receive a second half-dose of the H1N1 flu vaccine. The interval between the two half-doses should be a minimum of 21 days.
* Healthy children between 3 and 9 years of age should only receive a single half-dose of the H1N1 vaccine, and do not need to return for a second vaccine for now.
The page goes on to give the recommendations for adults, pregnant women, etc. and the usual "our advice may change in light of new studies" disclaimer. Original page here:
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/faq_rg_h1n1-eng.php
I'll post again when I find the studies they used to back up this changed recommendation for health kids. Now I'm wondering if those kids in the study got a full dose or half-dose.
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Hi Define_real,
No , not at this time. But the fact officials at the WHO are brushing the 225G mutation aside proves they know what this will likely lead to (higher virulence) and do not want to panic the public until something significant does happen.
The overwhelming stability of the virus has been incredible since the Pandemic was declared but H1N1 is running out of hosts, and with this 225G detected - we know it's trying to survive in it's most natural way.
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"Deep lung involvement appears to be supported as a trait enhancement via the D225G polymorphism on the viral Hemagglutinin. 225G is not a new incursion into ΣPF11, but now paired with 206T is becoming a higher concern. The US and Mexico demonstrated 225G with 206S early in the pandemic. 206T, as predicted, has now become fixed or consensus in many geographies. Recent studies on the Ukraine, Russia, China and Norway show 225G in the Hemagglutinin to be circulating alongside the dangerous 225E and the wildtype 225D bearing strains"
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Apparently the recommendation change came from a study of 51 kids in Spain who got a half-dose of the adjuvanted vaccine, and 150 kids in Quebec who got a half-dose and were later tested for antibody levels. 100% had the "right" level of antibodies for protection. I can find references to these studies in news articles, but still having a hard time tracking down the original studies (and I've learned from experience not to blindly trust the way studies get reported in the news!)
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Okay okay.. it is FOX, but seems to be AP originally. Not directly to do with H1N1 spreading, but wonder if it could be significant to the effacy of it's control?
http://www.foxnews.com/story/0,2933,576526,00.html
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#182: Given that there are no quotes around it, I'll hazard a guess that that is TS90's own opinion. The quoted part is able to be Googled and leads to flutrackers (which has been discussed upthread, I think...) from where it leads to a blog. Taking a few segments from the unquoted part leaves me with nothing found.
I am aware that Google searching is hardly the best way to find something, but given that TS90 gives no links to any site whatsoever, I am left with doing just that. Which does raise the question why he thinks public health officials are starting to panic and my paranoid side is going one step further by questioning if TS90 has a vested interest in seeing a panicked society.
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Questions,
This is about the most informative of the press releases I can find re: why Canada changed its recommendation. I leave it up to you to decide how much of the article is spin. (And the pic of the boy getting the jab bears an uncanny resemblance to how things went with our 4 year old, which is part of why we don't want to get the second jab if he doesn't need it).
http://www.coastreporter.net/article/GB/20091112/CP02/311129898/-1/sechelt/phac-says-healthy-kids-over-3-dont-need-second-dose-of-h1n1-vaccine&template=cpArt
Hope that helps. And I'd still love anyone who comes across a study of vaccine effectiveness in asthmatic kids to pass the info along. Thanks!
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Define_real,
I posted about the GSK recall of the batch of vaccine in Canada on my blog a few days ago. There was a higher than expected anaphylactic reaction rate (1 in 20,000 rather than 1 in 100,000 jabs), so GSK--not the provinces, as only some provinces saw this higher reaction rate--made the call to pull the vaccine and investigate. It was only one lot, and a small percentage of Canada's overall vaccine. The same manufacturer (the GSK plant in Quebec) is supplying vaccine to other countries, but so far no other lots seem to be affected. I know some anti-vaccers will jump all over this kind of thing, but I was actually quite pleased to see this. All the folks (6 of them, at least known cases) who had allergic reactions recovered, and I am very pleased to see GSK monitoring for this and that they, not the provinces, made the call to pull the batch.
For more, see:
http://www.google.com/hostednews/canadianpress/article/ALeqM5jsBLPnXbgzqiMA2dCtsgJRR1d1Qw
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"This does", not "which does" in post #187 - it's never wise to change from using a comma to a full stop if you're already a few lines down.
#186: The call for a stop on vaccination with that batch is a pretty standard one. As for efficacy (I think you mean) - please explain what you're trying to ask, because there's nothing on either spread or control of the SF (even if I feel that you can't control a pandemic virus...), apart from the amount of vaccines distributed (which is not the same as used.)
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TrueScotsman90,
Thanks. It looks as if you have swallowed the entire medical dictionary at post 177. Those of us on statins do not get the same cytokinic response, which was pointed out a long time ago in The New Scientist (or one of the other science journals).
I could talk a lot more about this subject but it would not be appropriate on a blog.
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