Saturday, 11 July 2009

Confirmed: Swine Flu pattern is similar to Spanish Flu

It is confirmed that swine flu kills more than 4 times in the age 5-59
compared to common flu, and still killing even in summer.

This is similar to the first wave of Spanish Flu.

Of course, they speculate( not confirmed) that it is due to mutation.
The data presented only supports the onset of winter and overloading
of medical services, that led to the large number of deaths in the
second wave.

It can be contained, as shown by Japan.
UK has failed to live up to its promise as its citizens threw all
cautions to the wind.

Malaysia has failed to emulate Japan because its citizens love pork
too much.

Japan, despite having worse infections, has limited it to only 500.
Malaysian now has more than 500 and still growing.

BAsed on the attitude of lots of Malaysian, Malaysia will suffer the
same fate as UK and Australia.

First wave of swine flu requires new public health strategy

8 July 2009

Effective distribution of limited vaccine and antiviral stockpiles
will be crucial to mitigate the expected second wave of the A(H1N1)
pandemic, according to scientists modelling the spread of the disease.

There is no way to know how the newest strain of the H1N1 influenza
virus will behave in the future, but scientists, notably those working
at the intersections of epidemiology, mathematics, modelling and
statistics, are monitoring it closely to identify anomalies on its
pattern of spread while evaluating ways of mitigating its impact.

"Public health officials have the ability to track confirmed cases and
hospitalizations in real-time with modern data collection approaches
and the aid of modelling as well as the ability to quickly identify
new strains and track their evolution," says mathematical
epidemiologist Gerardo Chowell-Puente, an assistant professor at
Arizona State University's School of Human Evolution and Social Change
in the College of Liberal Arts and Sciences.

Chowell-Puente is co-author of a new study of the A(H1N1) influenza
pandemic strain that is currently circulating around the world. The
study's findings reveal an age shift in the proportion of cases toward
a younger population when compared with historical patterns of
seasonal influenza in Mexico.

The findings have been published online in the New England Journal of
Medicine [1].

"The data show that the vast majority of cases of severe pneumonia and
deaths occurred among those ages between 5 and 59, which is atypical
when compared with the age pattern supported by seasonal flu," says
Chowell-Puente. "If resources or vaccine supplies are limited,
focusing prevention efforts on these age classes must be considered."

Specifically, according to the findings, 87% of the deaths and 71% of
the cases of severe pneumonia occurred in persons aged 5-59, compared
to an average 17% and 32%, respectively, for influenza seasons from
2006 through 2008. "These findings suggest relative protection for
those persons exposed to H1N1 influenza viruses during childhood prior
to the 1957 pandemic," Chowell-Puente says.

Chowell-Puente and other mathematicians and biostaticians attending a
swine flu workshop at Arizona State University June 25-28, note that
vaccines and anti-viral medications are in limited supply.

"Because achieving high vaccination rates before the fall is not
feasible with current technologies, effective distribution of a
limited vaccine and antiviral stockpiles will be crucial to mitigate a
potential second pandemic wave. The seasonal influenza vaccination
strategy focuses on the very young and the very old — the most
vulnerable populations. This is not necessarily the case for pandemics
as we showed in our study."

According to Chowell-Puente, the key to containing pandemic flu is
closely tied in to the ability to quickly produce a good stockpile of
vaccines and following a reactive distribution plan that targets the
appropriate age cohorts of the population. The first wave of the
current strain has not been particularly deadly, but subsequent waves
may be more virulent, though it is too early to tell, he notes.

"For the 1918 (Spanish flu) influenza pandemic, this was the pattern —
first a mild wave, and then a severe one with higher case fatality
rates," notes Chowell-Puente.

The features of the A(H1N1) epidemic, according to the findings, are
"somewhat similar to past influenza pandemics in that circulation of a
new influenza virus is associated with an unseasonal wave of disease
affecting a younger population."

It is the hope of Chowell-Puente that making this data available will
help politicians make science-based decisions on how to optimize the
use of limited resources to manage this and future epidemics.

In addition to this latest research, Chowell-Puente also was a co-
author on a recent study of the flu in Japan. "Here we looked at the
public health strategies they used that essentially stopped the spread
of the disease in its tracks," he says.

The researchers found that in Japan, more than 90% of the cases were
in school-aged children and teens. Quick action was taken to contain
the disease through school closures and other social distancing
measures, such as avoiding use of public transportation and the use of
face masks.

In addition, Japan employed active surveillance at airports, using
recently developed sensors to detect passengers with fevers for
additional screening. The disease was contained within two-to-three
weeks, with only about 500 cases and no fatalities. Findings from this
study appeared in the June 4 issue of Eurosurveillance in an article
titled Transmission potential of the new influenza A(H1N1) virus and
its age-specificity in Japan.

Reducing the spread of the disease is key to preventing deaths,
according to Chowell-Puente. "As transmissibility grows, timely
implementation of control measures is key to reduce epidemic impact on
the population."


1. Stefano Bertozzi, Arantxa Colchero, Hugo Lopez-Gatell, Celia
Alpuche and Mauricio Hernandez, Mark A Miller. Reported severe
respiratory disease and deaths concurrent with atypical A(H1N1)
influenza circulation of swine origin in Mexico, 2009. New England
Journal of Medicine 29 June 2009.

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