Swine Flu Pandemic Thread

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NormalSaline

NormalSaline

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This is another good reason to patrol our border.
 
NormalSaline said:
So the major news agencies are freaking out about this "previously unseen" H1N1 strain.

What do the level headed folks of SDN think about all this? Is this typical media hype, or may this really be a big deal?

CNN: http://edition.cnn.com/2009/HEALTH/04/25/swine.flu/index.html
FoxNews: http://edition.cnn.com/2009/HEALTH/04/25/swine.flu/index.html
MSNBC: http://www.msnbc.msn.com/id/30398682/
Click to expand...

Whenever there is a new unidentified contagious strain, it is ALWAYS, I repeat, ALWAYS a big deal. The reason for this is that we are due for a flu pandemic causing billions of death (1/2th world population easily). It is just a matter of when it will happen. The problem with the Flu is that it got so many strains and that it is always evolving (From Spanish Flu to the Asian aviane flu a few years ago). When they talk about pharmacists as mass immunizer, this is what they mean.
 
I hope the pharmacist can step up and show our value as accessible health providers.

I guess this means I hope it becomes a pandemic, such that we will need to give shots 🙁
 
I hope that this year's flu vaccine at least has partial coverage. 61 deaths after flu season ends can't be a good sign.

Same phenotype as the Spanish Flu, as well.
 
Praziquantel86 said:
I hope that this year's flu vaccine at least has partial coverage. 61 deaths after flu season ends can't be a good sign.

Same phenotype as the Spanish Flu, as well.
Click to expand...

From http://www.cdc.gov/flu/flu_vaccine_updates.htm

Will this year's vaccine protect me against the flu?
The flu vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season. This year’s influenza vaccine contains three new influenza virus strains.
They are:

  • A/Brisbane/59/2007(H1N1)-like virus;
  • A/Brisbane/10/2007 (H3N2)-like virus;
  • B/Florida/4/2006-like virus.

I dont know anything about this stuff yet. Will that H1N1 strain provide some protection from this new one?
​
 
NormalSaline said:
From http://www.cdc.gov/flu/flu_vaccine_updates.htm

Will this year's vaccine protect me against the flu?
The flu vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season. This year’s influenza vaccine contains three new influenza virus strains.
They are:



  • A/Brisbane/59/2007(H1N1)-like virus;
  • A/Brisbane/10/2007 (H3N2)-like virus;
  • B/Florida/4/2006-like virus.
I dont know anything about this stuff yet. Will that H1N1 strain provide some protection from this new one?

​
Click to expand...


Also from the CDC website (http://www.cdc.gov/flu/weekly/):

"Vaccination with seasonal influenza vaccine containing human influenza A (H1N1) would not be expected to provide protection against swine influenza A (H1N1) viruses."

I think the Texas cases were close to San Antonio, just a couple of hours from me. :scared:
 
mike36 said:
Also from the CDC website (http://www.cdc.gov/flu/weekly/):

"Vaccination with seasonal influenza vaccine containing human influenza A (H1N1) would not be expected to provide protection against swine influenza A (H1N1) viruses."

I think the Texas cases were close to San Antonio, just a couple of hours from me. :scared:
Click to expand...

Well that blows. I'd think that they're still testing just to be sure.

Anyone know if the adamantanes or M2s are any good?
 
Praziquantel86 said:
Well that blows. I'd think that they're still testing just to be sure.

Anyone know if the adamantanes or M2s are any good?
Click to expand...

cant remember where i read it, but it is only susceptible to oseltamavir and zanamivir
 
NormalSaline said:
From http://www.cdc.gov/flu/flu_vaccine_updates.htm

Will this year's vaccine protect me against the flu?
The flu vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season. This year's influenza vaccine contains three new influenza virus strains.
They are:

  • A/Brisbane/59/2007(H1N1)-like virus;
  • A/Brisbane/10/2007 (H3N2)-like virus;
  • B/Florida/4/2006-like virus.

I dont know anything about this stuff yet. Will that H1N1 strain provide some protection from this new one?
​
Click to expand...

Nope. Current flu vaccines will not provide ANY protection at all against the new strain. The flu vaccine usually consists of the major types (etc and whatever strains that the CDC got last year. However it does not protect what is there now. That is why a new highly contagious deadly flu strain is ALWAYS to be taken seriously because nobody has immunity to it yet.

For your information, the CDC is always collecting new strains to make vaccines in the South. (When it is winter here, it is summer down there). That is how we update our flu vaccine every year.

FYI update, the strain is now confirmed in NY where a bunch of school kids have it.
 
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NormalSaline said:
cant remember where i read it, but it is only susceptible to oseltamavir and zanamivir
Click to expand...

Most anti-virals reduce symptom days by 24 hours if taken from the START which is not a lot. That is why once a person gets the flu, they dont get anti virals especially after the first or 2nd day since most symptoms will resolve pretty soon. PS. This year, there is a high resistant rate to Oseltamavir. Refer to CDC warnings.
 
Aznfarmerboi said:
Most anti-virals reduce symptom days by 24 hours which is not a lot. That is why once a person gets the flu, they dont get anti virals. PS. This year, there is a high resistant rate to Oseltamavir. Refer to CDC warnings.
Click to expand...

They do have some benefit in prophylaxis, though. If this goes on for another few days, I feel like there's going to be an awful lot of prescriptions written for Relenza.
 
Praziquantel86 said:
Well that blows. I'd think that they're still testing just to be sure.

Anyone know if the adamantanes or M2s are any good?
Click to expand...

From http://www.cdc.gov/flu/weekly/:

"The viruses from all seven cases are closely related genetically and contain a unique combination of gene segments that have not been reported in the United States or elsewhere. Viruses from 6 cases are all resistant to amantadine and rimantidine and sensitive to zanamivir and oseltamivir, and sensitivity testing is underway for the remaining virus."
 
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Another scary thing about this is, like with the 1918 influenza, it seems to be healthy young adults that are being hit the hardest. I know out of the dead so far, at least some are in the 20-40 age range.

Some article had suggested this was due to that age range being the least vaccinated against flu, but I'd think it'd be more likely due to that group having the best immune system. What they think happened in 1918 was those with the really good immune systems basically died because their immune system was able to respond too well to the flu.

Anyone else feel like stocking up on non-perishables this weekend?? (Only half-kidding...)
 
FarscapeGirl said:
Some article had suggested this was due to that age range being the least vaccinated against flu, but I'd think it'd be more likely due to that group having the best immune system. What they think happened in 1918 was those with the really good immune systems basically died because their immune system was able to respond too well to the flu.
Click to expand...

I thought most of the fatalities in 1918 were secondary to post-influenza staphylococcal pulmonary infections, and not necessarily due to the viral infectious process. Although, it was going on 65 years before I was born, so who knows?
 
Priapism321 said:
I thought most of the fatalities in 1918 were secondary to post-influenza staphylococcal pulmonary infections, and not necessarily due to the viral infectious process. Although, it was going on 65 years before I was born, so who knows?
Click to expand...

Hmm... I think you may be right. It's been awhile since I've read stuff on the 1918 influenza.
 
FarscapeGirl said:
Hmm... I think you may be right. It's been awhile since I've read stuff on the 1918 influenza.
Click to expand...

After further reading, it happens to be controversial, and I think the answer may be a combination of our responses. The influenza may have "psyched" the immune system out, enabling usual bacterial flora to "take over." However, some scientists do say that the "hyper-response" of the immune system secondary to the virus may have been excessively overwhelming, not allowing enough time for a bacterial infection to claim most lives.
 
Last edited:
Priapism321 said:
I thought most of the fatalities in 1918 were secondary to post-influenza staphylococcal pulmonary infections, and not necessarily due to the viral infectious process. Although, it was going on 65 years before I was born, so who knows?
Click to expand...

Hmm...it's been several years since I've looked into it, but I remember reading something that suggested that the 1918 strain was "special" in that it could infect almost all of the tissues/organs in the body and not just the respiratory mucosa.

I was under the impression that most of the deaths were from the virus itself rather than bacterial super-infections. I remember hearing/reading that young and healthy individuals who felt symptoms in the morning could be dead before the day was out. Not really enough time for another infection to come along.

But yeah, who knows really, because it was a long time ago and all we can do is read the conflicting reports from when it happened.
 
mike36 said:
Hmm...it's been several years since I've looked into it, but I remember reading something that suggested that the 1918 strain was "special" in that it could infect almost all of the tissues/organs in the body and not just the respiratory mucosa.

I was under the impression that most of the deaths were from the virus itself rather than bacterial super-infections. I remember hearing/reading that young and healthy individuals who felt symptoms in the morning could be dead before the day was out. Not really enough time for another infection to come along.

But yeah, who knows really, because it was a long time ago and all we can do is read the conflicting reports from when it happened.
Click to expand...

You must have skipped my second post where I basically stated exactly what your post asserts. I know some clinicians who take care of critically ill patients with influenza are still on hyper-alert for staphylococcus if they happen to get them through the viral insult.
 
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Priapism321 said:
I know some clinicians who take care of critically ill patients with influenza are still on hyper-alert for staphylococcus if they happen to get them through the viral insult.
Click to expand...

However, they weren't alive in 1918 either, so once again, who knows? I have just heard the Staph story in every influenza discussion I have had, but not sure it should be accepted as dogma.
 
One of my preceptors told me that he spent all morning at the hospital answering questions from people who thought that they had the swine flu - a neurologist even stopped in thinking that he had symptoms. While I know that the swine flu could be serious, I'm not sure that the widespread panic that all of these news stories are generating is appropriate. Still, I think that I'd be worried if I knew anyone who had traveled to Mexico City recently.

Edit: this is an interesting article about a swine flu outbreak in 1976: http://www.time.com/time/health/article/0,8599,1894129,00.html?xid=rss-health
 
Moxxie said:
One of my preceptors told me that he spent all morning at the hospital answering questions from people who thought that they had the swine flu - a neurologist even stopped in thinking that he had symptoms. While I know that the swine flu could be serious, I'm not sure that the widespread panic that all of these news stories are generating is appropriate. Still, I think that I'd be worried if I knew anyone who had traveled to Mexico City recently.

Edit: this is an interesting article about a swine flu outbreak in 1976: http://www.time.com/time/health/article/0,8599,1894129,00.html?xid=rss-health
Click to expand...

Like I said, the swine flu or any flu strain from aviane or pig can be dangerous. As health professionals, we got to prepare for the worst and hope for the best. . .

I am really curious as to why the mortality and morbidity rate in Mexico is so high versus here and other countries who have case reports of it.
 
Just keep in mind also that this is the classic example of something we should be afraid of.

A strain of flu virus circulating in aviane/swine that has mutated enough to be transmitted from animal to human, and now human to human. There is no immunity in the human population to this flu. It has caused hundreds of death in Mexico and has already spread to North America plus cases in other countries. If we are not vigilant about this, at what point do you think we should be vigilant in? (No, really... legit question open for debate from you guys).
 
Now that the WHO has raised the pandemic alert level from 3 to 4, I can't buy Tamiflu or Relenza anymore...

Question: all the cases we've had in Canada (okay, all 6 of them) have been minor, while the Mexican death rate seems high. Two questions, actually:

1. Could the high death rate in Mexico mean that the total infection rate is really much, much higher than reported?

2. Could the relatively minor infection suffered by our (admittedly, only 6 young healthy kids) imply that northerners have more immunity to viral respiratory tract infections because we suffer lots of them every winter?

Looks like Americans also are having less serious consequences than Mexicans.
 
I don't think anyone should freak out (what good does that ever do anyone anyway?), but at the same time I don't think you should ever underestimate any pathogen.

I read an article on social distancing that was pretty interesting. I think it was on MSNBC this morning. Basically its just the whole concept of closing churches, schools, parks, any mass gathering of people. And if you do have to be around other people, you should keep at least a six foot radius. Something to keep in mind if the spread continues to grow.
 
I think the media is bordering on inciting irrational fear. The health organizations of the world are doing precautionary measures to ensure that the flu is contained and managed and allocate resources to determining the best suitable course of action. Titles articles with the words "our next pandemic" just makes matters worse.

Yes, it's volatile. Yes, it's potentially dangerous. No, healthcare organizations are not sitting on their asses waiting to see how bad it gets.

Be prepared, practice sanitary hygiene (like people are suppose to), and just watch for updates on the flu from the CDC, WHO, etc.

/end rant

Note: I say this only because I've been hearing people talk about how this is our next pandemic.
 
fhx06 said:
I think the media is bordering on inciting irrational fear. The health organizations of the world are doing precautionary measures to ensure that the flu is contained and managed and allocate resources to determining the best suitable course of action. Titles articles with the words "our next pandemic" just makes matters worse.

Yes, it's volatile. Yes, it's potentially dangerous. No, healthcare organizations are not sitting on their asses waiting to see how bad it gets.

Be prepared, practice sanitary hygiene (like people are suppose to), and just watch for updates on the flu from the CDC, WHO, etc.

/end rant

Note: I say this only because I've been hearing people talk about how this is our next pandemic.
Click to expand...

And what is the medical definition of a pandemic.... based on WHO and any other reputable sorce of medical organization
 
Aznfarmerboi said:
And what is the medical definition of a pandemic.... based on WHO and any other reputable sorce of medical organization
Click to expand...

The term "pandemic" refers to how much an infection has spread, not how severe the infection is. From www.who.gov:

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

So far, being only in Mexico and the US, we're not pandemic yet...but even if we were, it doesn't mean that people are going to drop dead everywhere. It just means that it's spreading.

Has anyone mentioned that the increase in deaths in the Mexican population may be due to the fact that it's a 3rd world country with poor access to healthcare?
 
On a related note, the pharmacy I work at has sold more tamiflu in the past few days than we have all last year
 
From a CNN article:

Mexican officials say they have confirmed 20 deaths from swine flu and are looking at more than 130 other deaths to determine how many may have been caused by swine flu.

Funny, since the news is saying that "152 people have died from swine flu"...apparently just speculation.
 
Vitamin K said:
The term "pandemic" refers to how much an infection has spread, not how severe the infection is. From www.who.gov:

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

So far, being only in Mexico and the US, we're not pandemic yet...but even if we were, it doesn't mean that people are going to drop dead everywhere. It just means that it's spreading.

Has anyone mentioned that the increase in deaths in the Mexican population may be due to the fact that it's a 3rd world country with poor access to healthcare?
Click to expand...


I read about confirmed cases in Spain, Canada and a few other countries (New Zealand?). From this, I am calling it a pandemic. Maybe they took back their reports and whats not.
 
Still waiting to see a confirmed diagnosis of swine flu in Orlando. I think it was some tourist from Mexico visiting Disney.
 
Argentium said:
couldn't get madagascar or cuba. both embargoed pretty early on and its not like anyone wants to go there anways.
Click to expand...

Keep your visibility low with fever as your only symptom, while building up your resistances. The once it gets in everywhere....jack up the hemorrhage 😱
 
On a related note, when Paris Hilton was asked if she was worried about the swine flu she replied "I don't eat that".
True story.
 
Aznfarmerboi said:
Just keep in mind also that this is the classic example of something we should be afraid of.

A strain of flu virus circulating in aviane/swine that has mutated enough to be transmitted from animal to human, and now human to human. There is no immunity in the human population to this flu. It has caused hundreds of death in Mexico and has already spread to North America plus cases in other countries. If we are not vigilant about this, at what point do you think we should be vigilant in? (No, really... legit question open for debate from you guys).
Click to expand...

Actually, there are only 20 reported deaths in Mexico that are FOR SURE from the swine flu. I believe as of the other day there were 150 or so POSSIBLE deaths. While 20 people dying is a terrible thing, it's hardly cause for global concern. On top of this, NO ONE in the US or Canada has died or is in danger of dying. So maybe people are dying in Mexico because (although it's our neighbor) it's still a 3rd world country with 3rd world health care. On top of this, the flu responds readily to Tamiflu.

I really don't think this is a big deal.
 
Carboxide said:
Actually, there are only 20 reported deaths in Mexico that are FOR SURE from the swine flu. I believe as of the other day there were 150 or so POSSIBLE deaths. While 20 people dying is a terrible thing, it's hardly cause for global concern. On top of this, NO ONE in the US or Canada has died or is in danger of dying. So maybe people are dying in Mexico because (although it's our neighbor) it's still a 3rd world country with 3rd world health care. On top of this, the flu responds readily to Tamiflu.

I really don't think this is a big deal.
Click to expand...

Actually one child just died today in Texas.
 
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