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June 30th, 2009 at 9:06 pm
Yesterday was the first report of a Tamiflu resistant strain, found in a Danish patient who was taking the drug to prevent infection. The patient recovered and it didn’t seem to be a more infectious or virulent form of H1N1. The New England Journal of Medicine has an article discussing accidental release as the cause of its reemergence in 1977, summarized on Mother Jones. I don’t have anything especially insightful to add though… The NEJM must have been fast-tracked to come out now, and the CDC and WHO are clearly still paying close attention.
The focus is supposed to be on the Southern Hemisphere, where it is winter/flu season, so i took a look at the news in Brazil for you. O Folha, one of the top São Paulo newspapers, has gripe suína on the front page – 55 new cases in Brazil, a total of 680 – but the headlines are because Buenos Aires has declared a public health emergency. The article states that there have been more than 30 deaths there, 1587 officially infected, but various medical institutions have denounced this number and say that it is much higher. The government asked all residents to stay home through Friday. Much as California did, they emphasize that declaring a state of emergency is a preventative, bureaucratic act, intended to permit more rapid mobilization of resources. Some of the measures described are kind of interesting: the declaration permits the government to enlist retired health officials in the effort. In both the capital and the provinces, they have shifted winter vacation dates to limit the spread of infection in schools, and suspended classes that were going on, but have not closed theaters, malls etc. The majority of Brazilian cases are in the southern most state of Rio Grande do Sul, which borders both Argentina and Uruguay. In one day in that state, the number of infected people jumped from 40 to 85.
PS i had this hyperlinked, but i can’t log in to vss to insert the urls. my apologies
July 1st, 2009 at 5:46 am
1) The virus is slowly but steadily circulating globally.
2) Epidemiologically, it has been a very mild pandemic so far. It is much more like a seasonal flu event. A good comparative case is the “pandemic” of 1977.
3) In the US, pandemic plans have not been put into practice, primarily because they have not been designed for such a type of event. What is being done is primarily counting cases and observing the unfolding epidemic. What experts are most afraid of is a possible shift in severity. That might happen or might not happen.
4) There is no way the global circulation of this virus can be controlled. The type of interventions that we have seen especially in Asian countries seems not very appropriate. It is quite worrisome that people are being quarantined due to an infection with the swine flu virus. The event should be handled like a regular seasonal flu event.
5) It might be that some governmental agencies are considering the current swine flu pandemic a suitable case to test possible modes of intervention.
6) Vaccine is being produced and will probably be available in a couple of months.
7) There have been interesting but inconclusive discussions regarding the possible origin of the virus.
July 3rd, 2009 at 8:08 pm
There has been an article in Nature (June 11) by the Hong Kong University team showing that this H1N1 has been circulating in the pig population in Asia for ten years, suggesting its emergence in America is due to pig commerce and transportation.
Interestingly people in the CDC have used this article to put the blame on Chinese pig industry instead of the American industry. The article rather showed that there had been surveillance of pigs in South China because of concerns for H5N1 while there was no such surveillance in America.
The main concern today is that the virus might go back to the pig population and possibly cross with an Avian virus.
I am in Hong Kong until mid-August if you want to pass by.
July 5th, 2009 at 12:20 am
Thanks for the comments! The officials here are very committed to the possibility of controlling the spread of the virus, in the newspapers it is described as building a 国门 or “national gate”. The officials I spoke with argued that the quaraninte measures were being employed for two reasons: 1) in order to buy time while the production of vaccines and stockpiling of drugs can take place, which they believe they have succesfully done and 2) as Carlo suggested, as an excercise or test of the possibility of controlling the spread of infectious disease through non-pharmaceutical measures alone, in case of a future outbreak of disease which is more severe but for which there are no vaccines or effective drugs. Meanwhile, some large clusters of H1N1 flu have been discovered in a primary school here in Beijing, so it will be interesting to see how policies change as the number of local cases grow.
November 17th, 2009 at 4:22 pm
How are things now in Beijin in regards to the Swine Flu? Has a vaccination campainge started?