Biotechnology

Influenza Gateway by BioMed Central

2009-05-20T13:30:00.001+03:00

Cases of the influenza A(H1N1) virus, known commonly as swine flu, continue to be recorded on a daily basis to the understandable unease of the general population. Whilst the media hype slowly dies down, BioMed Central continues to publish research investigating the H1N1 virus and has now compiled a collection of recently published research articles, commentaries, reviews and editorials relating to H1N1.

http://www.biomedcentral.com/gateways/influenza

HealthMap

2009-05-07T18:03:00.001+03:00

Global Disease Map

http://healthmap.org/swineflu

By Clark Freifeld and John Brownstein.

Predicting the future

2009-05-07T17:51:00.003+03:00

There is an on going debate about the future of the current pandemic. This debate is portrayed superbly in the following articles by the BBC. The first was published on May the 1st and the second only five days later. It is important to understand that scientific knowledge cannot predict the evolution of the virus; this is why the global scientific community is monitoring the progress of the pandemic in such an intense manner.

What scientists know about swine flu

Emma Wilkinson Health reporter, BBC News 13:17 GMT, Friday, 1 May 2009 14:17 UK

Preliminary analysis of the swine flu virus suggests it is a fairly mild strain, scientists say.

It is believed that a further mutation would be needed in order for the H1N1 virus to cause the mass deaths that have been estimated by some.

But at this point, it is impossible to predict with any accuracy how the virus will continue to evolve.

UK experts at the National Institute for Medical Research outlined on Friday the work they are due to start on samples of the virus sent from the US.

The research, being done at the World Influenza Centre in Mill Hill, will be vital for working out the structure of the virus, where it came from, how quickly it is capable of spreading and its potential to cause illness.

Structure

Analysis done so far suggests what they are dealing with is a mild virus and nowhere near as dangerous as the H5N1 avian flu strain that has caused scientists so much concern over the past decade.

Influenza A viruses are classified according to two proteins on the outer surface of the virus - hemagglutinin (H) and neuraminidase (N).

The swine flu strain is a H1N1 virus, the same type as seasonal flu which circulates throughout the world every year, and kills roughly 0.1% of those infected or higher in an epidemic year.

Professor Wendy Barclay, chair in influenza virology at Imperial College London says initial indications suggest there is nothing about the genetic make-up of the new virus which is a cause for particular concern.

The key to its potential lies largely in the H1 protein.

"There are two aspects - one is which receptors the virus tends to bind to and what we see is that it is binding to the upper respiratory tract rather than deep in the lungs."

When a flu virus binds to the upper respiratory tract, it tends to cause mild illness but can be easily spread as people cough and sneeze, Professor Barclay explains.

If a virus binds further down in the lungs, it tends to cause much more severe illness, as in the case of the H5N1 avian flu virus which has caused concern in recent years.

"With the H1 gene we also look at the cleavage site," she adds.

"The virus has to be cut into two pieces to be active and it uses an enzyme in the host to do that.
"Most influenza viruses are restricted to the respiratory tract because they use enzymes in the lungs.

"But some, like H5 viruses can evolve to cut into two pieces outside the lungs, so they can replicate outside the respiratory tract."

Analysis

These initial indications are largely guesswork from looking at the genetic sequence of the virus and comparing that to what is known from work on other influenza viruses.

It will take weeks and months of biological analysis to properly get a handle on the potential of the H1N1 virus.

The team at Mill Hill, one of four World Health Organisation's centres for influenza research will be working in close collaboration with the Health Protection Agency who are carrying out testing in the UK, and their findings will also feed into the development of a potential vaccine.

Soon, the Wellcome Trust Sanger Institute in Cambridge will begin the genetic sequencing of the virus and will also be monitoring any mutations or changes in how virulent it is.

However, there is one other reassuring aspect about what is known so far.

That is there seems to be nothing unusual as yet in another protein in the centre of the virus, called NS1, which is linked to the strength of the immune response the virus produces.

In some more pathogenic viruses, it is this NS1 protein which initiates a "cytokine storm", a particularly severe immune reaction that can be fatal in even healthy young people.

Predictions

Scientists have also played down concerns that the milder H1N1 virus, could combine with the more dangerous H5N1 avian flu virus, causing a super virus that has the ability to both spread easily between humans and cause severe illness.

This is unlikely - or at least just as unlikely as it ever was and the H5N1 virus has been around for a decade without combining with normal seasonal flu.

Professor Jonathan Ball, an expert in molecular virology at the University of Nottingham said: "The chance of swine H1N1 combining with H5N1 is as likely as any other strain recombining.
"What this outbreak does highlight is how difficult it is to predict new pandemic strains.

"Many people suspected that H5N1 was the most likely candidate for the next pandemic strain, but now it appears that this was a mistake - but that's not to say H5N1 or another reassortment containing parts of H5N1 may not happen in the future.

"That's the trouble - you can't predict."

http://news.bbc.co.uk/1/hi/health/8028371.stm

'Too early' to say flu virus mild

16:55 GMT, Tuesday, 5 May 2009

Sir Liam, who updated the government's weekly cabinet meeting on the flu situation, told BBC News: "We may see an apparent peak in the incidents over the next month or so, but that doesn't mean it's gone away.

"It could be that we'll see a resurgence of the virus in the autumn and winter when the normal flu season starts.

"We must not be complacent. We know that flu viruses can change their character very rapidly as they move through populations."

He added: "These next few months are vitally important in understanding what sort of virus we're dealing with."

The latest case of swine flu, confirmed on Tuesday, was in an adult from the Slough area of Berkshire, the South Central Strategic Health Authority said.

'Quarantine rooms'

The individual, who is associated with travel to Mexico, is responding well to antiviral drugs, the authority added.

It brings the overall totals to 24 in England and four in Scotland. (5/5)

Meanwhile Department of Health leaflets, stressing the importance of good hygiene, are being delivered across the UK.

A spokesman said: "It is right that we are preparing for the possibility of a global pandemic.
"The UK's arrangements are continuing to ensure that we are well-placed to deal with this new infection."

Five UK schools hit by the virus have begun rescheduling GCSEs and A-levels as the summer exam season begins.

Three of the schools are in London, with one in Devon and one in South Gloucestershire. Four are secondary schools.

The latest to be hit by the virus is Alleyn's School in Dulwich, London, where five year-seven pupils were diagnosed on Monday.

A sixth pupil from the independent school, who visited the US during the Easter holidays, was diagnosed with the virus on Sunday.

The school said it was rescheduling A-level exams in art, biology and foreign languages for next week.

In a statement it said: "In line with procedure, the school will be writing to the examination boards who are always sympathetic to students in these circumstances."

Nine out of 10 of the parents had now collected the Tamiflu anti-viral medication offered by the Health Protection Agency, the school added.

More than 1,200 private schools have been given legal advice by the Independent Schools Council, which suggests setting up "quarantine rooms" for pupils suspected of having the virus.
It also says schools should provide a policy on what to do in case of a pandemic.

Governors at Dolphin School in Battersea, London, closed its doors as a precaution after it emerged that two pupils - siblings of pupils at Alleyn's - had been confirmed with the virus.

Swine flu has already closed South Hampstead High School in north west London, Downend in South Gloucestershire and Paignton Community and Sports College in Devon.

Around 300 other people in the UK are currently awaiting the results of tests to determine whether they have the virus.

http://news.bbc.co.uk/1/hi/uk/8034260.stm

WHO says H1N1 pigs must be kept out of food supply

2009-05-07T00:15:00.002+03:00

Wed May 6, 2009 4:16pm EDT

WHO expert says flu viruses can survive freezing

Blood of H1N1 infected pigs may also contain virus

Meat from sick pigs or pigs found dead must not be eaten

Existing food safety, trade checks offer ample protection (Recasts with more comments on food safety standards)

By Tan Ee Lyn

HONG KONG, May 6 (Reuters)

Meat from pigs infected with H1N1 flu should not be eaten by humans, a WHO official said on Wednesday, while stressing that existing checks were sufficient to safeguard the food supply from the new virus strain.Jorgen Schlundt, director of the World Health Organisation's Department of Food Safety, Zoonoses and Foodborne Diseases, said care must be taken to ensure that pigs and their meat were checked for all diseases, including the H1N1 virus that may be present in the blood of infected animals."Meat from sick pigs or pigs found dead should not be processed or used for human consumption under any circumstances," he told Reuters.

It is possible for flu viruses such as the new H1N1 strain to survive the freezing process and be present in thawed meat, as well as in blood, the expert said. But he stressed that there was no risk of infection from eating or handling pork so long as normal precautions were adhered to."While it is possible for influenza viruses to survive the freezing process and be present on thawed meat, there are no data available on the survival of Influenza A/H1N1 on meat nor any data on the infectious dose for people," he wrote in an email reply to questions from Reuters about risks from the respiratory secretions and blood of infected pigs.

Schlundt said it was still unclear whether and how long the virus, which is commonly known as swine flu but also contains human and avian flu pieces, would be present in the blood and meat-juices of animals which contracted it."The likelihood of influenza viruses to be in the blood of an infected animal depends on the specific virus. Blood (and meat-juice) from influenza H1N1-infected pigs may potentially contain virus, but at present, this has not been established," he said.

The WHO has urged veterinarians, farm hands and slaughterhouse workers to exercise caution in their contact with pigs to avoid contamination until more is known about how it manifests in the animals."In general, we recommend that persons involved in activities where they could come in contact with large amounts of blood and secretions, such as those slaughtering/eviscerating pigs, wear appropriate protective equipment," Schlundt said.The Food and Agriculture Organisation (FAO) and World Organisation for Animal Health (OIE) have said import bans on pigs and pork are not required to safeguard public health because the disease is not food-borne and does not pose a threat in dead animal tissue.

BASIC GUIDANCE

While acknowledging technical questions remain about the conditions in which the virus may be present, Schlundt stressed that the WHO had not changed its basic guidance that pork is safe to eat.International trade and food safety guidelines -- drawn up well before the latest flu scare -- provide ample protection and ensure meat is not sourced from sick animals, he said."Sick animals should not enter the food chain. If you are following existing guidelines it (the virus) will not get into the human food chain," he said.

The Paris-based OIE has also said the new flu strain does not require supplemental care or checks besides those in place for other diseases, and stressed live pigs can continue to be traded using normal health inspection standards.The new H1N1 swine flu virus is being transmitted from person to person, not from pigs to people.Its global spread has prompted many countries to limit pork imports, however. As many as 20 governments have imposed import bans on live pigs and meat from affected countries to prevent exposure to the virus.Such fears increased after Canadian authorities said on Saturday a herd of swine was infected by a farmer who had returned from Mexico.

The WHO said its laboratories have confirmed more than 1,500 cases of the flu virus in 22 countries.While the strain is mainly spread from person to person through coughing and sneezing, experts do not know for sure how this virus came to be, which animal passed it to the first human patient and when that occurred.But the case of the farmer infecting the pigs in Canada fuelled fears of the virus yet again jumping the species barrier -- this time from pig to human -- and possibly becoming more virulent in the process.

(Additional reporting by Laura Macinnis in Geneva; Editing by Alison Williams)

http://www.reuters.com/article/swineFlu/idUSL6299708?feedType=RSS&feedName=swineFlu&virtualBrandChannel=10521

What happens if swine flu goes away?

2009-05-05T10:13:00.001+03:00

Tue May 5, 2009 2:45am EDT

By Maggie Fox, Health and Science Editor - Analysis

WASHINGTON (Reuters) - With Mexico saying the worst may be over and the new H1N1 virus starting to look more like a seasonal flu strain in the United States and elsewhere, critics are going to start asking if public health officials overreacted to the outbreak.

Since the new swine flu virus was first identified two weeks ago in two children in Texas and California, the World Health Organization pushed its pandemic alert level from a three to a five, meaning a pandemic is imminent.

Mexico closed schools, stopped public events and took a big hit to tourism. The U.S. government mobilized 25 percent of its stockpile of antiviral drugs and started work on a vaccine against the new strain.

But the death toll is being rolled back as Mexican officials realize it will be impossible to know if long-buried or cremated victims died of H1N1 swine flu. And while the infection is spreading rapidly across the United States, it appears to be no worse than seasonal flu.

Scientists who study flu say the coordinated, global response was appropriate.

"If it doesn't become more virulent, first of all, many people will heave a great sigh of relief," said Dr. Scott Lillibridge, who helped set up the Center for Disease Control and Prevention's Bioterrorism Preparedness and Response Program and who is now at the University of Texas Health Sciences Center in Houston.

But Lillibridge echoes what the WHO and CDC have been saying: viruses mutate and change all the time and it is too early to say how bad this virus really is.

"We are only a few days into a major international mobilization for an outbreak that could continue months into the future," Lillibridge said in a telephone interview.

The U.S. government has been preparing for this scenario for years.

One of the messages that has come up repeatedly is that the 1918 pandemic, cited as the worst-case scenario because it killed upwards of 40 million people, started with a mild arrival of a new virus, now identified as H1N1, in the spring.

It disappeared over the summer, but roared back with a vengeance in August.

REPEATING HISTORY

"Will there be later disease, and if so, will it be more severe?" CDC acting director Dr. Richard Besser asked on Monday.

"There is no doubt in my mind that CDC, the Department of Homeland Security, and the Health and Human Services Department will use the lull to get ready," said risk communications consultant Peter Sandman, who has taken a special interest in pandemic flu.

"They will stay focused on this problem. They will continue to get ready for a possible pandemic in the fall.".....

(art. cont.)

Influenza A(H1N1) - update 14 by the WORLD HEALTH ORGANIZATION

2009-05-05T00:37:00.002+03:00

4 May 2009

As of 18:00 GMT, 4 May 2009

21 countries have officially reported 1085 cases of influenza A (H1N1) infection.

Mexico has reported 590 laboratory confirmed human cases of infection, including 25 deaths. The United States has reported 286 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (101), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Colombia (1), Denmark (1), El Salvador (2), France (4), Germany (8), Ireland (1), Israel (4), Italy (2), Netherlands (1), New Zealand (6), Portugal (1), Republic of Korea (1), Spain (54), Switzerland (1) and the United Kingdom (18).

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

WHO advises no restriction of regular travel or closure of borders.

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Further information on the situation will be available on the WHO website on a regular basis.

Influenza A(H1N1) - update 13 by the WORLD HEALTH ORGANIZATION

2009-05-04T09:49:00.001+03:00

4 May 2009 of 06:00 GMT

20 countries have officially reported 985 cases of influenza A (H1N1) infection.

Mexico has reported 590 laboratory confirmed human cases of infection, including 25 deaths. The higher number of cases from Mexico reflects ongoing testing of previously collected specimens. The United States has reported 226 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (85), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Colombia (1), Denmark (1), El Salvador (2), France (2), Germany (8), Ireland (1), Israel (3), Italy (1), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (40), Switzerland (1) and the United Kingdom (15).

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

WHO advises no restriction of regular travel or closure of borders.

Further information on the situation will be available on the WHO website on a regular basis.

http://www.who.int/csr/don/2009_05_04/en/index.html

No meeting scheduled to review pandemic level - WHO

2009-05-04T02:08:00.001+03:00

No meeting scheduled to review pandemic level - WHO

GENEVA, May 3 (Reuters)

The World Health Organisation's emergency committee has no meeting currently scheduled to review the global pandemic level, a WHO spokesman said on Sunday.

Last week the WHO increased its pandemic level two notches, from 3 to 5 on a 6-point scale. Asked if that level may be raised again to the top level, which would trigger a series of measures to help poor countries fight an outbreak, the spokesman said: "That is not very easy to predict.""We cannot lower our guard," he told a news briefing.

He also said that world trade in meat should not be restricted as a result of the outbreak.

(Reporting by Laura MacInnis, edited by Richard Meares) (For more Reuters swine flu coverage, please see: http:/www.reuters.com/news/globalcoverage/swineflu )

Influenza A(H1N1) - update 12 by the WORLD HEALTH ORGANIZATION

2009-05-04T02:00:00.002+03:00

3 May 2009

As of 1600 GMT, 3 May 2009, 18 countries have officially reported 898 cases of influenza A(H1N1) infection.

Mexico has reported 506 confirmed human cases of infection, including 19 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens. The United States Government has reported 226 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (85), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Denmark (1), France (2), Germany (8), Ireland (1), Israel (3), Italy (1), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (40), Switzerland (1) and the United Kingdom (15).

Further information on the situation will be available on the WHO website on a regular basis.
WHO advises no restriction of regular travel or closure of borders.It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

Canada on 2 May reported the identification of the A(H1N1) virus in a swine herd in Alberta. It is highly probable that the pigs were exposed to the virus from a Canadian farm worker recently returned from Mexico, who had exhibited flu-like symptoms and had contact with the pigs.

There is no indication of virus adaptation through transfer from human to pigs at this time.

There is no risk of infection from this virus from consumption of well-cooked pork and pork

products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

http://www.who.int/csr/don/2009_05_03a/en/index.html

Influenza A(H1N1) - update 11 by the WORLD HEALTH ORGANIZATION

2009-05-03T17:21:00.002+03:00

3 May 2009 -- As of 0600 GMT, 3 May 2009,

17 countries have officially reported 787 cases of influenza A(H1N1) infection.

Mexico has reported 506 confirmed human cases of infection, including 19 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens. The United States Government has reported 160 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (70), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Denmark (1), France (2), Germany (6), Ireland (1), Israel (3), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (15).

Further information on the situation will be available on the WHO website on a regular basis.
WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

Canada on 2 May reported the identification of the A(H1N1) virus in a swine herd in Alberta. It is highly probable that the pigs were exposed to the virus from a Canadian farm worker recently returned from Mexico, who had exhibited flu-like symptoms and had contact with the pigs. There is no indication of virus adaptation through transfer from human to pigs at this time.
There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

Related linksInfluenza A(H1N1) web site
Daily updates will be posted on this site.

Canada pig flu case shows need for surveillance: FAO

2009-05-03T17:19:00.001+03:00

Sun May 3, 2009 9:00am EDT

By Silvia Aloisi

ROME (Reuters) - The transmission of the new H1N1 virus from a man to a herd of swine in Canada is a reason for concern and confirms the need for increased surveillance of pig farms, the United Nations food agency said on Sunday.

However, Joseph Domenech, chief veterinary officer at the Food and Agriculture Organization, said the incident was not surprising and reiterated pork and pork products handled in accordance with good hygienic practices were safe to eat.

"We are concerned that this happened but we are not panicking," Domenech told Reuters. "It just reinforces the principle that surveillance of pigs must be intensified."

Canadian health officials said on Saturday a swine herd in the western province of Alberta had apparently caught the virus from a carpenter who recently traveled to Mexico, the epicenter of a swine flu outbreak that has spread to 19 countries and may have killed more than 100 people, all but one in Mexico.

It was the first time the Canadian Food Inspection Agency had reported a case of the virus being transmitted from a human to a pig in Canada.

"It's rare but we have said from the beginning of this flu outbreak that this might happen," Domenech said.

He said FAO was awaiting the results of tests conducted in at least two laboratories in the United States and Canada, where strains of the virus isolated in humans in Mexico had been inoculated into pigs.

The Canadian Food Inspection Agency said the infected herd was quarantined pending more testing and the chance the pigs could transfer the virus to humans was remote. It said all the infected pigs had recovered or were recovering.

"That means it could be one of the viruses variously circulating in pigs that are not too severe, that can be dealt with in a normal way by strengthening surveillance and biosecurity of the pig population," Domenech said.

Doctor Alex Thiermann, advisor to the director general of the World Organization for Animal Health, also said surveillance was key.

"One has to monitors the health of all pigs ... Animals that are showing signs of illness cannot be marketed and cannot be slaughtered. After this event there is no need to make any changes in the recommendations," Thiermann said.

"Pigs are occasionally known to have influenza and they fully recover and are no longer infectious. In the pigs, once they recover, you can detect antibodies ... that the virus is no longer there," he added.

(Additional reporting by Anna Willard in Paris; Editing by Sophie Hares)

http://www.reuters.com/article/swineFlu/idUSTRE54217F20090503?feedType=RSS&feedName=swineFlu&virtualBrandChannel=10521

WHO says 615 people infected in 15 countries

2009-05-02T16:32:00.002+03:00

Sat May 2, 2009 5:39am EDT

GENEVA (Reuters) - The World Health Organization said on Saturday that 15 countries have reported 615 infections with the new flu virus A-H1N1, widely known as swine flu.

Most of the increase from Friday's 331 toll reflects the results of ongoing tests from Mexico, which had a backlog of samples in WHO labs, the United Nations agency said.

Mexico, the epicenter of the disease outbreak, now has 397 laboratory-confirmed human cases including 16 deaths, according to the WHO, whose data has been lagging national figures and is considered most authoritative.

The second-most affected country, the United States, has 141 cases confirmed in WHO labs including one death, the Mexican infant whose family crossed the border to seek medical help. Other countries have had the following number of confirmed H1N1 infections, with no deaths: Austria (1), Canada (34), Hong Kong - China (1), Denmark (1), France (1), Germany (4), Israel (2), Netherlands (1), New Zealand (4), South Korea (1), Spain (13), Switzerland (1) and Britain (13).

Mexico has cut its suspected death toll to 101 from as many as 176 because of test samples coming back negative in its labs, the government said late on Friday, in a sign the flu pandemic the WHO says is "imminent" may not be as severe as first feared.

On Saturday, the WHO repeated its view that borders should stay open and travel should not be limited as a result of the virus, but said "it is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention.

"Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness," the WHO said on its website.

(Reporting by Laura MacInnis)

http://www.reuters.com/article/swineFlu/idUSTRE5410YG20090502?feedType=RSS&feedName=swineFlu&virtualBrandChannel=10521

Swine Flu: Statistical Model Predicts Spread in U.S.

2009-04-30T08:44:00.001+03:00

Apr 28, 2009, By Blake Harris

Two different swine influenza infection computer models from Indiana and Northwestern Universities, generated on April 27, both predict about 1,000 cases in the United States within three weeks.

However, as of 6 a.m., April 28, there had only been 40 cases of swine influenza (H1N1) reported in the U.S. according to the national Centers for Disease Control and Prevention.

According to Indiana University Rudy Professor of Informatics Alessandro Vespignani, an internationally recognized expert on the statistical analysis and computer modeling of epidemics, the prediction of 1000 cases is actually pretty good news and it might not actually get that bad.

"This is a worst-case scenario, as we are always working in a worst-case scenario setting," Vespignani said in a press statement today. "What we are finding is that this is not a panic situation and that this thing is not ramping up in some crazy way. Right now we are confident that in the next few days things will be more optimistic."

His optimism is based largely upon the actions taken worldwide: the medical alert in Mexico, school closures in Texas, World Health Organization warnings, increased controls at international airports and the availability of an anti-viral drug for treatment.

However, Vespignani also pointed out that the next 72 hours would be critical. Even the computer model predictions could change as often as every 12 to 24 hours, depending upon what happens in the world.

Alessandro Vespignani is an internationally recognized expert on the statistical analysis and computer modeling of epidemics. (Indiana University)

http://www.govtech.com/dc/articles/649458?utm_source=rss&utm_medium=link

WHO raises pandemic alert to second-highest level

2009-04-30T08:32:00.003+03:00

GENEVA, Switzerland CNN

The World Health Organization on Wednesday raised its pandemic alert to 5, its second-highest level, warning of widespread human infection from the swine flu outbreak that originated in Mexico.

Dr. Margaret Chan, the U.N. agency's director-general, said the decision to raise the alert on the 6-point scale indicated that all countries should "immediately" activate pandemic preparedness plans.

"This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharm industry and the business community that certain actions now should be taken with increased urgency and at an accelerated pace," Chan said.

The announcement came as the number of confirmed cases increased rapidly across the world.

The WHO and national governments have confirmed 148 cases in nine countries. Most of those cases are in the United States, where the Centers for Disease Control and Prevention has confirmed 91 cases.

The figures include seven deaths in Mexico and one in the United States. More than 2,700 other patients worldwide are believed to be suffering from the virus that government officials call by its technical name, 2009 H1N1.

The first cases of the virus were detected in Mexico, where health officials suspect swine flu in more than 150 other deaths and roughly 2,500 illnesses. As of late Wednesday, 99 cases had been confirmed -- up from 26, Mexico's health secretary reported. An eighth fatality was also confirmed. iReport.com: "Regular life" in Mexico with masks

The additional cases and fatality were not immediately confirmed by WHO

Researchers do not know how the virus is jumping relatively easily from person to person, or why it's affecting what should be society's healthiest demographic. Many of the victims who have died in Mexico have been young and otherwise healthy.

The outbreak has prompted Mexican authorities to order about 35,000 public venues in Mexico City to shut down and restrict restaurants to serving only take-out meals.

All nonessential government offices and private business were ordered to close between May 1-5, with only skeletal staffing allowed when necessary, Mexico's health secretary announced Wednesday.

Mexican officials said it was too soon to determine what kind of economic impact the decision would have on the country.

Germany and Austria became the latest European countries to report swine flu on Wednesday, while the number of cases increased in the United Kingdom and Spain. Peru reported its first case late Wednesday.

Yet Chan reiterated the WHO's recommendation not to close borders or restrict trade in response to the outbreak, saying the world "is better prepared for an influenza pandemic than at any time" in history.

Watch how the U.S. is preparing for the worst »

"We need to maintain a level of calmness so that we will continue to manage this in a rational manner," she said, adding that pork is safe for consumption as long as it is cooked properly.
President Obama downplayed the possibility of closing the U.S. border with Mexico, where the recent occurrence of the deadly virus began.

"It would be akin to closing the barn door after the horses are out," Obama said during his Wednesday evening news conference.

Obama said he'll be looking to health officials for guidance on how to handle travel between the two countries.

The $1.5 billion Obama requested from Congress to help fight the outbreaks will help health officials monitor and track the virus and replenish the supply of anti-viral drugs, he said. Watch President Obama caution Americans on swine flu »

Swine influenza, or flu, is a contagious respiratory disease that affects pigs. When the flu spreads person to person, instead of from animals to humans, it can continue to mutate, making it harder to treat or fight, because people have no natural immunity.

Symptoms include fever, runny nose, sore throat, nausea, vomiting and diarrhea.

The WHO's "Phases of Pandemic Alert," which has been in existence for five years, characterizes phase 5 as a human-to-human spread of the virus into at least two countries in one WHO region, signaling that a pandemic is imminent.

The highest level, phase 6, is defined by community-level outbreaks in at least one other country in a different WHO region, according to the agency.

About a quarter of the U.S. stockpile of anti-viral drugs will be distributed to states by Sunday, Homeland Security Secretary Janet Napolitano said. Watch how U.S. officials are reacting to the virus »

U.S. officials also are asking scientists whether additional measures to screen for flu symptoms were needed at U.S. ports of entry, she said. Already, customs officers have asked 49 people to submit to tests for the H1N1 virus, she said. Of those tests, 41 have been negatives and the remaining eight have not yet come back.

Researchers in the United States have already taking steps to crack the genetic code of the virus behind the swine flu outbreak in order to produce a vaccine, U.S. officials said Wednesday.

The U.S. government is distributing 25 percent of its stockpile of antiviral medications Tamiflu and Relenza to all states, Homeland Security Secretary Janet Napolitano said Wednesday. Health officials stress that the medications are effective only if taken in the early stages of the infection. Learn more about swine flu and how to treat it »

The 91 confirmed cases in the United States includes the country's first swine flu fatality: a 23-month-old child visiting from Mexico who died Monday at a Houston, Texas, hospital.

A U.S. Marine in California is the military's first suspected case of swine flu, and three military family members in San Diego have confirmed cases, the CDC said.

As a precaution, the military is banning travel to Mexico for nonessential personnel.

Mexican officials also said they believe they may have found "patient zero" -- the first case of the global outbreak -- in the small mountain village of La Gloria.

Edgar Hernandez, 5, survived the earliest documented case of swine flu. He lives near a pig farm, though experts have not established a connection between that and his illness.

Edgar has managed to bounce back from his symptoms and playfully credits ice cream for helping him feel better.

In the United States, at least 74 elementary, junior high and high schools have closed across the country due to confirmed or probable cases of swine flu, the Department of Education said Wednesday.

Another 30 schools have closed as a precautionary measure, Department of Education spokesman Massie Ritsch said.

Governments around the world are scrambling to prevent further outbreak.

Some countries, such as China and Russia, have banned pork imports from the United States and Mexico, though the WHO said the disease is not transmitted through eating or preparing pig meat. Several other countries, such as Japan and Indonesia, are using thermographic devices to test the temperature of passengers arriving from Mexico.

Egypt reportedly is considering culling all pigs although there have been no reported cases of swine flu there.

Common seasonal flu kills 250,000 to 500,000 people every year worldwide, far more than the current outbreak of swine flu. But there is a vaccine for seasonal flu

CNN's Dr. Sanjay Gupta and Barbara Starr contributed to this report.

http://edition.cnn.com/2009/HEALTH/04/29/swine.flu/index.html

EU health ministers to hold swine flu talks

2009-04-30T08:29:00.001+03:00

The Associated Press April 29, 2009, 11:47AM ET

By CONSTANT BRAND

BRUSSELS

EU officials say a Europe-wide travel advisory to avoid Mexico and unified prevention and treatment measures for swine flu will top the agenda Thursday at an emergency meeting of European Union health ministers.

EU spokeswoman Nina Papadoulaki said top EU health officials met with European drugmakers on Wednesday to hear their efforts to find a treatment for the flu and EU envoys were looking at other joint measures to take to contain the virus.

"There is a certain level of concern, but it should not give rise to panic," Papadoulaki said.
Britain, Spain, Austria and Germany already have confirmed cases of the disease, which is blamed for over 150 deaths and 2,400 infections in Mexico.

Health ministers from across the 27-nation bloc will meet in Luxembourg on Thursday to go over additional measures. French Health minister Roselyne Bachelot said she would push at those talks for the EU to suspend flights to Mexico to curb the spread of the disease.

National authorities are already sharing information on diagnosis and lab results through the European Center for Disease Prevention and Control in Stockholm, which has strongly advised against traveling to Mexico because of the outbreak there.

EU Health Commissioner Androulla Vassiliou also urged Europeans to avoid nonessential travel to Mexico and to affected parts of the United States, but that was strongly criticized by airlines on Wednesday.

Ulrich Schulte-Strathaus, secretary general of the Association of European Airlines called the warnings "irresponsible and ill-advised." He warned that advisories could do more harm than good and said airlines are "well-prepared to handle health crises."

Airline stocks dropped Monday on concerns that swine flu would keep travelers off planes, much as Asia's 2003 SARS epidemic did.

He said his group's 34 member airlines, including carriers like Lufthansa, British Airways and Air France-KLM, were informing passengers about the disease, risks and precautions.

"A priority now is to establish a coordinated European response and avoid a diversity of national rules and requirements," he said.

http://www.businessweek.com/ap/financialnews/D97S7D680.htm

Current level of influenza pandemic alert raised from phase 4 to 5

2009-04-29T23:49:00.004+03:00

Based on assessment of all available information and following several expert consultations, Dr Margaret Chan, WHO's Director-General raised the current level of influenza pandemic alert from phase 4 to 5. She stated that all countries should immediately activate their pandemic preparedness plans. At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.

Statement by WHO Director-General, Dr Margaret Chan 29 April 2009

Swine influenza

Ladies and gentlemen,

Based on assessment of all available information, and following several expert consultations, I have decided to raise the current level of influenza pandemic alert from phase 4 to phase 5.

Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world.

On the positive side, the world is better prepared for an influenza pandemic than at any time in history.

Preparedness measures undertaken because of the threat from H5N1 avian influenza were an investment, and we are now benefitting from this investment.

For the first time in history, we can track the evolution of a pandemic in real-time.

I thank countries who are making the results of their investigations publicly available. This helps us understand the disease.

I am impressed by the work being done by affected countries as they deal with the current outbreaks.

I also want to thank the governments of the USA and Canada for their support to WHO, and to Mexico.

Let me remind you. New diseases are, by definition, poorly understood. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour.

WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.

WHO will be tracking the pandemic at the epidemiological, clinical, and virological levels.

The results of these ongoing assessments will be issued as public health advice, and made publicly available.

All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.

At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.

This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency, and at an accelerated pace.

I have reached out to donor countries, to UNITAID, to the GAVI Alliance, the World Bank and others to mobilize resources.

I have reached out to companies manufacturing antiviral drugs to assess capacity and all options for ramping up production.

I have also reached out to influenza vaccine manufacturers that can contribute to the production of a pandemic vaccine.

The biggest question, right now, is this: how severe will the pandemic be, especially now at the start?

It is possible that the full clinical spectrum of this disease goes from mild illness to severe disease. We need to continue to monitor the evolution of the situation to get the specific information and data we need to answer this question.

From past experience, we also know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries.

No matter what the situation is, the international community should treat this as a window of opportunity to ramp up preparedness and response.

Above all, this is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.

As I have said, we do not have all the answers right now, but we will get them.

Thank you.

http://www.who.int/mediacentre/news/statements/2009/h1n1_20090429/en/index.html

watch the statement here

http://news.bbc.co.uk/1/hi/health/8025979.stm

H1N1 Swine Flu - Google Maps

2009-04-29T18:18:00.000+03:00

View H1N1 Swine Flu in a larger map

Has globalization made us more catastrophe-prone?

2009-04-29T18:14:00.001+03:00

Wed Apr 29, 2009 10:36am EDT

By Andrew Marshall, Asia Political Risk Correspondent

SINGAPORE (Reuters) - As the world grapples with the worst economic downturn in decades and the possibility of a flu pandemic, a growing body of research suggests the complexity of the modern global economy may make us more vulnerable than ever to catastrophe.

The financial crisis began as turmoil in one small segment of the U.S. mortgage market. Within months it had morphed into a global meltdown affecting almost everyone on earth.

"The speed at which these events unfolded was unprecedented," said the World Economic Forum's 2009 report on global risk.

"It has demonstrated just how tightly interconnected globalization has made the world and its systems."

Disease, too, can spread faster than ever before. Modern air travel means that any contagious outbreak can be worldwide in a matter of days. In the past, it would have taken months or years.

The more complex and efficient a system, the faster and wider any contagion can spread. Yet this interdependence is by no means always negative. The complexity of the world economy means risk can be more easily distributed, and often more easily mitigated.

Complex systems can often be adaptable -- if one part fails, other parts of the network can assume the burden.

Network theory suggests that complex diversified systems can often bring greater stability. But only to a point.

"While this helps the system diversify across small shocks, it also exposes the system to large systemic shocks," Raghuram Rajan, who has been an IMF chief economist and adviser to Indian Prime Minister Manmohan Singh, wrote in a 2005 research paper.

"It is possible that these developments...create a greater (albeit still small) probability of a catastrophic meltdown."

BUTTERFLIES, BLACK SWANS AND SWINE FLU

One key issue is the so-called "butterfly effect" -- in highly complex systems, even a small event can be magnified and transmitted with highly unpredictable results. Edward Lorenz, a pioneer of chaos theory, noted that a butterfly flapping its wings in one corner of the world could cause a tornado far away.

Benoit Mandelbrot, a French mathematician and the father of fractal geometry, applied the theory to markets to show how "wild variability" is intrinsic to the system.

In network theory, one key finding is that complex interconnected systems organize themselves around key nodes. If one of these is hit, the whole house of cards can collapse.

This is one reason the damage done by the subprime crisis to major global investment banks had such a devastating impact.....

art. cont.

Swine Flu

2009-04-28T10:50:00.001+03:00

Pandemic: What would happen next?

2009-04-28T10:49:00.000+03:00

By Kevin VoigtCNN.com/heatlh

The world hasn't seen a pandemic in 41 years, when the "Hong Kong" flu crossed the globe and killed about one million people worldwide. If swine flu reaches pandemic levels, what would happen next?

Recurrent outbreaks of Avian Influenza and the outbreak of SARS in 2003 rang alarm bells as potential pandemics.

Although both jumped the "animal-to-human" barrier, neither disease mutated enough to enable sustained human-to-human infection, said Dr. K.Y. Yuen, head of microbiology at Hong Kong University.

Strictly speaking, Avian Influenza and SARS did not become pandemics because they were too good at killing their hosts.

"For a sustained pandemic, it needs to be able to maintain human-to-human contact without killing its host off," he said.

Avian influenza "never became a man-to-man disease," said Dr. Lo Wing-Luk, an infectious disease expert.

"Swine flu is already a man-to-man disease, which makes it much more difficult to manage . and swine flu appears much more infectious than SARS."

But the WHO cautions, it cannot say whether or not it will indeed cause a pandemic. According to epidemiologists and health experts, here's what the world might see if there is another pandemic, based on past experience:

The disease would skip from city to city over an 18-to-24 month period, infecting more than a third of the population. World health Organization officials believe as many as 1.5 billion people around the globe would seek medical care and nearly 30 million would seek hospitalization. Based on the last pandemic and current world population, as many as 7 million people could die, epidemiologists said.

"Hospitals will become overcrowded, schools will close, businesses will close, airports will be empty," Dr. Lo said.

"Business will become very bad, as people avoid as much social contact as possible," added Dr. Yuen.

Health facilities will become overrun with patients and there would be less-than-adequate staffing, as medical health professionals fall ill themselves, experts say. "We saw cases in SARS where people who should have gone to the hospital for things like cancer treatment didn't go, and that resulted in higher deaths," Dr. Lo said.

The very young and very old will likely be the most susceptible to the illness.

Experts caution, much is still unknown about the current swine flu virus and its severity and it is too early to say whether it will lead to a pandemic. Right now, the focus is on finding answers and containing the spread.

http://edition.cnn.com/2009/HEALTH/04/27/pandemic.next/index.html

The current WHO phase of pandemic alert is 4

2009-04-28T10:22:00.002+03:00

27 April 2009 -- The Emergency Committee, established in compliance with the International Health Regulations (2005), held its second meeting on 27 April 2009. The Committee considered available data on confirmed outbreaks of A/H1N1 swine influenza in the United States of America, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries. On the advice of the Committee, the WHO Director-General has raised the level of influenza pandemic alert from the current phase 3 to phase 4.

In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities.

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.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

Director-General's statement - Swine influenza

The Emergency Committee, established in compliance with the International Health Regulations (2005), held its second meeting on 27 April 2009.

The Committee considered available data on confirmed outbreaks of A/H1N1 swine influenza in the United States of America, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries.

On 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.

http://www.who.int/en/

Swine Flu Latest News

2009-04-28T00:04:00.001+03:00

CDC Media Availability on Human Swine Influenza Cases

April 27, 2009, 1 p.m. EST

Press Briefing Transcripts

Swine influenza frequently asked questions

2009-04-27T10:24:00.002+03:00

A pdf fact file by the World Health Organization, covering the following questions

25 April 2009

• What is swine influenza?
• What are the implications for human health?
• Where have human cases occurred?
• How do people become infected?
• Is it safe to eat pork meet and products?
• What about the pandemic risk?
• Is there a human vaccine to protect swine influenza?
• What drugs are available for treatment?

Download

Influenza A virus subtype H1N1 and the Pandemic of 1918

2009-04-27T10:11:00.003+03:00

Influenza A virus subtype H1N1

H1N1 is a subtype of the species Influenza A virus. The "H" refers to the Hemagglutinin protein, and the "N" refers to the Neuraminidase protein. H1N1 has mutated into various strains including the Spanish Flu strain (now extinct in the wild), mild human flu strains, endemic pig strains, and various strains found in birds. A variant of H1N1 was responsible for the Spanish flu pandemic that killed some 50 million to 100 million people worldwide from 1918 to 1919. A different variant exists in pig populations.

Low pathogenic H1N1 strains still exist in the wild today, causing roughly half of all flu infections in 2006. When the 1918 virus was compared with human flu viruses in 2005, it was noticed that it had alterations in just 25 to 30 of the virus's 4,400 amino acids. These changes were enough to turn a bird virus into a version that was human-transmissible.

In April 2009, an H1N1 outbreak killed over one hundred (100) in Mexico, and was believed to have infected more than 1600 individuals worldwide as of April 27, 2009. The U.S. Centers for Disease Control warned that it was possible the outbreak could develop into a pandemic.

Spanish Flu

The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiological data are inadequate to identify the geographic origin of the virus. Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The pandemic lasted from March 1918 to June 1920, spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 20 to 100 million people were killed worldwide, or the approximate equivalent of one third of the population of Europe, more than double the number killed in World War I. This extraordinary toll resulted from the extremely high illness rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. The pandemic is estimated to have affected up to one billion people: half the world's population at the time.

Some scholars have theorized that the flu probably originated in the Far East. Scholar John Barry has proposed that Haskell County, Kansas was the location of the first outbreak of flu. The disease was first observed at Fort Riley, Kansas, United States, on March 4, 1918,and Queens, New York, on March 11, 1918. In August 1918, a more virulent strain appeared simultaneously in Brest, France, in Freetown, Sierra Leone, and in the U.S. at Boston, Massachusetts. The Allies of World War I came to call it the Spanish flu, primarily because the pandemic received greater press attention after it moved from France to Spain in November 1918. Spain was not involved in the war and had not imposed wartime censorship.

Scientists have used tissue samples from frozen victims to reproduce the virus for study. Given the strain's extreme virulence there has been controversy regarding the wisdom of such research. Among the conclusions of this research is that the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths.

The global mortality rate from the 1918/1919 pandemic is not known, but is estimated at 2.5 to 5% of the human population, with 20% or more of the world population suffering from the disease to some extent. Influenza may have killed as many as 25 million in its first 25 weeks (in contrast, AIDS killed 25 million in its first 25 years).Older estimates say it killed 40–50 million people while current estimates say 50 million to 100 million people worldwide were killed. This pandemic has been described as "the greatest medical holocaust in history" and may have killed more people than the Black Death.

An estimated 17 million died in India, about 5% of India's population at the time.In the Indian Army, almost 22% of troops who caught the disease died of it. In the U.S., about 28% of the population suffered, and 500,000 to 675,000 died.In Britain as many as 250,000 died; in France more than 400,000. In Canada approximately 50,000 died. Entire villages perished in Alaska and southern Africa. Ras Tafari (the future Haile Selassie) was one of the first Ethiopians who contracted influenza but survived, although many of his subjects did not; estimates for the fatalities in the capital city, Addis Ababa, range from 5,000 to 10,000, with some experts opining that the number was even higher, while in British Somaliland one official there estimated that 7% of the native population died from influenza. In Australia an estimated 12,000 people died and in the Fiji Islands, 14% of the population died during only two weeks, and in Western Samoa 22%.

This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred." The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.

The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%. Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old. This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70), and may have been due to partial protection caused by exposure to a previous Russian flu pandemic of 1889.

Spanish flu research

Spanish flu research concerns scientific research regarding the causes and characteristics of the "Spanish flu", a variety of influenza that in 1918 was responsible the worst influenza pandemic in modern history. Many theories about the origins and progress of the Spanish flu persisted in literature, but it wasn't until 2005, when various samples recovered from American World War I soldiers and an Inuit woman buried in the Alaskan tundra, that significant research has been possible.

Origin of Virus

One theory is that the virus strain originated at Fort Riley, Kansas, by two genetic mechanisms — genetic drift and antigenic shift — in viruses in poultry and swine which the fort bred for local consumption. Though initial data from a recent reconstruction of the virus suggested that it jumped directly from birds to humans, without traveling through swine, this has since been cast into doubt. One researcher argues that the disease was found in Haskell County, Kansas as early as January 1918.A similar and even more deadly virus had been seen earlier at British camps in France and at Aldershot.

Discovery of viral genomes

In February 1998, Johan Hultin recovered samples of the 1918 influenza from the frozen corpse of a Native Alaskan woman buried for nearly eight decades in permafrost near Brevig Mission, Alaska. He brought the samples to a team led by Jeffery Taubenberger of the US Armed Forces Institute of Pathology (AFIP). Brevig Mission lost approximately 85% of its population to the 1918 flu in November 1918. One of the four recovered samples contained viable genetic material of the virus. This sample provided scientists a first-hand opportunity to study the virus, which was inactivated with guanidinium thiocyanate before transport. This sample and others found in AFIP archives allowed researchers to completely analyze the critical gene structures of the 1918 virus. "We have now identified three cases: the Brevig Mission case and two archival cases that represent the only known sources of genetic material of the 1918 influenza virus", said Taubenberger, chief of AFIP's molecular pathology division and principal investigator on the project.

The February 6, 2004 edition of Science magazine reported that two research teams, one led by Sir John Skehel, director of the National Institute for Medical Research in London, another by Professor Ian Wilson of The Scripps Research Institute in San Diego, had managed to synthesize the hemagglutinin protein responsible for the 1918 flu outbreak of 1918. They did this by piecing together DNA from a lung sample from an Inuit woman buried in the Alaskan tundra and a number of preserved samples from American soldiers of the First World War. The teams had analyzed the structure of the gene and discovered how subtle alterations to the shape of a protein molecule had allowed it to move from birds to humans with such devastating effects.

On October 5, 2005, researchers at the Mount Sinai School of Medicine in New York announced that the genetic sequence of the 1918 flu strain, a subtype of avian strain H1N1, had been reconstructed using historic tissue samples.

Characteristics of virus

Influenza viruses have a relatively high mutation rate that is characteristic of RNA viruses. The H5N1 virus has mutated into a variety of types with differing pathogenic profiles; some pathogenic to one species but not others, some pathogenic to multiple species.The ability of various influenza strains to show species-selectivity is largely due to variation in the hemagglutinin genes. Genetic mutations in the hemagglutinin gene that cause single amino acid substitutions can significantly alter the ability of viral hemagglutinin proteins to bind to receptors on the surface of host cells. Such mutations in avian H5N1 viruses can change virus strains from being inefficient at infecting human cells to being as efficient in causing human infections as more common human influenza virus types. This doesn't mean one amino acid substitution can cause a pandemic but it does mean one amino acid substitution can cause an avian flu virus that is not pathogenic in humans to become pathogenic in humans.

In July 2004, researchers led by H. Deng of the Harbin Veterinary Research Institute, Harbin, China and Robert Webster of the St Jude Children's Research Hospital, Memphis, Tennessee, reported results of experiments in which mice had been exposed to 21 isolates of confirmed H5N1 strains obtained from ducks in China between 1999 and 2002. They found "a clear temporal pattern of progressively increasing pathogenicity". Results reported by Webster in July 2005 reveal further progression toward pathogenicity in mice and longer virus shedding by ducks.

In December, 2008, research by Yoshihiro Kawaoka of University of Wisconsin linked the presence of the three specific genes (termed PA, PB1, and PB2) and a nucleoprotein derived from the 1918 flu samples was enough to trigger similar symptoms in animal testing.

Research of viral pathogenesis

Recent research of Taubenberger et al has suggested that the 1918 virus, like H5N1, could have arisen directly from an avian influenza virus. However, researchers at University of Virginia and Australian National University have suggested that there may be an alternative interpretation of the data used in the Taubenberger et al. paper.Taubenberger et al responded to these letters and defended their original interpretation.

Other research by Tumpey and colleagues who reconstructed the H1N1 virus of 1918 came to the conclusion that it is was most notably the polymerase genes and the HA and NA genes that caused the extreme virulence of this virus. The sequences of the polymerase proteins (PA, PB1, and PB2) of the 1918 virus and subsequent human viruses differ by only 10 amino acids from the avian influenza viruses. Viruses with seven of the ten amino acids in the human influenza locations have already been identified in currently circulating H5N1. This has led some researchers to suggest that other mutations may surface and make the H5N1 virus capable of human-to-human transmission. Another important factor is the change of the HA protein to a binding preference for alpha 2,6 sialic acid (the major form in the human respiratory tract). In avian virus the HA protein preferentially binds to alpha 2,3 sialic acid, which is the major form in the avian enteric tract. It has been shown that only a single amino acid change can result in the change of this binding preference. Altogether, only a handful of mutations may need to take place in order for H5N1 avian flu to become a pandemic virus like the one of 1918. However it is important to note that likelihood of mutation does not indicate the likelihood for the evolution of such a strain; since some of the necessary mutations may be constrained by stabilizing selection.

On 18 January 2007, Kobasa et al reported that infected monkeys (Macaca fascicularis) exhibited classic symptoms of the 1918 pandemic and died from a cytokine storm.

Blood plasma as an effective treatment

In the event of another pandemic, US military researchers have proposed reusing a treatment from the deadly pandemic of 1918 in order to blunt the effects of the flu. Some military doctors injected severely afflicted patients with blood or blood plasma from people who had recovered from the flu. Data collected during that time indicates that the blood-injection treatment reduced mortality rates by as much as 50 percent. Navy researchers have launched a test to see if the 1918 treatment will work against deadly Asian bird flu. Results thus far have been inconclusive. Human H5N1 plasma may be an effective, timely, and widely available treatment for the next flu pandemic. A new international study using modern data collection methods, would be a difficult, slow process. But many flu experts, citing the months-long wait for a vaccine for the next pandemic, are of the opinion that the 1918 method is something to consider.

In the world wide 1918 flu pandemic, "physicians tried everything they knew, everything they had ever heard of, from the ancient art of bleeding patients, to administering oxygen, to developing new vaccines and sera (chiefly against what we now call Hemophilus influenzae—a name derived from the fact that it was originally considered the etiological agent—and several types of pneumococci). Only one therapeutic measure, transfusing blood from recovered patients to new victims, showed any hint of success."

(modified articles from wikipedia)

Swine Flu Outbreak

2009-04-26T02:36:00.001+03:00

The news from Mexico are alarming, at least. The global scientific community is very concerned with the rapid development of events in that part of the world. First of all it is important to keep in mind that panic is our worst enemy. It is true that an influenza pandemic is possible nevertheless, we must remain calm. It is imperative that information about this matter should flood the internet in order to create a spherical and scientific based awareness to all.

BBC News

Mexico flu 'a potential pandemic'

A new flu virus suspected of killing at least 60 people in Mexico has the potential to become a pandemic, the World Health Organization's chief says.

Margaret Chan said the outbreak was a "health emergency of international concern" and must be closely monitored.

Health experts say tests so far seem to link the illnesses in Mexico with a swine flu virus in the southern US.

Several people have also fallen ill in the US, and the authorities there are watching the situation.
A top US health official said the strain of swine flu had spread widely and could not be contained.
Ms Chan cut short a visit to the US and returned to Geneva where the WHO's emergency committee met.

The committee can recommend declaring an international public health emergency and raise the global pandemic alert level - a move that could lead to travel advisories, trade restrictions and border closures.

The WHO says it does not know the full risk yet but it quoted Mrs Chan as saying that "the current events constitute a public health emergency of international concern".

It is advising all member states to be vigilant for seasonally unusual flu or pneumonia-like symptoms among their populations - particularly among young healthy adults.

Officials said most of those killed so far in Mexico were young adults - rather than more vulnerable children and the elderly.... (full article here)

Fuel for Poverty

2008-10-15T17:37:00.002+03:00

It was in back in 2007 when President Bush and the left-of-center Brazilian President Luis Inacio Lula da Silva, proclaimed a partnership between their countries in order to promote the use of biofuel as a source of alternative energy.

That was an amazing turn of events, considering the fact that the American administration never had the best of relationships with governments that come from the left side of the political spectrum. Even more amazing was the fact, that George W. Bush, a person whose political career revolves around petroleum, would support partnerships involving alternative sources of energy.

It seems that President Bush was a strong supporter of the “development and production of fuels and automobiles that would decrease the use of oil” way before his visit to Brazil. 1

The consequences of this sudden interest on the future of the environment were extremely worrying. The prices of agricultural products rocketed, violent riots erupted in many of the underdeveloped countries and a climate of insecurity struck masses of people that already lived in abhorrent conditions.

There are unconfirmed rumors that the increasing production of biofuel was responsible for 75% of the total increase in food prices. The correlation between biofuel production was described in the best way possible in the articles that follow, both by C. Ford Runge and Benjamin Senauer.

1 Bush Urges Cuts in Gasoline Use, More Biofuel Production

How Biofuels Could Starve the PoorC. Ford Runge and Benjamin Senauer

From Foreign Affairs, May/June 2007

Summary: Thanks to high oil prices and hefty subsidies, corn-based ethanol is now all the rage in the United States. But it takes so much supply to keep ethanol production going that the price of corn -- and those of other food staples -- is shooting up around the world. To stop this trend, and prevent even more people from going hungry, Washington must conserve more and diversify ethanol's production inputs.

C. Ford Runge is Distinguished McKnight University Professor of Applied Economics and Law and Director of the Center for International Food and Agricultural Policy at the University of Minnesota. Benjamin Senauer is Professor of Applied Economics and Co-director of the Food Industry Center at the University of Minnesota.....

Link to the article

How Ethanol Fuels the Food Crisis

C. Ford Runge and Benjamin Senauer

From foreignaffairs.org - author update, May 28, 2008

Summary: Runge and Senauer's update to their May/June 2007 essay ''How Biofuels Could Starve the Poor.''

In the year since the publication of our article, "How Biofuels Could Starve the Poor" (May/June 2007), the average price of corn has increased by some 60 percent, soybeans by 76 percent, wheat by 54 percent, and rice by 104 percent. What at first seemed alarmist has turned out to be an underestimate of the effects of biofuels on both commodity prices and the natural environment. These price increases are substantial threats to the welfare of consumers, especially in poor developing countries facing food deficits. They are especially burdensome to the rural landless and the urban poor, who produce no food at all. Josette Sheeran, the Executive Director of the World Food Program, calls this a global "tsunami of hunger." Robert Zoellick, President of the World Bank, estimates that there are 100 million newly poor and hungry people as a result of rising food prices.....

Link to the article

C. Ford Runge is Distinguished McKnight University Professor of Applied Economics and Law at the University of Minnesota. Benjamin Senauer is Professor of Applied Economics at the University of Minnesota.

Weekly BioNews 8 - 15 Sep 2008

2008-09-17T15:30:00.002+03:00

Cryopreservation techniques bring hopes for women cancer victims and endangered species

September 10, 2008 09:39 AM

Emerging cryopreservation techniques are increasing hope of restoring fertility for women after diseases such as ovarian cancer that lead to destruction of reproductive tissue. The same techniques can also be used to maintain stocks of farm animals, and protect against extinction of endangered animal species by maintaining banks of ovarian tissue or even nascent embryos that can used to produce offspring at some point in the future.

Until now these clearly related fields of research concerning preservation of animal and human ovarian tissue have been largely separate, but are now coming together to reinforce each other, following a highly successful workshop on cryopreservation of ovarian tissue, organised by the European Science Foundation (ESF). The human and animals cryopreservation fields have much to teach each other, and progress in both is likely to be accelerated as a result of growing collaboration, according to the ESF workshop's convenor Claus Yding Andersen.

Both parties can learn from each other," said Andersen. "Experiments which cannot be performed in women can be done in animal species," he noted, pointing out that much of the progress in humans has come as a result of animal experiments. But it is in humans where most successful transplantations of frozen ovarian tissue after thawing have been carried out, and where greatest experience in the field has been gained. Therefore the ESF conference considered how this could be applied to conservation of endangered species. "The vast experience in women, with several children born as a result of transplantation of frozen/thawed ovarian tissue, can be applied in endangered species to know where to implant and how to obtain pregnancies," said Andersen. The techniques will also be valuable in agriculture, for preserving ovaries of farm animals in tissue banks with the potential for subsequent re-creation...

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