The data from Forbes came by way of another thread here on DU.
The notable information there is that this virus, new to humans, has spread from Mexico to across the globe in just fourteen days.
The virulence of the H1N1 virus appears variable at first glance. The mortality rate appears to be higher in Mexico than the US. However, the data shows that, by comparison Mexico has had 1,995 people who have been hospitalized with serious cases of pneumonia since the first case of swine flu was reported on April 13 while the US has had only 40 confirmed cases. Of those 149 who have died in Mexico, 20 cases were confirmed, the remainder are suspected of death from swine flu.
The word “suspected” has come under scrutiny as apparently viral and pathologic studies have not been completed and the results are awaited. The word “suspected” to have died of H1N1 viral infection means that there is a reasonable degree of medical probability that the virus in question was causative, as opposed to other causes of pneumonia, clearly they are being cautious and await final confirmation. However, in the meantime, these patients would have undergone extensive laboratory testing, chest x-rays, bronchial lavage, cultures, gram stains among other studies, to rule out other causes of pulmonary infection, sepsis or respiratory failure.
The clustering of a relatively large number of people with aseasonal flu symptoms has led to this being reported and monitored by WHO and shared with national health authorities. In the US that is the CDC. The CDC has now reported 40 confirmed infections in the US. No one has died of this in the US, on the other hand since the infection rate in absolute numbers is low, only 40, as compared to almost 2,000 in Mexico, I am not certain that we can actually say much about the pathogenicity of the H1N1 virus in the US. BTW- as of Saturday, the infection rate in the US was at 14 people.
There is something about this virus, it’s newness, which means there is no vaccine known at this time to cover this pathogen, the use of antiviral medication efficacy is unknown, it’s rapid spread across the world, albeit in small numbers, but rather widely dispersed in just two weeks has led national and international health care authorities in an abundance of caution to do a number of things.
In addition, to providing travel advisories, tips on maintaining sanitary practices, some regions use masks to protect from aerosolized viral spread such as coughing and sneezing, there has been close monitoring by WHO and the CDC, and today WHO raised from a Phase3 to a phase4 level status, while in the US Secretary of the Department Homeland Security, Janet Napolitano, declared a public health emergency in the United States and “the CDC's Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak.”
The take home message here is that this is a somewhat unique situation that is being well monitored and the public rightfully want to know as much about it as possible to remain well informed.
In the meantime, remember that:
On Sunday morning’s press briefing, members of the Obama administration referred to this as a “pre-pandemic,” and not a pandemic.
The WHO has stated that “Phase 4 indicates a significant increase in risk of a pandemic
but does not necessarily mean that a pandemic is a forgone conclusion.” There is no reason for any response other than remaining well informed about the guidelines for prevention and personal and family safety and monitoring this matter as it develops.
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http://www.forbes.com/feeds/ap/2009/04/27/ap6343467.htmlAssociated Press
Mexico: Suspected swine flu deaths climb to 149
Associated Press, 04.27.09, 01:42 PM EDT
..the suspected death toll has climbed to 149,
20 of those cases confirmed to be from swine flu
the government was awaiting tests results on the rest.
He says 1,995 people have been hospitalized with serious cases of pneumonia since the first case of swine flu was reported on April 13.
The government does not yet know how many were swine flu.
Of those hospitalized, 1,070 have been released.
Mexico's government is ordering closed schools nationwide as the suspected death toll from swine flu climbed to 149.
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http://www.cdc.gov/swineflu/State # of laboratory
confirmed cases
California 7 cases
Kansas 2 cases
New York City 28 cases
Ohio 1 case
Texas 2 cases
TOTAL COUNT 40 cases
International Human Cases of Swine Flu Infection
CDC activated its Emergency Operations Center to coordinate the agency's response to this emerging health threat and yesterday the Secretary of the Department Homeland Security, Janet Napolitano, declared a public health emergency in the United States. This will allow funds to be released to support the public health response. CDC's goals during this public health emergency are to reduce transmission and illness severity, and provide information to assist health care providers, public health officials and the public in addressing the challenges posed by this newly identified influenza virus. To this end, CDC has issued a number of interim guidance documents in the past 24 hours. In addition, CDC's Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak. Laboratory testing has found the swine influenza A (H1N1) virus susceptible to the prescription antiviral drugs oseltamivir and zanamivir. This is a rapidly evolving situation and CDC will provide updated guidance and new information as it becomes available.
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http://www.who.int/mediacentre/news/statements/2009/h1n1_20090427/en/index.htmlOn the advice of the Committee, the WHO Director-General decided on the following.
The Director-General has raised the level of influenza pandemic alert from the current phase 3 to phase 4.
The change to a higher phase of pandemic alert indicates that the likelihood of a pandemic has increased, but not that a pandemic is inevitable.
As further information becomes available, WHO may decide to either revert to phase 3 or raise the level of alert to another phase.
This decision was based primarily on epidemiological data demonstrating human-to-human transmission and the ability of the virus to cause community-level outbreaks.
Given the widespread presence of the virus, the Director-General considered that containment of the outbreak is not feasible. The current focus should be on mitigation measures.
The Director-General recommended not to close borders and not to restrict international travel. It was considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention.
The Director-General considered that production of seasonal influenza vaccine should continue at this time, subject to re-evaluation as the situation evolves. WHO will facilitate the process needed to develop a vaccine effective against A/H1N1 virus.
The Director-General stressed that all measures should conform with the purpose and scope of the International Health Regulations.
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Great updated map and stats.
http://www.idemc.org/index.php?area=...........
Source: WHO.
In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.
In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.
In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.
Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.
Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, 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.
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.
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