Sunday, April 26, 2009

Swine Flu


Saw this in the news :

60 % of the residents in the town of La Gloria, Perote, state of Veracruz, were stricken with the flu in late March. The WHO was apparently notified on April 2 by a bio surveillance company called Veratect. Link

and the government's response :
The government has insisted it acted quickly and decisively when presented with the evidence of a new virus.

But even as it did so, it acknowledged the outbreak began earlier than April 12, the date it had previously linked to the first case. Cordova confirmed Monday that a 4-year-old boy who was part of an outbreak in eastern Veracruz state that began in February had swine flu. He later recovered.

Residents of the town of Perote said at the time that they had a new, aggressive bug — even taking to the streets to demonstrate against the pig farm they blamed for their illness — but were told they were suffering from a typical flu. It was only after U.S. labs confirmed a swine flu outbreak that Mexican officials sent the boy's sample in for swine flu testing.

Mexico's Agriculture Department said Monday that inspectors found no sign of swine flu among pigs around the farm in Veracruz, and that no infected pigs have been found yet anywhere in Mexico.



The current lack of mortality in the U.S and Canada, based on 20-30 cases, is not fully significant. The 1918 pandemic had a mortality rate of between 2-4 %. And, there might be multiple strains of the disease, with a more virulent mutation having developed in Mexico. A lot is unknown.

One speculation:
After flu infections, people can develop an additional bacterial "superinfection" that could be lethal, said Brian Currie, an infectious-diseases doctor and director of clinical research at Montefiore Medical Center in New York City. Currie said it remained a mystery why people in Mexico were dying while the cases reported in the United States have been relatively benign. "You've got to remember, this is a strain of flu nobody has seen before," Currie said.

Might this occur if there is no initial treatment of the flu symptoms ?

Many people in very poor areas of the developing world, for instance, the slums outside Mexico City - will go to a doctor only if they are very ill. There are simply not enough medical facilities in these areas. And, people don't have the money to justify seeing a doctor for anything mild. Because of that , the current denominator of this disease is unknown, and much higher than the hospitalized cases.

It looks like the disease spreads easily, given the outbreaks dispersed throughout Mexico, and the clusters in New Zealand and New York. This is extremely concerning.

The 1918 pandemic was most destructive in its second phase, after it evolved, not the initial outbreak in Kansas.

Given the availability of Tamilu and generally good health care in the developed world - the brunt of this, if it continues unabated, will be felt by the very poor of the developing world. And, their struggles will not necessarily be reported or acknowledged by people in power.

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