Swine Flu Pandemic - Preparation

[ainsleyclare]

Hi everyone,
There was an all-hands meeting at CDC this morning, and I wanted to update everyone one some of the info that came out of that.

Before I do, I want to make the observation that the information I am getting as an "insider" is not much more than is available at the CDC website or any number of other reputable sources. One of the hallmarks of Rich Besser's CDC directorship is an extraordinary ammount of communication (he is still Acting Director, because we don't have an appointed Director yet, but I know that I and many of my colleagues hope he will be kept on). We were urged to communicate the information that was shared with us to our larger communities.

Re the specific question ("should we be walking around in masks?")- only if you want to. This was discussed at the meeting. The concern is that while a mask may make you feel more secure, it may be a false sense of security for two reasons: 1) it is hard to wear a mask all the time, and often times they are not well fitted, and 2) there is no solid evidence that masks reduce transmission of the virus, and there is very good evidence that good handwashing and keeping your distance from sick people will reduce your chances of getting sick...things that people might not do as well if they rely on a mask to keep them healthy.

Other interesting points:

a) This virus strain is susceptible to Tamiflu (and Relenza), but only people with very high risk factors (ie, pregnant women and people with underlying medical conditions such as COPD) should take it unless they actually have symptoms and live in an area where the virus is known to be active. This policy is to help keep the virus from becoming resistant to these medicines, and to keep the drug supply sufficient for people that are already sick.

b) Yes, there are expected to be deaths from this flu. Even the regular flu causes approx 35,000 deaths per year. So get your flu shot!

c) If you got your flu shot this year, good for you...but it probably won't protect you from this swine flu. The process of making a vaccine takes 4-6 months, and the first steps have already been started. Don't expect a vaccine 'til about September. However, we are fortunate that the regular flu season is near its end- this will most likely mitigate the number of cases in the USA and other northern hemisphere countries.

d) This swine flu contain genetic info from four differant elements (human, bird, and two swine sources). However, the standard flu circulating among pigs in North America already contains three of those four elements. Both the public health community and the intelligence community (ie, the CIA) believe this is an entirely natural occurance- there is no evidence of bioterrorism.

e) You can monitor the situation at www.cdc.gov/flu/swine. However, the CDC will almost certainly report numbers lower than than the media or the states. CDC makes a point of reporting cases only after the individual states have reported those cases, in order to respect for the individual state and local governments' right to make recommendations and reports to the media based on the most up-to-date information they have.

That's all I can remember for now. I'll keep you all posted.

A.

[Witchiepoo]

I have a question. Why in the world is the CDC supporting the pork industry's attempt to change the name of swine flu to something else? I think it makes a lot more sense to call a spade a spade.

[ainsleyclare]

Witchiepoo,
Could you post a link to an article from a reputable source that claims that CDC is making that effort? I can look into it, but so far I haven't heard anything about it. What I have heard direct from CDC sources is that the swine flu cannot be caught from pork or other meat products. So far as what it is being named...I haven't heard anything one way or another.
A.

[Witchiepoo]

It was supposedly the pork industry starting it, with the CDC "considering" it. But I'm glad to hear that they aren't wasting their efforts on such ridiculousness. Thank you.

[Witchiepoo]

I work as a resident doctor in one of the biggest hospitals in Mexico City and sadly, the situation is far from "under control". As a doctor, I realise that the media does not report the truth. Authorities distributed vaccines among all the medical personnel with no results, because two of my partners who worked in this hospital (interns) were killed by this new virus in less than six days even though they were vaccinated as all of us were. The official number of deaths is 20, nevertheless, the true number of victims are more than 200. I understand that we must avoid to panic, but telling the truth it might be better now to prevent and avoid more deaths.
Yeny Gregorio Dávila, Mexico City

http://news.bbc.co.uk/2/hi/talking_point/8018428.stm

In there words.... This has been going on from other reports I have not posted for longer than we are seeing...

What were you guys vaccinated with? From what I've heard they have a swine flu vaccine for pigs, but not humans.

[StilesBC]

Vaccines are useless and usually do more harm than good. Case in point is the 1976 Swine Flu outbreak where dozens more were killed by the vaccine than the flu itself prior to the vaccine being recalled. But the entire idea of vaccines for the flu lacks common sense. The virus undergoes countless mutations by the time a vaccine is available.

[Amon]

And here stands a guy who's used to toughing it out.

With the current news updates, there's now six possible cases in my home state of Washington, although thankfully none of them are around the coastal areas yet. That fortune can't hold out, and honestly, as excited as I am to hear whenever anything seriously bad is happening in the world (I have no faith whatsoever in humanity), this is actually frightening, especially when I don't think I can finance taking even the basic precautions.

[Centuron]

There have been a 26 cases of swine flu here in Texas, according to the CDC, second only to New York at 50. We've also had the only US death, a toddler who had just returned from Mexico with family. We've had school closings because of it, but for the most part it's been business as usual.
Really from what I hear this thing isn't much worse than seasonal flu, and normal clean habits like washing hands and the like are sufficient to help keep it at bay. The actions of schools and such are just precautionary measures (because even mild diseases can spread rapidly in high-density places like schools). Remaining calm and distributing useful precautionary information have really been the most helpful measures. There's really not much call for all the scare-talk going on.

Vaccines are tricky. From what little I know, they work by subjecting the immune system to a substance that simulates the virus (or a 'dead' form of the virus itself), but doesn't cause illness. This makes the immune system form antibodies, essentially training the immune system to recognize and fight the virus, so that if you contract the actual virus your body will be able to defend against it. It's the same principle that allows you to (generally) avoid having chicken pox more than once. But I'd imagine creating a safe substance simulating an unsafe virus isn't easy, and yes, if its a fast-mutating virus, it may be ineffective. Other problems often occur because the body's immune system overreacts to the virus (and thus the vaccine or vaccine substance), and cause some form of harm (that's what allergies are, immunological overreactions).
So vaccines are tricky, and they're not foolproof (nothing is), but they're not completely useless. After all, vaccines are the reason polio is so rare these days. Vaccines are just another option, and should simply be considered another available tool in an arsenal of clean precautions.

[Witchiepoo]

Looks like the swine flu is suspected in several areas of Chicago now, but as far as I can tell nobody is having a freakout about it.

My question about vaccines wasn't to say they're good or bad, just wondering what The Powers That Be are passing off as a swine flu vaccine for humans when there actually is no such thing. And yeah, the flu viruses do mutate quickly, in ways that other viruses like smallpox and polio don't.

[ainsleyclare]

Last I heard, the Powers that Be aren't anything as a "swine flu" vaccine for humans- they are being very clear that there will be no vaccine against this new strain of influenza for many months (September?).

The normal seasonal flu vaccine is made up of antigens (aka, things the immune system reacts to) from several strains of the flu- typically one B type and several A types that are circulating at the time. The CDC does careful analysis of 1000s of strains throughout the year in order to determine which strains are most common, and which are becoming more common.

There are two sorts of genetic changes that the flu virus undergoes. One is a sort of "drift" where small changes accumulate and make the virus more difficult for the immune system to detect, even if it has encountered a similar virus before. This is occurs all the time and is the reason why the contents of the flu vaccine need to be changed every year or so. The other change is the kind of large scale rearrangement that the new "swine" flu vaccine has undergone. This can occur when a person or animal is infected with more than one strain of flu at once. Since no-one's immune system has ever seen the new combination, the new virus can spread readily.

Centuron's explanation of how vaccines work is quite good.

I've tried to find any support for the concept that there is "a swine flu vaccine for pigs but not for humans", and couldn't find any. Like I just described, since this new H1N1 virus is unlike anything that has circulated in the last few decades, there is no vaccine available (at this time) that could protect humans, or pigs for that matter.

Another issue: the name of this virus. The communications I've seen today are describing it as "swine-origin influenza virus" rather than swine flu. I guess the term "swine flu" would indicate that it primarily infects pigs, and since this new H1N1 flu virus is circulating among human populations, the term "swine flu" is misleading. Who knows what it will be called tomorrow or next week. I just bring it up because of earlier posts on this thread.

At this point, the WHO has described the 2009 H1N1 virus as being too widespread to contain. Personally, I take this to mean that sooner or later, most of us will get exposed to it and many of us will get sick. Fortunately the newer information suggests that the virus is not as virulent as originally feared. People that were exposed to certain earlier pandemics (ie 1957) may have some immunity since there are similarities between the virus. My preparations at this time are focused on getting ready to have everyone in the house sick for a week or so, rather than buying masks and gloves.

Be well, everyone.