In the face of bird flu

2009

مايو May

12 12

احتجاز‏11‏ حالة بكفر الشيخ والبحيرة والغربية وسوهاج وإعدام‏10‏ آلاف طائر بالقليوبية والشرقية

The case of the detention of 11 in Kafr Sheikh and the lake and the West, Sohag, 10 executions of thousands of birds and Eastern Balqlliopip

مازالت الحملات المكثفة مستمرة في مكافحة إنفلونزا الطيور وسط تحذيرات منظمة الصحة العالمية‏..‏ وحالة الطواريء في جميع مستشفيات الحميات‏..‏ ومازالت حالات الاحتجاز والأشتباه‏..‏ وعمليات الأعدام للطيور داخل المزارع وإزالة العشش من المنازل بالقري والمدن ومراكز المحافظات مستمرة‏..‏ ورغم حملات التوعية‏..‏ مازالت هنا تساؤلات من المواطنين‏..‏ فما هو البديل‏..‏ وسلوكيات بعض المواطنين تمثل اللامبالاة أمام خطورة المرض‏..‏ فما هو الوضع بالمحافظات‏.‏

Intensive campaigns are still continuing in the fight against avian influenza amid warnings by the World Health Organization .. and a state of emergency in all hospitals and fever .. still cases of detention and suspicion .. and executions of the birds in the farms and the removal of the nests of the houses in villages, cities and provincial centers continuing .. Despite the awareness campaigns are still here .. questions from citizens, what is the alternative .. .. and the behavior of some citizens are indifferent to the seriousness of the disease .. What was the situation nationwide.

كفر الشيخ ـ من علاء عبدالله‏:‏

Kafr El-Sheikh Alaa Abdullah:

واصل مستشفي الحميات بكفر الشيخ احتجاز الحالات المشتبه في إصابتهم بمرض إنفلونزا الطيور سواء من أبناء المحافظة أو المحافظات المجاورة حيث تم احتجاز‏4‏ حالات جديدة داخل المستشفي للإشتباه في إصابتهم بهذا المرض وذلك بعد شعورهم بآلام شديدة في العظام وإرتفاع في درجة الحارة وسعال دائم ورشح من الأنف‏,

‏

The fever hospital in Kfar-Sheikh in the detention of suspected cases of bird flu patients, both the people of the area or the neighboring provinces have been 4 new cases of detention in the hospital with a suspected infection of the disease, after feeling severe pain in bones and a rise in the degree of heat and a cough lasting and nominated nose,

وهم أمينة صالح أحمد‏(5‏ سنوات‏)‏ من مركز كفر الشيخ وحنان جاب الله جاب الله‏(35‏ سنة‏)‏ من مركز سيد سالم وراندا سليمان علي‏(24‏ سنة‏)‏ من مركز سيدي سالم وعبدالحميد أحمد محمد‏(12‏ سنة‏)‏ من مركز الرياض‏,‏ وقد تم علي الفور أخذ
عينة من دمائهم ومسحة حلق وإرسالها إلي المعامل المركزية التابعة لوزارة الصحة بالقاهرة فقد وافقت المستشفي علي خروج‏8‏ حالات بعدما جاءت العينة الثانية الخاصة بهم سلبية وتم المسح لهم بالخروج من المستشفي‏.‏

They Amina Ahmed Saleh (5 years) from the Center for the joy of Kafr El-Sheikh Djaballah Djaballah (35 years) from the Center for RANDAN Syed Salim and Suleiman Ali (24 years) from the Center, Mr. Salim and Abdul Hamid Ahmad Mohammad (12 years) from the Center of Riyadh, were immediately taken a sample of blood and swab hours and sent to the central laboratory of the Ministry of Health has agreed in Cairo hospital after exit 8 of the second sample was negative for their Survey them to leave the hospital.

البحيرة ـ من تامر عبدالرءوف

Tamer Abdul Rauf of the lake

قام فريق من اللجنة الخماسية لمكافحة الإنفلونزا في محافظة البحيرة أمس بإعدام‏110‏ خنزيرا في مزرعة بناحية الضبعة بمركز بدر و‏17‏ خنزيرا في حظيرتين بمنطقتي السلام والوادي الفارغ بوادي النطرون وفي دير السريان بوادي النطرون تم ذبح‏56‏ خنزيرا وأعدام‏30‏ بينما يتبقي‏244‏ أخري سيتم إعدامها‏.‏ وعلي الجانب الآخر تم حجز الطفلة‏(‏ مي محمد زكي‏)(4‏ سنوات‏)‏ وتقيم بالمحمودية والمجند محمد ابراهيم غنيم‏(23‏ سنة‏)‏ أبو حمص داخل مستشفي حميات دمنهور للأشتباه في إصابتهما بإنفلونزا الطيور‏,‏ بينما تم تحويل عطيات رضا فتحي‏250‏ سنة‏)‏ ربة منزل وتقيم بقرية آبيس بكفر الدوار‏,‏ إلي مستشفي حميات الإسكندرية‏.‏

A team from the Committee of Five to combat influenza in the province of the lake on the execution of 110 pigs at a farm in County Dabaa Badr and the status of 17 pigs in the pens and the valley of peace zones, empty valley in the Monastery of the Syrian Natrun Valley Natrun 56 pigs were slaughtered and the execution of 30 About 244 more will be destroyed. On the other hand, has been reserved girl (Mai Mohamed Zaki) (4 years) and evaluate and recruit Mahmudiya Ghneim Mohammed Ibrahim (23 years) Abu Homs in the hospital Damanhour admitted for suspected bird flu, while the conversion Attiyat Reza Fathi 250 years old), a housewife and has the village of Kfar Apis dizziness, admitted to hospital in Alexandria.

بنها ـ من أبو سريع أمام

Banha Abu quick to

أعلن المستشار عدلي حسين محافظ القليوبية‏,‏ أنه تم أعدام‏5‏ آلاف دجاجة و‏30‏ ألف كتكوت‏,‏ داخل مزرعتين للدواجن بقرية اسنيت بكفر شكر وذلك بعد ظهور حالة إيجابية‏,‏ داخل المزرعتين‏..‏ وذلك تحت إشراف مديرية الطب البيطري بالمحافظة‏.‏

Chancellor Qaliubiya Governor Adli Hussein, had been culled thousands of chickens 5 and 30 A chick, poultry farms within the village of Kafr thanked Asnet and after the emergence of positive, within the farms .. and under the supervision of the maintenance of the Directorate of Veterinary Medicine.

وأكد المحافظ‏,‏ استمرار اتخاذ الإجراءات الصارمة حيال مواجهة إنفلونزا الطيور‏,‏ بكل المدن وإزالة العشش المخالفة‏,‏ لتربية الدواجن‏.‏

The governor pointed out, continued to take strict measures to the response to avian influenza, with all the cities and the removal of the nests contrary, for the breeding of poultry.

الشرقية ـ من نرمين الشوادفي‏:‏

Nermin Ahawadwi East:

قررت محافظة الشرقية تشكيل لجان مشتركة من الطب البيطري والتموين وشرطة المسطحات المائية بالتسنيق مع كلية الطب البيطري للتفتيش علي محال الجزارة والأسواق والمجمعات ومصانع اللحوم ومنافذ بيعها للتأكد من صلاحية المعروض وصرح الدكتورعطية مصطفي وكيل الوزارة للطب البيطري بأنه تقرر تكثيف الحملات علي المنافذ والأكمنة الحدودية وتدعميها بعدد إضافي من الأطباء البيطريين لإحكام الرقابة عليها وضبط أية سيارات محملة بالطيور والسبلة‏,‏ مشيرا الي أنه تم الأنتهاء من أعدام‏5‏ آلاف طائر حي بالمحلات والباعة الجائلين وإزالة‏273‏ عشة دواجن بالمدن‏.‏

The eastern province of the formation of joint committees of veterinary medicine, supply of water bodies and the police in coordination with the Faculty of Veterinary Medicine for the inspection of butcher shops, markets, parks and factories and meat sale outlets to ensure the validity of supply and Acanutorattiyp said Mustafa, undersecretary of the ministry of Veterinary Medicine that he decided to intensify crackdowns on the border entry points, ambushes, and the number of additional Tdamiha of veterinarians to tighten oversight and control of any vehicle loaded with birds and Sblp, pointing out that it was completed the execution of thousands of birds, 5 neighborhood stores and street vendors and the removal of 273 poultry shanty towns.

ومن جهة أخري تم احتجاز الطفلة نورهان الديداموني‏(9‏ سنوات‏)‏ بعد الاشتباه بإصابتها بإنفلونزا الطيور بمستشفي ههيا العام لتلقي العلاج المناسب حيث تم أخذ عينة منها وإرسالها للمعامل المركزية ومن جانبه أكد أحمد عزمي المشرف علي الأكمنة بالمحافظة أنه تم ضبط سيارة محملة بعدد‏1200‏ دجاجة عمر‏45‏ يوما مهربة من أحد المزارع بأبو كبير لبيعها بالأسواق وتم التحفظ علي السيارة المضبوطة ونقل الدجاج إلي المزرعة مرة أخري لاستكمال تربيتها‏.‏

On the other hand was holding the girl Norhan Aldedamouni (9 years) suspected of having bird flu Haia General Hospital to receive appropriate treatment, where a sample was taken and sent to labs central part, Ahmed Azmi, the maintenance supervisor on the ambushes that have been seized a car packed with a number 1200 age 45 days, a chicken smuggled from a farm in Abu large market to sell the reservation on the car was seized and transfer chicken to the farm again for the completion of breeding.

الغربية ـ من أحمد أبوشنب‏:‏

Ahmed vast portions of the West:

تم احتجاز حالتين‏,‏ إحداهما لربة منزل‏,‏ بمستشفي حميات طنطا والمحلة‏,‏ وذلك بعد الاشتباه في اصابتهما بمرض انفلونزا الطيور واخذ عينة من دمهما ومسحة حلق وارسالها للمعامل المركزية بوزارة الصحة‏,‏ من جهة اخري اظهرت نتائج تحاليل المعامل المركزية سلبية‏4‏ حالات ك ان قد تم الاشتباه في اصابتهم بالمرض‏,‏ صرح بذلك الدكتور شريف حمودة وكيل وزارة الصحة بالغربية‏.‏

Two were detained, one of the housewife, hospital admitted Tanta and Mahala, and are suspected of having SARS and bird flu to take a sample of blood and swab hours and sent to labs central Ministry of Health, on the other hand the results of laboratory tests showed a central negative 4 k cases that had been suspected of having avian flu, said Dr. Sharif Hammouda Undersecretary of the Ministry of Health meeting Sunday attended.

سوهاج ـ من محمد مطاوع علام ونيفين مصطفي‏:‏

Suhaj Mutawe Mohamed Mostafa Allam and Nivine:

أعلن الدكتور محمد عبدالعال‏,‏ وكيل وزارة الصحة بسوهاج‏,‏ أن الطفلة المصابة في طما بمرض إنفلونزا الطيور غير مخالطة للطيور‏,‏ وتبين أنها تلاقت مع مخلفات طيور كانت ملقاة في الشارع أمام المنزل‏,‏ وقد تم اتخاذ جميع الإجراءات الوقائية اللازمة وتطهير المنزل والمنازل المجاورة والشارع لمنع انتشار أي عدوي‏.‏

Dr. Mohamed Abdel Aal, Under-Secretary, Ministry of Health in Sohag, the patient is disease surged in the avian influenza virus of the non-contact birds, and found that it converged with the remnants of birds had been dumped in the street in front of the house, which was to take all necessary preventive measures and clean the house and nearby houses and the street to prevent the spread of any contamination.

وقامت لجنة برئاسة الدكتور إيليا عزيز‏,‏ رئيس غرفة العمليات بمديرية الطب البيطري‏,‏ بالتوجه لقرية أم دومة لإعدام جميع الطيور في دائرة قطرها‏500‏ متر من بؤرة الإصابة بالقرية والقري المجاورة‏,‏ والتخلص الآمن منها بدفنها بالمدفن الصحي بالظهير الصحراوي‏.‏

The Commission, headed by Dr. Aziz Elia, President of Chamber Operations Department of Veterinary Medicine, go to the village or the execution of all Domat birds in a radius of 500 meters from the center of the village of infection and the surrounding villages, and safe disposal by burying the cemetery health dahir Desert .

وكانت المعامل المركزية بوزارة الصحة قد أعلنت عن إصابة رابع حالة بفيروس إنفلونزا الطيور بمحافظة سوهاج لطفلة تبلغ من العمر‏5‏ سنوات من قرية أم دومة بمركز طما‏.‏ من ناحية أخري‏,‏ تم حجز ربة منزل من المخالطين لطيور منزلية بمستشفي حميات سوهاج لاشتباه إصابتها بمرض إنفلونزا الطيور وهي رسمية عبدالعال محمد‏60‏ سنة من نجع صفرة بمركز أخميم‏,‏ تم أخذ عينة ومسحة منها وإرسالها للمعامل المركزية بوزارة الصحة للفحص والتحليل‏.‏

The Central Laboratory, Ministry of Health has announced a fourth case of infection with avian influenza for the governorate of Sohag, a girl aged 5 years from the village or the status of Domat surged. On the other hand, has been reserved housewife household contacts of bird hospital fevers Suhaj on suspicion of being infected with bird flu, the official Mohammed Abdel Aal, 60 years of Naga Okhmim a zero status, the sample, survey, and sent to the central Ministry of Health laboratories for examination and analysis.

Tageddin: Tamiflu is ineffective for the treatment of children with HIV infections

الأثنين، 11 مايو 2009 - 16:16 Monday, May 11, 2009 - 16:16

د.محمد عوض تاج الدين وزير الصحة السابق D. Mohamed Awad Tag Eddin said former health

Exploded injuring the girl behind the magic of Minur, 5 yrs from Sohag Governorate of bird flu "virus that 1 H 5" on a surprise win, as he said. Mohammed Awad Tag Eddin, Minister of Health the past, to Altammivloa drug used to treat both influenza altered pigs and birds, however, the glory of the children, pointing out that the drug Tamiflu ‮‬‬ efficiently used only for those over the age ‮ ‬ on ‮ ‬ 12 ‮ ‬ ‮ ‬ years only, ‮ ‬ but it does not benefit in ‮‬‬ therapy for those over the age of one year - snip-

The logical explanation is that the lack of response in children receiving Tamiflu treatment, after influenza infection altered, as it was so far a total of 14 children of injury and reached the 69 case of bird flu in Egypt, The Egyptian is one of the countries that recorded the highest number of flu infections birds, and spent the disease since it broke out in February 2006 in Egypt, 26 people, but most of the victims in Egypt are women and children, who often have direct contact with birds.

In return, the World Health Organization has called for the Egyptian government to conduct a study on the causes of the spread of bird flu among children in particular; and after the announcement of the death of an infant no more than 18-month-old virus H5N1 strain of bird flu, which was No. 58 is the victim of the disease in Egypt, in addition to infection case No. 69 on the disease.

The World Health Organization this case is the latest in a series of injuries among children in Egypt; which raised concern the World Health Organization officials.

10 suspected bird flu injured in Kafr Sheikh

Monday, May 11, 2009 - 16:14

الحالات المحتجزة بالمستشفى 39 حالة تم 16

Cases, the hospital retained 39 out 23 cases and the rest 16

Detained Kafr El-Sheikh hospital admitted 10 new cases of suspected bird flu infected, and the names of the children, Saad Abdel-Kader, and two years old Ibrahim Ahmed Gomaa, 6 years of the status of the Nile Delta, and the Center for Kulain Nahed Abdel Fattah Marzouk (28 years) Abeer Fathi Abdullah (22 years ) and the Bella Center Feryal Abdullah Rashid (35 years) and at the center of Riyadh Sherine Hamdy Bassiouni (26 years) while the center of Kafr el-Sheikh Sulaiman Daud goods and Mona Abdel-Hamid, Samir Mansour Wafaa Mahmoud Mohamed Mahmoud Abed Rabbo.

Samples were taken from ten cases of factor analysis and the central Ministry of Health.

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It is noteworthy that the 39 cases retained the status of the hospital was out the rest of 16 and 23, in addition to the ten new cases.

Laos-Journalists attend seminar on swine flu

(KPL) Twenty journalists of Ministry of Informational and Culture (MIC) became more knowledgeable on the influenza strain A/H1N1, which originated in Mexico and this disease could reach the pandemic stage soon.
The workshop, held on 7 May, was organized by MIC and NAHICO and supported by World Bank.
The objective is to get the people in the media to have a good knowledge on this strain of influenza so that they are well equipped to disseminate such information to the general population.
Dr Manyvong Khaiyavong, Head of equipment Produce and Advertisement Service of Medical News Centre of Ministry of Public Health, said the new influenza A(H1N1) does not come from eating pork but she added that it important one cook the pork so as not to be infected by other diseases.
The symptoms of this influenza are sore throat, cough, runny nose, fever, malaise, headache, joint muscle pain and with a body temperature that is above 38cc.
To prevent from being infected by this disease, Dr Manyvong said that people should be in a state of good health and they should consume fresh vegetables and fruits.
They should allocate some time to relax, they should do some exercises, refrain from smoking and drinking alcoholic drinks and they should clean their hands with soap and water before they dine.
She also said that if you happen to visit someone who is stricken with this disease you should be one or two metres away, you should wear a facial mask and wash your hands with soap and water after your visit.
If you get stricken by any kind of influenza you should stay at home and keep away from public places in order to minimise the possibility of infecting other people.
There is a need to cover you nose and mouth with a tissue when you cough or sneeze and then throw the tissue in the bin after use, the doctor added.

The Geopolitics of Pandemics

A new strain of influenza causes global panic.

John F. Mauldin
11 May 2009 07:17

Word began to flow out of Mexico the weekend before last of well over 150 deaths suspected to have been caused by a new strain of influenza commonly referred to as swine flu. Scientists who examined the flu announced that this was a new strain of Influenza A (H1N1) derived partly from swine flu, partly from human flu and partly from avian flu strains (although there is some question as to whether this remains true). The two bits of information released in succession created a global panic.

This panic had three elements. The first related to the global nature of this disease, given that flus spread easily and modern transportation flows mean containment is impossible. Second, there were concerns (including our own) that this flu would have a high mortality rate. And third, the panic centered on the mere fact that this disease was the flu.

News of this new strain triggered memories of the 1918-1919 flu pandemic, sparking fears that the "Spanish flu" that struck at the end of World War I would be repeated. In addition, the scare over avian flu created a sense of foreboding about influenza - a sense that a catastrophic outbreak was imminent.

By midweek, the disease was being reported around the world. It became clear that the disease was spreading, and the World Health Organization (WHO) declared a Phase 5 pandemic alert. A Phase 5 alert (the last step before a pandemic is actually, officially declared, a step that may be taken within the next couple of days) means that a global pandemic is imminent, and that the virus has proved capable of sustained human-to-human transmission and infecting geographically disparate populations. But this is not a measure of lethality, only communicability, and pandemics are not limited to the deadliest diseases.

'Pandemic,' not 'Duck and Cover'

To the medical mind, the word "pandemic" denotes a disease occurring over a wide geographic area and affecting an exceptionally high proportion of the population. The term in no way addresses the underlying seriousness of the disease in the sense of its wider impact on society. The problem is that most people are not physicians. When the WHO convenes a press conference carried by every network in the world, the declaration of a level 5 pandemic connotes global calamity, even as statements from experts - and governments around the world - attempt to walk the line between calming public fears and preparing for the worst.

The reason to prepare for the worst was because this was a pandemic with an extremely unclear prognosis, and about which reliable information was in short supply. Indeed, the new strain could mutate into a more lethal form and re-emerge in the fall for the 2009-2010 flu season. There are also concerns about how its victims disproportionately are healthy young adults under 45 years of age - which was reported in the initial information out of Mexico, and has been reported as an observed factor in the cases that have popped up in the United States. This was part of the 1918 flu pandemic pattern as well. (In contrast, seasonal influenza is most deadly among the elderly and young children with weaker immune systems.)

But as the days wore on last week, the swine flu began to look like little more than ordinary flu. Toward the end of the week, a startling fact began to emerge: While there were more than a hundred deaths in Mexico suspected of being caused by the new strain, only about 20 (a number that has increased slightly after being revised downward earlier last week) have been confirmed as being linked to the new virus. And there has not been a single death from the disease reported anywhere else in the world, save that of a Mexican child transported to the United States for better care. Indeed, even in Mexico, the country's health minister declared the disease to be past its peak May 3. STRATFOR sources involved in examining the strain have also suggested that the initial analysis of the swine flu was in fact in error, and that the swine flu may have originated during a 1998 outbreak in a pig farm in North Carolina. This information reopens the question of what killed the individuals whose deaths were attributed to swine flu.

While little is understood about the specifics of this new strain, influenza in general has a definitive pattern. It is a virus that affects the respiratory system, and particularly the lungs. At its deadliest it can cause secondary infections - typically bacterial rather than viral - leading to pneumonia. In the most virulent forms of influenza, it is the speed with which complications strike that drives death rates higher. Additionally, substantively new strains (as swine flu is suspected of being) can be distinct enough from other strains of flu that pre-existing immunity gained from flus of years past does not help fend off the latest variation.

Influenza is not a disease that lingers and then kills people - save the sick, old and very young, whose immune systems are more easily compromised. Roughly half a million people (largely from these groups) die annually worldwide from more common strains of influenza, with the Centers for Disease Control and Prevention (CDC) pegging average American deaths at roughly 36,000 per year.

Swine flu deaths have not risen as would be expected at this point for a highly contagious and lethal new strain of influenza. In most cases, victims have experienced little more than a bad cold, from which they are recovering. And infections outside Mexico so far have not been severe. This distinction of clear cases of death in Mexico and none elsewhere (again, save the one U.S. case) is stark.

Much of what has occurred in the last week regarding the new virus reminds us of the bird flu scare of 2005. Then as now, the commonly held belief was that a deadly strain was about to be let loose on humanity. Then as now, many governments were heightening concerns rather than quelling them. Then as now, STRATFOR saw only a very small chance of the situation becoming problematic.

Ultimately, by the end of last week it had become clear to the global public that "pandemic" could refer to bad colds as well as to plagues wiping out millions.

A Real Crisis

The recent swine flu experience raises the question of how one would attempt to grapple with a genuine high-mortality pandemic with major consequences. The answer divides into two parts: how to control the spread, and how to deploy treatments.

Communicability

The flu virus is widely present in two species other than humans, namely, birds and pigs. The history of the disease is the history of its transmission within and across these three species. It is comparatively easy for the disease to transmit from swine to birds and from swine to humans; the bird-to-human barrier is the most difficult to cross.

Cross-species influenza is of particular concern. In the simplest terms, viruses are able to recombine (e.g., human flu and avian flu can merge into a hybrid flu strain). What comes out can be a flu transmissible to humans, but with a physical form that is distinctly avian - meaning it fails to alert human immune systems to the intrusion. This can rob the human immune system of the ability to quickly recognize the disease and put up a fight.

New humanly transmissible influenza strains often have been found to originate in places where humans, pigs and/or fowl live in close proximity to each other - particularly in agricultural areas where animal and human habitation is shared or in which constant, close physical contact takes place.

Agricultural areas of Asia with dense populations, relatively small farms and therefore frequent and prolonged contact between species traditionally have been the areas in which influenza strains have transferred from animals to humans and then mutated into diseases transmissible by casual human contact. Indeed, these areas have been the focus of concern over a potential outbreak of bird flu. This time around, the outbreak began in Mexico (though it is not yet clear where the virus itself originated).

And this is key to understanding this flu. Because it appears relatively mild, it might well have been around for quite awhile - giving people mild influenza, but not standing out as a new variety until it hit Mexico. The simultaneous discovery of the strain amid a series of deaths (and what may now be in hindsight inflated concerns about its lethality) led to the recent crisis footing.

Any time such threats are recognized, they already are beyond containment. Given travel patterns in the world today, viruses move easily to new locations well before they are identified in the first place they strike. The current virus is a case in point. It appears, although it is far from certain, that it originated in the Veracruz area of Mexico. Within two days of the Mexican government having issued a health alert, it already had spread as far afield as New Zealand. One week on, cases completely unrelated to Mexico have already been confirmed on five continents.

In all probability, this "spread" was less the discovery of new areas of infection than the random discovery of areas that might have been infected for weeks or even months (though the obvious first people to test were those who had recently returned from Mexico with flu symptoms). Given the apparent mildness of the infection, most people would not go to the doctor. And if they did, the doctor would call it generic flu and not even concern himself with its type. What happened last week appears to have been less the spread of a new influenza virus than the "discovery" of places to which it had spread awhile ago.

The problem with the new variety was not that it was so deadly; had it actually been as uniquely deadly as it first appeared to be, there would have been no mistaking its arrival, because hospitals would be overflowing. It was precisely its mildness that sparked the search. But because of expectations established in the wake of the Mexico deaths, the discovery of new cases was disassociated from its impact. Its presence alone caused panic, with schools closing and border closings discussed.

The virus traveled faster than news of the virus. When the news of the virus finally caught up with the virus, the global perception was shaped by a series of deaths suddenly recognized in Mexico (as mentioned, deaths so far not seen elsewhere). But even as the Mexican Health Ministry begins to consider the virus beyond its peak, the potential for mutation and a more virulent strain in the next flu season looms.

Mortality

As mentioned, viruses that spread through casual human contact can be globally established before anyone knows of it. The first sign of a really significant influenza pandemic will not come from the medical community or the WHO; it will come from the fact that people are catching influenza and dying, and are doing so all over the world at the same time. The system established for detecting spreading diseases is hardwired to be behind the curve. This is not because it is inefficient, but because no matter how efficient, it cannot block casual contact - which, given modern air transportation, spreads diseases globally in a matter of days or even hours.

Therefore, the problem is not the detection of deadly pandemics, simply because they cannot be missed. Rather, the problem is reacting medically to deadly pandemics. One danger is overreacting to every pandemic and thereby breaking the system. (As of this writing, the CDC remained deeply concerned about swine flu, though calm seems to be returning.)

The other danger is not reacting rapidly enough. In the case of influenza, medical steps can be taken. First, there are anti-viral medicines found to be effective against the new strain, and if sufficient stockpiles exist - which is hardly universally the case, especially in the developing world - and those stockpiles can be administered early enough, the course of the disease can be mitigated. Second, since most people die from secondary infection in the lungs, antibiotics can be administered. Unlike with the 1918 pandemic, the mortality rate can be dramatically reduced.

The problem here is logistical: The distribution and effective administration of medications is a challenge. Producing enough of the medication is one problem; it takes months to craft, grow and produce a new vaccine, and the flu vaccine is tailored every year to deal with the three most dangerous strains of flu. Another problem is moving the medication to areas where it is needed in an environment that maintains its effectiveness. Equally important is the existence of infrastructure and medical staff capable of diagnosing, administering and supporting patients - and doing so on a scale never before attempted.

These things will not be done effectively on a global basis. That is inevitable. But influenza, even at the highest death rates ever recorded for the disease, does not threaten human existence as we know it. At its worst, flu will kill a lot of people, but the human race and the international order will survive.

The true threat to humanity, if it ever comes, will not come from influenza. Rather, it will come from a disease spread through casual human contact, but with a higher mortality rate than flu and no clear treatment. While HIV/AIDS boasts an extraordinarily high mortality rate and no cure exists, it at least does not spread through casual contact as influenza does, and so the pace at which it can spread is limited.

Humanity will survive the worst that influenza can throw at it even without intervention. With modern intervention, its effect declines dramatically. But the key problem of pandemics was revealed in this case: The virus spread well before information on it spread. Detection and communication lagged. That did not matter in this case, and it did not matter in the case of HIV/AIDS, because the latter was a disease that did not spread through casual contact. However, should a disease arise that is as deadly as HIV, that spreads through casual contact, about which there is little knowledge and for which there is no cure, the medical capabilities of humanity would be virtually useless.

There are problems to which there are no solutions. Fortunately, these problems may not arise. But if they do, no amount of helpful public service announcements from the CDC and the WHO will make the slightest bit of difference.

Swine flu is suspected on Alaska cruise ship

H1N1: If confirmed by CDC, would be first case in Alaska

By MARY PEMBERTON
The Associated Press

Published: May 10th, 2009 09:51 AM
Last Modified: May 10th, 2009 04:30 PM

A crew member aboard a cruise ship in Alaska waters is recovering from what health officials suspect is swine flu.

The female crew member of the Serenade of the Seas, a Royal Caribbean ship, became ill May 2 while sailing from San Francisco northward. The woman was isolated two days later and was treated with antiviral medication, Dr. Jay Butler, Alaska's chief medical officer, said Sunday.

The U.S. Centers for Disease Control and Prevention notified Alaska health officials over the weekend that there was a probable case of swine flu aboard the ship.

Testing was performed at the Washington State Public Health Laboratory and forwarded to the CDC. The CDC is in the process of validating the results, which were expected Monday.

In the meantime, the state conducted its own testing on a sample taken in Ketchikan when the ship docked there. That sample was sent Friday to the new virology lab at the University of Alaska Fairbanks and came back negative on Saturday.

Those results were not a surprise, Butler said, because the woman had already been three days on Tamiflu, an anti-viral medication effective against swine flu, and for several days had no fever.

The swine flu has been blamed for 53 deaths worldwide, including 48 in Mexico, three in the U.S., one in Canada and one in Costa Rica.

Confirmed cases, according to the World Health Organization and CDC are more than 4,500 in 29 countries, including at least 1,626 in Mexico, at least 2,532 in the United States and 280 in Canada.

On April 18, before embarking for Alaska, the Serenade of the Seas departed San Juan, Puerto Rico. During the 14-night Panama Canal voyage it visited Huatulco and Acapulco, Mexico.

On May 2, the ship departed San Francisco for a 14-night voyage to southeast Alaska and Canada.

No other cases of suspected swine flu have been diagnosed aboard the ship.

Butler said the ship's medical staff followed strict isolation procedures to prevent the spread of the illness.

One other crew member was diagnosed with regular influenza on April 30 when the ship was in California. That person, a male crew member, was placed in isolation the next day, treated with medication and has recovered.

The ship on Sunday was in Icy Strait in southeast Alaska for docking in Sitka.

Butler said as long as passengers continue to feel well and have no symptoms there is no need to keep them from enjoying Alaska's ports of call.

"People who are well there is no need to restrict their movements," he said.

Dr. Bernd Jilly, laboratories chief for the Alaska Department of Health and Human Services, said testing for swine flu has kept state health officials very busy. The state laboratories in Anchorage and Fairbanks have received well over 1,000 samples for testing so far, he said. While some have tested positive for regular influenza, none have come back positive for swine flu, Jilly said. Butler said the ship took appropriate precautions for controlling the spread of the infection.

"This is very reassuring news for Alaskans who might have come in contact with passengers and crew members who disembarked from the ship while it was in port," Butler said.

Cynthia Martinez, a spokeswoman for Royal Caribbean International, said the ship followed procedures to screen all guests, crew members and ship visitors for flu-like symptoms before boarding. Hand sanitizers are placed throughout the ship.

The ship's voyage ends May 16 in Vancouver, British Columbia. It stops in Alaska at Ketchikan, Juneau, Skagway and Sitka. It also stops in Prince Rupert and Victoria, British Columbia.

Butler said the case aboard the ship can't be considered Alaska's first case of swine flu for several reasons, including that the woman became ill before entering Alaska waters, is a non-Alaskan and the initial testing was conducted outside Alaska.

But, he said, the suspected case is a harbinger of what likely will be more cases for Alaska health officials.

"This is not just going to go away," Butler said.

More on the Nepal situation

Situation Update No. 1
On 08.05.2009 at 05:31 GMT+2

The unidentified illness that claimed 13 lives in Gumla Village Development Committee of Gorkha district in western Nepal, has been diagnosed to be viral fever bya medical team that flew into the village Thursday. According to myrepublica.com report, the team that included Health Minister Giriraj Mani Pokharel and District Public Health Chief Dr Gunaraj Lohani treated around 70 patients suffering from viral fever, seven of whom are serious in the village, some 75 km west of Kathmandu. The illness had killed 13, including four children, in the last two weeks. The medical team has been instructed to stay in the village till the disease is controlled.

Pneumonia scourge in hostel

Last Updated : 2009-05-10 8:41 AM

THT Online

GORKHA: More than 50 per cent of the students living in a hostel of Manakamana Deaf Secondary School at Taksar in Gorkha-8 are suffering from pneumonia. Over 40 students are suffering from the disease while condition of eight students is reported to be critical, a school source said.
According to Khadananda Regmi, chairman of the school management committee, the number of students suffering from the disease was increasing everyday while more and more students were showing symptoms of the disease of headache, fever and vomiting.
The students suffering from the disease are undergoing treatment in the hostel with the help of the staffers from the district public health office.
The school is running classes up to Grade IX and 80 deaf students from several districts are living in the school hostel, the school source said.
Okieman

Suspicion of a whole family injured bird flu Menoufia

Sunday, May 10, 2009 - 20:25

Mnov General Hospital, was arrested Sunday morning, a whole family of a mother and three sons on suspicion of having bird flu, following the emergence of symptoms of infection to them.

The d. Hesham Atta, Deputy Minister of Health Menoufia, four cases of the same family, and they Sha'baan Afaf Abdullah (39 years old), a housewife and her children Tamer Mohamed Taher (5 years) and Samar (3 years) and love (and a half years), residing in Mnov were confined Mnov General Hospital following the emergence of symptoms of infection are high fever, vomiting, fever, and was taking a sample of blood, the injured and sent to labs central Ministry of Health for testing.

It was found that the cause of injury to domestic birds and the relevant bodies of Veterinary Medicine, health and local council to move into the homes of the injured and the culling and disinfection and the surrounding areas of health through the safe.

Probable case of swine flu on cruise ship

Posted:
May 10, 2009 02:14 PM EDT

Updated:
May 10, 2009 02:30 PM EDT

by Channel 2 News staff
Sunday, May 10, 2009

ANCHORAGE, Alaska -- The Alaska Department of Health and Social Services said Sunday a crew member on a cruise ship sailing in Alaska waters is the first suspected case of swine flu in Alaska.

The Serenade of the Seas crew member is said to be recovering from a probable infection of the H1N1 virus. The Centers for Disease Control tested the person at the Washington State Public Health Laboratory because the illness began in Washington on May 2 and is in the process of verifying the results.

The DHSS press release said the crew member is in isolation onboard the Royal Caribbean ship and has completed a course of antiviral medication.

"The Serenade of the Seas medical staff members have done an excellent job in caring for the patient, following strict isolation procedures in order to prevent spread to others onboard the ship, and notifying state and federal health officials of the patient's illness," said Dr. Jay Butler, Alaska's chief medical officer.

One other crew member on the ship was diagnosed with influenza last month while in California, but it was not suspected to be swine flu. No other influenza cases have been diagnosed on the ship.

"Appropriate precautions were taken in accordance with current recommendations for controlling the spread of influenza. This is very reassuring news for Alaskans who might have come in contact with passengers and crew members who disembarked from the ship while it was in port," Butler said.

The Serenade of the Seas is a 962-foot cruise ship with a passenger capacity of 2,501.

Bangladeshi passenger held in Kuwait airport on suspicion of swine flu

Health 5/10/2009 11:24:00 PM

By Mubarak Al-Hajri KUWAIT, May 10 (KUNA) -- The Ministry of Health said here Sunday that a Bangladeshi passenger was held in Kuwait airport on suspicion of being infected with the swine flu. Head of the Public Relations Department Faisal Al-Dowsiri told KUNA that the captain of Kuwait airways' flight from New York told ground-control that he suspected that the Bangladeshi female passenger had the disease due to her high blood pressure and sugar level, adding that the medical team at the airport had treated the passenger and she was on her way to Bangladesh. The Ministry had taken precautionary measures against the swine flu, cooperating with several institutions such as Kuwait General Directorate of Civil Aviation to prevent the presence of swine flu in the country. (end)

Egyptian girl contracts bird flu, 69th case

10 May 2009 20:12:51 GMT
Source: Reuters
CAIRO, May 10 (Reuters) -

A five-year-old Egyptian girl has contracted the highly pathogenic bird flu virus after coming into contact with infected birds, the state news agency MENA reported on Sunday.


The case brings to 69 the number of people confirmed to have contracted the H5N1 avian influenza virus in Egypt, which has been hit harder than any another country outside Asia.

While the avian influenza virus rarely infects people, experts say they fear it could mutate into a form people could easily pass to one another, sparking a pandemic that could kill millions.

MENA, citing the Health Ministry, said the girl from Sohag province was admitted to hospital on Saturday. It said she was being treated with the anti-viral drug Tamiflu and was in a stable condition.

Some 26 Egyptians have died after contracting the virus.

Most of those infected had come into contact with infected domestic birds in a country where roughly 5 million households depend on domestically raised poultry as a significant source of food and income.

Last month, Egypt ordered the culling of all the country's 300,000 to 400,000 pigs as a precaution against the new H1N1 influenza strain, also known as swine flu.

The World Health Organisation on Sunday reported 4,379 people in 29 countries have been infected by the new virus. No cases have been reported in Egypt.

hattipIronorehopper

Now you have it, now you don't

well which is it?


Taiwan says no influenza A cases for now

10 May 2009 18:40:58 GMT
Source: Reuters
(Updates with tests showing no influenza A)
By Lee Chyen Yee
TAIPEI, May 11 (Reuters) -

Tests on two people earlier thought to have been the first to be suffering from influenza A in Taiwan have shown they do not have the virus after all, the island's health department said on Monday.

Health Minister Yeh Ching-chuan said earlier a 32-year-old mother and her baby from the city of Taipei most probably had the virus after returning from the United States six days ago.

"After carrying out a series of tests, we have confirmed that the mother and daughter who returned from the United States do not have influenza A," the Department of Health said in a brief statement.

Over the weekend, the United States said a Washington state man with the H1N1 influenza died last week, the third U.S. sufferer to die as the new flu strain confirmed in more than 2,200 Americans appeared in Japan and Australia. [ID:nSP117286]

Another 48 people have died in Mexico and one each in Canada and Costa Rica.
hattip ironorehopper)

and suspected cases in China with a total of 150 passengers

(Boxun Beijing May 11, 2009 reprint)

Core Tip: with the mainland's first suspected influenza H1N1 patients arrived in Chengdu on the same plane a total of 150 passengers.

Sichuan Provincial Health Department called for 3u8882 take flight on the 9th of the passengers and return to Chengdu in the know, as soon as possible to contact local health authorities.

With close contact with suspected cases of taxi drivers have been found, and has put in isolation.

The evening of 10 informed the Ministry of Health, the mainland of China found that the first suspected cases of influenza H1N1 influenza.

The reporter learned from the Sichuan Provincial Health Department was informed that after the incident in Sichuan Province to start the rapid response and working mechanism of joint prevention and control of epidemic prevention and control of specialized research and deployment.

At present, there is close contact with suspected cases of taxi drivers have also been found, and has put in isolation.

The afternoon of May 10, the Ministry of Health received a report of Health Department of Sichuan Province, Sichuan Province People's Hospital found that one cases of fever, according to clinical manifestations and laboratory test results, the initial diagnosis of suspected cases of influenza type H1N1.

At present, patients have been transferred to hospitals in Chengdu isolation and treatment of infectious diseases, and its treatment in the process of close contacts has also taken measures to medical observation.

Sichuan Province, Wang Zhengrong, deputy director of the Health Department said that the Ministry of Health has been in the first suspected cases will take the flights, transport and stopovers, and to the Ministry of Health, South West Civil Aviation Authority, Inspection and Quarantine Bureau and other departments informed of the import and export, and treatment of suspected cases of the Provincial People's Hospital conducted a terminal disinfection treatment of patients with suspected close contacts in the process also has taken measures to medical observation.

10 evening 20 o'clock, Health Department has sent samples of patients with suspected Chinese Center for Disease Control and Prevention testing laboratory for review.

It is reported that by 9, a total of 3U8882 flight 150 passengers.

In this regard, is to the relevant provinces and cities in Sichuan Province and the province made an investigation letter to search for patients with other close contacts.

Sichuan Provincial Health Department call by 9 am flight back to Chengdu 3U8882 passengers and insiders, as soon as possible to contact local health authorities.

It is understood that the Ministry of Health dispatched a group of experts has arrived in Chengdu guide treatment and prevention and control work.

China found the first suspected cases of influenza H1N1 influenza

At 22:35 on May 10, 2009 Source: China News Net

By May 10 Beijing Xinhua informed the Ministry of Health on the 10th night, the mainland of China found the first suspected cases of influenza H1N1 influenza.

The first suspected cases of influenza type H1N1 in Chengdu after the plane directly to the Sichuan Provincial People's Hospital for treatment.

Patients have been transferred to hospitals in Chengdu isolation and treatment of infectious diseases, the treatment of close contacts have been isolated for observation.

The afternoon of May 10, the Ministry of Health received a report of Health Department of Sichuan Province, Sichuan Province People's Hospital found a case of fever, according to clinical manifestations and laboratory test results, the initial diagnosis of suspected cases of influenza type H1N1.

Patients with a certain package, M, the three-year-old, the current study of a university in the United States.

May 7 patients in the United States by St. Paul to St. Louis, Tokyo, Japan, May 8 flight from Tokyo by NW029 in at 1:30 on May 9, arrived in Beijing Capital International Airport, and on the same day 10:50 to take off from Beijing, by Sichuan Airlines 3U8882 flight arrived at 13:17 Chengdu.

The circular pointed out that the Ministry of Health, May 9 patients in the flight from Beijing to Chengdu, consciously fever, accompanied by pharyngodynia, cough, stuffy nose and a very small number of symptoms such as runny nose, in Chengdu after the self-inductance of the plane does not, then go directly to the Sichuan People's Hospital for treatment.

The morning of May 10, Sichuan Provincial Center for Disease Control and Prevention detected twice the review, the results of Type A H1N1 influenza virus are weakly positive.

Sichuan Province Health Organization expert group for consultation, in accordance with the "Type A H1N1 influenza treatment program (the pilot version of the first edition in 2009)", for initial diagnosis in patients with suspected cases of influenza type H1N1.

The Ministry of Health has sent a group of experts arrived in Chengdu on the 10th to guide treatment and prevention and control work.

Sichuan Province, the Ministry of Health asked health departments to enhance their clinical treatment, epidemiological investigations, and do a good job related to close contact tracing, were immediately sent to patients in China Center for Disease Control and Prevention testing laboratory for review.

Ministry of Health has notified the relevant provinces and cities in search of the emergency patients in close contact with visitors and called for by the passengers of these flights and in the know as soon as possible to contact local health authorities.

Ministry of Health has informed WHO of the situation, the countries and regions.

Taiwan found two cases of confirmed cases of Influenza A

Boxun Beijing May 11, 2009

Source: Xinhua

Taiwan's disease control agency on the 11th early morning release of the latest news shows that Taiwan has found two cases of confirmed cases of influenza H1N1 influenza.





According to the briefing, the two man-made a pair of mother and daughter, respectively, for a 39-year-old female and 1-year-old 9-month-old daughter, by the United States on the 5th they fly back to Taiwan, does not appear on the 6th, 7 to 9 have 3 times by the family car to the National Taiwan University, gynecology, Charity Hospital for treatment.
At present, the two hospital patients are being treated in isolation in Taipei in peace.

Another 9 were observed as a target.


Taiwan's health authorities were responsible for Yeh Chin-chuan said that a mother and her daughter is still undergoing final testing, about 2 o'clock there will be the exact final results, but there are still ways to deal with confirmed cases.

EQUINE INFLUENZA - INDIA (03): (GUJARAT, RAJASTHAN), UPDATE

Date: Sun 10 May 2009
Source: Xinhuanet [edited]
<http://news.xinhuanet.com/english/2009-05/10/content_11344407.htm>


Though India has remained free so far from influenza A/H1N1, another
animal disease, equine influenza, or horse flu, has killed 43 horses
in the west Indian states of Rajasthan and Gujarat, local Hindi daily
Danik Bhaskar reported Saturday [9 May 2009].

A laboratory based in Hissar of Haryana, in north India, has
confirmed that the deaths were caused by equine influenza, commonly
called "horse flu."

The 1st death occurred in January 2009 in Gandhinagar in Gujarat,
where 15 horses died of the disease last month [April 2009], said the report.

To prevent the disease from spreading, the Gujarat government has
instituted a ban on buying and selling horses in the state.

In Rajasthan, 25 horses have died at a horse fair in the Jodhpur
area, according to the report.

Equine flu is caused by strains of influenza A that are endemic in
horses. The virus can cross the species-barrier and affect humans as well.

Equine influenza is characterized by a very high rate of transmission
among horses and has a relatively short incubation time of one to 5 days.

Horses with horse flu can develop symptoms of fever, dry hacking
cough and runny nose.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[An extensive epizootic of equine influenza, reportedly caused by the
virus A/equi-2, Serotype H3N8, has been continuing its spread in
India since June 2008. For an OIE summary on the 24 outbreaks
reported in the immediate notification, submitted 27 Nov 2008, and in
the 4 follow-up reports, the most recent one submitted 22 Apr 2008, refer to
<http://www.oie.int/wahis/public.php?page=event_summary&reportid=7561>.
Follow-up report No. 4, submitted 22 Apr 2009, added the following
data pertaining to the 4 covered recent outbreaks: Susceptible horses
- 161; cases - 59; deaths - 5. A map showing all 24 outbreaks since
June 2008, with all reported outbreaks, is included.

Equine influenza is not regarded as zoonotic. - Mod.AS]

[see also:
Equine influenza - India: (GJ) confirmed 20090414.1422
Equine influenza - India: (GJ), susp., RFI 20090405.1321]
................................................arn/msp/dk

Probable case of H1N1 (swine) flu detected on ship in Alaska waters

Department of Health and Social Services to hold press availability Sunday morning

Contact:
Ann Potempa, Cell (907) 230-4001, ann.potempa@alaska.gov
Clay Butcher, Cell (907) 351-2778, clay.butcher@alaska.gov

The U.S. Centers for Disease Control and Prevention (CDC) notified the Alaska Department of Health and Social Services (DHSS) this weekend that a crew member onboard the Serenade of the Seas, a Royal Caribbean ship currently traveling through Alaska waters, is recovering from a probable infection with H1N1 (swine) flu. Testing was performed at the Washington State Public Health Laboratory because the patient became ill while the ship was in the Washington area. The CDC is in the process of validating the laboratory’s results. The crew member, whose illness began on May 2, is taking antiviral medication and has been in isolation since the ship left Washington. She will remain isolated throughout the duration of the ship’s voyage in Alaska waters.

“The Serenade of the Seas medical staff members have done an excellent job in caring for the patient, following strict isolation procedures in order to prevent spread to others onboard the ship, and notifying state and federal health officials of the patient’s illness,” said Dr. Jay Butler, Alaska’s Chief Medical Officer.

Ship medical staff members routinely evaluate every passenger and crewmember who is identified with influenza-like illness for influenza. One additional crewmember was diagnosed with influenza that began on April 30, when the ship was in California; he was placed in isolation, treated with antiviral medications, and recovered uneventfully. An H1N1 (swine) flu confirmatory test was not performed on this patient. No other cases of influenza have been diagnosed onboard the ship this month.

“Appropriate precautions were taken in accordance with current recommendations for controlling the spread of influenza. This is very reassuring news for Alaskans who might come in contact with passengers and crew members who disembarked from the ship while it was in port,” Dr. Butler said.

WHAT: Press availability about probable case of H1N1 (swine) flu on a cruise ship

WHEN: Sunday, May 10, 11 a.m.

WHERE: Department of Health and Social Services Emergency Operations Center
DHSS Public Health Laboratory in Anchorage
4500 Boniface Parkway (map to lab)

WHO: Dr. Jay Butler, Alaska’s Chief Medical Officer
Dr. Bernd Jilly, DHSS Chief of the Section of Laboratories

Swine flu suspected for cruise ship crewman

Swine flu suspected for cruise ship crewman
ANCHORAGE, Alaska (AP) -- Federal health officials say a crew member aboard a cruise ship currently traveling in Alaska waters is recovering from a probably infection of swine flu.
Alaska Department of Health and Social Services officials on Sunday said they were informed of the case by the U.S. Centers for Disease Control and Prevention.
Testing was performed at the Washington State Public Health Laboratory since the crew member became ill while the Serenade of the Seas, a Royal Caribbean ship, was in the Washington area.
The crew member's illness began on May 2. State officials say she is taking antiviral medication, and has been in isolation since the ship left Washington.
Officials say she will remain in isolation for the ship's cruise through Alaska waters.

Algeria quarantines Ukrainian suspected of infected with swine flu

Health 5/10/2009 8:58:00 PM

ALGIERS, May 10 (KUNA) -- Algerian health authorities quarantined Sunday an Ukrainian national for 48 hours because they suspected he suffered swine flu symptoms. A health official, requesting anonymity, told the press that the Ukranian, whose name nor age were not disclosed, was undergoing medical tests in Ibn Rushd Hospital in the city of Annaba, 520 KMs east of Algiers, to determine whether he was infected or not. The Ukranian, who works in a foreign company and had entered Algeria through Annaba port, suffered fever and severe sinus, said the official. Algeria had already announced that it was clear of swine flu cases, however it was beefing up medical control on expatriates and Algerian nationals who come from countries with swine flu disease.

Swine flu case suspected on cruise ship in Alaska waters

A crew member on a cruise ship traveling in Alaska waters has been isolated on the vessel after being diagnosed with a probable case of swine flu, state health authorities said this morning.
If confirmed by the Centers for Disease Control, it would be the first case of H1N1, or swine, flu in Alaska since the outbreak began.

It was not immediately clear where the ship is. State public health authorites have scheduled a news conference for later this morning.

The state Division of Public Health issued the following written statement:

"The U.S. Centers for Disease Control and Prevention (CDC) notified the Alaska Department of Health and Social Services (DHSS) this weekend that a crew member onboard the Serenade of the Seas, a Royal Caribbean ship currently traveling through Alaska waters, is recovering from a probable infection with H1N1 (swine) flu.

"Testing was performed at the Washington State Public Health Laboratory because the patient became ill while the ship was in the Washington area. The CDC is in the process of validating the laboratory’s results. The crew member, whose illness began on May 2, 2009, has completed a course of antiviral medication and has been isolated onboard.


“The Serenade of the Seas medical staff members have done an excellent job in caring for the patient, following strict isolation procedures in order to prevent spread to others onboard the ship, and notifying state and federal health officials of the patient’s illness,” said Dr. Jay Butler, Alaska’s Chief Medical Officer.

"Ship medical staff members routinely evaluate every passenger and crewmember who is identified with influenza-like illness for influenza. One additional crewmember was diagnosed with influenza that began on April 30, when the ship was in California. He was placed in isolation, treated with antiviral medications, and recovered uneventfully. An H1N1 (swine) flu confirmatory test was not performed on this patient. No other cases of influenza have been diagnosed onboard the ship this month.

“Appropriate precautions were taken in accordance with current recommendations for controlling the spread of influenza. This is very reassuring news for Alaskans who might have come in contact with passengers and crew members who disembarked from the ship while it was in port,” Dr. Butler said."

Hattip Pablomorgan

In southern China, a Russian student hospitalized with symptoms of influenza A/H1N1

If the diagnosis is confirmed, it will be the first case of infection with the virus a citizen of Russia

VLADIVOSTOK, May 10, PrimaMedia.
In southern China, a Russian student, came to the hospital with symptoms of porcine influenza. Doctors refused to comment, but if the diagnosis is confirmed, it will be the first time that a dangerous virus infected a citizen of Russia, the Gazeta.ru In the Chinese city of Guilin to the symptoms of pig influenza hospitalized student from Russia Dinara Fathudinova.
Student studying in the Pedagogical University Guangxi. In the May holidays, she flew to Shanghai, where the suspect returned to the disease. On Wednesday morning it had sharply increased the temperature, there is an inflammation of the lung.
At first, doctors have refrained from comment, and not to make an accurate diagnosis, and only about 13.00 Moscow time employees of the university stated that the pig influenza is not confirmed. Contradictory information doctors raised concerns of staff - the fact is that Shanghai, which went Fathudinova, has flights from Mexico.
Chinese doctors have officially confirmed only one case of pork flu in the country, has affected a citizen of Mexico. Immediately after the case of Mexico, Embassy staff in Beijing reported that Chinese authorities have kept the country in hotels a few dozen Mexicans who fear the spread of the virus. The Foreign Minister of Mexico Patricia Espinosa condemned these actions. She stated that "citizens do not have symptoms, isolated and kept in unacceptable conditions." Words Espinoza quotes
Associated Press .

.
In Russia there is no single case of infection: Rossiyanka captured on April 27 at the Sheremetyevo airport to high temperatures, has been healthy. The statement was made by the head of Rospotrebnadzor Gennady Onishchenko.
Later, speaking about the virus, Onyshchenko broadcast channel "Vesti" WHO criticized for reluctance to give Russia and other countries information about the properties of influenza A. Chapter Rospotrebnadzor WHO requires information, what exactly medicines can cure the virus. WHO now recommends that only one drug - oseltamivir. According to Onishchenko, the silence of the WHO incorrectly and contrary to the Charter of the Organization. "

Health officially announced the 3 suspected cases of "H1N1"

الأحد، 10 مايو 2009 - 18:47

Sunday, May 10, 2009 - 18:47

منظمة الصحة العالمية رفعت حالة التأهب إلى مرحلة من المستوى الوبائى الخامس

World Health Organization has raised the alert status to the stage of the epidemic-level V

كتبت أميرة عبد السلام

Written by Amira Abdel-Salam

أعلنت منظمة الصحة العالمية، رفع حالة التأهب فى جميع الدول إلى مرحلة من المستوى الوبائى الخامس، وأوصت بعدم فرض قيود على السفر أو إغلاق الحدود ونصائحها للمرضى بتأجيل سفرهم، وتواصل الإدارة المركزية للشئون الوقائية بوزارة الصحة عمليات الترصد النشط والتقصى الوبائى الميدانى والتشخيص المختبرى لحالات الاشتباه بفيروس الوباء العالمى H1N1 فى الإنسان على مستوى الجمهورية، واحتجزت أمس 3 حالات إثر الاشتباه فى إصابتهم بالمرض.

The World Health Organization, the lifting of the state of preparedness in all countries to the stage of the epidemic-level V, and recommended against the imposition of restrictions on travel or border closures and advice for patients to postpone their travel, and continues to the central administration of the affairs of the Ministry of preventive health of the active surveillance and epidemic field investigation and laboratory diagnosis of suspected cases of HIV global epidemic H1N1 in humans at the level of the Republic, was detained yesterday following the 3 cases of suspected SARS patients.

وأوضح د.عبد الرحمن شاهين المتحدث الرسمى لوزارة الصحة، أنه تم احتجاز نجار مسلح من محافظة حلوان يدعى ميلاد رضا غنى بشرى يبلغ من العمر (23 سنة) بحميات حلوان، وكذلك الطفلة فاطمة سمير رمضان عمرها سنتان وثلاثة أشهر من محافظة القليوبية بمستشفى صدر 23 يوليو، إضافة إلى الطبيب البيطرى نجيب إسكندر جرجس (57 سنة) من محافظة القاهرة، وتم حجزه بحميات العباسية، مؤكداً أن نتائج التحاليل المعملية جاءت جميعها سلبية لفيروس الوباء العالمى H1N1، لافتاً إلى أن هناك فرقاً بين كل من التصريح بوجود حالة اشتباه، والتى يتبعها اتخاذ مجموعة من الإجراءات للتأكد من سلامة الشخص أو الحيوان من المرض وبين وجود حالات إصابة بالفعل، وفى ضوء ذلك نؤكد أنه لا توجد أى حالة إصابة بمرض أنفلونزا الخنازير فى مصر حتى اليوم، وأن ما حدث هو مجرد اشتباه فى بعض الحالات، وتم التأكد من خلوها من المرض بعد الكشف عليها.

And he added. Abdel-Rahman Shahin, official spokesman of the Ministry of Health, he was detained by armed carpenter Helwan governorate named Reza birth indispensable Boshra-old (23 years) Bhmyat Helwan, as well as old Fatma Samir Ramadan, two-year-old and three months of the County Hospital Qaliubiya issued July 23 , in addition to the doctor of Veterinary Jiryes Najib Iskandar (57 years) of the Governorate of Cairo, was detained Bhmyat Abbasiyah, stressing that the results of laboratory tests were all negative for the HIV global pandemic H1N1, pointing out that there is a difference between each of the suspicion of the existence of a state permit, which followed the adoption of a set of procedures to ensure the safety of a person or animal disease and the existence of cases already, in the light of this, we stress that there are no cases of swine flu in Egypt until today, and that what happened is just a suspicion in some cases, have been confirmed free of disease after the disclosure.

وأضاف المتحدث الرسمى، أن الخط الساخن 105 قد تلقى من أول مايو حتى مساء أمس 24894 اتصالاً ما بين استفسارات وبلاغات تربية وبلاغات عن نفوق فى الطيور والخنازير، فيما ارتفعت حالات الإبلاغ لغرفة الطوارئ الوقائية بالوزارة إلى 3877 عن أنفلونزا الطيور والخنازير وأعراض شبيهة بالأنفلونزا، مشيراً إلى صرامة إجراءات الحجر الصحى بجميع المنافذ والموانئ والتنسيق المستمر والمتابعة الدورية من وزارة الصحة وجميع الوزارات المعنية والموانئ والمطارات والمعابر للتأكد من سلامة جميع القادمين إلى مصر، بالإضافة إلى متابعة القادمين من الدول المصابة طوال فترة تواجدهم فى مصر واتخاذ جميع التدابير الوقائية بجميع الموانئ البرية والبحرية وتطبيق إجراءات الحجر الصحى على جميع القادمين من الدول الموبوءة.

His official spokesman, the hotline had received 105 of the first of May until late yesterday between 24,894 telephone inquiries and complaints and reports of breeding mortality in birds and pigs, and increased reporting to the emergency room of preventive ministry from 3877 to the avian flu and swine flu-like symptoms and, referring to the stringent quarantine measures in all outlets, ports, and ongoing coordination and periodic follow-up of the Ministry of Health and all relevant ministries, ports, airports and border crossings to ensure the safety of all visitors to Egypt, in addition to the follow-up from the affected States for the duration of their presence in Egypt and to take all preventive measures to all land and sea ports and the application procedures quarantine on all travelers from the affected States.

وأكد شاهين مواصلة الجهود للحد من انتشار المرض ورفع درجة الاستعداد القصوى فى جميع المنشآت، والتأكيد على البدء فى تأهيل العاملين فى جميع المجالات لتنفيذ أنشطة المواجهة قامت الوزارة بعقد 29 ندوة عن أنفلونزا الوباء العالمى فى المديريات الصحية بجميع المحافظات، حضرها مسئولون من جميع المديريات لجميع الوزارات الأخرى والمرافق العامة فى المحافظات وعمل 264 ندوة فى الإدارات الصحية و4600 على مستوى القرى والوحدات الصحية، وكذلك عقد دورات تدريبية لتوعية أطقم الطائرات بشركة مصر للطيران والعاملين بوزارة الطيران المدنى والعاملين بجميع المجالات والمطارات والموانئ، إضافة إلى عمل برنامج تدريبى لـ450 طبيباً بجميع المحافظات وندوة عن الوباء العالمى للمسئولين الصحيين والأطباء العاملين بالبنوك والمنشآت السياحية.

Shaheen told to continue efforts to reduce the spread of the disease and raise the high state of alert in all enterprises, and the emphasis on rehabilitation to start working in all areas of the implementation of the activities of the ministry to hold the front 29 a symposium on the global avian influenza epidemic in the health directorates in all governorates, attended by officials from all departments of all ministries and other public facilities in the provinces and the work of 264 health departments in the symposium and 4600 at the village level, health units, as well as holding training courses to raise the aircraft's crew of the Egypt Air and the Ministry of civil aviation workers and employees in all areas, airports and ports, in addition to the work of a training program for 450 physicians in all provinces and a symposium on the epidemic World health officials, physicians working with banks and tourist facilities.

وأشار شاهين إلى أن الحالات المؤكدة حتى اليوم، كما أعلنت منظمة الصحة العالمية، توجد فى 29 دولة على مستوى العالم بإجمالى 4379، توفى منهم 45 بالمكسيك و2 فى الولايات المتحدة الأمريكية وحالة واحدة فى كل من كندا وكوستاريكا ليصل إجمالى عدد الوفيات إلى 49 حالة وفاة.

Shaheen noted that the confirmed cases to date, also announced that the World Health Organization, there are in 29 countries around the world a total of 4379, of whom 45 died in Mexico and 2 in the United States and one each in Costa Rica and Canada, bringing the total number of deaths to 49 cases.

فيما واصلت حالات الاشتباه بمرض أنفلونزا الطيور والارتفاع أمس فقط إلى 52 حالة بمحافظات القاهرة والإسكندرية والفيوم والمنيا وسوهاج وقنا وأسوان ودمياط والبحيرة والقليوبية والمنوفية والشرقية والدقهلية والغربية وكفر الشيخ والوادى الجديد ليصل إجمالى حالات الاشتباه منذ دخول المرض مصر عام 2006 إلى 7231 وتتوقف الحالات المؤكدة عن 68 حالة، توفى منهم 26 وشفى 42 حالة.

With the continued cases of suspected bird flu and rising only to 52 on the status of the provinces of Cairo, Alexandria, Fayoum and Minya, Sohag, Qena and Aswan, Damietta, and the lake Qalubia Monoufia, East and West, Dakahlia, Kafr El-Sheikh, the New Valley, bringing the total of suspected cases of the disease since the entry into Egypt in 2006 and 7231 confirmed cases depends on the situation of 68 , of whom 26 died and 42 recovered cases.

Hattip Fla 1

Egypt-World Health Organization warns:

.. Conceal any information about the swine flu .. يهدد بكارثة Threatens disaster
No medication .. Consult a doctor before

World Health Organization has warned that the concealment of any information on the swine flu virus will lead to real disaster also warned citizens to purchase drugs on their own without consulting doctors.
The Organization Eastern Mediterranean Region is still free of swine flu, noting that it is monitoring the position of the disease without relying on the reports of the ministries of health.
Ministry of Health has announced that the results of tests 5 and 6 Egyptian British and Spanish were negative.
Head of the trade sector the Interior, Major General Mohamed Obo_ak_i that there are campaigns on the market of meat and plants to prevent the infiltration of pigs, he said. Hamid Samaha chief of veterinary services that the pigs will not seep into the butcher shops and Ulkiptp pointed out that the detention and the closure will be in waiting for violators.
Awareness moved convoys sent by the National Party to all governorates in order to educate the citizens and the seriousness of the virus, the Ministry of the Environment operations room to receive reports of the virus on the swine flu hotline .19808

Health Minister lashes out at WHO for causing panic to citizens

5/10/2009 4:01:00 PM

CAIRO, May 10 (KUNA) -- Egyptian Minister of Health Dr. Hatem el-Gabali on Sunday issued a sharp criticism at the World Health Organization (WHO) for causing panic to citizens after raising the degree of readiness to five out of the six degree level sclae in regard to the swin flu epidemic. El-Gabali said in a statement before a meeting of the People Assembly's Health Committee that raising the alert level to this extent does not reflect at all the ferocity of the disease nor the the numbers of injured. He said that such matter would only be justified should the epidemic spreads in two different areas, in addition to a considerable overestimation of the Western media about the disease and the rejection of a link between what happened with the Spanish flu, which emerged after the Second World War and the swine flu. He expected a lethargic of swine flu virus spread in the two or three weeks to come to be then followed by another period of revitalization for this dreaded disease in the autumn, calling for resistance to the rumors about the disease and to inquire about anything about it. He said that about 2,500 suspected cases had been examined so far, which all were confirmed negative, stressing that all outlets are strictly controlled and the red Xrays would be introduced at these outlets to prevent any suspected swine flu cases.

WARDEN MESSAGE

May 4, 2009

Local media are reporting that there have been demonstrations at several locations in and around Cairo in response to the Egyptian Government’s forcible culling of swine. According to media and other sources, residents and farmers involved in pork farming have assaulted health workers and security officers attempting to carry out the government’s decision to slaughter all pigs, further exacerbated by rumors about compensation for the culled animals. Protests in Giza and Moqattam included violent confrontations and rock-throwing that resulted in a number of injuries and arrests. There are a number of charitable organizations in the Moqattam area.

If these actions do take place they may lead to some road closures and traffic disruption in the general vicinity of these areas. The police preparations might cause similar traffic disruptions. As always, we strongly urge you to avoid areas where you see heavy police presence or crowds assembling and to exercise caution if within the vicinity of any large public gatherings. As a reminder, even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.

American citizens are advised to maintain valid travel documents and register with the Department of State or the U.S. Embassy Cairo through the State Department travel registration website, https://travelregistration.state.gov. For further information, U.S. citizens may call the Embassy’s American Citizen Services Unit at 2797-2301 during business hours, Sunday to Thursday from 8:00 a.m. until 4:30 p.m. For emergencies after business hours and on weekends and holidays, U.S. citizens can contact the Embassy Duty Officer via the Embassy switchboard on 2797-3300. The Embassy is located at 5 Tawfik Diab Street (formerly known as Latin America Street), Garden City, Cairo.

China reports suspected swine flu case

May 10th, 2009 @ 9:35am

BEIJING (AP) - "China's Health Ministry has reported the first suspected case of swine flu on the mainland. The ministry said Sunday that the patient is a 30-year-old Chinese man surnamed Bao who had returned on Saturday to Chengdu, the capital of southwestern Sichuan province, from the United States where he is attending a university.

The ministry says Bao took a flight from Tokyo and arrived in Beijing on Saturday. He flew onward from Beijing to Chengdu the same day."
hattip= Rikk

Dutch tourist with flu symptoms admitted to hospital in Bali

Sun, 05/10/2009 6:25 PM


A Dutch tourist arriving in Bali with flu-like symptoms was admitted to hospital in Denpasar for treatment, tempointeraktif.com reported Sunday.

Michele Van Dorssen, a Malaysia Airlines passenger, arrived Sunday from the Netherlands via Kuala Lumpur with a fever and nausea.

Fearing she was sick with the H1N1 strain of flu, officials at Ngurah Rai International Airport immediately took her to Sanglah Hospital in Denpasar.

“We're still examining her and waiting for the lab results, because [the H1N1 flu virus] has an incubation period of three to five days,” said the hospital's Dr. Ken Wirasandhi.

He added van Dorssen had a fever of 36.9 degree Celsius, but the symptoms were still regular flu symptoms and doctors could not yet determine whether she had H1N1 flu.

Van Dorssen is still being treated at the hospital, after she was given tamiflu for a precautionary measure. (adh)
thanks Pixie!

Instructed hospitals not to the announcement of the cases of swine flu

09/May/09

Hospitals received the diets at the level of the Republic, yesterday, a circular from the Ministry of Health carries the words "secret" yesterday warned of the Declaration on the arrival of any infected or suspected cases of bird flu virus, swine flu, in a move designed not to provoke a state of panic among the Egyptians, and to promote an atmosphere of trust After the World Health Organization warned of the possibility of the transformation of this virus to a pandemic.

This comes after the hospital, medical sources told the rain that the hospital had received a positive case of bird flu to pigs of a certain Arab Hosni Mohamed Abdel-Razzaq was admitted to hospital last Thursday evening, where he was admitted to the transmission Abbasiyah.

And recommends that the circular, the doctors in the case of suspected cases of swine flu to write in the report attached to the patient's ticket to a regular flu is another report which demonstrated the true diagnosis of the disease, and to notify the Ministry of Health immediately, with a blood sample for the suspect in the laboratory for analysis in the central Cairo, the factor "Nmro 3" of the freedom of the American Hospital in Cairo, Abbasid, taking all the precautions necessary preventive Mkhaltin of the suspect died.

The statement calls, doctors to avoid making statements to the media about the existence of a suspected infected, or inform them of the results of any tests carried out on patients, and threatens violators with instructions to investigate the assignment immediately, if any leaked information on cases of suspected disease.

The issuance of this circular, synchronized with the government to deny discovery of cases of swine flu infection in Egypt, known in short as "The 1 H 1" in Egypt, and Anas Al-Fiqi and Information Minister, said that the deployment of some private newspapers is not true and totally false.

He stressed that it must be addressed by all the print media and audio-visual and electronic utmost transparency and credibility and caution of a slide at the turn of the promotion of the rumors would create panic and confusion among the citizens.

And Dr. Abdel Rahman Shahin, spokesman of the Ministry of Health that there was no positive case of bird infected pigs so far, all cases of suspected mortgage each examination, and said he would be punished both confirmed the existence of such a situation occasioned by the confusion and panic among the citizens, calling for not following the rumors.

For its part, denied the fulfillment of Dr. Atta, director of specialized central laboratory of the Ministry of Health is responsible for screening samples suspected to be infected swine flu, have been a documented case of a positive in Egypt until this moment.

She pointed out that any suspected case is to enter any government or private hospital or even through the quarantine samples immediately after the shift to the central laboratory to be examined by the lab finished particular.
snip
hattip Helblindi

Pulau Bulan, Riau ::: People develop illness.

May 10, 2009

Pulau Bulan, Riau – Number of people in Pulau Air, Kecamatan Bulang, Batam developed illness. Pulau air is an island nearby Pulau Bulan where a pig farm of PT Indo Tirta Suaka (ITS) is located. People are reported to have sudden illness accompanied with high fever and nausea. Until now the cause of the illness is uncertain. People have gone to local public health to get medical help.

Head of the neighborhood RT 01 Pulau Air, Amri said his people developed high fever within these days. Amri admitted that he also had fever which he never experienced before. “We worry because many people, especially children are developing fever”, said Amri.

He mentioned that people often complaining about swine flu issues which had killed hundreds of people in Mexico and other countries. “Besides worrying about possibility of swine flu infection, people also disturbed by the smell of the pig farm in Pulau Bulan”, added Amri.

The same issue also stated by head of neighborhood RT 02 Pulau Seraya, Kelurahan Batulenggong, Kecamatan Bulan, Ibrahim. He said his people are starting to have high fever. “Until now two-three households reported fever. We have brought them to local public health center”, said Ibrahim.

Authority of Kecamatan Bulang, Ruslan confirmed that he received several reports from chieftains about the illness developed by people in Kecamatan Bulang.
hattip Dutchy

8 suspected cases of infection with bird flu and West Menoufia

Sunday, May 10, 2009 - 12:43


The Directorate of Health Affairs Menoufia of two new suspected cases of bird flu


The Directorate of Health Affairs Menoufia two suspected cases of bird flu and the status of the seven Swimming Echmoun following the emergence of symptoms.

Pointed out. Hesham Atta, Deputy Minister of Health Menoufia that the first case of a woman called Hoda Abdel Wahab Bayoumi (46 years) and a housewife in a pond has been booked seven hospital Shebin fevers, and the second case Reza Abdul Hakim (12 years) and assess student district of Kafr Mansour Echmoun Center, and was transferred to a hospital in Sadr بالعباسية because of his relatively late, following the emergence of symptoms of infection by the high temperature, fever and vomiting, were taken samples of blood, the injured and sent to labs central Ministry of Health for testing.

It was found that the cause of injury in the first case of contact with dead birds, and the second coming into the house alive, and the relevant bodies of Veterinary Medicine, health and local council to move into the homes of the injured and the culling and disinfection and the surrounding areas of health through the safe.

On the other hand held area and hospital fevers BANHA 6 new cases of suspected bird flu virus, they Zakia Abdul Hadi Mustafa, from the village of Mit Alharon Center Zvty (62 years) housewife Bhmyat milk, and detained fevers Mahala Baker Sarwat Sharif (6 years) Kfrhijazy village and marina Suad Abdul Salam (30 years) from the village of Abu Sir, and our son Ahmed Mahmoud soldier (4 years) and the detention of children, Imam Mustafa Mohammed Mustafa (3 and a half years) of the area and the status of the Ottoman Mohamed Bassiouni Mohamed Mustapha (a year and a half) of the Ottoman Empire Center Mahala .

Blood samples were taken and the melancholy hours of the patients were placed under observation and detention places allocated to it, and was given a drug Altaymflo, as the result of a sample of 7 negative, and the faith of Muhammad Muhammad cane and Norhan Sameh Mohammed Azim and Abdullah Hussam Abdullah Shahawi and Mr. Khalid Mohammed Ahmed Abdulla Fawzi and Huwaida SNOUSSI Fayza Zeinhom and Eid Mustafa Hassan El-Shafei.

They were allowed to leave the hospital to check on their condition

Egypt-42 suspected bird flu in one day

Distributed to 12 County

42 حالة اشتباه بأنفلونزا الطيور فى يوم واحد

42 suspected bird flu in one day

الأحد، 10 مايو 2009 - 12:35

Sunday, May 10, 2009 - 12:35

عدد الإصابات المؤكدة منذ 2006 وصل إلى 68 حالة

The number of cases confirmed since 2006 arrived in the case of 68

كتبت أميرة عبد السلام

Written by Amira Abdel-Salam

.

Ministry of Health announced in a statement on Sunday that suspected cases of bird flu in Egypt and the case reached the 42 on Saturday, at a rate of 6 cases of the Governorate of Cairo and Alexandria, and 8 cases, 5 cases in each of the Monoufia and 3 cases of the West and the eastern region, Damietta, two Rawash Qalubia and one each in Fayoum, Menya, the lake and Dakahliya.

.

This brings the number of suspected cases of bird flu in humans since the disease in Egypt in 2006 to the 7179 case, the confirmed infection of 68, and 26 cases died of disease, while 42 corresponded to the situation of recovering.

Recombinomics: Swine H1N1 Fatality in Washington

Commentary

Recombinomics Commentary 07:46
May 10, 2009

The Snohomish County man, who officials said was in his 30s, had an underlying heart condition. He became sick on April 30 and died Wednesday from what appears to be complications of swine-origin influenza (H1N1), officials with the state Department of Health said.

The above comments describe the first reported H1N1 swine influenza death in Washington state. The death follows two deaths in Texas and one in Canada. These deaths highlight concerns that H1N1 deaths in the United States will parallel the deaths in Mexico when the number of cases increase.

The virus is rapidly spreading in the United States (see updated map), but the vast majority of reported cases are in children or young adults and most of these cases have been mild and did not require hospitalization. However, as the number of deaths in the United States increase, the similarities with Mexico will become clearer.

These similarities are most easily seen in the sequences of the swine H1N1 from patients in Mexico and the United States (see list here), which are virtually identical. Moreover the same sequences had been identified in isolates worldwide, strongly suggesting that differences in mortality are largely due to testing and detection frequencies.

The H1N1 in Mexico was recently confirmed by labs in the United States and Canada. Prior to the lab confirmation, the reports out of Mexico were mixed. It was clear that patients between the ages of 25-44 were dying from atypical pneumonia, but the etiological agent was unclear. The identification of swine H1N1 that matches the virus circumnavigating the globe provides a tight association between prior events in Mexico and future events in countries with more recent introductions.

However, the timing of these introductions remains uncertain. The mild nature of the vast majority of case allows for silent spread. The first two cases in the United States were identified through a border surveillance system. Other infections would go undiagnosed or misdiagnosed because of similarities with seasonal flu. Most infected patients would not seek medical attention, and those that did would be positive for influenza A and treated as seasonal flu patients.

This silent spread will likely continue because of decisions to limit testing of patients by state labs. Many have indicated that they will concentrate on more severe cases. Although an influenza A positive at this time of the year in the northern hemisphere will be increasingly likely to be H1N1 swine flu, a lab confirmation is the best tracking data.

The deaths of the young adults in Texas and Washington highlights the similarities between the H1N1 swine flu pandemic of 2009 and the 1918 outbreak, which also began with mild influenza due to efficient swine H1N1 transmission in a human population.

The rapid spread in the human population increases the likelihood of co-infrection with H1N1 seasonal flu and the acquisition of key polymorphisms linked to adaptation in human hosts. Two likely acquisitions are NA H274Y and PB2 E627K, which are fixed in human H1N1.

Close monitoring of sequences, including those from the southern hemisphere in the near term, will allow for detection of key changes that will drive swine H1N1 infections in the northern hemisphere in the fall.
The key acquisitions were recently demonstrated in the fixing of oseltamivir (Tamiflu) fixing in H1N1 seasonal flu, and acquisition of key polymorphisms via homologous recombination remains a cause for concern.

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