Swine flu spread puts World on alert

Pandemic prevention in Mexico City
Pandemic prevention in Mexico CityCourtesy Chupacabras

No mass at Cathedral of Mexico City Sunday

In addition to churches, Mexico closed schools, museums, libraries and theaters, hoping to contain the outbreak of a swine flu variety that is killing people. Officials say as many as 81 people have died and more than 1,300 others are sickened from a new type of flu.

The virus contains genetic pieces from four different flu viruses; North American swine influenza, North American avian influenza, human influenza A N1H1, and swine influenza viruses found in Asia and Europe.

Swine flu symptoms

Symptoms of the flu-like illness include a fever of more than 100 degrees Fahrenheit (37.8 degrees Celsius), body aches, coughing, a sore throat, respiratory congestion and, in some cases, vomiting and diarrhea. Click this link for more key facts about swine influenza (swine flu).

Global swine flu alert

China, Russia and Taiwan plan to put anyone with symptoms of the deadly virus under quarantine. Ten students from New Zealand who took a school trip to Mexico "likely" caught this swine flu. Four possible cases of swine flu are currently under investigation in France. More than 100 students at the St. Francis Preparatory School, in Queens, New York recently began suffering a fever, sore throat and aches and pains. Some of them had recently been in Mexico.

"The United States government is working with the World Health Organization and other international partners to assure early detection and warning and to respond as rapidly as possible to this threat," Dr. Richard Besser, acting director of the CDC, said during a Friday afternoon press briefing.

How to track illnesses globally

There are several useful online resources that track health information and disease outbreaks.

  1. The World Health Organization (WHO) has an Epidemic and Pandemic Alert and Response (EPR) webpage.

    As of 26 April 2009, the United States Government has reported 20 laboratory confirmed human cases of swine influenza A/H1N1 (8 in New York, 7 in California, 2 in Texas, 2 in Kansas and 1 in Ohio).

  2. HealthMap is a website that aggregates news feeds from the WHO, Google News, ProMED, and elsewhere to map out all of the disease outbreaks. (Click the box in front of influenza under "Diseases, last 30 days" to see just flu cases.)

What is a pandemic?

The WHO's pandemic alert level is currently up to phase 3. The organization said the level could be raised to phase 4 if the virus shows sustained ability to pass from human to human. Phase 5 would be reached if the virus is found in at least two countries in the same region.

"The declaration of phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short," WHO said. Associated Press

Phase 6 would indicate a full-scale global pandemic.


Your Comments, Thoughts, Questions, Ideas

ARTiFactor's picture
ARTiFactor says:

The U.S. declared a public health emergency Sunday to deal with the emerging new swine flu, much like the government does to prepare for approaching hurricanes. Homeland Security Secretary, Janet Napolitano, said roughly 12 million doses of the drug Tamiflu will be moved from a federal stockpile to places where states can quickly get their share if they decide they need it. Priority will be given to the five states with known cases so far: California, Texas, New York, Ohio and Kansas. She urged people to think of it as a "declaration of emergency preparedness." Associated Press.

posted on Sun, 04/26/2009 - 3:50pm
ARTiFactor's picture
ARTiFactor says:

Hong Kong taking strict swine flu measures

Hong Kong uses infrared scanners to measure the facial temperatures of all arrivals at its airport and at its border crossings with mainland China.

Dr. Thomas Tsang, the controller of the Hong Kong government’s Center for Health Protection, said Sunday afternoon at a news conference that any traveler who had passed through a city with laboratory-confirmed cases and who arrived in Hong Kong with a fever and respiratory symptoms would be intercepted by officials and sent to a hospital to await testing.

“Until that test is negative, we won’t allow him out,” he said.

An aide later said that the cutoff for having a fever would be 100.4 degrees, and that it would take two or three days to obtain test results. New York Times.

posted on Sun, 04/26/2009 - 4:20pm
ARTiFactor's picture
ARTiFactor says:

Click this link to see
H1N1 Swine Flu cases on Google Maps.

posted on Mon, 04/27/2009 - 7:00am
Liza's picture
Liza says:

I thought this map was so interesting, and it seems legitimate. I sure wish I knew who the creator is, though, and where he or she is pulling information from...

posted on Tue, 04/28/2009 - 9:27am
ARTiFactor's picture
ARTiFactor says:

The map is the work of Recombinomics, Inc. Founder and President, Henry L Niman. He earned a PhD at the University of Southern California in 1978.
He might be getting data from his own "what is new" page of aggregated swine flu links.

I also noted that in the 1200+ comments attached to the map people are linking to news data worldwide.

posted on Tue, 04/28/2009 - 10:21am
ARTiFactor's picture
ARTiFactor says:

I started reading the comments attached to this map. Lots can be learned by reading through them. You can start from the beginning with this link.

posted on Tue, 04/28/2009 - 10:44am
ARTiFactor's picture
ARTiFactor says:

Magnify.net has a mash-up of swine flu videos, maps, tweets, etc. all on one page.

posted on Mon, 04/27/2009 - 7:32am
Liza's picture
Liza says:

Nielsen Online reported that about 2% of all Twitter posts yesterday had to do with swine flu. (See them at Magnify.net, as ARTiFactor posted above, or at Twitter directly.) The CNN article correctly points out that not all of the Twitter posts contain good information. (They aren't all bad, though: the CDC itself maintains several Twitter accounts, including this one.) It's a good reminder to consider your sources.

posted on Tue, 04/28/2009 - 9:33am
Laurie's picture
Laurie says:

Are we over reacting or is this the real thing?

posted on Mon, 04/27/2009 - 11:57am
Liza's picture
Liza says:

I've been wondering that myself, and I think we're missing at least two crucial pieces of information. (Which is why I wouldn't want to be sitting in a high-level policy meeting right now!)

  1. We don't yet have a clear picture of the incidence or prevalence of illness. The 40 cases confirmed in the US have only resulted in one known hospitalization and no deaths, so that's evidence of mild disease (at least here). In Mexico, some 1600 people have gotten sick, and 149 have died. That makes it look like some 9% of people who pick up the virus die. (And that's an incredible statistic: 1918 flu killed some 2.5% of the Americans who got sick.) Luckily, it's also not a very good statistic. Surveillance in Mexico isn't as good as it is here; lots of mild cases probably haven't been reported, and that's throwing the numbers off. The lack of good statistics means it's tough to figure out just how transmissible and/or dangerous the new virus really is.
  2. Also, influenza viruses are really unpredictable. The 1918 flu caused a wave of mild illnesses that spring, then died down, only to come back with a vengeance in the fall and winter. It's unusual that a virus becomes more lethal instead of less so. (Think about it: a virus that kills too quickly generally doesn't spread very far.) Could we be seeing a mild wave of disease now leading up to a more deadly wave in the fall? Perhaps, but there's no way to tell right now.

More deaths have occurred in adults between 20 and 50 than epidemiologists would expect with regular old flu. (Seasonal influenza is most dangerous to the very old and the very young.) The 1918 flu was most deadly to people between the ages of 20 and 40. So that's a bit disturbing.

On the other hand, back in 1918 we were at war. Troops were living under crowded, stressful conditions and moving around the world. And back at home, authorities worried about public morale were slow to adopt public health measures to check the spread of the virus. Also, antibiotics weren't yet available, nor were antiviral drugs or mechanical ventilators, and medical staff, equipment, and supplies were in short supply in some areas already.

Nothing to do but wait and see. And, of course, wash your hands often with soap and water, and stay home and call your doctor if you develop symptoms of influenza.

Want up to the minute news? Try the Swine Flu thread on the New York Times' Lede blog.

posted on Mon, 04/27/2009 - 1:19pm
Liza's picture
Liza says:

Oh, and Minnesota Public Radio devoted an hour of the Midday program today to an interview with epidemiologist Gary Kravitz about swine flu.

posted on Mon, 04/27/2009 - 1:27pm
Thor's picture
Thor says:

I think the current state of our media hypes things like this too much. I was watching CNN last night and the reporter doing an update on this was wearing a facemask, even though he wasn't in high risk area. But the message comes across to be really afraid of this. Watching the Today show this morning, on the other hand, there were national experts saying that his should be a national concern, but people don't need to be taking extraordinary measures, at least until there are confirmed cases of swine flu in their area. It seemed a lot more measured and thoughtful approach on this issue.

posted on Tue, 04/28/2009 - 8:54am
Liza's picture
Liza says:

Yeah, I think the cable news shows, with a need to fill a 24-hour news cycle, are really pushing this much harder than others.

The surgical mask thing...I heard epidemiologist Michael Osterholm saying that the masks don't do much to prevent you picking up the virus. If anything, they work better to prevent the spread of disease from a person with a known infection to others. And, of course, it totally depends on the type of mask. (All masks are not created equal! Minnesota's own 3M makes two respirator masks that have been shown, in some studies, to protect against viruses. Today's Pioneer Press suggested that the phones at 3M are ringing off the hook. Here's hoping it's all emergency agencies wanting to add to their stockpiles instead of individual Joes led astray by the news...) My opinion? The reporters wearing those masks on the news are just showing how "brave" they are. It's the same deal as the guys reporting in the middle of hurricanes: you're setting a bad example, but you look tough.

posted on Tue, 04/28/2009 - 9:11am
Thor's picture
Thor says:

Here's a great analysis of the hype job that almost all media were putting into the initial coverage of the Swine flu story and that quantity and intensity of coverage = importance of story.

posted on Tue, 04/28/2009 - 3:47pm
Liza's picture
Liza says:

CNN is featuring an article about Dr. Ira Longini, who specializes in the mathematical and statistical theory of epidemics. He's built a model that simulates the spread of a fictional killer influenza.

There isn't enough information about the new swine flu yet to drop it into Longini's model and forecast how it will behave. But other simulations suggest that containment measures (staying home when you're sick, closing places where large numbers of people gather, making antivirals available to sick people) reduce the spread of viruses by up to two-thirds. And that buys time until a well-matched vaccine can be produced and distributed.

(You can watch some of these computer models running different scenarios.)

posted on Tue, 04/28/2009 - 10:51am
ARTiFactor's picture
ARTiFactor says:

Which headline do you think will get the most attention today?

  1. About 20,000 Americans die each year from the flu.
  2. First U.S. Death From Swine Flu Is Reported
posted on Wed, 04/29/2009 - 7:31am
Liza's picture
Liza says:

To be fair, the Centers for Disease Control remind Americans with every flu season that seasonal influenza lands 200,000 people in the hospital and kills or contributes to the deaths of 36,000 of them. That's why they recommend that a broad swath of the population get vaccinated against the flu every year. I think it's hard to miss that message; I feel like the news hammers it home every fall. But based on this Twitter feed, lots of people have. And you're right. For the first few days of this, at least, many media outlets made the flu seem much more deadly than it appears to be, which makes a headline like "First US Death from Swine Flu" all the more sensational.

That said, the emergence of this new H1N1 swine flu is newsworthy, in my opinion, for three reasons:

  1. So far, outside of Mexico anyway, this flu seems relatively mild. But it's a new strain to which we don't have any immunity. Even if it's not a killer flu, it's an easily transmissible flu, and we can expect people to catch it. That's interesting.
  2. Most of the time, deaths related to influenza occur in very young or very old people. Healthy, young people might get sick, but they usually don't die. In Mexico, anyway, the new H1N1 swine flu seems to be deviating from that, with a peak in deaths in people ages 20 - 50. Also interesting.
  3. The new strain of flu has surfaced at the very end of flu season, when the disease is no longer on anyone's radar. Influenza typically dies down over the summer. Will that happen in this case? Will we have time to add this strain to the batch of flu vaccine for next fall? Should we add this strain to the vaccine for next fall? If this flu reappears later on, can we expect it to be milder? More virulent? The same? All interesting questions.

I'm not worried about it. I'm not stockpiling antivirals or respirators. I'm not hoarding canned foods or bottled water. I don't anticipate that I'll have to keep my family at home for weeks on end. I'm not imagining the end of the world. But I am very interested, and I'm keeping my eye on a variety of different news sources.

posted on Wed, 04/29/2009 - 9:49am
Liza's picture
Liza says:

Reuters now has a country-by-country breakdown of 2009 H1N1 flu cases.

posted on Wed, 04/29/2009 - 9:23pm
shanai's picture
shanai says:

I agree, this is really fascinating - both because of what we're learning about the virus itself, and because it's interesting to see how new technologies (like Twitter and the maps you link to above) are being deployed in formal and informal ways during what is perceived by a lot of people as a crisis.

I'm not particularly worried about it - but there's something about watching a thing spread across the globe in real time (or very close to real time) that makes it hard to look away for very long.

posted on Wed, 04/29/2009 - 10:22pm
Thor's picture
Thor says:

Interesting, Swine Flu concerns are impacting the sports world. High school sports events have been put on hold for a week to ten days in Texas and Alabama. And in Mexico, all professional soccer and baseball games are being played with now spectators in the stands to keep people from congregating in large numbers and possibly spreading the virus. The link above to the USA Today story also includes news on cancellations and other schedule changes to sporting events being held in Mexico or involving Mexican national teams.

posted on Thu, 04/30/2009 - 8:40am
Thor's picture
Thor says:

Here's a nice, quick information link to four questions and answers about swine flu, how big a risk it might be to you and how it spreads and reproduces.

posted on Thu, 04/30/2009 - 9:43am
Deidra gibson's picture
Deidra gibson says:

i think that the sine flew will eventually kill a lot more people then end up being at one of themost danguruos desieses

posted on Thu, 04/30/2009 - 9:54am
Anonymous's picture
Anonymous says:

Ohhh! all i have to say is that scare!!!

posted on Thu, 04/30/2009 - 6:48pm
Laurie's picture
Laurie says:

Now that we are a few months out from the initial "scare" it is interesting to think about what we knew, what happened and what we should look for as fall approaches. I suspect we have all been exposed to H1N1 at this point. Some of us have felt miserable for nearly a week and some of us seemed to have been lucky. Do you have a story to share?

Also, if you like maps and charts take a look at Wired Magazine for some interesting comparisons (although I think it is silly to compare it to a Stephen King book). I'm still a little worried about what will happen this fall, but it seems that this first wave was a good practice session for something more serious.

One last thing, it seems to me people have gone back to their lazy ways. Coming into work sick, sending sick kids to school/camp and not washing hands. Has anyone else noticed this?

posted on Mon, 06/29/2009 - 9:27am

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