W.H.O.'s tally of A/H1N1 influenza cases rises to 4,379

GENEVA (Xinhua) - As of 0730 GMT today, 29 countries have officially reported 4,379 laboratory confirmed human cases of A/H1N1 infection, the World Health Organization (WHO) said in a latest report.

Mexico, the epicenter of the outbreak, has reported 1,626 confirmed cases, including 45 deaths.

The United States has reported 2,254 cases, including two deaths.

Canada has reported 280 laboratory confirmed human cases, including one death.

Costa Rica has reported eight confirmed cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths: Argentina (1), Australia (1), Austria (1), Brazil (6), China's Hong Kong (1), Colombia (1), Denmark (1), El Salvador (2), France (12), Germany (11), Guatemala (1), Ireland (1), Israel (7), Italy (9), Japan (4), the Netherlands (3), New Zealand (7), Panama (3), Poland (1), Portugal (1), Republic of Korea (3), Spain (93), Sweden (1), Switzerland (1) and Britain (39).

The WHO has said that it currently has no plan to raise its pandemic alert level to phase 6, the highest level which means a global pandemic is underway.

To raise the alert level, there must be enough evidence to show that community-level human-to-human transmission of the new virus has occurred in regions outside North America, it said.

The WHO said, however, that it was closely monitoring the situation in European countries such as Spain and Britain, which have reported the largest numbers of cases outside North America.

U.S. has more than 2,500 H1N1 flu cases

WASHINGTON (Reuters) - The United States has 2,532 confirmed cases of the new H1N1 swine influenza in 44 states, and three deaths, the U.S. Centers for Disease Control and Prevention said on Sunday.

On Saturday, the CDC reported 2,254 confirmed cases, with 104 people in the hospital.

Washington state health officials said on Saturday a man in his 30s with underlying heart conditions succumbed to the virus last week. It was the first death in the state.

Although most cases appear to be mild, just as in seasonal flu the swine flu strain has killed, with 48 confirmed deaths in Mexico, three in the United States, one in Canada and one in Costa Rica.

It has moved into the southern hemisphere, where influenza season is just beginning, and could mix with circulating seasonal flu viruses or the H5N1 avian influenza virus to create new strains, health officials said.

(Reporting by World Desk Americas)

Seven further UK swine flu cases

Seven new swine flu cases in the UK have been confirmed, the Department of Health has said.

A spokeswoman said all the people diagnosed were in England, bringing the total in the UK to 55.

She added that the cases involved two adults and four children in London and an adult in the east of England.

"So far, all infections in the UK have been mild, and cases have been diagnosed and treated early," the spokeswoman said.

Laboratory investigation

A Health Protection Agency (HPA) spokeswoman said the adult in the east of England and one of the London adults had been in contact with individuals who had previously been confirmed with swine flu.

The other adult in London and all four children "were swabbed last week and may have acquired their infection before the closure of their school", she said.

She added that anti-viral drugs had been given to all children and staff as a precaution, and all symptomatic patients were recovering at home.

According to the HPA, a further 384 cases were under laboratory investigation as of 1500BST on Sunday.

Of the 55 cases in the UK, 50 have been confirmed in England and five in Scotland.

H1N1 flu tally 4,379 in 29 countries - W.H.O.

* 4,379 people infected with H1N1 flu in 29 countries

* Big increase in confirmed cases in United States

* First death reported in Costa Rica



ZURICH, May 10 (Reuters) - H1N1 flu has infected 4,379 people in 29 countries, the World Health Organisation (WHO) said on Sunday, increasing its count by almost a thousand in a day.

The WHO tally tends to lag national reports but is considered more definitive.

The U.N. agency said Mexico has reported 1,626 confirmed cases, up from 1,364 on Saturday, and repeated that 45 people have died there from the new flu strain that is a genetic mixture of swine, bird and human viruses.

The Mexican government has said the worst is over and eased restrictions on commercial and public activity in the country that has been at the epicentre of the outbreak.

The WHO's latest flu tally increased the number of confirmed infections in the United States to 2,254 from 1,639 reported on Saturday, while the number of reported deaths remained at two.

U.S. officials on Saturday said a man died from the new flu in Washington state last week, bringing the toll in the United States to three.

WHO increased the number of infections in Canada to 280, from 242, and repeated one person had died there.

It said one person had also died in Costa Rica, which had eight confirmed cases.

European countries with cases confirmed in WHO laboratories include Spain (93), Britain (39), Germany (11), Italy (9), France (12), Portugal (1), Ireland (1), Netherlands (3), Austria (1), Denmark (1), Sweden (1), Switzerland (1) and Poland (1).

The WHO also confirmed the following infections in the rest of the world: Israel (7), New Zealand (7), Brazil (6), Japan (4), Panama (3). South Korea (3), El Salvador (2), Hong Kong, China (1), Guatemala (1), Colombia (1) Argentina (1) and Australia (1).

Evidence that the disease, popularly known as swine flu, has taken hold in communities outside the Americas would prompt WHO Director-General Margaret Chan to declare a full pandemic.

Chan raised the global pandemic alert level last week to 5 out of 6 in response to the spread of H1N1 flu. Phase 5 means a pandemic is imminent.

The WHO also repeated its guidance that international travel should not be restricted as a result of the outbreak.

Swine Flu Is as Severe as 1957 Pandemic, Study Shows

May 12 (Bloomberg) -- The swine flu strain that has sickened people in 30 countries rivals the severity of the 1957 “Asian flu” pandemic that killed 2 million people, scientists said.

About four of 1,000 people infected with the new H1N1 strain in Mexico by late April died, according to a study published yesterday in the journal Science that was led by Neil Ferguson of the Imperial College London. Seasonal flu epidemics cause 250,000 to 500,000 deaths each year, the World Health Organization has said.

Scientists are trying to determine whether swine flu will mutate and become more deadly as it spreads to the Southern Hemisphere and back. The virus is more contagious than seasonal flu, the Geneva-based WHO said yesterday. A “moderate” pandemic like the 1957 Asian flu could kill 14.2 million people and shave 2 percent from the global economy in the first year, the World Bank said in October.

“While substantial uncertainty remains, clinical severity appears less than that seen in 1918 but comparable with that seen in 1957,” the Science study authors wrote.

Flu pandemics occur when a strain of the disease to which few people have immunity evolves and begins spreading. Pandemics usually occur two to three times a century, scientists have said. A worldwide outbreak as severe as the 1918 Spanish flu might cause 180 million to 360 million deaths, according to a 2005 study in the New England Journal of Medicine.

The last pandemic hit in 1968, and health officials have been anticipating another since the H5N1 strain began spreading widely in birds in 2003.

World Spread

Swine flu has been confirmed in 4,694 people, according to the WHO, the health agency of the United Nations. Sixty-one people have died, including 56 in Mexico, three in the U.S., and one each in Canada and Costa Rica, health officials said. The U.S. confirmed 2,618 cases in 44 states, according to the Centers for Disease Control and Prevention.

Thai Prime Minister Abhisit Vejjajiva today confirmed the country’s first case of swine flu. Separately, former Cuban President Fidel Castro said a Mexican medical student in the island nation has the virus. The WHO’s latest tally doesn’t include these figures.

Each person infected with swine flu in Mexico in April gave it to 1.4 more people on average, the study said. While that’s in the lower range of transmission speed for a pandemic virus, it’s quicker than most seasonal flus, the authors said.

An estimated 23,000 people in Mexico were infected by late April, the researchers said. That number was based on case reports and assumptions about the speed of spread, and may have been as high as 32,000 and as low as 6,000, according to the study.

More Contagious

In seasonal flu, each person who comes in contact with someone who’s sick has a 5 percent to 15 percent probability of illness, according to a statement on the WHO’s Web site. In swine flu, the probability increases to 22 percent to 33 percent, WHO said.

Swine flu has been “overwhelmingly mild outside Mexico,” the WHO statement said. The reason for that variation “is still not fully understood,” it said.

Swine flu is making more young people seriously ill, compared with seasonal flu, and “is of particular concern” because it’s causing more significant medical effects in people with other health conditions, the WHO said.

40 new cases of swine flu in Canada: officials

OTTAWA (AFP) — Health officials in Canada on Monday confirmed 40 new cases of swine flu, bringing the total number across the country to 331.

Thirty-four of the new cases were found in Ontario, the nation's most populous province, which now has had a total of 110 cases since the start of the outbreak.

The remaining cases, most of them mild, are scattered around the vast country, including two new cases in Quebec and three in Alberta -- where the only Canadian death from the virus was confirmed by authorities last week.

Health officials reported that to date, there have been 79 swine flu cases in British Columbia, on the Pacific coast; 57 in Nova Scotia on the Atlantic coast; 52 in Alberta; 17 in Quebec; 10 in Saskatchewan; three on Prince Edward Island; two in New Brunswick and one in Manitoba.

Copyright © 2009 AFP. All rights reserved. More »

Don't shoot the scientists

Simon Jenkins is right to say that obsessive media coverage of swine flu, ever thirsty for hyperbole and impatient for new developments, can be misleading (Sophie's sniffle mocks the peddlers of swine flu panic, 6 May). And advice issued by government should rightly be debated.

But the suggestion that scientists "depend on regular pandemic scares for government grants" is paranoid (we might as well say Jenkins invents contrary opinions in order to be paid by the Guardian). In his dismay at the lack of a pandemic he reminds me of a man playing Russian roulette who, after two squeezes of the trigger, declares: "Ha! This isn't dangerous after all!" The possibility of a pandemic is real but cannot yet be predicted with assurance.

Jenkins declares that "no medical authority ... has confined its reporting to the facts". Yet the majority of scientists have been cautious and measured on the subject. At the Science Media Centre we have spoken to dozens of scientists on the subject and I haven't yet found one who is clamouring to make more media appearances; these people are hardly underworked at the moment.

I am proud of our virologists, epidemiologists and microbiologists for giving up their time to explain complex and uncertain science. Imagine the alternative: scientists having secret meetings with ministers, and official statements issued from behind closed doors. The bad old days - now that would make me panic.

There is no excuse for hyping a story, but the source of that hype is not always plain. Here's an example: a senior virologist I know was asked by a journalist how many deaths might be expected if a full-scale pandemic were to take a global hold. He said the figure was impossible to predict with any accuracy, but between one and 50 million would be a reasonable estimate. "Fifty million could die, say scientists" was the next day's headline. Was the virologist wrong to make his statement? Absolutely not: it was scientifically valid and defensible. But after some editorial lopping it's no wonder Jenkins concludes that swine flu was greeted with "pandemonium".

Except that in the UK I don't see this pandemonium. I see people going to work, children going to school, and not a face mask in sight. Why? Because largely conscientious science journalism has ensured we have been well-informed. We get the science. We're not panicking.

"At last an expert speaks," Jenkins says of London schoolgirl Sophie de Salis describing her symptoms as mild. But such glee as scientists appear to be wrong is hollow schadenfreude. I don't hear any crowing that the flu pandemics of the past "might not have happened". They did; another one will; and it might start off looking very similar to this one.

Let's not forget that these pandemics are in living memory, and that the direction this infection will take remains unknown. And let's be cautious about how we get our news, remembering that media saturation and big headlines don't mean Armageddon. Which is why you might make a case for shooting the odd editor. But please, Simon, don't shoot any virologists; you never know when you might need one.

• Tom Sheldon is a biologist and spokesman for the Science Media Centre

Swine flu could affect third of world's population, says study

The swine flu virus will infect a third of the world's population if it continues to spread at its current rate, scientists warned today, as three more cases were confirmed in the UK.

In what the journal Science described as the "first quick and dirty analysis" of swine flu, a study by researchers at Imperial College London predicted the virus was likely to cause an epidemic in the northern hemisphere in the autumn.

One of the authors, the epidemiologist and disease modeller Neil Ferguson, who sits on the World Health Organisation's emergency committee for the outbreak, said the virus had "full pandemic potential".

Speaking on BBC Radio 4's Today programme, he said: "It is likely to spread around the world in the next six to nine months, and when it does so, it will affect about one-third of the world's population.

"To put that into context, normal seasonal flu probably affects around 10% of the world's population every year, so we are heading for a flu season which is perhaps three times worse than usual – not allowing for whether this virus is more severe than normal seasonal flu viruses."

The Health Protection Agency announced three more confirmed cases of the virus in the UK, bringing the total to 68. The three patients – two children and one adult from London – all had close contact with previously confirmed cases.

Today's study estimated the contagiousness of the disease by analysing the number of people travelling to Mexico who became infected, and comparing that with a study of a Mexican village where the disease has spread. The research also examined how the virus was mutating.

It estimated that swine flu had killed between 0.4% and 1.4% of its victims in Mexico. The report's lead author, Christophe Fraser, said it was too early to predict what the death rate was likely to be outside Mexico. "My hunch is that the death rate will be lower elsewhere – Mexico has underlying issues with respiratory disease," he said.

The researchers said this H1N1 virus appeared to be about equal in severity to the flu of 1957, and less severe than the deadly 1918 version.

"At the moment the virus is not spreading fast in the northern hemisphere because we are outside the normal flu season, but come the autumn it is likely to cause a really major epidemic," Ferguson said.

He declined to put an estimate on the number of deaths that may occur. "We have some assessment, but the uncertainty is still quite broad," he said.

"We can say it is not going to be as catastrophic as the Spanish flu pandemic of 1918, it is milder than that. But it is still possible it could be [like] 1957 – where about three to four out of 1,000 people who were infected died and overall about 3 million to 4 million people died that year because of the pandemic worldwide – or it could be even milder than that, like the 1968 pandemic which was barely worse than a normal seasonal flu year.

"I am not predicting three million to four million [deaths]. That was what happened in 1957. The world is a very different place today. There are more people in the world, but there is also a much better healthcare system. We have drugs and vaccines, particularly in developed countries, which should markedly reduce the burdens of the disease."

Ferguson said the findings of the study confirmed that decisions must be taken swiftly on vaccine production.

"One of the key decisions which has to be made this week by the world community is how much do we switch over current vaccine production for seasonal flu to make a vaccine against this particular virus."

Today Cuba and Thailand confirmed their first case of the virus. The patient in Cuba is a Mexican student at a medical school.

Fidel Castro accused Mexico of failing to disclose the spread of swine flu until after Barack Obama, the US president, had visited the country on 16 April. In a newspaper column, the former Cuban leader wrote: "Mexican authorities did not inform the world of the presence [of swine flu], while they waited for Obama's visit."

At least 61 people have been killed by swine flu around the world, and the WHO has confirmed about 4,800 cases.

Swine flu goes person-to-pig; could it jump back?

MEXICO CITY – Now that the swine flu virus has passed from a farmworker to pigs, could it jump back to people? The question is important, because crossing species again could make it more deadly.

The never-before-seen virus was created when genes from pig, bird and human viruses mixed together inside a pig. Experts fear the virus that has gone from humans back into pigs in at least one case could mutate further before crossing back into humans again. But no one can predict what will happen.

"Could it gain virulence? Yes," Juan Lubroth, an animal health expert at the U.N. Food and Agriculture Organization in Rome, said Sunday. "It could also become milder. It could go in both directions."

Canadian officials announced Saturday that the virus had infected about 200 pigs on a farm — the first evidence that it had jumped to another species. It was linked to a farmworker who recently returned from Mexico, where 19 people have died from the virus. The farmworker has recovered, and the mildly infected pigs have been quarantined.

Agriculture officials believe the worker may have sneezed or coughed near the pigs, possibly in a barn. About 10 percent of the herd experienced loss of appetite and fever, but all are recovering.

Experts say pork — even from infected pigs — is safe to eat.

Lubroth stressed that sick people should avoid contact with swine, but said healthy farmworkers don't need to take any extra precautions because the chance of catching flu from a pig is small.

Unlike the H5N1 bird flu virus, which infects the blood, organs and tissue of poultry, most swine flus are confined to the respiratory tract, meaning the risk of a human getting infected by a pig is "probably 10 or a 1,000 times less," Lubroth said.

But pigs are of special concern because they share some basic biological similarities with humans, and they have served as "mixing vessels" in which various flu strains have swapped genetic material. That's what happened to create the current swine flu strain.

Scientists are unsure when the virus leaped from pigs to humans — possibly months or even a year ago — but it was identified as a new strain about a week and a half ago. Since then, nearly 800 cases have been confirmed worldwide. The only death outside Mexico occurred when a Mexican toddler died in a Texas hospital.

There have been sporadic cases of pigs infecting humans with influenza in the past. Most cases resulted in mild symptoms, typically among people who were in close contact with sick pigs. A few deaths have been recorded, and limited human-to-human transmission also has been documented, but nothing sustained.

Dr. Tim Uyeki, an epidemiologist with the U.S. Centers for Disease Control and Prevention who has worked on SARS and bird flu outbreaks, said there may be more pig-to-human cases that have gone unnoticed because surveillance among swine populations tends to be weaker than among poultry stocks.

Given that the past three flu pandemics — the 1918 Spanish flu, the 1957-58 Asian flu and the Hong Kong flu of 1968-69 — were all linked to birds, much of the global pandemic preparedness has focused on avian flus.

"The world has been watching and preparing and trying to prevent a pandemic from an avian influenza reservoir," he said. "The focus has been on birds, and here is a virus that's coming from a swine reservoir. Now it's a human virus."

Swine H1N1 Fatality in Washington

The Snohomish County man, who officials said was in his 30s, had an underlying heart condition. He became sick on April 30 and died Wednesday from what appears to be complications of swine-origin influenza (H1N1), officials with the state Department of Health said.

The above comments describe the first reported H1N1 swine influenza death in Washington state. The death follows two deaths in Texas and one in Canada. These deaths highlight concerns that H1N1 deaths in the United States will parallel the deaths in Mexico when the number of cases increase.

The virus is rapidly spreading in the United States (see updated map), but the vast majority of reported cases are in children or young adults and most of these cases have been mild and did not require hospitalization. However, as the number of deaths in the United States increase, the similarities with Mexico will become clearer.

These similarities are most easily seen in the sequences of the swine H1N1 from patients in Mexico and the United States (see list here), which are virtually identical. Moreover the same sequences had been identified in isolates worldwide, strongly suggesting that differences in mortality are largely due to testing and detection frequencies.

The H1N1 in Mexico was recently confirmed by labs in the United States and Canada. Prior to the lab confirmation, the reports out of Mexico were mixed. It was clear that patients between the ages of 25-44 were dying from atypical pneumonia, but the etiological agent was unclear. The identification of swine H1N1 that matches the virus circumnavigating the globe provides a tight association between prior events in Mexico and future events in countries with more recent introductions.

However, the timing of these introductions remains uncertain. The mild nature of the vast majority of case allows for silent spread. The first two cases in the United States were identified through a border surveillance system. Other infections would go undiagnosed or misdiagnosed because of similarities with seasonal flu. Most infected patients would not seek medical attention, and those that did would be positive for influenza A and treated as seasonal flu patients.

This silent spread will likely continue because of decisions to limit testing of patients by state labs. Many have indicated that they will concentrate on more severe cases. Although an influenza A positive at this time of the year in the northern hemisphere will be increasingly likely to be H1N1 swine flu, a lab confirmation is the best tracking data.

The deaths of the young adults in Texas and Washington highlights the similarities between the H1N1 swine flu pandemic of 2009 and the 1918 outbreak, which also began with mild influenza due to efficient swine H1N1 transmission in a human population.

The rapid spread in the human population increases the likelihood of co-infrection with H1N1 seasonal flu and the acquisition of key polymorphisms linked to adaptation in human hosts. Two likely acquisitions are NA H274Y and PB2 E627K, which are fixed in human H1N1.

Close monitoring of sequences, including those from the southern hemisphere in the near term, will allow for detection of key changes that will drive swine H1N1 infections in the northern hemisphere in the fall.
The key acquisitions were recently demonstrated in the fixing of oseltamivir (Tamiflu) fixing in H1N1 seasonal flu, and acquisition of key polymorphisms via homologous recombination remains a cause for concern.

NIAID Lab Attacks Flu From Different Directions

Jeffery K. Taubenberger, M.D., Ph.D., a senior investigator in the Respiratory Viruses Section of the NIAID Laboratory of Infectious Diseases, is a world-renowned expert on influenza viruses, particularly the strain that caused the infamous 1918 flu pandemic. Today, his laboratory at NIAID studies a number of viruses, including influenza A viruses (IAVs), which are the pathogens that cause yearly flu epidemics and have caused periodic pandemics, such as the 1968 outbreak that killed an estimated one million people.

This negative-stained transmission electron micrograph depicts the structural details of an influenza virus particle. Influenza A and B are the two types of influenza viruses that cause epidemic human disease. Credit: CDC/ Dr. Erskine. L. Palmer; Dr. M. L. Martin

Dr. Taubenberger’s research aims to inform public health strategies on several important aspects of flu: seasonal flu; avian flu, which circulates among birds and has infected humans in the past; swine flu, which circulates among pigs and has infected humans in the past; and pandemic flu, which can arise from numerous sources and spread quickly because humans have little to no immunity to it.

Responding to New Viruses

The emergence of 2009 H1N1 influenza made international headlines as it affected mostly young people in Mexico, the United States, and other parts of the world.

Dr. Taubenberger’s lab is currently studying the 2009 H1N1 flu virus to understand how this strain emerged and to try to identify factors that allow it to spread and cause disease in humans. It is investigating models of how this new virus infects the respiratory tract of animal models and what allows the virus to be transmitted. Additionally, Dr. Taubenberger and his colleagues will be evaluating how exposure to prior strains of flu may contribute to the immune response to this 2009 H1N1 virus.

Taking on Seasonal Flu

Seasonal flu affects most of the general population at some point in their lives. Its incidence increases at regular, expected times during the winter months. These epidemics are estimated by the World Health Organization to cause between 250,000 and 500,000 deaths worldwide each year.

In a recent analysis, Dr. Taubenberger and several co-authors examined 1,302 complete IAV genomes. Their results showed that virus strains do not persist from one flu season to the next; rather, new strains of flu arise each year. Understanding how IAV evolves is central to its surveillance and control. With this study, Dr. Taubenberger and his collaborators have contributed information that could allow public health officials to determine more quickly and accurately which strains of flu to include in the annual vaccine.

For more information, read Study Provides New Understanding of Forces Behind Seasonal Flu Virus Evolution.

Studying Avian Flu

IAVs in humans are thought to be ultimately derived from avian influenza viruses. Dr. Taubenberger and collaborators were able to determine the complete genomic sequences of 167 wild bird IAVs and, based on their observations, proposed that IAVs in wild birds form transient “genome constellations.” These constellations continually reshuffle, making it difficult to predict what prevention methods will work on which strains. Understanding the ecology and evolution of avian IAV is important for pandemic preparedness and to understand how these viruses might adapt to humans.

Researching Swine Flu

IAVs also infect pigs around the world, and different strains of flu viruses have circulated in pigs at least since 1918. Pigs can be infected with flu viruses adapted to pigs, humans, and birds, so they have been called a “mixing vessel” for flu viruses.

Dr. Taubenberger and his collaborators have been studying swine flu in the laboratory and recently published a study of the evolution of different strains of swine flu since 1918. These studies are shedding light on how flu viruses adapt to pigs. His lab is also actively involved in studies evaluating how different swine influenza viruses cause disease in various animal models.

Preparing for a Pandemic

Pandemic flu has led to tremendous loss of life. For example, the 1918 pandemic resulted in the deaths of 40 to 50 million people worldwide. Modern vaccines and health preparations have usually been able to stay ahead of new flu viruses in recent years; however, new pandemic IAVs are an ever-present threat. To prepare for a pandemic, understanding the how’s and why’s of past pandemics is essential.

Dr. Taubenberger, and other co-authors from NIAID, developed a comprehensive analysis of victims of the 1918 pandemic. In addition to studying actual tissue samples from 58 U.S. soldiers who died of influenza between 1918 and 1919, the co-authors identified and reviewed 118 contemporary autopsy series reports on victims of the pandemic, comprising 8,398 individual autopsies conducted in 15 countries. Their results showed that the primary cause of death among the victims was not the influenza virus but rather bacterial pneumonia. Flu weakened the victim’s immune system, allowing the bacteria to invade and kill. This realization promises to make preparations for diagnosing, treating, and preventing bacterial pneumonia a major component of planning efforts for a future pandemic.

Plenty of flu caution as Mexico returns to work

MEXICO CITY — In gleaming office towers and gritty markets, Mexicans returned to work Wednesday after a five-day swine flu shutdown, and dozens returned to a heroes' welcome from "humiliating" quarantines in China. But Mexico's death toll rose, feeding fears of more infections now that crowds are gathering again.

The World Health Organization urged countries not to quarantine visitors or impose trade restrictions without scientific reasons. But China defiantly justified its quarantines as protection for its densely populated cities. Even impoverished Haiti turned away a Mexican ship carrying desperately needed food aid because of flu fears.

In Mexico City, friends and co-workers greeted each other with back slaps, firm handshakes — and dollops of hand sanitizer. Some high-rises stationed doctors in their lobbies who questioned returning employees and required visitors to fill out forms stating they had no flu symptoms. Maitre d's in surgical masks stood at attention amid rows of sidewalk tables that were pulled out and washed down for the first time in days.

The city's health secretary late Wednesday announced that all businesses — including sports arenas, dance halls, movie theaters and all restaurants — will be allowed to operate today. But Armando Ahued said businesses must screen for ill people and make surgical masks mandatory for employees and customers.

"We're returning to normal," said Eugenio

---

---

Velis, 57, a graphic artist sipping coffee with friends in the trendy Condesa neighborhood.

But Ernesto Viloria, 40, worried about his children using public transit and returning to school.

"Nothing can be the same," insisted Viloria, who works in finance. "The virus continues, even though it's declining, and we have to pay attention."

The confirmed death toll in Mexico reached 42 on Wednesday — mostly as backlogged cases got tested, but also two new deaths were reported .

Flu overhyped? Some say officials 'cried swine'

CHICAGO — Did government health officials "cry swine" when they sounded the alarm on what looked like a threatening new flu?

The so-far mild swine flu outbreak has many people saying all the talk about a devastating global epidemic was just fear-mongering hype. But that's not how public health officials see it, calling complacency the thing that keeps them up at night.

The World Health Organization added a scary-sounding warning Thursday, predicting up to 2 billion people could catch the new flu if the outbreak turns into a global epidemic.

Many blame such alarms and the media coverage for creating an overreaction.

Schools shut down, idling healthy kids and forcing parents to stay home from work; colleges scaled back or even canceled graduation ceremonies; a Cinco de Mayo celebration in Chicago was canned; face masks and hand sanitizers sold out — all because of an outbreak that seems no worse than a mild flu season.

"I don't know anyone who has it. I haven't met anyone who knows anyone who contracted it," said Carl Shepherd, a suburban Chicago video producer and father of two. "It's really frightening more people than it should have. It's like crying wolf."

Two weeks after news broke about the new flu strain, there have been 46 deaths — 44 in Mexico and two in the United States. More than 2,300 are sick in 24 countries, including more than 800 U.S. cases. Those are much lower numbers than were

---

Advertisement

---

feared at the start based on early reports of an aggressive and deadly flu in Mexico.

Miranda Smith, whose graduation ceremony at Cisco Junior College in central Texas was canceled to avoid spreading the flu, blames the media.

"It's been totally overblown," she said Thursday.

"Everyone seems to know it's not going to kill you and it's not as deadly as they think," she said. "Everybody needs to just calm down and chill out."

Public health authorities acknowledge their worst fears about the new virus have not materialized. But no one's officially saying it's time to relax. Experts worry that people will become too complacent and tune out the warnings if the virus returns in a more dangerous form in the fall.

"People are taking a sigh of relief too soon," said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention.

Wednesday, Besser said the outbreak in the United States appears to be less severe than was first feared. But the virus is still spreading and its future potential as a killer is not clearly understood.

Flu Cases Rise in U.S.; Mexico Reports More Deaths

WASHINGTON -- Federal health officials said Wednesday they remain concerned about the new H1N1 influenza strain despite lifting a recommendation that schools and daycares close if they have students or staff with H1N1 flu.

Richard Besser, acting director of the Centers for Disease Control and Prevention, said the majority of H1N1 cases are in young people and that officials are starting to see some severe cases among the hundreds of mostly mild ones seen to date.

Flu: Complete Coverage

View Slideshow

Getty Images

Back to Business: Mexico City chefs and waiters listened to the manager as he went over measures to avoid contagion.

View Map

• Testimonies: Living Through a Flu Quarantine
• Live Updates: Latest news on the outbreak
• China Journal: Reports From People Quarantined in China
• WHO's updates | CDC's updates
• WSJ.com/Flu: News, video, more

Discuss

• Vote: How worried are you? Discuss

Timeline

View Interactive

• More interactive graphics and photos

"I want to say we remain concerned," Mr. Besser said during a daily influenza briefing. "Influenza can be a serious infection." The CDC reported continued increases in confirmed H1N1 influenza cases with 642 in 41 states. Two people have died in Texas, both with underlying health problems.

Other health officials, who testified before a House Foreign Affairs subcommittee Wednesday said, common-sense measures like hand-washing, staying home when sick and keeping children with flu-like illnesses -- a fever with a sore throat or cough -- home from school for seven days are effective at limiting the spread of a new virus that most people previously haven't been exposed to.

Anne Schuchat, interim deputy director for the science and public health program at CDC, told lawmakers that any vaccine for the H1N1 flu strain "is not likely to be widely available." The CDC is currently growing a seed strain that would be given to vaccine makers if global health authorities decide to move forward with a new vaccine. The earliest such a vaccine would be available is September.

Indeed, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health said, "it is important to remember that we are only at the earliest stages of understanding how the 2009 H1N1 influenza virus emerged and what impact it might have."

Health officials said while H1N1 influenza illnesses have been similar to the seasonal flu -- which hits about 30 million Americans annually and contributes to about 36,000 deaths -- the virus has been seen at higher rates in young people, with 58% of cases being reported in people younger than 18.

Besser explained that it could simply be because students brought the virus back to the U.S. after spring-break trips to Mexico. But, he said, older Americans might have some immunity to the virus, possibly from being exposed to more influenza strains over the past several years.

Officials are concerned the H1N1 virus could mutate and come back stronger when regular influenza season hits later this year as was the case in the 1918-1919 flu pandemic, which killed more than 50 million people.

CDC has distributed H1N1 test kits to states, which should allow for faster confirmation of new H1N1 cases, and will likely contribute to daily jumps in the number of cases. Previously CDC and just a handful of states could confirm such cases.

Besser said while the numbers are partly reflecting catch-up test results, he stressed that the H1N1 virus is still causing new illnesses.

A woman living near the Mexican border in south Texas became the second person in the U.S. to die of the new strain of flu. Judy Trunnell, who was a U.S. citizen in her early 30s, had chronic health conditions, according to Texas authorities. She had been hospitalized for about three weeks, after falling ill around April 14. None of her immediate family is ill, they said. They declined to elaborate further.

In Mexico, dozens of nationals quarantined in China despite having no flu symptoms arrived home Wednesday on a government-chartered jet, some complaining of "humiliation and discrimination" by the Chinese. But as Mexicans emerged from their own five-day swine flu shutdown, the death toll rose and many remained fearful. While the rate of new cases and hospitalizations has declined, epidemiologists said the virus has spread throughout Mexico. "We have seen a tendency [of the outbreak] to diminish, but not disappear," Health Secretary Jose Angel Cordova said.

Haitian officials rejected a Mexican aid ship carrying 77 tons of much-needed food aid because of flu fears, Mexico's ambassador said Wednesday.

Elsewhere Wednesday, Swedish authorities confirmed the Scandinavian country's first swine flu case -- a woman who recently visited the U.S. The Swedish Institute for Infectious Disease Control said the woman, in her 50s, has recovered.

—The Associated Press contributed to this article.

Is it the "Mexican Flu", the "Swine Flu" or the "Human Flu"?

What are the origins of the pandemic? by Michel Chossudovsky

Global Research, May 4, 2009

Email this article to a friend Print this article

The WHO announced on May 1st that it will be dropping the designation of "swine flu". The flu will henceforth be designated A H1N1, to be known more broadly as "the Mexican Flu", intimating that the disease originated in Mexico through human to human transmission. Swine influenza refers to "strains of influenza virus, that usually infect pigs". The terminology, therefore, is important, because if the pandemic is labelled "Mexican flu", the presumption is that Mexicans, namely humans, are the source of the disease. The term "Swine Flu', on the contrary, suggests that the pigs, at least initially, transmit the virus to humans, and, therefore, the issue of animal health must also be addressed. The news reports have largely focussed on the transmission from humans to humans. They have failed to address the abysmal environmental and health conditions affecting the hog population in factory farms, which are central to an understanding of two fundamental processes: a) the proliferation of the disease within the hog factory farms. b) the process of transmission of the virus from pigs to humans. The swine flu can be transmitted from pigs to humans under very specific circumstances, invariably to people working in hog farms who are exposed on a daily basis to the pigs. Scientists are unequivocal: "People who work with pigs, especially people with intense exposures, are at risk of catching swine flu." Swine influenza is an acute, highly contagious, respiratory disease that results from infection with type A influenza virus. Field isolates of variable virulence exist, and clinical manifestation may be determined by secondary organisms. Pigs are the principal hosts of classic swine influenza virus. (Human infections have been reported, but porcine strains of influenza A do not appear to easily spread in the human population. ... The disease in swine occurs commonly in the Midwestern USA (and occasionally in other states), Mexico, Canada, South America, Europe (including the UK, Sweden, and Italy), Kenya, China, Japan, Taiwan, and other parts of eastern Asia.(The Merck Veterinarian Manual) Canadian Pigs Infected by Mexicans The media has the distinct ability of turning realities upside down. Canada's print media, radio and network TV, in chorus, point to a Mexican worker on a hog farm in Alberta, identified as being responsible for having infected 220 pigs out of a herd of 2200 in an unnamed central Alberta hog factory farm. "The bans came quickly after authorities revealed Saturday that a central Alberta pig farm is quarantined under suspicion that a farm worker returning from Mexico spread the “swine flu” to hogs." (Calgary Herald, May 4, 2009, emphasis added) Some ten percent of the herd is said to be "recovering", according to federal officials. A quarantine has been placed on the farm. "Public-health officials said yesterday they were watching closely for movement of the swine-flu virus between people and pigs after a Canadian herd became infected, but took pains to counter a growing fear around the world of pork products. As a quarantine was imposed on an unnamed Alberta hog farm where 220 of the herd contracted the novel flu" (National Post, May 4, 2009, emphasis added) "Pig flu" is not a "novel" phenomenon as suggested by the media, neither is the H1N1 strain. Known and documented pigs are the original source of transmission: from pigs to humans and from humans to humans. The official story, however, is that the Canadian pigs in the province of Alberta had been infected with swine flu by a Mexican farm worker, namely human to pig transmission. Conversely, these same officials deny the transmission from pigs to humans. The official reports are unequivocal: Canadian pigs could not have infected people working in the hog factory including the Mexican farm worker: "It was the first time the Canadian Food Inspection Agency had reported a case of the virus being transmitted from a human to a pig in Canada, although this has been known to happen elsewhere. The agency said the infected herd was quarantined pending more testing "but that the chances the pigs could transfer the virus to humans was remote." (Reuters, May 2, 2009) Dr. Brian Evans, a veterinarian with the Canadian Food Inspection Agency (CFIA), stated that "it's common to see influenza in pigs and human transmission to pigs is known to occur." Dead Pigs from Hog Factory Farms In Mexico, which was identified by the WHO as the original source of the virus, a high incidence of swine flu was recorded in La Gloria, Perote Municipality, Veracruz State. "Sources characterized the event as a ‘strange’ outbreak of acute respiratory infection, which led to bronchial pneumonia in some pediatric cases. According to a local resident, symptoms included fever, severe cough, and large amounts of phlegm. Health officials recorded 400 cases that sought medical treatment in the last week in La Gloria, which has a population of 3,000; officials indicated that 60% of the town’s population (approximately 1,800 cases) has been affected. No precise timeframe was provided, but sources reported that a local official had been seeking health assistance for the town since February." (quoted in F. William Engdahl, Flying Pigs, Tamiflu and Factory Farms, Global Research, April 2009) There are indications that the hog factory farms in Mexico contributed to the initial outbreak of swine flu. La Gloria is a company town, which houses pig farms and surrounding toxic hog manures. Granjas Carroll de Mexico (GCM) is among the world's largest hog factories, producing almost one million factory hogs per annum. (Ibid) "GCM is a joint venture operation owned 50% by the world’s largest pig producing industrial company, Smithfield Foods of Virginia. (Ibid). Smithfield Foods (SFD) is the world's largest hog producer and slaughterhouse. With over 14 million hogs per annum, the Mexican plant of La Gloria represents over 7 % of its Worldwide production. Who is Infecting Whom? The Alberta incident where a Mexican farm worker allegedly infected 220 pigs, out of a herd of 2200 (exactly ten percent, which suggests an approximation rather than a precise estimate), is crucial to the understanding of the transmission process. The historical evidence suggests that transmission has, despite precautions, occurred from pigs to humans in giant hog factories. There is reason to believe that hog factories in North America could potentially be the source of transmission. In the US since 2005, 12 reported cases of swine flu among humans were recorded, all of which were related to direct contact or proximity to pigs, according the the Centre for Disease Control (CDC). These figures do not included unreported cases. What is the underlying causality. The fundamental question with regard to Alberta and other hog producing regions in North America is: Who is infecting whom? Did a farm worker returning from Mexico infect the pigs? Or did the Canadian pigs, confined to an unsanitary, polluted and confined environment, transmit the disease, initially within the 2200 herd, which then led to the infection of humans, namely people working in the hog factory in proximity of the pigs? If this is the case, the origins and causes of the pandemic are dramatically different to those presented by the WHO and the Obama Administration. We would no longer be dealing with the "Mexican Flu", transmitted from Mexico, but with a disease which originates in North America's hog factory farms. One would at least expect in an investigation that all the facts and causalities underlying the transmission of the virus be carefully examined. The name of the farm in central Alberta has not been released. No press interview or reports have been conducted at the farm on location. The identity of the Mexican worker who allegedly infected the pigs has not been made public. An aura of secrecy prevails: From the available information, the official story that the pigs were infected by a farm worker, who contracted the swine flu in Mexico cannot be corroborated. In recent developments, six more infections were reported in Alberta (Total 24, May 4, 2009). A young Alberta girl has been hospitalized "with a serious case of human swine flu" "Alberta Health announced Monday an Edmonton girl is in stable condition in hospital after contracting the disease, although it is not clear where she picked it up since she wasn't travelling."

US Swine Outbreak Is An 'Influenza'? Not So Fast

By Lawrence Broxmeyer MD
5-7-9


Medical researcher/physician Lawrence Broxmeyer MD, lead investigator in a Journal of Infectious Diseases study, has a message for the officials and scientists of WHO and the CDC: There is more to flu-like illness than either "Influenza" or "H1N1".

WHITESTONE, NY -- The CDC has a short memory. There was much the same "Influenza" talk when in 1990, a new multi-drug-resistant (MDR) tuberculosis outbreak took place in a large Miami municipal hospital. Soon thereafter, similar outbreaks in three New York City hospitals left many sufferers dying within weeks. By 1992, approximately two years later, drug-resistant tuberculosis had spread to seventeen US states, with mini-epidemics in Florida, Michigan, New York, California, Texas, Massachusetts, and Pennsylvania and was reported, by the international media, as out of control. Viral forms of swine, avian and human TB can be transmitted from one species to another.

"There have been about three influenza pandemics in each century for the last 300 years", points out Lawrence Broxmeyer MD . "Yet when the horrendous H1N1 1918 pandemic first got national attention in America in April, 1918, authorities didn't even considered Influenza or "the Flu" lethal enough to be a reportable disease."

Yet ironically, this very 1918 "Influenza" strain itself held clinical and epidemiologic similarities to the influenza pandemics of 1889, 1847, and even earlier. So it can be easily understood why some experts, from 1918 to the present, validly question how such an explosively fatal disease could have been or is presently caused by "Influenza".

Even Lancet, one of the most prominent medical journals in the world, calls the Mexican epidemic "flu-like" because frankly we do not have enough facts or verification in to call it anything else.

No one can deny the similarities between the onset of the 1918 epidemic and that of today. Yet a Press Release, issued on August 19, 2008, by the National Institute of Allergy and Infectious Diseases (NIAID), contains a striking finding and conclusion: The 20 to 40 million deaths worldwide from the great 1918 Influenza ("Flu") Pandemic were NOT due to "flu" or a virus, but to pneumonia caused by massive bacterial infection.

Subsequently, a study published in JAMA by Talbot and Moore in 2000 showed that Mexican immigrants to the US have the highest case rates for tuberculosis among foreign born persons.

The research of Lawrence Broxmeyer MD, first proclaimed that the 1918 pandemic was due to bacteria, particularly mutant forms of flu-like fowl, swine, bovine, and human tuberculosis (TB) bacteria. These forms of tuberculosis are often viral-like, mutate frequently and can "skip" from one species to another. Moreover the antibodies from such viral TB forms react in the compliment fixation and later "viral" assays. They also grow on cultures which are supposed to grow only viruses.

In 2006 Medline paper published in Elsevier's Medical Hypothesis, Lawrence Broxmeyer, MD wrote: "Influenza is Italian for "influence", Latin: influentia. It used to be thought that the disease was caused by a bad influence from the heavens. Influenza was called a virus long, long before it was proven to be one." Elsevier is a major medical publisher which also publishes The Lancet.

In 2005, an article in the New England Journal of Medicine estimated that a recurrence of the 1918 influenza epidemic could kill between 180 million and 360 million people worldwide. It is yet to be seen whether the present pandemic will be what that journal had in mind. Yet similar to the present Swine episode, a large part of the previous bird-flu hysteria was fostered by a distrust among the lay and scientific community regarding the actual state of our knowledge regarding the bird flu or H5N1 and the killer "Influenza" Pandemic of 1918 that it was compared to. Such distrust was not completely unfounded. Traditionally, "flu" does not kill. Experts, including Peter Palese of the Mount Sinai School of Medicine in Manhattan, remind us that even in 1992, millions in China already had antibodies to the Bird Flu H5N1, meaning that they had contracted it and that their immune system had little trouble fending it off.

In 2000 Dr. Andrew Noymer and Michel Garenne, UC Berkeley demographers, reported convincing statistics showing that undetected tuberculosis may have been the real killer in the 1918 flu epidemic. Although scientists have recently spun that a "new" strain of "Influenza" strikes healthy young people, flu traditionally attacks the old and the infirm. The 1918 killer, on the other hand, went after men and women in their prime, between 20-40, prime ages for a TB onslaught. Flu didn't traditionally show the male preference recorded in 1918. TB did. With TB routinely, there was extremely low mortality between the ages of 5 and 15, also reflected in 1918. Besides, Noymer pointed out, Influenza typically came in the winter, this one began in the late spring and summer. The first autopsy of a 1918 pandemic victim occurred in Chicago in April, the very same month that the Mexican swine "flu" came to our attention .This mystery 1918 disease would subside, but come back in the fall with a vengeance.

Yet, Gorgas, Head of the US Army Medical Corp. at that time, insisted on referencing it as ''Influenza'', an old and heretofore not that deadly disease. Furthermore, argued Noymer, flu traditionally gave mild to moderate fever, but in the 1918 pandemic, patients could spike to 105 or 106 degrees, not uncharacteristic for an acute attack of tuberculosis.

And so, Noymer and Garenne, aware of recent attempts to isolate the "Influenza virus" on human cadavers and their specimens, nevertheless concluded that: "Frustratingly, these findings have not answered the question why the 1918 virus was so virulent, nor do they offer an explanation for the unusual age profile of deaths".

"By 1918", Lawrence Broxmeyer, MD continued, "it could be said, in so far as tuberculosis was concerned, that the world was a supersaturated sponge ready to ignite and that among its most vulnerable parts was the very Midwest where the 1918 unknown pandemic began. A critical mass, much like the Mexican experience, had been reached. It is theorized that the lethal pig epidemic that began in 1918 Kansas just prior to the first human outbreak was a disease of avian and human tuberculosis genetically combined through mycobacteriophage interchange, with the pig susceptible to both, and as its involuntary living culture medium." This to is much like the inception of the Mexican epidemic.

In commenting on the NIAID report, Lawrence Broxmeyer MD writes that euphemisms like "pneumonia", "bronchitis" , "chest ailment", "the flu" etc. have been with us since time immemorial to describe tubercular involvement. This was noted in 1944 in pathologist Arnold Rich's classic test, "The Pathogenesis of Tuberculosis." It is also well known that bacterial secondary infection in TB cases is common. And since NIAD's 2008 report there can be little doubt that bacterial infection was the cutting edge of death in 1918.

Whatever the "connection" between TB bacteria , influenza, and a virus-caused "flu" epidemic, the August, 2008 report by the NIAID is a reminder that epidemics and pandemics are complex disease processes, which should not simply be assumed to be due merely to a "virus" of great ferocity.


______________________


Reference: Broxmeyer L. Bird flu, influenza and 1918: The case for mutant Avian tuberculosis. Med Hypotheses. 2006;67(5):1006-15. Epub 2006 Jun 27. http://drbroxmeyer.netfirms.com/PDF%20001%20Bird%20Flu%20Editorial.pdf

Readers interested in the subject of Influenza/TB can also go to Dr. Ron Paul, MD's take at:http://informationclearinghouse.info/article22507.htm

This and other papers regarding Lawrence Broxmeyer MD's ongoing research can be viewed by going toHttp://drbroxmeyer.netfirms.com



1.
2.
http://www.24-7pressrelease.com/press-release/a-recent-who-report-over-two-decades-after-
the-global-aids-epidemic-began-shows-no-signs-of-aids-abating-why-asks-lawrence-
broxmeyer-md-6482.php
Press Release - A recent WHO report, over two decades after the Global ...

US Swine Outbreak is an "Influenza"? Not so fast, says Lawrence Broxmeyer MD ...Copyright © 2004-2009 24-7 Press Release.com ...
24-7pressrelease.com/press-release/a-recent-who-report-over-two-dec... -
"http://rds.yahoo.com/_ylt=A0oGkiqgAAJK4RMAsFxXNyoA/SIG=1h446on1
v/EXP=1241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%26p=
US%2bSwine%2bOutbreak%2bis%2ban%2b%2522Influenza%2522%253F%2b
Not%2bso%2bfast%252C%2bsays%2bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

3. http://newsblaze.com/story/2009050500190200007.tf/topstory.html
US Swine Outbreak is an 'Influenza'? Not so fast, says Lawrence ...

US Swine Outbreak is an 'Influenza'? Not so fast, says Lawrence Broxmeyer MD. WHITESTONE, NY, May 05, 2009 /24-7PressRelease/ -- The CDC has a short memory. ...
newsblaze.com/story/2009050500190200007.tf/topstory.html - "http://rds.yahoo.com/_ylt=A
0oGkiqgAAJK4RMAslxXNyoA/SIG=1d522d9or/EXP=1
241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%26p=US%2bSwine%2bOutbreak
%2bis%2ban%2b%2522Influenza%2522%253F%2bNot%2bso%2bfast%252C%2bsays%2
bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

4. http://www.timesoftheinternet.com/press-releases/247/99097.html
US Swine Outbreak is an "Influenza"? Not so fast, says Lawrence ...

... NY, May 05, 2009 /24-7PressRelease/ -- The CDC has a short memory. There was much the same "Influenza" talk when ... so fast, says Lawrence Broxmeyer MD ...
www.timesoftheinternet.com/press-releases/247/99097.html

5. http://www.upi.com/finance/?GUID=8746106&Page=MediaViewer&ChannelID=652
News. Analysis. Insight. - 100 Years of Journalistic Excellence

WHITESTONE, NY, May 05, 2009 /24-7PressRelease/ -- The CDC has a ...
US Swine Outbreak is an"Influenza"? Not so fast, says Lawrence Broxmeyer MD. 04:00 AM ...
www.upi.com/finance/?GUID=8746106&Page=MediaViewer&ChannelID=6521 - 119k - "http://rds.yahoo.com/_ylt=A0oGkiqgAAJK4RMAtVxXNyoA/SIG=1e6pon5d5/EXP=
1241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%26p=US%2bSwine%2
bOutbreak%2bis%2ban%2b%2522Influenza%2522%253F%2bNot%2bso%2bfast%252C
%2bsays%2bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

6. http://markets.chron.com/chron/?GUID=8746106&Page=MediaViewer&ChannelID=6521
Stock market news and prices

US Swine Outbreak is an "Influenza"? Not so fast, says Lawrence Broxmeyer MD ...
markets.chron.com/chron/?GUID=8746106&Page=MediaViewer&ChannelID=6521 - 79k - "http://rds.yahoo.com/_ylt=A0oGkiqgAAJK4RMAt1xXNyoA/SIG=1ea6mo0iu/EXP=
1241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%26p=US%2bSwine
%2bOutbreak%2bis%2ban%2b%2522Influenza%2522%253F%2bNot%2bso%2bfast%
252C%2bsays%2bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

7. http://finance.banks.com/intersearch/?Account=banks&GUID=8746106&Page=MediaViewer&ChannelID=6521
US Swine Outbreak is an "Influenza"? Not so fast, says Lawrence ...

WHITESTONE, NY, May 05, 2009 /24-7PressRelease/ -- The CDC has a ...
US Swine Outbreak is an"Influenza"? Not so fast, says Lawrence Broxmeyer MD. 04:00 AM ...
finance.banks.com/intersearch/?Account=banks&GUID=8746106&Page=MediaViewer&Chan... - 101k -"http://rds.yahoo.com/_ylt=A0oGkiqgAAJK4RMAuVxXNyoA/SIG=1f6teq3uq/EXP
=1241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%26p=US%2bSwine
%2bOutbreak%2bis%2ban%2b%2522Influenza%2522%253F%2bNot%2bso%2bfast%
252C%2bsays%2bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

8. http://studio-5.financialcontent.com/mi/?Account=miamiherald&GUID=8746106
&Page=MediaViewer&ChannelID=6521>FinancialContent

US Swine Outbreak is an "Influenza"? Not so fast, says Lawrence Broxmeyer MD ...
studio-5.financialcontent.com/mi/?Account=miamiherald&GUID=8746106&Page=MediaViewer&Chan... -105k - "http://rds.yahoo.com/_ylt=A0oGkiqgAAJK4RMAu1xXNyoA/SIG=1ffk880ho/EXP=1
241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%26p=US%2bSwine%
2bOutbreak%2bis%2ban%2b%2522Influenza%2522%253F%2bNot%2bso%2bfast%
252C%2bsays%2bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

9.
http://markets.sltrib.com/mng-sltrib/?GUID=8746106&Page=MediaViewer&ChannelID=6521
markets.sltrib.com/mng-sltrib/?GUID=8746106&Page=MediaViewer&ChannelID=6521

WHITESTONE, NY, May 05, 2009 /24-7PressRelease/ -- The CDC has a ...
US Swine Outbreak is an"Influenza"? Not so fast, says Lawrence Broxmeyer MD. 04:00 AM ...
markets.sltrib.com/.../?GUID=8746106&Page=MediaViewer&ChannelID=6521 - 98k - "http://rds.yahoo.com/_ylt=A0oGkiqgAAJK4RMAvVxXNyoA/SIG=1eg4h
i1n5/EXP=1241731616/**http%3a//74.6.146.127/search/cache%3fei=UTF-8%
26p=US%2bSwine%2bOutbreak%2bis%2ban%2b%2522Influenza%2522%253
F%2bNot%2bso%2bfast%252C%2bsays%2bLawrence%2bBroxmeyer%2bMD%2bMay
Cached

alancantwell@sbcglobal.net
http://www.ariesrisingpress.com
author of, AIDS & The Doctors of Deathand Queer Blood

10 Genes Of A Human Flu Virus, Furiously Evolving

Joe Raedle/Getty Images

PREPARED Doctors wearing protective gear with a possible flu patient in Mexico City.

• • Facebook
  • Mixx
  • MSpac
  • Yahoo! Buzz
  • Permalink

Evolutionary biology may sometimes seem like an arcane academic pursuit, but just try telling that to Gavin Smith, a virologist at Hong Kong University. For the past week, Dr. Smith and six other experts on influenza in Hong Kong, Arizona, California and Britain have been furiously analyzing the new swine flu to figure out how and when it evolved.

Skip to next paragraph

Multimedia

Graphic

The Flu Virus

Related

Times Topics: Swine Flu

Centers for Disease Control and Prevention

H1N1 An image of the newly identified swine flu virus. Partly because they can mutate very fast and can mix genes, viruses are turning out to be astonishingly diverse.

The first viruses from the outbreak were isolated late last month, but Dr. Smith and his colleagues report on their Web site that the most recent common ancestor of the new viruses existed 6 to 11 months ago. “It could just have been going under the radar,” Dr. Smith said.

The current outbreak shows how complex and mysterious the evolution of viruses is. That complexity and mystery are all the more remarkable because a virus is life reduced to its essentials. A human influenza virus, for example, is a protein shell measuring about five-millionths of an inch across, with 10 genes inside. (We have about 20,000.)

Some viruses use DNA, like we do, to encode their genes. Others, like the influenza virus, use single-strand RNA. But viruses all have one thing in common, said Roland Wolkowicz, a molecular virologist at San Diego State University: they all reproduce by disintegrating and then reforming.

A human flu virus, for example, latches onto a cell in the lining of the nose or throat. It manipulates a receptor on the cell so that the cell engulfs it, whereupon the virus’s genes are released from its protein shell. The host cell begins making genes and proteins that spontaneously assemble into new viruses. “No other entity out there is able to do that,” Dr. Wolkowicz said. “To me, this is what defines a virus.”

The sheer number of viruses on Earth is beyond our ability to imagine. “In a small drop of water there are a billion viruses,” Dr. Wolkowicz said. Virologists have estimated that there are a million trillion trillion viruses in the world’s oceans.

Viruses are also turning out to be astonishingly diverse. Shannon Williamson of the J. Craig Venter Institute in Rockville, Md., has been analyzing the genes of ocean viruses. A tank of 100 to 200 liters of sea water may hold 100,000 genetically distinct viruses. “We’re just scratching the surface of virus diversity,” Dr. Williamson said. “I think we’re going to be continually surprised.”

Viruses are diverse because they can mutate very fast and can mix genes. They sometimes pick up genes from their hosts, and they can swap genes with other viruses. Some viruses, including flu viruses, carry out a kind of mixing known as reassortment. If two different flu viruses infect the same cell, the new copies of their genes get jumbled up as new viruses are assembled.

Viruses were probably infecting the earliest primordial microbes. “I believe viruses have been around forever,” Dr. Wolkowicz said.

As new hosts have evolved, some viruses have adapted to them. Birds, for example, became the main host for influenza viruses. Many birds infected with flu viruses do not get sick. The viruses replicate in the gut and are shed with the birds’ droppings.

A quarter of birds typically carry two or more strains of flu at the same time, allowing the viruses to mix their genes into a genetic blur. “Birds are constantly mixing up the constellation of these viruses,” said David Spiro of the J. Craig Venter Institute.

From birds, flu viruses have moved to animals, including pigs, horses and humans. Other viruses, like H.I.V. and SARS, have also managed to jump into our species, but many others have failed. “It’s a very rare event when a virus creates a new epidemic in another species,” said Colin Parrish of Cornell University. In Southeast Asia, for example, a strain of bird flu has killed hundreds of people in recent years, but it cannot seem to move easily from human to human.

Only a few strains of influenza have managed to become true human viruses in the past century. To make the transition, the viruses have to adapt to their new host. Their gene-building enzymes have evolved to run at top speed at human body temperature, for example, which is a few degrees cooler than a bird’s.

Influenza viruses also moved from bird guts to human airways. That shift also required flu viruses to spread in a new way: in the droplets we release in our coughs and sneezes.

“If the virus settles down on the floor, then it’s gone,” said Peter Palese, chairman of microbiology at Mount Sinai School of Medicine. Winter is flu season in the United States, probably because dry air enables the virus-laden droplets to float longer.

Up to a fifth of all Americans become infected each flu season, and 36,000 die. During that time, the flu virus continues to evolve. The surface proteins change shape, allowing the viruses to evade the immune systems and resist antiflu drugs.

• 1
• 2

Next Page »

The Big Influenza Gamble

On Sept. 27, 1918, the Andover Board of Health closed all schools, the library, and the movie theater. Church services were voluntarily discontinued. These actions were taken because of the Great Influenza Epidemic of 1918-19. The Board of Heath reported 1,503 cases of influenza in 1918 and 25 people died. The Andover Townsman reported 341 new cases in one week. In 1919, there were 274 more cases, but the Board of Health was too busy dealing with the epidemic to file a report and no deaths were stated. (The town's population was 8,000.) In Lawrence, open air hospitals were set up in tent villages. In Massachusetts, 45,000 people died.

The Great Influenza was one of the worst events in human history. Twenty million Americans were infected, 20 percent of the population. It killed 675,000 of those people, 10 times more Americans than died in World War I. Half the American troops who died in the war died of the influenza. Worldwide, between 20 million and 100 million died, with 50 million being a widely quoted number. More people died from the Great Influenza in one year than died from the "Black Death" (Bubonic Plague) during the Middle Ages.

The mortality rate for the annual "flu" is 0.1 percent. Last year, the flu killed about 34,000 worldwide. That was a normal year. The mortality rate during the Great Influenza was 2.5 to 5 percent. Not only was that influenza much more contagious than ever, it killed a high percent of the people infected. The 1918-19 Influenza came in three waves. The first wave was relatively benign; the second wave was deadly; and the third wave was benign.

Virus mutation rate calculations are for scientists, but rapid mutation is what makes viruses so dangerous. Simply stated, viruses go through countless generations and mutations during the time it takes humans to go through a single generation.

"(H1N1) Influenza A," formerly called the "Swine Flu" is now causing concern. The 1918-19 was an H1N1 virus, but within the designation H1N1 are large numbers of variations. Some variations are harmless, some will make you sick, and some will kill you.

We had a Swine Flu scare in 1976, and it affected a presidential election. That year, a small number of soldiers at Fort Dix were diagnosed with Swine Flu. One died. Acting with the recommendation of the Centers for Disease Control and with Congressional approval, President Gerald Ford implemented a Swine Flu program that included the vaccination of 40 million Americans. Three elderly people died shortly after being vaccinated and the media assumed a connection. Public outcry stopped the vaccination program. Today we know that there was no scientific connection between those deaths and the vaccinations. However, after the vaccinations were stopped, as many as 500 people developed Guillain-Barre syndrome (GBS), a serious neurological disorder. Up to 25 of these people died. GBS is rare and can be caused as a response to a vaccination.

Before large scale vaccination programs are begun, experts predict the number of health issues that will be caused by the vaccine. It is a risk/reward analysis: how many people will be hurt as compared to how many will be helped by the vaccine. With flu vaccinations, it is predicted that one person in a million will get GBS. The 1976 Swine Flu Vaccine had an abnormally high 500. (That may have been a statistical anomaly, or something unique in the vaccine, or a heightened awareness of the side effects caused by media attention, or a combination of all of these.)

President Ford was criticized for overreacting to the Swine Flu. This "overreaction" may have played a role in his defeat by Jimmy Carter. In 1979, I was at the Kennedy School, and we studied the 1976 "Swine Flu Crises." The important part of the discussion was not about whether Ford had overreacted but whether the perception that he'd overreacted might cause future Presidents to underreact in similar situations.

The predictable cries that the government, the media, and "we" are overreacting began several days ago. Part of my full-time job involves risk management. Besides insurance (which is really shifting risk rather than managing it), risk management means that you do things that cost time and money to prevent people from getting hurt and assets from being destroyed. The trouble with risk management is that you can't always quantify whether you had the desired results. In other words, you don't know what problems you prevented.

This is a high stakes game, folks. If I were betting money, I'd bet that this will all blow over, and maybe laugh about it. However, I'm in favor of overreaction as opposed to underreaction when the stakes are so high.

Postscript. As the paper goes to press, it appears more than likely that the latest flu is no more dangerous than an ordinary flu. However, the government will have to make a decision as to whether it manufactures a vaccine for this new strain of influenza or whether it keeps on with its plans to manufacture a vaccine for the routine annual flu. There may not be enough capability to manufacture both, but that could change. Remembering that this H1N1 may be able to remake itself into a deadly second wave in time for the colder weather and flu season, like the H1N1 of 1918-19 remade itself, the stakes remain very high.

UPDATE 1-United States has 896 cases of new flu, CDC says

(For full coverage of the flu outbreak, click [nFLU])

* CDC says swine flu outbreak continues to spread

* No signs of it petering out

(Updates throughout with quotes, details)

By Maggie Fox, Health and Science Editor

WASHINGTON, May 7 (Reuters) - Outbreaks of the new H1N1 swine flu continue to spread across the United States, with 896 confirmed cases and more to come, the U.S. Centers for Disease Control and Prevention reported on Thursday.

U.S. officials have said they expect the swine influenza virus to spread to all 50 states and to cause many infections ranging from mild to severe.

Acting CDC Director Dr Richard Besser said the actual numbers matter less than the pattern of disease. "So far we are not seeing any signs of this petering out," Besser told reporters. "We are on the upswing."

And even though Mexican officials said they were over the worst, Besser said there was still significant transmission there, too. Continued...

View article on single page

Previous Page 1 | 2 | 3 Next Page

WHO says up to 2 Billion people might get swine flu

GENEVA (AP) — Up to 2 billion people could be infected by swine flu if the current outbreak turns into a pandemic lasting two years, the World Health Organization said Thursday.

WHO flu chief Keiji Fukuda said the historical record of flu pandemics indicates one-third of the world's population gets infected in such outbreaks. Independent experts agreed that the estimate was possible.

In Mexico, the hardest hit country so far, high schools and universities opened for the first time in two weeks as the government's top health official insisted the epidemic is on the decline. All students were checked for swine flu symptoms and some were sent home.

"If we do move into a pandemic, then our expectation is that we will see a large number of people infected worldwide," Fukuda said. "If you look at past pandemics, it would be a reasonable estimate to say perhaps a third of the world's population would get infected with this virus."

With the current total population of more than 6 billion, that would mean an infection total of 2 billion, he said, but added that the world has changed since pandemics of earlier generations, and experts are unable to predict if the impact will be greater or smaller.

"We don't really know." said Fukuda. "This is a benchmark from the past. Please do not interpret this as a prediction for the future."

Chris Smith, at flu virologist at Cambridge University in England, said the 2 billion estimate was possible.

"That doesn't sound too outlandish to me for the simple reason that this is a very infectious virus," Smith told The Associated Press. "You're talking about a virus that no one in the population has seen before and therefore everyone is immunologically vulnerable. Therefore it's highly likely that once it starts to spread, people will catch it. And since the majority of the world's population are in contact with one another, you're going to get quite a lot of spread."

John Oxford, professor of virology at St. Bart's and Royal London Hospital, agreed.

"I don't think the 2 billion figure should scare people because it's not as though 2 billion people are going to die. The prediction from WHO is that 2 billion people might catch it. Half of those people won't show any symptoms. Or if they show any symptoms, they will be so mild they will hardly know they've had it."

Fukuda said it also is impossible to say if the current strain of swine flu will become severe or mild, but that even with a mild flu, "from the global perspective there are still very large numbers of people who could develop pneumonia, require respirators, who could die."

A mild outbreak in wealthier countries can be "quite severe in its impact in the developing world," Fukuda said.

People react differently to the flu depending on their general state of health and other factors, he said. Some younger people in the Southern Hemisphere may be more vulnerable because of poor diet, war, HIV infections and other factors.

"We expect this kind of event to unfold over weeks and months," Fukuda said. "Really if you look over a two-period that is really the period in which you see an increase in the number of illnesses and deaths during a pandemic influenza."

So far the swine flu virus has spread to 24 countries.

Mexican dance halls, movie theaters and bars were allowed to fully reopen Thursday after a five-day shutdown designed to curb the virus' spread. Businesses must screen for any sick customers, and restaurant employees must wear surgical masks.

Fans can attend professional soccer matches this weekend after all were played in empty stadiums last weekend.

Mexico confirmed two more deaths, for a total of 44, while 1,160 people have been sickened, up 90 from Wednesday. Despite death tolls and confirmed caseloads that rise daily, Health Secretary Jose Angel Cordova insisted the epidemic is waning in Mexico.

WHO raised its global total of laboratory-confirmed cases to 2,099, from 1,893 late Wednesday, and said swine flu also has caused two deaths in the United States.

This swine flu seems to have a long incubation period — five to seven days before people notice symptoms, according to Dr. Marc-Alain Widdowson, a medical epidemiologist from the U.S. Centers for Disease Control and Prevention now tracking the flu in Mexico City. That means the virus can keep being spread by people who won't know to stay home.

Laughing and joking, high school students gathered at the entrance of the National School of Graphic Arts in Mexico City, waiting to fill out forms that asked about their health.

Of 280 students entering the school in the first 20 minutes, two showed symptoms of swine flu, including coughing and nasal congestion, said assistant principal Ana Maria Calvo Vega. Their parents were notified and they won't be readmitted without a statement from a doctor saying they don't have the virus, she said.

Students at a Mexico City vocational high school were welcomed with a hand sanitizer and a surgical mask. Joyful to see each other again, students embraced and kissed — some through masks.

But some worried that the virus could surge back once young people gather in groups again.

"My 17-year-old daughter is afraid. She knows she must go back but doesn't want to," said Silvia Mendez as she walked with her 4-year-old son, Enrique, in San Miguel Topilejo, a town perched in forested mountains near the capital.

Working parents have struggled to provide child care during the shutdown. It forced many to stay home from work, bring their youngsters to their jobs, or leave them at home.

Each school, Mexican officials said, had to be cleaned and inspected this week. Complicating the task: Many schools are primitive buildings with dirt floors and lack proper bathrooms. It was unclear how students attending those schools could adhere to the government's strict sanitary conditions.

The government promised detergent, chlorine, trash bags, anti-bacterial soap or antiseptic gel and face masks to state governments for delivery to public schools. But some local districts apparently didn't get the word.

U.S. health officials are no longer recommending that schools close because of suspected swine flu cases since the virus has turned out to be milder than initially feared. But many U.S. schools have done so anyway, including the school of a Texas teacher who died.

In Asia, top health officials said the region must remain vigilant over the threat of swine flu, stepping up cooperation to produce vaccines and bolstering meager anti-viral stockpiles.

The virus has so far largely spared Asia. Only South Korea and Hong Kong have confirmed cases. On Thursday, China and Hong Kong released dozens of people quarantined over suspected contact with one of the region's few swine flu carriers.

Past experience has been the spur to WHO to make sure the world is as prepared as possible for a pandemic, which would be indicated by a rise to phase 6 from the current phase 5 in the agency's alert scale. That would mean general spread of the disease in another region beyond North America, where the outbreak so far has been heaviest.

"I'm not quite sure we know if we're going to phase six or not or when we would do so," Fukuda said. "It's really impossible for anybody to predict right now."

Officials said the agency was likely to shorten its annual meeting of its 193 member states later this month from 10 days to five because of the outbreak, which it was scheduled to discuss.

"That is under consideration," Fukuda said. "Sure it is possible."

Contributions from AP Medical Writer Maria Cheng in London and Associated Press writers Andrew O. Selsky in Mexico City and Michael Casey in Bangkok.