Clue as to why more fatality in US

It may be just down to poor health care system in US especially for
migrant and poor workers.

It is time for the adoption of universal health care for US especially
for infection diseases or else it will suffer even more.

In Malaysia, I was told that for infectious diseases, even illegal
immigrants can get free medical care. This is vital for infectious
diseases like TB.

Fatality rate in Europe and Japan is still zero so hopefully this
Swine Flue can be controlled with proper care and Malaysia is up to
that standard.

http://www.bloomberg.com/apps/news?pid=20601124&sid=ah5TJ82PZ_T0

Swine Flu 'Overwhelmed' U.S. Health-Care System, Report Says
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By Catherine Larkin

June 4 (Bloomberg) -- The swine flu outbreak has overwhelmed the U.S.
health-care system, a report said.

Communication between government agencies and doctors isn't well
coordinated and the World Health Organization's six-step pandemic-
alert scale causes confusion, according to an analysis released today
by the Robert Wood Johnson Foundation, the Trust for America's Health
and the University of Pittsburgh's Center for Biosecurity. Worried
citizens flood emergency rooms while undocumented immigrants and the
uninsured delay getting medical care, the report said.

The H1N1 influenza virus has spread to more than 11,000 people in the
U.S. and caused 17 deaths, according to the Centers for Disease
Control and Prevention, in Atlanta. WHO is at phase 5 of its alert
scale, meaning a pandemic is imminent, even as the bug causes little
more than a fever and cough in most patients. Researchers say it is
critical to address vulnerabilities in the system before a crisis
strikes.

"H1N1 is a real-world test of our initial emergency response
capabilities," said Jeff Levi, executive director of the Trust for
America's Health, a nonprofit organization in Washington, in an e-
mailed statement. "The country is significantly ahead of where we were
a few years ago. However, the outbreak also revealed serious gaps in
our nation's preparedness."

The report includes 10 recommendations for strengthening the public-
health infrastructure, including halting job cuts in state and local
health departments, providing care for uninsured Americans during an
emergency and helping health-care facilities prepare for a surge in
new patients.

The work was supported by a grant from the Robert Wood Johnson
Foundation, a Princeton, New Jersey-based endowment fund that provided
$523.3 million in grants and contracts last year to support health
programs in the U.S., according to its Web site. The family of Robert
Wood Johnson started Johnson & Johnson, now the world's largest health-
care products company.

To contact the reporter on this story: Catherine Larkin in Washington
at clarkin4@bloomberg.net.
Last Updated: June 4, 2009 10:00 EDT

More data on pre-conditions for Swine Flu Hospitalisation Rate

Hospitalisation rate indicates serious conditions and will burden
hospitals if there are too many of them. Untreated they can lead to
deaths.

41% are those with Asthma
18% under 2 years old
13% immune system compromised
12% heart disease
Other risk factors include pregnancy, diabetes, kidney problems, blood
disorders, emphysema and liver problems.

In a situation where there is no vaccine for swine flu, pneumoncoccal
vaccination should be give to those with the above risk factors.
Since asthma is among the highest, they should be given first.

My wife has her immune system compromised by taking steroids due to
SLE. Not sure if she can take any vaccination.

Two More Deaths in City Reported From Swine Flu

Article Tools Sponsored By
By JENNIFER 8. LEE
Published: June 3, 2009

Two more deaths linked to swine flu — both of adults in their 40s —
were reported by the New York City Department of Health and Mental
Hygiene on Wednesday, bringing the total H1N1-related fatalities in
the city to seven.

The department said that six of the seven people who had died —
including Mitchell Wiener, an assistant principal at a public school
in Queens, who was the first swine flu death in the city — had
underlying conditions that could interfere with normal breathing. The
seventh death is still under investigation. The city will not release
the underlying medical conditions, citing medical confidentiality.
Officials would not disclose where in the city the latest two victims
lived.

However, the department did release an analysis that showed some 80
percent of the more than 300 people hospitalized with swine flu since
mid-April have one or more underlying conditions that put them at
risk. Asthma, which affects 10 percent of New York City children, is
by far the most common underlying condition, affecting some 41 percent
of those hospitalized.

The analysis also found that about 18 percent of those hospitalized
were younger than 2, 13 percent had a compromised immune system and 12
percent had heart disease. Other risk factors include pregnancy,
diabetes, kidney problems, blood disorders, emphysema and liver
problems.

Both the city's health department and the Centers for Disease Control
and Prevention have added obesity as a risk factor in swine flu
hospitalizations and deaths.

Obesity is not generally considered a risk factor for other strains of
flu. Dr. Donald Weiss, the director of surveillance for the
department's bureau of communicable disease, said that it was not
known why it was a factor in the swine flu cases.

A more detailed analysis of hospitalized patients' health histories is
still being conducted, as assembling the data has been relatively
challenging, Dr. Weiss said.

About 70 percent of the data about the hospitalizations that comes is
of decent quality, but 30 percent of it has to be chased down. Then
the information has to be double-checked. "It's a bit of work on the
part of the health department," Dr. Weiss said.

The health department recommended that people with chronic illness,
especially asthma, should see a doctor if they develop flulike
symptoms. It also emphasized only people with severe symptoms, like
difficulty breathing, should visit emergency departments, which have
been inundated by flu-related visits.

However, flu-related emergency department visits declined last week
from a peak on May 25.

Even if Swine Flu is not as bad as normal flu!

Normal flu kills 500,000 people worldwide annually. Some quote 1
million.

But normal flu has vaccine which limits its spread.
Swine Flu still hasn't got a proven vaccine so its death toll should
be higher anyway, certainly more than 500,000.

The increase should be proportional to the number of vaccinations for
normal flu.

Is it advisable to reduce the number of normal flu vaccinations in
order to shift production to Swine Flu? Given the large number of
doctors who believe that Swine Flu is not as bad as Normal Flu, we can
safely assume that there will be no vaccination produced for Swine Flu
making fatality of Swine Flu, similar to the normal flu fatality, but
this is an addition to the normal flu fatality, making the combined
fatality to be at least 1 million.

If some governments decide to divert production to Swine flu, the
number of deaths arising from normal flu will also increase,
offsetting the number of lives saved from Swine Flu. Either way, the
number of deaths will still increase.

Why did the world not care for the deaths of 500,000?

Flu: stop squealing normal virus worse

Alex de Vos

4th June 2009 04:00:03 PM

Doctors have advised residents that normal influenza is often worse
than swine flu as the virus begins breaking out in the Geelong region.

Barwon Health confirmed on Tuesday that doctors had diagnosed the
region's first case of swine flu.

The virus has been blamed for deaths overseas but has failed to claim
lives among Australia's growing number of victims.

General Practitioner Association of Geelong's Dr Jane Opie said the
organisation was expecting "more local cases" as the virus spread.

However, she considered swine flu relatively "mild".

"Certainly, what we've seen is no worse than normal influenza," Dr
Opie said.

Barwon Health spokesperson Kate Nelson said Geelong's first swine flu
victim was undergoing treatment in home quarantine.

"A patient presented at Geelong Hospital's emergency department and
tested positive for H1N1 Influenza," Ms Nelson said.

"Infection control measures have been adhered to and have followed the
guidelines for the control of infectious diseases."

Last week Ms Nelson told the Independent an outbreak was "inevitable".

She advised anyone with flu-like symptoms to contact their doctor.

"What you need to do is ring ahead first and advise your doctor
whether you have those symptoms so they can implement infection-
control procedures to minimise the risk of transmission," Ms Nelson
said.

"We also need people to practice good personal hygiene.

"Cover your nose and mouth with a tissue when you cough or sneeze,
wash your hands and avoid touching eyes, nose or mouth."

Ms Nelson said Barwon Health would continue working with Department of
Human Services, the city's General Practitioners Association and City
of Greater Geelong to contain the virus.

"But we need the public's cooperation to minimise transmission," she
said.

Swine flu has hit Victoria harder than any other state, accounting for
three quarters of the country's 500-plus confirmed cases.

best exora detail specifications comparisons

http://nuvobriteside.blogspot.com/2009/03/proton-exora-technical-information.html

This led me to buy the exora today and it is immediately available to
me provided I've the cash.

Unfortunately I still have to make arrangements for borrowing and
proton dealers prefer loans to cash payment.

3 hospitalisations in 42 confirmed cases

That is almost 10%. It will burden hospitals once Swine Flu spreads
rapidly. Unlike normal flu, these are not just the very young and old.

"To date, Onondaga County has had 42 confirmed cases of H1N1,
including three hospitalizations. The flu has stricken students in
Syracuse and five other neighboring school districts."

http://abclocal.go.com/wabc/story?section=news/local&id=6845800

Eyewitness News

NEW YORK (WABC) -- The health department says there have been two more
deaths in New York City related to the swine flu.

The Health Department says both people who died were adults in their
early and mid 40s.

[GET EYEWITNESS NEWS DELIVERED: Click here to sign up]

Story continues below
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That brings the number of New York City deaths related to swine flu to
seven.

Six of the seven deaths have occurred in people with other health
problems, presumably including at least one of the new deaths. One
case is still being investigated.

Health officials say an adult in Onondaga County is the first person
outside New York City to die of swine flu.

Onondaga County Health Commissioner Dr. Cynthia Morrow says the
resident had underlying medical conditions.

She says officials aren't identifying the patient at the family's
request and to protect their privacy. The person died recently in a
hospital and the state confirmed the death Tuesday night.

To date, Onondaga County has had 42 confirmed cases of H1N1, including
three hospitalizations. The flu has stricken students in Syracuse and
five other neighboring school districts.

State officials reported 780 confirmed cases of the H1N1 virus as of
Tuesday.

Reason why it is good to panic

This is a good explanation as to why we should panic rather than being
careless.

http://www.wausaudailyherald.com/article/20090601/WDH06/906010320

wausaudailyherald.com

June 1, 2009

Our View: Swine flu threat fizzled, but be vigilant

It's pretty clear now that the swine flu calamity predicted by the
world's health officials won't come to pass.

Though outbreaks continue to pop up, only a few thousand cases of H1N1
have been reported, with just 11 American deaths linked to the virus.
It's a far cry from the wave of death and illness that was predicted.

But it's no accident that the toll hasn't been higher. And the
institutions that are being criticized for inflating the threat posed
by swine flu really should be thanked for keeping the outbreak under
control.

That begins with Mexico, where the first cases of flu were reported.
As soon as the World Health Organization and Mexican officials learned
of the nature of H1N1 -- a virus resistant to flu vaccines and that
threatens normally healthy people, unlike most flus -- the government
essentially shut down the country.

Schools were closed. Commerce came to a halt as people were warned to
stay home -- and this in Mexico City, with a metro population of 19
million. Health officials quarantined the ill and got them immediate
treatment.

As a result, Mexico's economy lost tens of billions of dollars; the
total still is being calculated. But the flu's spread was brought
nearly to a halt.

The same thing happened in the United States -- though to a far lesser
degree because fewer cases were reported here.

The Centers for Disease Control and Prevention issued warnings about
the dangers posed by swine flu. Those dangers included the possibility
of pandemic with thousands or even tens of thousands of deaths.

Municipal and school leaders planned for local infections. When they
happened, at least in initial stages of the threat, schools sent kids
home and closed their doors. Later, as in the D.C. Everest School
District late in May, sick students simply were kept home and
facilities were sanitized.

The media and health organizations have taken some heat for the
attention they paid to swine flu. Some of the criticism might be
justified -- comparisons of this flu's potential death toll to the one
that followed the 1918 Spanish flu epidemic, for example, were
overblown.

Even emerging-world health systems, such as those in Mexico, are far
more capable of responding to an emergency today than even advanced
nations in Europe were during World War I. Technology for spreading
warning messages, medications, sanitation -- it all is vastly better
than a century ago.

But modern success in handling medical emergencies also poses an
enormous threat. Swine flu fizzled, so the temptation will be to
dismiss warnings next time a pandemic threatens.

That would be a mistake -- just as it's a mistake not to head to the
basement every time the tornado siren sounds, even though the last 10
times it went off, a funnel cloud didn't touch down.

Health officials are paid to assess the threats we face and warn us
accordingly. We'd be foolish to ignore their direction.

AWARE has a good start

About 100 people showed up Thursday to the public forum hosted by the
All Wisconsin Alcohol Risk Education in Wausau. That's a good turnout
for the first of what will be several statewide forums AWARE will
host. We applaud those people who cared enough to participate. Next,
let's translate that paticipation into action by talking to your
legislators, and to others in the community, about the best way to
address the culture of alcohol abuse. It's past time to find a
solution to this problem.

Pneumococcal Vaccination against Flu deaths

I got this idea from this article:
http://www.thestandard.com.hk/breaking_news_detail.asp?id=14771

Flu, even Swine Flu does not really kill directly. It is only the
onset of other diseases the most virulent is Pneumonia that kills most
of the time.

Many details are still missing and we need confirmation and direction
from experts at CDC and WHO as well as other health control centres
all over the world.

Since swine flu or other flu vaccinations are so difficult to develop
and very expensive because it has to be taken every year, it is better
to concentrate on preventing pneumonia. I am not sure if this really
helps but this microbiologist seems to think so.

Vaccinate elderly, HKU microbiologist urges
(05-31 15:12)
Elderly people should receive vaccines for pneumococcus and seasonal
flu if there is a widespread outbreak of human swine flu in the
community, University of Hong Kong microbiologist Yuen Kwok-yung has
said.

Speaking on a radio program, Yuen quoted an HKU study last year
showing the two vaccines could effectively lower the death rate of
elderly people by 26 percent and their hospital stay by 13 percent in
the flu season.

The government should also consider introducing a new vaccine for
human swine flu if there is a high fatality rate caused by the
infection, Yuen added.

But he warned that the government must also explain to patients the
possible side effects and the health risks the new vaccine may entail.

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