Friday, 1 May 2009

Swine Flu – The Facts(?)

I thought I'd mention a couple of articles I'd seen, firstly the Independent traces the origin of the disease:

Swine flu: Was first victim a modern Typhoid Mary?

Authorities admit that census taker transmitted the virus door-to-door.

The first person to die of swine flu was a 39-year-old tax inspector whose job required her to make door-to-door visits, putting her in contact with at least 300 unsuspecting members of the public when the disease was at its most virulent, Mexican authorities have said.

Maria Adela Gutierrez, a census-taker in the southern tourist city of Oaxaca, was admitted to a local hospital on 8 April and died five days later. She'd been suffering acute respiratory problems, exacerbated by diabetes and severe diarrhoea, and is believed to have infected scores of people.

The story of her death, which occurred three weeks before the virus was officially identified, came as Mexico remained on a state of high alert, with schools, government offices and many workplaces closed. The suspected death toll in Mexico reached 152 last night, with over 2,000 people infected. In the US the confirmed total of cases jumped to 64; California, with more than a dozen infected, declared a public health emergency and the World Health Organisation said it had notification of 79 confirmed cases worldwide.

Ms Gutierrez's demise may fuel controversy over Mexico's handling of the outbreak, which has been criticised as chaotic and secretive. Authorities at Oaxaca's Hospital Civil Aurelio Valdivieso, where she was treated, did not confirm that an infectious disease had broken out there until 21 April, by which time one further patient had also died.

Doctors initially thought Gutierrez was suffering from pneumonia. But when 16 further patients exhibited signs of severe respiratory infection, they established a quarantine area around the emergency room. Shortly afterwards, state health authorities began to track down every person she'd had recent contact with and conduct check-ups.

That discreet search suggested that Gutierrez may have unwittingly been a latter-day "Typhoid Mary". It turned up more than 300 people, including many members of the public whom she'd interviewed as she knocked on doors in late March and early April. Local sources told Veratect, the US disease-tracking company which sounded the alarm, that between 33 and 61 of those interviewees "exhibited symptoms" of a flu-like illness, though none have died.

Oaxaca is the historic capital of Oaxaca state, a mountainous region on Mexico's southern Pacific coast. Its location may be crucial to tracking the spread of swine flu, because it borders Veracruz, the state where the virus is believed to have first infected humans.

Edgar Hernandez, a boy who contracted the disease on 2 April and subsequently made a full recovery, was on Monday identified by Mexico's health secretary Jose Angel Cordova as "patient zero" – the first officially identified victim of the disease. He lives in the small town of La Gloria, in Veracruz province, five miles downwind of a vast pig farm identified a potential source of the outbreak. The farm is owned by owned by Smithfield Foods, a US agribusiness corporation, whose Mexican subsidiary raises a million pigs per year.

In February, dozens of locals began falling ill from a mysterious, flu-like disease. On 6 April, authorities in La Gloria declared an "alert," saying 400 people had required treatment and 1,800 were exhibiting respiratory problems. The town has a population of 3,000.

Public health workers sealed off the town and began exterminating huge numbers of flies that had reportedly begun swarming through homes. However, they are yet to identify this outbreak as swine flu. News teams who have descended on the town have been urged against jumping to conclusions.

But the locals aren't convinced. Jose Luis Martinez, a 34-year-old resident of La Gloria, told reporters yesterday that he knew the disease which had infected his town was swine flu the minute he heard description of its symptoms: fever, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhoea. "When we saw it on the television, we said to ourselves, 'This is what we had,' " he said. "The symptoms they are suffering are the same that we had here."

Factory farming is already a contentious issue in Veracruz state because thousands of farmers claim they were evicted from their land there by the Mexican government in 1992, in an alleged move to make way for US farming companies seeking to exploit relaxed welfare standards. If La Gloria was indeed the source of the original outbreak, it is likely to have quickly spread to major cities. Roughly half the people with homes in the town live and work in Mexico City during the week.

Yesterday, the capital was again in a state of high alert. Most people were wearing surgical masks in public, large gatherings of people are banned, restaurants can only serve take-out food, and bars forced to shut at 6pm. Those measures are almost certainly too late. Swine flu is likely to have arrived in the city during the first fortnight of April – timing which may have been fatal, since it coincided with Semana Santa (Holy Week), bringing a million people to the capital from all over the country.

'Typhoid Mary'

Mary Mallon was an Irish chef who became the first person in the US to be identified as a carrier of typhoid fever. She is believed to have infected 53 people, three of whom died. She denied spreading the disease and refused to cease working. Born in 1869, she died in quarantine in 1938.

Source: Independent

And secondly the Guardian tries to break it down a little and offers a decent swine flu FAQ:

What is swine flu?

Swine flu is a form of influenza that originated in pigs but can now be caught by and spread among people. The current outbreak started in Mexico, with cases now confirmed in the US, Canada, New Zealand, Spain, the UK, Germany, Austria, Israel, Costa Rica and South Korea. At the time of writing there have been more than 150 confirmed deaths from the infection in Mexico but only one death elsewhere, a 23-month-old Mexican boy in Texas.

Human strains of flu kill a few hundred thousand people worldwide every year, but strains of flu virus that originate in livestock such as pigs or chickens have the potential to kill millions worldwide if they start spreading among people. This is because, unlike ordinary strains of winter flu, humans have little resistance to them.

Swine flu is caused by a type A influenza virus, and the new strain belongs to the most common subtype, known as H1N1. Public health experts are particularly concerned about strains like this one that have spread from pigs to humans, because the animals can act as "crucibles", harbouring several flu viruses at once which can swap genes and become more virulent.

Influenza viruses are made up of only eight genes: the new strain has six genes from a swine flu virus known to have been circulating in North America – itself a mixture of human, pig and avian flu viruses – and two from a swine virus found in European and Asian pigs.

How do humans catch it?

Swine flu spreads to people in two ways. They can acquire the virus after being in contact with infected pigs or areas where the pigs have been – which is only likely to happen in Mexico – or they can catch it from an infected person. The disease spreads in the same way as human flu, by inhaling airborne particles from coughs and sneezes, or by touching a contaminated surface and then touching the nose or mouth.

It should be emphasised that in most cases the infection makes people unwell but is not life-threatening. For reasons that are not yet known, the infection seems to be more severe in Mexico than elsewhere. From published data on confirmed cases, the mortality rate in Mexico appears to be 4% and outside Mexico 1%.

What can I do to avoid infection – and stop spreading it to others?

Virus particles can survive for hours on surfaces such as doorhandles, so it's important to wash your hands frequently with soap and water. You should cover your mouth with a handkerchief if you cough or sneeze. If you don't have a handkerchief, cover your mouth with the crook of your elbow rather than your hand. But if you do use your hands when coughing or sneezing, wash them as soon as possible afterwards.

Avoid touching your mouth and nose with your hands or rubbing your eyes.

Should I wear a mask?

There is little point wearing a mask unless you yourself or someone you are caring for is suspected of having the infection. Masks only work if changed regularly and they get damp easily, becoming an infection risk. Not all masks will be effective. Surgical masks are not designed to prevent virus particles being inhaled but to stop germs spreading from doctors to patients. Masks that protect against viruses conform to the European standard FFP3 and the US equivalent N95.

What are the symptoms?

The symptoms of swine flu are similar to normal flu and include fever, cough, sore throat, headache, aching limbs, chills and fatigue. Some patients infected with swine flu have also reported loss of appetite, diarrhoea and vomiting. In very young children, the warning signs include fast or troubled breathing, a bluish skin tone, a failure to interact with others, and being highly irritable.

As with seasonal flu, swine flu varies in severity, with the worst cases leading to fatal pneumonia and respiratory failure. The new strain seems to be more lethal to those in the 25 to 45 age range. This was a hallmark of the Spanish 1918 flu pandemic that killed tens of millions worldwide. Younger people were probably hit harder than the elderly by the 1918 flu virus because their immune systems overreacted.

What should I do if I think I'm infected?

This is highly unlikely in the UK unless you have recently returned from Mexico or the US, or have come into contact with someone who has. Ordinary flu and any number of other infections can cause flu-like symptoms.

However, if you've been to Mexico or the US, or another country that has been affected by swine flu, the UK's Health Protection Agency says you should monitor your health for seven days after your return. If you develop flu-like symptoms during that time, you should stay at home and phone your GP, or phone NHS Direct on 0800 1513 513. Make sure you tell them where you've been travelling. Further information about swine flu is available online from the UK government's Directgov website.

Your doctor may arrange diagnostic tests, which can be carried out at home or in hospital. Until you get the results you should avoid contact with other people. You should also take sensible hygiene precautions (see above) to avoid spreading the virus.

Are there effective treatments?

The antiviral medicines oseltamivir (Tamiflu) and zanamivir (Relenza) are effective treatments for swine flu. The UK has sufficient stocks to provide a total of 33.5 million treatment courses.

Is there a vaccine for swine flu?

The seasonal flu jab given to the elderly over the winter months works well against human flu viruses, but is unlikely to be effective against swine flu. The World Health Organisation will decide whether to divert resources from manufacturing regular flu vaccine into making swine flu vaccine.

What is the UK government doing to control the spread of infection?

GPs and hospitals across the UK are preparing for a pandemic, and the UK government is working with the WHO to monitor the situation. Confirmed cases are being treated with antiviral drugs. The UK has agreements with manufacturers to produce a vaccine if the WHO gives the green light.

What do the WHO's pandemic categories mean?

The WHO defines stages in the progression towards a pandemic from level one to six, with level one meaning there are no animal viruses reported to be infectious to people, and level six meaning an animal virus has caused sustained community outbreaks in two or more WHO regions and a pandemic is declared. At the time of writing we are at level five.

Source: Guardian

Even though the above article is just over 24 hours old there are new cases being reported worldwide almost hourly so the totals are constantly changing.....


pat said...

Following links may be of interest..

Whilst we are all looking at Swine Flu dangers the Government is progressing with it's potentially lethal, plague-creating AWC bin scheme. The situation may worsen if and when monthly collections are instigated as in Fife.


indianist said...

your blog give nice information now i understood what is Swine Flu? thanks