Epidemiology looks at the causes, spread and treatment of epidemics
Scientists at the Erasmus Medical Centre in Rotterdam say they have been able to mutate the H5N1 virus so that it can be transmitted through the air.
Until now it was thought it could be transmitted between humans only via close physical contact.
“In a laboratory, it was possible to change the H5N1 into a virus… that can easily be spread through the air. This process could also happen naturally,”
http://uk.news.yahoo.com/terror-fear-scientists-create-killer-flu-114600583.html
There will be a wild badger cull in England.
The new Conservative Liberal coalition government has said the vaccination programme isn’t enough so badgers in TB hotspots will be killed.
Culling badgers to control Bovine TB in dairy cattle is controversial with many farmers facing increased incidence of TB reactors in cattle supporting a cull, and wildlife conservationists pointing out that culling badgers is not effective anyway.
New DEFRA farm minister Jim Paice, Conservative MP for South East Cambridgeshire has confirmed that badgers will be culled in England to combat bovine tuberculosis in cattle. A targeted cull of badgers will take place once the right “hot spot” locations have been identified.
The Badger Trust opposes culling, which they say would be in reality an unselected slaughter. The badger is one of Britain’s best loved and iconic animals and as such is part of our National Heritage. They are a poignant symbol of the British countryside and a protected species.
On culling badgers, Trust chairman Dave Williams says “The overwhelming scientific evidence and research shows that it is not the way to control bovine TB It has been tried for many years in one form or another, and it has never worked.”
Badger
Creative Commons Badger photo by Andreas-photography
It’s been more than six months since the swine flu epidemic erupted worldwide and in that time we have seen at least two major waves of illness around the northern hemisphere. The first was in our summer as the new virus spread in pockets after international travellers returned home already infected and affected wider populations in specific areas, particularly noticable when attributed to schools. The second wave started when the schools went back in September, in advance of our real winter which is only just beginning now, but peaked within weeks as the warm autumn weather held the virus in check.
November is traditionally the start of the flu season and this year is no exception apart from the fact that the flu virus in circulation is in most cases much more likely to be the new variant of type A H1N1 rather than the usual human h5n1 seasonal flu virus.
So this is either a third wave or a reprise of the second wave if you prefer, and the signs are that this has just passed a temporary peak, with the number of new reported cases dropping week on week for the first time (UK estimate 46,000 new cases of swine flu in the last week, down from 53,000 week before.) An important question now is whether or not there are any signs of the virus mutating into a type that is more deadly as has happened previously in history with influenza pandemics caused by new strains. The pattern to look out for is one of successive waves of increasing numbers infected, followed eventually by one or more waves which are not only more deadly to victims but also more easily transmittable. Then eventually once a tragic number of fatalities have been cleared away, the flu virus mutates into a milder form that goes on to infect the rest of the world’s population who haven’t already acquired immunity, but without taking nearly such a bad toll in terms of lives. It is reasoned that it’s for this eventuality that various governments have planned vaccination programmes for whole populations, at present being implemented first only for the most “at risk” demographics - young people, children and those with underlying health problems.
For the UK, another important fear is if the virus becomes resistant to the antiviral drug Tamiflu, since the government has taken the precaution of buying in huge stocks of the tablets, enough to treat one half of the country’s population.
The Thanksgiving holiday is typically followed by at least a modest bump in early seasonal flu cases, according to reports from the past few years. But this, of course, is not a typical year. Swine flu is a new virus that accounts for nearly all flu cases right now. Usually, seasonal flu is just getting going in late November, and holiday get-togethers allow illness to jump from small pockets to other parts of the country. Swine flu, in contrast, has been widespread for months.
“It’s not like we expect to see a bunch of infected people going to uninfected cities and towns”
said Andrew Pekosz, a flu expert at Johns Hopkins University. The swine flu pandemic hit the US in two waves: first in the spring, then a larger wave that started in the late summer.
The World Health Organization said H1N1 flu was moving eastward across Europe and Asia after appearing to peak in parts of Western Europe and the United States.
Mutations of the DNA of influenza viruses are typical of any pandemic and world experts are watching carefully for any first signs of a dangerous mutation. So far the indications are that early warning systems are working but that no such mutation with a deadly combination of easy transmission, deadly payload and/or drugs resistance has shown up – yet. Isolated cases of different mutations have been reported from Brazil, Norway and China and drug resistance in a hospital in Wales.
from MetroNews.CA Toronto
WHO’s spokeswoman in Beijing, Vivian Tan, said the agency is aware of three such cases in China that occurred in June and July that were similar to the cases being investigated in Norway. Tan said WHO had no information on the cases mentioned in the Xinhua report Wednesday.
There is no evidence the mutated swine flu virus is circulating widely in the world, Tan said, but since it has been linked to deaths in Norway and elsewhere, investigators are focusing on whether this mutation could be a marker for more severe disease.
“We are concerned, but realize that influenza viruses, including A/H1N1, are relatively unstable and change easily, especially as they infect more people,” Tan told The Associated Press. “Some mutations can have minimal effects on how a virus functions, while other mutations can create important changes with significant public health impact.”
Several troubling outbreaks of drug-resistant H1N1 have been documented but it has been noted they are limited so far and there are no indications yet that the virus is mutating in a sustained way.
Saudi authorities announced four pilgrims have died of the H1N1 swine flu virus in the days leading up to the pilgrimage which began on Wednesday 26th November 2009. A Moroccan woman, a Sudanese man and an Indian man, all 75, and a 17-year-old Nigerian girl, died from H1N. The Saudi Health Ministry said the four had not followed ”recommended procedures, especially vaccination against swine flu”.
All the victims so far had been suffering from underlying health conditions with 16 other cases of swine flu infection among pilgrims. Health authorities in Saudi have mobilised for the world’s largest gathering since swine flu began spreading across the globe, but the number of pilgrims going on Hajj is likely to be lower this year due to rainstorms, and local officials admitting that fears of swine flu may keep away at least 40 percent of local pilgrims.
A Tamiflu resistant strain of the swine flu has spread between hospital patients in Cardiff, Wales. They are thought to be the first confirmed cases of person-to-person transmission of a Tamiflu resistant strain in the world. Five patients at Cardiff’s University Hospital of Wales appear to have acquired the infection while being treated for other conditions, and these have now been joined by a sixth related case of the drug resistent flu strain.
The H1N1 virus has been remarkably stable since it emerged in April, but virologists had been half expecting new resistant strains to emerge somewhere in the world, and it appears to have happened first at the University Hospital of Wales in Cardiff.
Scientists in Norway announced recently that they had detected a mutated form of the swine flu virus in two patients who died of the flu and a third who was severely ill. The Norwegian mutation could possibly make the virus more prone to infect deeper in the airways and thus cause more severe disease, such as pneumonia. Influenza is a mutable virus, and changes are to be expected, this is typical early in the spread of a pandemic virus.
Some 680,000 Norwegians are estimated to have been infected with swine flu to date, of which 23 have died.
WHO says there have been over 6,750 deaths worldwide so far.
Although the world was alerted to the new strain of flu virus spreading in Mexico City back in April, the preparations made for a vaccination programme have been effected later than was originally hoped. Last week in the UK for example, it was announced that more than three million healthy children under five across the UK will be offered the swine flu jab, whereas the announcements back before the summer were that a widespread vaccination programme would begin in September. Over in France, the first cases of a vaccine induced illness have been reported, reviving fears of a repeat of the terrible situation in the US during the 1975 pandemic when a vaccination programme was halted due to large numbers of tragic side effects.
Dr David Hill ( from the World Innovation Foundation ?) left a comment on my previous post – “Swine Flu Caccination Plan” which I feel deserves to be promoted to a post of its own, below. He points out the real danger of a mutated swine flu variant, the problem with a vaccination plan due to the timescales involved, and proposes a solution for preventing swine flu and other fatal flu pandemics based on eradicating the conditions in which new variants arise.
Here is the comment from Dr David Hill in full:
The problem is that no one listens including the media. Swine flu if it mutates to something equivalent to the Spanish flu of 1918/1919 (Spanish flu was a swine flu variant) has the same potential to kill humans on an unprecedented scale as it did 90 years ago. The problem is that both swine and avian are constantly mutating into something different. So by the time you have isolated and made a vaccine for the last one, it has changed again and circumvented the old guard and becomes useless. The problem is that this happens all the time and where drugs become irrelevant. The reason, it takes three months to develop an antidote and 6 months to mass produce and distribute it (a logistic nightmare in itself alone) and where on average therefore the vast majority have to wait 9 months for the cure. The problem is that even in slow coach travel times 1918, the Spanish flu which took between 20 and 100 million lives worldwide (there is no authoritive number but where it is estimated between the two), did its deadliest between week 14 and week 26, some 12 weeks at least before the masses would ever receive the drug cure presently. The 1918 killer flu had a very similar circumstance as today, a mild version before the deadly version arrived in the fall of 1918 with a vengeance. The only way that this deadly killer can be stopped therefore, if anyone is listening out there, is through a complete overhaul of modern farming and husbandry methods and to give considerable financial help to those who breed the livestock that we all eat. Basically as a single example, just stop them sleeping with the animals on cold nights in the tropics as this is how the flu virus passes from pig to chicken to man – eventually; and where the pig is the receptive incubator. Simply give them a heater and fuel, a much cheaper option that global suicide in both human and econmic terms as it will be. For the ‘Tropics’ are where some of the most eminent virologists and micribiologists in the field say is the place where the killer virus will emerge.The philosophy of not letting it happen in the first place. The drugs strategy is futile and it is only a matter of time before the killer strain that will kill literally 100s millions appears. The problem is that the vast profits of drug companies and the government’s ignorance to the real facts will be the nails in all our coffins. The statistics and potential speak for themselves,
World Population 2 billion – 1920
Range of deaths
20mil/2billion = 1 in 100
100mil/2billion = 5 in 100
World Population now at 6.8 billion now equates to,
1 in 100 – 70 million min. today
5 in 100 – 340 million max. today
But, these figures could well be higher, as rapid world transit now makes for faster and wider transmission than in 1918.
I therefore say lets start now as I have been saying for the past three years and defeat this mass killer like no other by field work and not the futile drugs strategy that will do very little indeed to save lives. For presently we are all fooling ourselves.
If we put only £50 billion into this field work globally ( a small price for the human nightmare and financial melt-down that a global equivalent to Spanish flu would bring),we could eradicate the situation but where this £50 billion will no doubt end up alternatively in the pockets of the large pharmaceutical companies with little effect whatsoever. Get real everyone before it is basically too late and I am not joking – force governments to change their strategies from something that is impotent presently to something that will eradicate the problem at source. Common sense really but where currently no one seems to have any.
Worryingly also is the fact that as examples of other problems on the horizon is that the United States makes only 20 percent of its flu vaccines it uses and my country Britain makes zero percent of its flu vaccines, as all its flu vaccines are produced abroad. When a killer pandemic happens it will be hard for the producing countries to release any before their own people are serviced. Little known but true (Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota – 16.07.09).
I have been stopped from putting these comments and facts out by the media before. Let’s hope that minds are fully opened now and that the real solution can be heard and not just the bottom-line for drug companies!
Dr David Hill
So Dr Hill has identified the main obstacles to implementing a simple cost effective solution to prevent swine flu –
1) World health strategies are distorted by the production of drugs for profit.
2) The production of food still takes place in semi-feudal conditions in large parts of the world.
3) Nation states will compete to look after their own populations first rather than collaborate internationally for the good of all.
And hints at a solution – the people have to wake up and force governments to change strategies. He doesn’t go as far as I would, and point out that the implementation of a global plan to make food production safe and the harnessing of all the modern scientific understanding and technologies for the benefit of world health instead of the drugs companies can never take place all the while these means of production are in private hands run for the purpose only of making a profit for shareholders. So ‘forcing governments to change strategy’ will mean in practice, forcing governments to take over the industries involved and run them under some form of democratic ownership and control.
The first step must be education and I hope the reproduction of this alternative viewpoint here stimulates further thinking and debate, and in due course maybe, action to prevent the possibility of further killer swine flu pandemics and other variants of what should surely be preventable human diseases.
As I write, a massive vaccination plan is swinging into action for the UK. There has been a noticable media cautiousness when reporting the swine flu story in recent weeks, perhaps a responsible reaction to a perception of over hype when the epidemic was still very young. This is ending now as daily reports of increasing fatality numbers roll in. People are understandably worried and cannot understand why schools and workplaces are not closing where the swine flu has taken victim, to help prevent the spread of the virus. In fact, any idea of containing the outbreak has now been dropped. It’s too late, the disease cannot be contained, it has already spread widely. What would happen if we all stayed away from school and work for two weeks? – an interesting question but the emphasis now is on trying to keep serious cases to a minimum, and on vaccination.
GPs are being told to prepare for a nationwide vaccination campaign.
Dr Peter Holden, the British Medical Association’s lead negotiator on swine flu, who has been attending Department of Health meetings on the outbreak, said GPs’ surgeries were prepared for one of the biggest vaccination campaigns in almost 50 years. Although swine flu was not causing serious illness in patients, health officials were eager to start a mass vaccination campaign, starting first on priority groups. First, the jabs would reduce the chances of a shortage of hospital beds because of people suffering from swine flu. Second, it would reduce the effect on the economy by ensuring workers were protected from the virus.
“The high-risk groups will be done at GPs’ surgeries. People are still making decisions over this, but we want to get cracking before we get a second wave, which is traditionally far more virulent.”
Holden said it was likely the elderly would be given their seasonal flu jab as well as the swine flu vaccination. The new vaccine is likely to require two doses.
The swine flu vaccine will be safety tested and fast-tracked for use in Britain within just five days once it is developed.
In the week after the fictional Torchwood – Children of Earth, was shown on TV, with a government using an emergency vaccination programme as the cover story for taking ruthless action against their own population, people will want to know more about this vaccination programme before submitting their familes to it.
Some of the main questions will be:
I have written about swine flu recently from an epidemiological point of view but now, unfortunately, I’m in the position of being able to provide a first person account of the disease as it progresses in my own body.
I’ve been ill for two days, not had a thing to eat, and the symptoms showed no signs of easing up. Then the sore throat and cough started up, adding to the intestinal discomfort. Temperature still fluctuating, so it was time to call the GP. Linda phoned in for me, but could only speak to the nurse and they made an appointment, if you call it that, for a doctor to call back and talk to me which they did a few hours later. After a question and answer session which I was really not able to cope with very well, she decided I needed Tamiflu which is being sent out to chemists, not on prescription but as part of the emergency preparations for the swine flu pandemic, or any other flu pandemic for that matter such as avian flu ( H5N1) which is also on it’s way perhaps, but was suddenly overtaken by the swine flu A H1N1 virus, first reported in Mexico.
So anyway, after some fussing over which was the nearest chenist and whether they had stocks yet, Linda went out to get the tamiflu. Apparently there was a queue of people there, all for the same purpose, so this gives an idea of how widely the swine flu has spread around London now. No hype, it’s here amongst us and multiplying fast despite it being high summer in England now.
Tom Reynolds, the London ambulance driver reports that ambulance call outs have increased dramatically:
Our call rate has gone from the normal 4,200-4,500 calls per day to around 5,200-5,700 in the last few days. This is an increase of around 26% Rather obviously this is having us run ragged.
The tamiflu arrived and I’ve taken one tablet so far as well as some rehydrating fluid. It’s too early to expect anything positive but adding nausea to the symptoms was most unwelcome. Unpleasant as this is, not to mention extremely inconvenient (we were due to go out to the theatre tonight) it’s generally less severe than ‘normal’ seasonal flu. Not the headcolds that some people call ‘flu but influenza.
Thanks to the people who sent well wishes via twitter and facebook etc, and for suggesting I might as well write about it – it’s a useful distraction in between times. For those concerned about Linda, she’s not 100% but doesn’t seem to have gone down with the swine flu, which the doctor said would usually be both at the same time, but there’s some evidence that people who had Spanish Flu in the 1967 epidemic have some residual immunity.
People might need to know so here are the symptoms in order of appearance in my case – for others it may be different. Look away now if you don’t want read it.
The only one missing is muscular aches and pains I think.
Andy Roberts is a writer who initiated DARnet. Contact me on aroberts@gmail.com or @aroberts on twitter
