45% Swine Flu deaths were normal

Normal here means that 15% were completely healty, whereas 30% have
only slight medical problems.

Since this distribution is the normal population distribution, it
shows that Swine Flu does not differentiate between healthy and non-
healthy individuals.

The only clear data is on pregnant women that are more than 4 times
likely to die from Swine Flu compared to the general population.

http://www.express.co.uk/posts/view/117389/Swine-flu-killing-even-the-healthy

UK NEWS
SWINE FLU KILLING EVEN THE HEALTHY
Story Image

Home of the Newman family whose daughter Natasha has been diagnosed
with swine flu

Friday July 31,2009
By Jo Willey Health Correspondent

Comment Speech Bubble Have your say(0)

ALMOST half of all swine flu deaths are among healthy people or those
with only mild or moderate health conditions, it emerged yesterday.

New figures show 45 per cent of people who have died from the disease
had not been considered seriously ill before catching the disease and
that 15 per cent of those were completely healthy.

So far, the virus has killed 27 people in England and four in
Scotland. The number of patients being treated in hospital has dropped
to 793 from 840 a week earlier. However, at least 110,000 new cases
were confirmed in England last week – a 10 per cent increase.

Meanwhile, British schoolgirl Natasha Newman, 16, from London, remains
on a life support machine in Athens after suffering lung damage caused
by the illness while on a family holiday in Greece.

Her father, Julian, said: "All our energy and prayers are focused on
her getting well."

Malaysian Doctors giving bad advice

Malaysian doctors treat H1N1 virus as though it is much milder than
common flu.

So much that even those that have asthma and suspected of having Swine
Flu, was allowed to go home to rest. Fortunately the patient survived.

It shows that Malaysian doctors are not well trained in mathematical
analysis and believe that 10 deaths a month of an infectious disease
is much milder than 30,000 in a year.

NO. 10 A MONTH MEANS that it is 1 TRILLION DEATHS, I.E. 12 ZEROS.

Since the population of the earth is only about 6 billiion, i.e. only
10 zeros, it will wipe out the entire population. This is what the
figure very clearly states and it is shown very clearly by the facts.
In 3 months, 1000 DEATHS already.

These doctors also don't read the news in the internet, let alone
newspapers.
They only LOOK AT THE 10 DEATHS IN A MONTH.

http://www.bernama.com/bernama/v5/newsgeneral.php?id=429010

July 30, 2009 16:34 PM

H1N1: Doctors Who Don't Comply With Guidelines To Be Called Up

PUTRAJAYA, July 30 (Bernama) -- Doctors who fail to comply with the
guidelines from the Health Ministry to detect the Influenza A (H1N1)
infection much earlier will be called up by the Health Ministry for an
explanation so that the problem would not recur.

The Director-General of Health Services, Tan Sri Dr Mohd Ismail
Merican said the investigation was not meant to penalise the doctors
concerned but to understand why they did not comply with the
guidelines.

For this purpose, he said the Director of the Disease Control
Division, Datuk Dr Hasan Abdul Rahman would instruct a team to
question the doctors concerned to get further information on the
medical examinations carried out.

"If there are doctors who still don't adhere to the guidelines issued
by the ministry, we will call up the doctors concerned, ask them
whether they understand (the guidelines issued).

"Some of them may not understand, so I will call them. Like in the
case who died within 24 hours (first death of H1N1), he saw the doctor
and after one hour, he died. So I want to find out from the doctor,
did he examine the patient? And if so, why is it not recorded in the
outpatient department (OPD) card? How can a patient collapse just like
that?" he said.

Dr Mohd Ismail said all doctors must also have their own computers
with internet facilities to ensure that they kept abreast with current
developments on the infection, particularly directives issued by the
ministry on the matter.

"I was told that some doctors don't even own a computer, so please buy
a computer, hook on to the internet and visit our (ministry's) website
so that they will be up to date in the management of their patients,
and it is not just for H1N1, it is for continual professional
development (CPD).

"Find out what are the things that you need to do, be aware of things
like guidelines about tamiflu, about wearing mask, about treating
patients, everything is there. There is no excuse for people to say
they do not know anything," he said.

Dr Mohd Ismail said this when asked about the action to be taken
against doctors who failed to adhere to the guidelines on examining
Influenza A (H1N1) as stipulated by the Meeting of the Technical
Committee on the Influenza A (H1N1) Wednesday.

The guidelines which, among other things, stated that all severe cases
of pneumonia for which a throat swab was required to be taken for
Influenza A (H1N1) tests and antiviral treatment given, were issued
because there were doctors who failed to detect the ailment in the
four fatal cases of Influenza A (H1N1) recorded earlier.

Asked whether the investigation was carried out in the four fatal
cases earlier, Dr Mohd Ismail said so far the doctors concerned were
only given reminders, and further action would depend on the
subsequent developments.

He also said doctors could not refuse to see patients with influenza
like illness (ILI) on their second visit, and the patients could
actually insist on being tested for Influenza A (H1N1) on their second
visit, if they had not recovered from their flu.

When asked about a case in Hospital Kuala Lumpur (HKL), where a
patient suffering from asthma and suspected to be infected with H1N1
was asked to go home and rest instead, Dr Mohd Ismail said he would
bring the matter up with HKL.

-- BERNAMA

Obesity is not a factor in Swine Flu Fatality

At least some sense is preserved by this report.
I wonder why initial reports by doctors indicate that obese people are
more prone to Swine Flu deaths?

http://www.bloomberg.com/apps/news?pid=20601103&sid=aBbVm.._rtP8

Swine Flu Kills at Similar Rate for Obese and Skinny Patients
Share | Email | Print | A A A

By Tom Randall

July 29 (Bloomberg) -- Being fat doesn't increase the risk of death
from swine flu, according to a U.S. analysis that contradicts initial
reports.

About 34 percent of the U.S. population is obese, while 38 percent of
patients who died with swine flu had the condition, according to a
report presented today at a vaccine conference at the U.S. Centers for
Disease Control and Prevention in Atlanta. Extremely obese people make
up 6 percent of the population and 7 percent of swine flu deaths.

For the seasonal flu virus that strikes every year, obesity isn't
considered a separate risk factor, and global health authorities were
studying a possible link with swine flu complications from anecdotal
reports by hospitals. After analyzing the available data, scientists
at the CDC today said there was no unique threat for the overweight.

"Obesity should not be considered a new risk factor," said Anthony
Fiore, a CDC researcher. Obese patients may have other conditions that
can complicate the flu, and doctors should still consider that when
making treatment recommendations, he said.

A person is obese if their body mass index is greater than 30 or about
186 pounds for a person who is 5 feet, 6 inches tall.

About 70 percent of patients hospitalized with swine flu, also known
as H1N1, have an underlying medical condition that adds to their risk
for complications, Fiore said.

The analysis was prompted in part by a CDC report July 11 that 9 of 10
patients with the pandemic flu strain admitted to an intensive care
unit at a hospital in Ann Arbor, Michigan, from late May to early June
were obese, and seven were "extremely obese," with a body mass index
of at least 40. Three of the 10 died and seven had no other known
health problems.

To contact the reporters on this story: Tom Randall in New York at
trandall6@bloomberg.net
Last Updated: July 29, 2009 15:56 EDT

Worst Spanish Flu only has fatality rate of 0.7%

This is for Wales in 1918 but it caused so much suffering because it
spread so quickly.

In New York, by looking at the chart which I copied at my blog,
othmanaahmad.blogspot.com, the fatality rate is less than 0.1% while
the highest is at 1.3%.

Compare it with Swine Flu of 2009, with a peak fatality rate of 1.4%
in Argentina and this is only the beginning of winter, not the peak,
and there is treatment for Swine Flu, unlike Spanish Flu.

It clearly shows that Swine Flu is much worse than Spanish Flu.

Even when the Spanish Flu pandemic is at its early stage, it has
already swamped health care in parts of New Zealand and UK.

http://www.walesonline.co.uk/news/wales-news/2009/07/29/when-flu-wiped-out-50-million-91466-24263017/

When flu wiped out 50 million

Jul 29 2009 by David Williamson, Western Mail
Add a comment
Recommend

As the number of swine flu patients in Wales continues to soar, David
Williamson looks at the parallels – and the differences – with
previous pandemics, and speaks to survivors of the Asian and Hong Kong
flu outbreaks

DISTANT memories of the devastation which influenza wreaked across
Wales less than a century ago may be a reason why the mere spectre of
swine flu is enough to make many of us shiver.

Wales swine flu

The so-called Spanish flu pandemic of 1918-19 killed many more people
than the battles of World War I. Between 40 and 50 million are thought
to have died worldwide, with at least 10,000 perishing in Wales.

This apocalyptic moment demonstrated that a virus pays no heed to the
borders for which men were prepared to go to war.

The true cost to Wales is detailed in work by retired doctor Edward
Davies of Cerrigydrudion in Conwy.

He has studied records which show Caernarfonshire had the highest
death rate in the whole of Wales and England, with 6.7 people in every
1,000 falling victim to the pandemic. Flintshire ranked fourth in this
grim league table of death.

Soup kitchens had to be opened in Caernarfon and Llanberis to care for
families that had been struck with the virus. And 80 Canadian
soldiers, among 17,000 troops waiting to go home, were among those who
died at Bodelwyddan, Denbighshire.

At the time, newspaper Herald Cymraeg reported: "We live in terrible
days, fearing every minute of the day that we will hear of the death
of neighbours and friends."

Dr Roland Salmon, director of the communicable disease surveillance
centre of the National Public Health Service for Wales, said the high
death rate linked to the Spanish flu has never been satisfactorily
explained.

In many ways, society was in a fundamentally weaker condition than
modern Wales.

He said: "These were the last years of the Great War. The British had
a naval blockade over the central powers and it was remarkably
effective. Meanwhile, the German submarines were preventing food
reaching France and Britain."

Food scarcity had an automatic effect on nutrition. To make matters
worse, millions of people were living in the ideal environment for a
disease to be communicated.

He said: "There were these huge agglomerations of people in the Army
which were perfect conditions for the transmission of the virus. These
are circumstances we wouldn't expect to be replicated in the next few
months."

Furthermore, flu-related fatalities often come when infection has
crept in. Today's antibiotics can quickly deal with a multitude of
complications.

There are memories of more recent flu outbreaks, such as in 1957-58,
when 37,500 died in the UK over two winters, and the 1968-70 "Hong
Kong" virus which led to the deaths of 78,000 people in Britain.

However, other instances of widespread flu have been largely
forgotten.

There were 29,169 deaths in a 1989 epidemic – including 1,627 in
Wales.

Dr Salmon said: "The comforting thing about that is very few people
have a marked recollection of 1989 as a year of Biblical carnage."

The spectacle of the Berlin Wall collapsing was not eclipsed by terror
at the latest flu strain. Similarly, Dr Salmon urges people to keep
the latest outbreak in proportion.

He said: "The message we try and get across is not necessarily that
this is mild or severe, but that this is flu and it behaves like flu
does, so most people's experience will be reasonably benign."

He considers the reporting of swine flu "rather frenzied" but believes
the Government's efforts are worth while.

"I think this is a reasonable threat to prepare for and I think the
preparations we've got will stand us in good stead," he said.

Mark Honigsbaum, author of Living With 'Enza: The Forgotten Story of
Britain and the Great Flu Pandemic of 1918, said the establishment
refused to treat the Spanish flu outbreak as a crisis.

He said: "There was not anything like the same response [as today]
because there was no NHS, there was no Minister of Health, and it was
decided it was in the best interests of the country to simply ignore
the threat because the war took precedence and it was important to
keep up morale."

However, individual medical officers in cities often decided to give
their own guidance as the disaster mounted.

He said: "Many of them took it upon themselves to issue advice to the
public which was very, very, very similar to the advice the
Government's putting out in its leaflets. It's uncanny how similar."

Mr Honigsbaum does not sense that hysteria has seeped into modern
Britain.

"I think there is a difference between how the media project risk and
threats, and how people actually react in practice," he said. "My
feeling about the British is, actually, there have been scary
headlines for several months and most people's response is quite
common-sensical."

However, were men and women to start showing the symptoms which hit
the victims of Spanish flu, panic could spread at a faster rate than
in any prior epidemic.

He said: "If it was to mutate and lots of people were turning blue and
choking, as they did in 1918, I think the potential today for that to
be much scarier is much larger. It would not be something that's
taking place in isolated communities behind closed doors.

"In 1918, doctors witnessed this but it wasn't something witnessed
widely."

Despite the tragedies that influenza brought to families as it ripped
through Britain, the trauma did not spur strong demands for social
change.

Mr Honigsbaum said: "Within individual families, if you lost a beloved
aunt, father, sister or mother, it was passed on in the memory of
families so it left a trace in that respect.

"But did it have lasting social impacts? The answer is, surprisingly,
no."

It was not until 1948 that the National Health Service was born. And
it took the arrival of antibiotics as part of a revolution in modern
medicine for the fear of premature deaths through sickness to largely
recede from the public consciousness.

Worries about crime and addiction have replaced the dread of TB and
pneumonia in our society. But throughout much of the world, the threat
of malaria and water- born disease remains a real and present source
of fear. According to Unicef, more than 5,000 children a day die from
diarrhoeal diseases.

The drama of this swine flu pandemic has brought an anxiety to
developed countries that a virus may strike and disrupt our plans.
This gives us a reminder of the monumental power of nature to destroy
and terrify.

Swansea cultural historian Peter Stead believes caution should take
hold as society recognises it is not invulnerable to viruses.

He said: "I've got a feeling in the future we are going to have to be
far more careful than we were in the past. Standards have slipped. The
whole thing about washing hands and using handkerchiefs is going to
come back."

Mr Stead believes that the way technology has enabled the media to
display magnified images of the virus has personalised the threat.

He said "[These] red jellyfish that look like science fiction things
from outer space – that makes it all the more terrifying."

When measured against the scale of history, bacteria and not humans
are the true survivors.

Mr Stead said: "Viruses and bacteria are the strongest things. They
are always going to be here, they are going to see us off."

Doctors must learn to play GOD

Malaysia should also be prepared and doctors must be given guidelines
as to who should be saved or not.

YBs are the most vulnerable but need not necessarily be the best
candidate to be saved since they are not of perfect health.

It is just a waste of ICU bed if they die anyway.

Our problem is also caused by them since they had followed UK and
Australian methods of not controlling the borders unlike China that
has managed to reduce the infection rate tremendously that it had no
death so far, except Hong Kong which is under a different
administration that is also lax in immigration control of Swine Flu
carriers.

Japan is even more strict with big thermal scanners directed to their
head.

FLU DOCS ARE 'PLAYING GOD'
ABOVE: Victims of swine flu will be rated on their chances of survival
by docs.
ABOVE: Doctors are asking victims not to come into surgeries for fear
of spreading the virus.
28th July 2009
By Josh Layton

DOCTORS will "play God" in deciding which swine flu victims to save
under a Doomsday scenario.

Patients with the best chance of survival will be given priority.

But a "scoring" system would rule out intensive care treatment for
people with problems such as advanced cancer.

The grim plans will only be introduced if half the population becomes
infected with the H1N1 virus.

So far the UK death toll stands at more than 30, with 100,000 new
cases diagnosed last week.

But health experts fear that swine flu could mutate into an even
deadlier virus.

Their concerns are contained in a Department of Health report called
Pandemic Flu – Managing Demand And Capacity In Health Care
Organisations.

The study says that 6,600 patients a week could be left competing for
just under 4,000 intensive care beds.

Patients unlikely to benefit from treatment would be given painkillers
and left in "dying rooms".

Intensive Care Society president Dr Carl Waldmann said: "Even if we
doubled intensive care capacity, with a pandemic hitting at the level
outlined in this report we would run out of beds."

Dr Tony Calland, chairman of the British Medical Association's ethics
committee, said: "I seriously doubt we will get anywhere near a 50%
clinical attack rate, but if 25% of the population were infected that
could cause major problems for the health service.

"The Department of Health is right to address this in the report and
the NHS must face the issue, but many doctors would doubtlessly feel
extremely uncomfortable if they found themselves having to face these
kinds of decisions."

A Health Department spokesman said: "We can't be certain how the
current pandemic will develop, but we have to prepare for the
reasonable worst case."

Tamiflu should be rationed to younger adults, Italian scientists said
in the journal BMC Infectious Diseases.

Meanwhile, an expert warned the Army could be called in to keep the
country going if the pandemic escalates.

Virologist Nigel Dimmock, University of Warwick Emeritus Professor,
said a worker shortage could mean Britain "would begin to creak or
even grind to a halt".

Doctors must learn to play 'g

FLU DOCS ARE 'PLAYING GOD'
ABOVE: Victims of swine flu will be rated on their chances of survival
by docs.
ABOVE: Doctors are asking victims not to come into surgeries for fear
of spreading the virus.
28th July 2009
By Josh Layton

DOCTORS will "play God" in deciding which swine flu victims to save
under a Doomsday scenario.

Patients with the best chance of survival will be given priority.

But a "scoring" system would rule out intensive care treatment for
people with problems such as advanced cancer.

The grim plans will only be introduced if half the population becomes
infected with the H1N1 virus.

So far the UK death toll stands at more than 30, with 100,000 new
cases diagnosed last week.

But health experts fear that swine flu could mutate into an even
deadlier virus.

Their concerns are contained in a Department of Health report called
Pandemic Flu – Managing Demand And Capacity In Health Care
Organisations.

The study says that 6,600 patients a week could be left competing for
just under 4,000 intensive care beds.

Patients unlikely to benefit from treatment would be given painkillers
and left in "dying rooms".

Intensive Care Society president Dr Carl Waldmann said: "Even if we
doubled intensive care capacity, with a pandemic hitting at the level
outlined in this report we would run out of beds."

Dr Tony Calland, chairman of the British Medical Association's ethics
committee, said: "I seriously doubt we will get anywhere near a 50%
clinical attack rate, but if 25% of the population were infected that
could cause major problems for the health service.

"The Department of Health is right to address this in the report and
the NHS must face the issue, but many doctors would doubtlessly feel
extremely uncomfortable if they found themselves having to face these
kinds of decisions."

A Health Department spokesman said: "We can't be certain how the
current pandemic will develop, but we have to prepare for the
reasonable worst case."

Tamiflu should be rationed to younger adults, Italian scientists said
in the journal BMC Infectious Diseases.

Meanwhile, an expert warned the Army could be called in to keep the
country going if the pandemic escalates.

Virologist Nigel Dimmock, University of Warwick Emeritus Professor,
said a worker shortage could mean Britain "would begin to creak or
even grind to a halt".

we must prepare sufficient burial sites

UK is already planning for 65,000 deaths this year, which is about
0.1% of the population.

At the rate at which Swine Flu spreads, this is not an unreasonable
estimate. Even in normal flu season, UK experienced thousands of
deaths. It is only that Swine flu will kill up to 20 times more than
usual but this is sufficient to swamp the burial sites.

Please note that the deaths due to normal flu is despite flu
vaccinations and antivirals also. Similarly for Swine Flu except that
it is 20 times more infectious and spreads faster, while having a much
higher fatality rate.

In Sabah, we should have about 3000 deaths. At Kota Kinabalu, it
should be about 1,000.

If you think our current quarantine procedures are good, please take
note that UK and USA also practises similar quarantine procedures,
closing entire schools that are affected and yet the death rate
continues.

China is different. It quarantines all entrances, unlike Malaysia, UK
and USA.

Just imagine 1000 deaths at the abandoned Queen Elizabeth Hospital.

If you think vaccinations work, please take note that vaccinations are
also used for normal flu with little effect, still killing millions
every year.

Vaccinations are useful for front-line workers. They are the ones who
are in contact with most people and will care for the sick that are
the most vulnerable to Swine Flu. WHO will give it for free.

In UK, flu vaccine costs 6 pound, equivalent to RM36 whereas in
Malaysia it will cost RM200. Why should it cost so much in Malaysia?

If it were to cost only RM40, many people can afford the vaccine.

http://www.guardian.co.uk/world/2009/jul/25/swine-flu-bodies-catacombs

Catacombs may be used to store bodies of swine flu victims

Exeter city council plans to use 19th century burial chambers as
emergency mortuary if pandemic worsens

* Buzz up!
* Digg it

* Staff and agencies
* guardian.co.uk, Saturday 25 July 2009 11.52 BST
* Article history

A city council is considering using 19th century catacombs to store
the bodies of swine flu victims if the outbreak worsens, it was
confirmed today.

Exeter city council has identified the empty underground burial
chambers, currently used as a tourist attraction, as a potential
mortuary.

A council spokesman said the plan would be implemented if the
crematorium and cemeteries could not keep up with funeral demands.

"We have some empty catacombs in an old cemetery in the city," he
said. "These are 19th century underground burial chambers which are
normally a tourist attraction. They can, however, be safely used for
their original purpose and allow us to temporarily store bodies in the
remote possibility that the need should arise."

So far at least 31 people have died in the UK after contracting the
virus. Yesterday, the World Health Organisation said 800 people had
now died worldwide from the H1N1 virus and as many as 2 billion people
could eventually be infected.

Doctors have warned that NHS intensive care wards could be overwhelmed
by severely ill swine flu patients if infection rates climb rapidly.

The growing pressure on critical care beds was underlined this week
when a pregnant 26-year-old was flown from a hospital in Kilmarnock to
Sweden for life-saving treatment because of a shortage of equipment in
Britain. Sharon Pentleton's family said she was gravely ill, but her
doctors believe she has a good chance of recovery.

According to Dr Alan Hay, director of the WHO's London-based world
influenza centre, the first wave of UK infections is likely to peak
within the next week or two before re-emerging in the winter.

Research published in the journal Anaesthesia suggests that when the
peak comes, demand for intensive care beds could outstrip supply
by130% in some regions, while the demand for ventilators could exceed
supply by 20 %. Paediatric facilities are likely to become "quickly
exhausted" as hospitals confront "massive excess demand", according to
experts in intensive care and anaesthesia from the University of
Cambridge, the Intensive Care Society and St George's Healthcare NHS
trust in London.

The Department of Health said the NHS was prepared for the pandemic.
"Guidance has been issued which contains information for primary and
secondary care services in the UK on managing surge capacity and the
prioritisation of services and patients during a widespread influenza
outbreak," a spokesman said.

Confirmed: 16% of Swine Flu deaths were previously health

This is an excellent article summarising the situations in UK and
their attempts at controlling the spread the deaths. Let us monitor
their cases closely so that we can apply the lessons learned from them
to our countries.

http://www.dailymail.co.uk/news/article-1201701/Swine-flu-epidemic-160-Britons-held-quarantine-abroad-children-super-spreaders-virus.html

Swine flu: Up to 160 Britons held in quarantine overseas

By Daniel Martin
Last updated at 4:59 PM on 24th July 2009

* Comments (75)
* Add to My Stories

At least 160 Britons are in quarantine worldwide because of swine flu,
the Foreign Office said today.

A spokeswoman said assistance was being given to people in China,
Singapore, India and Egypt.

Not all will be suffering from the virus. Some will have been
quarantined after being in contact with people who are.

The spokeswoman said there were likely to be other people abroad being
kept in quarantine who had not sought help from the Foreign Office.

It comes as experts said children under the age of 14 have become
'super-spreaders' of the virus, leaving England battling a raging
epidemic.
Masked Italian students arrive at Stansted as news breaks that swine
flu cases in England doubles in a week to 100,000

Prepared: Masked Italian students arrive at Stansted as news breaks
that swine flu cases in England doubles in a week to 100,000

The number of swine flu cases has doubled in a week to 100,000 with
most of the new cases among children below 14 years old, according to
officials.

A third of those who have died from the virus have been under 15 and
20 per cent of those who have ended up in hospital were under the age
of five.

The NHS is now planning for up to 65,000 deaths from swine flu, with
30 per cent of the population - and 50 per cent of children - catching
the infection.

Meanwhile, a British family on holiday in Bodrum, Turkey, have been
put in quarantine in hospital after a six-year-old boy was diagnosed
with the virus.

The child, who has not been named, was spotted after thermal cameras
showed he was extraordinarily hot and tests later found he had swine
flu.

Head doctor at the 75th State Hospital Dr Levent Ozbek said: 'After
further investigations and treatment, the family will be our guests in
the hospital where all necessary treatment is given to the patients.'

The Health Protection Agency yesterday said for the first time that
the disease was probably at epidemic levels - or one in 500 people
reporting flu-like illness.

It makes it the most virulent flu outbreak since the winter of
1999/2000, when 21,000 lost their lives.

Officials have also warned that a third of those who have died so far
had no serious underlying health problems.

Such is the level of concern that the new National Flu Pandemic
Service website crashed within minutes of going live after receiving
2,600 hits a second, or 9.3million an hour.

The dramatic news emerged as:

* Universities warned campuses may have to close in the autumn if
the epidemic gets worse;
* GPs started to cancel summer holidays to deal with extra cases
and call in temporary staff to cover for sick colleagues;
* Small businesses appealed for extra help over fears they would
be driven to the wall through absences and swine flu sickies.

Workers at one of the 19 National Pandemic Flu Service call centres
answer calls from people concerned about swine flu

Alarm: Workers at one of the 19 National Pandemic Flu Service call
centres answer calls from people concerned about swine flu

The National Pandemic Flu Service website crashed within minutes of
going live after receiving 2,600 hits a second

Emergency website: The National Pandemic Flu Service website crashed
within minutes of going live after receiving 2,600 hits a second

Chief medical officer Sir Liam Donaldson coined the phrase 'super-
spreaders' to describe children under 14.

He said yesterday that 26 people in England and four in Scotland are
believed to have died.

More...

* Pregnant woman rushed to Swedish hospital after suffering rare
complication from swine flu
* 'Are you unconscious?': What happened when the Mail phoned the
new swine flu hotline
* SIMON JENKINS: Britain is losing its sense of proportion over
swine flu
* Swine flu travel advice: what to do if you're going on holiday

The figure is no different from last week because further
investigations have revealed that some who were listed at that time
had not actually died from the virus.

But for the first time, Sir Liam was able to announce that around 16
per cent of those who had swine flu on their death certificates were
perfectly healthy and were on no medication.

A further 17 per cent had only mild and moderate conditions such as
high blood pressure and diabetes.

The rest had serious health problems undermining their immune systems,
such as leukaemia.
A man walks in to a NHS walk-in-center in London, Britain, 21 July
2009

Cause for concern: Chief medical officer Sir Liam Donaldson said
around 16 per cent of those who died of swine flu were perfectly
healthy

In an attempt to reassure the public, Sir Liam said: 'The bad thing
would be if 100 per cent of the deaths were healthy people. The vast
majority of people, even with an underlying condition, will get the
flu and recover well.'

The Health Protection Agency said that, to all intents and purposes,
England is in the grip of a swine flu epidemic.

Justin McCracken, chief executive of the HPA, said: 'The view is that
we are there or thereabouts. On the evidence of people going to their
GPs, it is on the border of what we would expect in an epidemic.'

Professor Hugh Pennington, a bacteriologist at Aberdeen University,
said: 'I have seen cases myself of people dying from flu who are
healthy.

'The fact that younger people are being hit is similar to previous
pandemics. Social factors obviously play a part - young people hang
around each other more - but the reasons are not known.'

The HPA estimates that 100,000 came down with swine flu last week -
compared with 55,000 the previous week. It said the number could even
be as high as 140,000. Some 840 are in hospital, including 63 in
intensive care.
A woman receives the swine flu vaccine in Adelaide, Australia, where
the strain is believed to have originated

World's first trials: A woman receives the swine flu vaccine in
Adelaide, Australia, where the 1999/2000 strain is believed to have
originated
swine flu vaccine

Soaring profits: GlaxoSmithKline has been accused of profiteering over
its H1N1 vaccine, which is expected to cost £6 a jab

The National Pandemic Flu Service website went down only three minutes
after being launched at 3pm.

A message said: 'The service is currently very busy and cannot deal
with your request at this time. Please try again in a little while.'

The site was down for at least two hours, but later appeared to be
working normally.

The Tories claimed the problems were because it had been set up too
late and that it should have been launched as a global pandemic was
declared weeks ago.

Health spokesman Mark Simmonds said: 'People couldn't access the
information. They couldn't discover themselves whether they had the
appropriate symptoms that would give them the opportunity to get
Tamiflu.'

But Sir Liam Donaldson blamed the crash on people's curiosity rather
than desperation of those fearing they had the virus.

'We would estimate around the very, very most that there were 20,000
out there when the flu line was switched on who might have had genuine
flu.

'Nine million people decided to visit the site because there was such
intense media interest in this story and many, many more people were
aware of it than if it had moved into use in a routine way.'

Those who suspect they have swine flu log on to the site -
www.direct.gov.uk/pandemic flu - and go through an online checklist
ticking the boxes that correspond with their symptoms.

If the system diagnoses them with the virus they are given a special
'voucher number' that enables them to go along to their nearest
pharmacy or surgery to collect their Tamiflu.

Universities yesterday revealed they could be forced to remain closed
in the autumn to limit the spread of swine flu.

Almost two million students will be converging on universities from
September when the epidemic is expected to peak.

Departments could be closed, freshers' activities cancelled, or
students could even be quarantined.

Meanwhile, the Archbishops of Canterbury and York have recommended the
suspension of the sharing of the chalice at communion.

They have written to bishops in the Church of England setting out the
measures following official advice not to share 'common vessels' for
food or drink.

Italy, which has had no deaths from swine flu, yesterday added Britain
to a list of travel trouble spots - which also includes Iran and
Ethiopia.
Mahood swine flu cartoon

Asked why the UK seemed to be particularly badly affected compared
with the rest of Europe, Sir Liam said it could be that Britain had
better surveillance systems.

But in a sign that the NHS is under strain, companies which provide
cover when GPs and practice nurses go off sick have reported a massive
surge in demand.

Steve Field, chairman of the Royal College of GPs, said: 'Swine flu is
getting very busy all over the country. It is going up in all parts of
England.

'GPs are at full stretch - both answering phones but also seeing
patients in surgery, all at a time when historically people are going
on holiday. We are hearing that doctors are cancelling their holidays
to do clinical work.'

Some 22,000 died in Britain's last flu epidemic in 1999-2000 - a death
rate ten times higher than the average for a normal winter.

The strain, believed to have originated in Australia, crippled the
NHS. At the epidemic's peak there were as few as 11 intensive care
beds available across the country.

Yesterday, a pregnant Scottish woman critically ill with swine flu was
transferred to Sweden for a rare treatment after suffering lung
problems.

The procedure involved circulating the patient's blood outside the
body and adding oxygen to it artificially. The UK has a unit for such
treatment but all five beds are being used.

The number for the National Pandemic Flu Service for England is 0800
1513 100 and the website address www.direct.gov.uk/pandemicflu

Read more:
http://www.dailymail.co.uk/news/article-1201701/Swine-flu-epidemic-160-Britons-held-quarantine-abroad-children-super-spreaders-virus.html#ixzz0MHUDrVDT

Quarantine is cheaper than Tamilflu

UK started giving out Tamilflu to anyone who suspects themselves to be
suffering from Tamilflu, approved by online services that may not be
manned by doctors.

If UK had adopted a tougher quarantine procedures as China had done,
UK won't suffer such a fate. It is too late for Australia and New
Zealand authorities who are convinced that Swine Flu is milder than
common flu.

The next step would be for everyone to wear masks in public places. It
will not stop swine flu or protect ourselves, but it will slow down
the spread so that medical care is still sufficient for all and
protect those that we may infect.

Those who die are those with underlying diseases and I suspect those
that are thought to be healthy are not really that healty, but Swine
Flu is much more virulent than common flu that even slight immune
deficiencies are exaggerated. That includes weak heart and kidney
(diabetic) that normally will allow people to still survive if not for
Swine Flu.

Malaysia is having perpetual summer so its infection rate should not
be so high as long as not many people visit air conditioned shopping
centres that have centralised air conditioned systems.

Air condition manufacturers should have developed anti virus air
filters by incorporating ultra violet lights and ion producers but
they are not so concerned about safety as much as they should.

Despite the SARS scare, air conditions are still not equipped with UV
light except a tiny one offered by Hitachi. Only a tiny LED light that
will not be sufficient to kill any virus at all.

http://edition.cnn.com/2009/HEALTH/07/25/uk.swine.flu.pharmacies/

By Melissa Gray
CNN
Decrease font Decrease font
Enlarge font Enlarge font

LONDON, England (CNN) -- Pharmacies in England are reporting a run on
supplies like surgical masks, thermometers and anti-bacterial gels by
customers concerned about swine flu amid a surge in the number of
people infected by the virus.
A box of leaflets containing information about swine flu, distributed
by the UK's Department of Health.

A box of leaflets containing information about swine flu, distributed
by the UK's Department of Health.

In some cases, drug stores in England say they are out of the items
and may not get more in for weeks or months.

"People are very panicked," said a pharmacy assistant at Zafash
Pharmacy in southwest London. "That's why everyone is running for
thermometers, surgical masks, and anti-bacterial gels."

The UK's Department of Health estimated this week that there were
around 100,000 new cases of swine flu in England in the week ending
July 17 -- nearly double the number of cases for the previous seven
days.

The UK has been hit hard by the H1N1 virus, with only the U.S. and
Mexico recording more cases of infection, according to World Health
Organization figures earlier this month.

The World Health Organization has stopped giving a global tally of
cases but said Friday that swine flu has now spread to more than 160
areas and territories in the world.

At least 26 people have died of the disease and this week the British
government set up a national flu hot line and Web site to allow those
suspected of having swine flu to get a prescription for antiviral
medication over the phone.

Those who are given prescriptions must pick up the medication at
designated collection points in their area.

But at Hodgetts Chemist in north London, a supply of surgical masks
that normally lasts for half a year has gone in three days, said
pharmacy assistant Sylwia Sznyk.
Don't Miss

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* Swine flu facts

Sznyk displayed a receipt from the chemist's suppliers that showed
three types of digital thermometers that were out of stock. The
pharmacy is now out of thermometers.

"One of the manufacturers, he said the next thermometers they will
have is in October, so now there is no chance to get them from this
particular supplier," she told CNN.

The supplier is also out of stock of three different types of anti-
bacterial gel, she said, even though the gel is ineffective against
viruses.

Central Pharmacy in Ashington, in northern England, is also out of
thermometers, pharmacist Nadeem Shah told CNN. He said he believes
most shops and pharmacies in the area are also out.

"There's no thermometers at all, which is worrying because it's just a
sign that it's going to impact on other supplies as well linked to
people generally not feeling well -- in particular paracetamol
(acetaminophen), ibuprofen, and other medications," Shah said.

The pharmacy was out of stock of anti-bacterial gels last month, but
manufacturers are making more so it's back on the shelf, he said.
However, it's being sold for nearly double the price, he said.

"They're pennies otherwise to buy, but very quickly some manufacturers
have got into the market of producing gels and their prices are quite
high," Shah said.

At their sister pharmacy in nearby Morpeth, any anti-bacterial
products at the checkout counter are "gone in a day, rather than in a
month," he said.

"Some of the gels don't do anything different to your soap at home,"
he said, emphasizing that good hygiene, good handwashing, and
disposable tissues are the best way to ward off viral infection.

"There's definitely some kind of misunderstanding -- people are
thinking that having those type of products will give them a bit more
confidence. But it's their choice, obviously."

Though Central Pharmacy does not normally sell surgical masks, they
considered stocking some when the virus broke out a few months ago,
Shah said. They decided against it so as not to stoke panic.

"It could be seen as a sign of endorsement rather than asking people
to get advice," he said. "It would just give a very visible panic
message."

Croydon Pharmacy, south of London, still has stocks of thermometers
despite higher demand, but it has run out of surgical masks, said
pharmacist Michael Hammond. He said the pharmacy has noticed a rise in
people asking questions and wanting information about swine flu.

"I think the reaction has been in response to what they've heard on
the news," Hammond said. "And even where it is not a true case of the
patient suffering, they still want more information. But I think
generally we've been able to give them what they need."

A branch of the Boots pharmacy chain in Fulham, southwest London, has
been out of thermometers for two weeks, said employee Wilson Le.
They're also running out of anti-bacterial gels; the store doesn't
stock surgical masks.

While it is not running out yet, one pharmacy in the eastern English
city of Norwich said it is noticing an increase in demand for masks,
thermometers, and anti-bacterial items.

"It's not completely a foregone situation where I can't get hold of
it, but it's becoming difficult," said the pharmacist, who asked not
to be identified because his pharmacy is one of the government's
distribution points for the antiviral medication Tamiflu, and he
didn't want to spark concern.

The pharmacist said he was doling out Tamiflu to 70 to 80 people a day
and described the lack of supplies as worrying.

"From a business point of view, yes, and from a clinical point of
view, yes, because I can't offer the services I need to," he said.
"And if people want reassurance from (the supplies), I'm not able to
reassure them."

The pharmacist complained that the paperwork he is required to fill
out for each patient takes him five minutes per person, giving him
less time to spend consulting with other customers.

"I wish somebody would have organized it a little bit better," the
pharmacist said.

Shah, of Central Pharmacy, said the run on supplies makes him worry
that they won't be available later in the year, when flu season kicks
in.

"Manufacturers would have made their plans for winter a while ago, but
if we're consuming these products early, in August and July, I don't
know if those manufacturing plans are in place yet," he said.

The government advises anyone suspected of having swine flu to send a
friend or relative -- a "flu friend" -- to their pharmacy to pick up
the medicine for them. But that advice isn't being followed by
everyone.

"Some patients come in directly rather than ask their friend to come,"
said Le, of Boots pharmacy in Fulham. He said one dispenser has come
down with swine flu after being infected by a sick customer.

Winter not mutation that made Flu deadly

There is no proof that the flu virus had mutated but it is certainly
winter in Argentina.

Similarly for Spanish Flu. It was more deadly in winter than in
Summer.

Similarly for the current swine flu. It is more deadly than Spanish
Flu in Summer of 1918 but because it is less deadly than the Winter
Spanish Flu, the idiots start concluding that Swine Flu is much milder
than Spanish Flu.

Please note that the higher fatality in Summer due to Swine Flu now is
despite advanced medical care and the availability of Tamilflu. There
was none in the Summer of 1918.

The only danger to Swine Flu are idiots who believe confidently that
Swine Flu is milder than common flu.

SARS was much more deadly and also very infective, infecting entire
hospitals in just a few days, and yet we managed to control it because
everyone treat it as deadly.

Swine Flu, despite having a much lower fatality rate, has killed many
more than SARS.

China has done the right way. Despite failing to stop the spread of
swine flu, it has managed to slow it down tremendously with its
aggressive quarantine procedures, despite condemnations from people
all over the world.

But China has been rewarded with ZERO fatality.

http://www.bloomberg.com/apps/news?pid=20601086&sid=aljo5vnxK3z8

Argentina Flu Death Mystery Sparks Probe for Virus Mutation
Share | Email | Print | A A A

By Eliana Raszewski and Jason Gale

July 24 (Bloomberg) -- Scientists wondering why swine flu has killed
more people in Argentina than almost any other nation are studying
whether a more dangerous mutant has emerged.

The Latin American country has reported more than 130 deaths from the
pandemic H1N1 flu virus since June. Analyses of specimens taken from
two severely ill patients showed subtle genetic differences in the
virus, the International Society for Infectious Diseases said in a
report via its ProMED-mail program yesterday.

Scientists from Columbia University and Argentina's National Institute
of Infectious Diseases now plan to decode the complete genomic
sequences of at least 150 virus samples over the next 10 days to gauge
the frequency of the changes and whether they are linked to more
severe illness. Major changes in the pandemic virus could erode the
effectiveness of vaccines being prepared to fight the scourge.

"We are cautious about the findings until we have more sequences,"
said Gustavo Palacios, assistant professor of clinical epidemiology at
Columbia University, who is participating in the study. The changes
already noted haven't previously been associated with greater
virulence, he said today in a telephone interview from New York.

Roche Holding AG's 454 Life Sciences unit, which makes genetic-
sequencing technology, is helping to decode viruses swabbed from
patients' noses and throats. The sequence data will be shared with
other scientists for broader analysis, according to ProMED.

U.S. Fatalities

The pandemic virus has infected at least 125,000 people globally,
killing about 800, the World Health Organization said. Only the U.S.,
with 263 deaths, has recorded more fatalities than Argentina. More
than 3,000 people have caught the bug in the country, with the biggest
surge in cases occurring in the first two weeks of July.

To cope, hospitals such as the Federico Abete, on the outskirts of the
capital, Buenos Aires, converted halls and waiting areas into
treatment rooms to double the number of beds to 200. At the peak, 120
swine flu patients were hospitalized at Federico Abete with a death
rate of four a day. It now has 90 patients confirmed or suspected to
have the virus.

"We could say that we are on a downward trend, but we may have a new
outbreak in August, when kids go back to school because this flu isn't
going to disappear," said Carlos Rubinstein, head of research at the
hospital, one of the major pandemic-treatment centers in the province
of Buenos Aires. "We see fewer patients sent from other hospitals and
fewer people coming in who are concerned they have swine flu."

Seasonal Strain

Rubinstein said he can't explain why so many cases in Argentina were
fatal. Nine of every 10 cases of flu in the country are caused by the
pandemic strain, Health Minister Juan Luis Manzur said on July 6.
Rubinstein said it's possible the virus circulating in Argentina
swapped some of its genes with a seasonal strain, spawning a new
variant.

Others blame the health system and the distraction of a mid-term
election on June 28, which saw the ruling coalition lose majority
control of congress and was followed by the resignation of former
health minister Graciela Ocana.

"We have a more dramatic situation than in other countries because
Argentina delayed taking measures before the mid-term elections," said
health economist Ariel Umpierrez, who heads a nongovernmental
organization called Medicos sin Banderas, or Doctors Without Flags,
which teaches poor people about hygiene and how to prevent and respond
to sickness. "We wasted a lot of time."

A spokeswoman for the Health Ministry in Buenos Aires didn't
immediately respond to a message left by Bloomberg seeking comment.

The Argentine government ordered companies to give 15 days paid leave
to pregnant women and people suffering diabetes and auto-immune
diseases. It also closed all public offices -- which led to banks and
financial markets not operating -- on Friday, July 10, creating a four-
day weekend that started with the July 9 national holiday.

To contact the reporters on this story: Eliana Raszewski in Buenos
Aires at eraszewski@bloomberg.net; Jason Gale in Singapore at
j.gale@bloomberg.net
Last Updated: July 24, 2009 12:41 EDT

Singapore will pay for treating Swine Flu as milder than Normal Flu

600 will die of flu and will continue to die but 20 times will die
from Swine Flu based on the 95% incidence of Swine Flu over normal
flu.

Compare this with China that has zero fatality despite having a
population 500 times larger than Singapore.

That is based on the assumption that Swine Flu is as lethal as normal
flu. Based on reports so far, Swine Flu is much more deadly. BAsed on
the age distribution, it appears to be more than 5 times deadly.

Even assuming that Swine Flu is only 2 times deadly, it will take the
death toll in Singapore to 24,000 i.e. 1% of the population of
Singapore which is what is shown in those nations that had been
affected with Argentina the worst at 1.4%.

The disparity is in the level of health care and effort to control the
spread of the disease.

China has zero fatality.

This is assuming that health care is sufficient for all patients. As
WHO experts had mentioned, it is only the beginning of the pandemic.
Later on, when health care is owerwhelmed, fatality will be much
higher.

The lady died because of incompetence of Singaporean Health Care
workers. She should have been diagnosed with Swine Flu in line with
WHO official recommendation instead of waiting for official Swine Flu
tests that are too slow and expensive.

If she were given Tamilflu earlier, she should have survived.
Japan is a lesson. Despite having failed to control the spread of
Swine flu as well as China, it has managed to have zero fatality as
well.

http://www.straitstimes.com/Breaking%2BNews/Singapore/Story/STIStory_407814.html

July 25, 2009
H1N1 FLU PANDEMIC
Fourth H1N1-related death
Woman had thyroid disease; two people with no risk factors critically
ill
By Jessica Jaganathan & Teh Joo Lin

The 42-year-old Chinese Singaporean woman died of pneumonia, with H1N1
as a contributing factor. -- ST PHOTO: SAMUEL HE

A FOURTH patient has died in Singapore after developing complications
from Influenza A (H1N1). The 42-year-old Chinese Singaporean woman
died of pneumonia, with H1N1 as a contributing factor, said the
Ministry of Health on Friday.

She went to Changi General Hospital's (CGH) emergency department last
Saturday after having had a fever, a cough, a sore throat and
shortness of breath for five days. She was moved to intensive care
that day but died on Friday morning. Earlier, the ministry had said
she had thyroid disease and hypertension, but it has since clarified
that she suffered only from the former.

At her wake in Sengkang last night, her husband said her thyroid
condition had been under control for two years, and she had not needed
medication. 'She was in fine health. That's why it is a total
surprise,' the man, who declined to be named, said.

Before she was warded last week, the woman, who had a 12-year-old son,
had seen doctors thrice in five days to treat flu-like symptoms,
including a fever. She went to a general practitioner's clinic on
July14. The next day, she sought a second opinion at another clinic.

Last Saturday, she visited the second clinic again. This time, the
doctor told her she might have a lung infection and advised her to go
to the hospital. She was nursing a fever of 38.6 deg C at the time,
said her 51-year-old brother-in-law, who drove her to CGH.

He said that sometime after 11pm that day, she was 'still conscious
and could still talk'. 'She could even pick up the phone to call her
husband and call us.' But just a few hours later, her situation
suddenly worsened. She was wheeled into intensive care the next day.

Singapore's four H1N1-related deaths have occurred within the space of
a week. The first came last Saturday, when a 49-year-old man who had
multiple health problems such as diabetes, hypertension and high
cholesterol died. On Wednesday, two others died - a 13-year-old boy
with epilepsy and a 55-year-old man with motor neuron disease.

When asked if these deaths in such a short span were cause for alarm,
the Health Ministry noted that 600 people a year die from seasonal flu
in Singapore.

Experience elsewhere has shown that fatalities will rise as more
people get infected, and Singaporeans should be mentally prepared to
see a similar pattern here, the ministry said. It added: 'Our best
chance to reduce the adverse effects of the pandemic is to continue to
be socially responsible to reduce the disease transmission and seek
early medical treatment if unwell.'

Meanwhile, two people in their 20s with no known risk factors have
fallen critically ill after testing positive for the virus. They are
the first seriously ill patients who do not fall into the high-risk
category of those with underlying illnesses, who are pregnant or who
have low immunity. Both are in intensive care, with low levels of
oxygen in their blood. Of the 94 H1NI patients now in hospital, five
are critically ill.

jessicaj@sph.com.sg

joolin@sph.com.sg

Confirmed: Swine flu more virulent than Common Flu

At least on animals. Swine flu effects on humans are very clear for
everyone to see for those honest enough to study based on facts,
instead on hunches or common cold, which is completely different from
flu, common or swine.

http://timesonline.typepad.com/science/2009/07/swine-flu-just-how-virulent-is-it.html
Swine flu: just how virulent is it?

Swine flu As two more UK deaths reported today --a 6-year-old girl and
a GP -- brought Britain's total toll to 17, it is becoming clearer and
clearer that it's wrong to see swine flu as a mild disease. Yes, it's
nowhere near as lethal as the Spanish Flu of1918-19, but that doesn't
mean it's OK to rush out and organise a swine flu party (not that
anyone necessarily is -- Martin Robbins has taken down the evidence
for that rather nicely). The H1N1 virus can be extremely nasty, and we
shouldn't be complacent about it.

Swine flu's pathogenic potential was illustrated two weeks ago in two
papers published by Science, which Ed Yong has summarised rather
nicely. Their verdict -- that animal models suggest swine flu is more
virulent than seasonal H1N1 strains -- has today been endorsed by a
more extensive piece of research by Yoshihiro Kawaoka and colleagues,
published by Nature and freely available online.

Kawaoka's study shows that the CA04 swine flu strain, isolated from a
patient in California, replicates more easily than H1N1 in the lungs
than seasonal H1N1 in ferrets, mice and macaque monkeys. It also
inflicts greater damage on the lungs, creating larger lesions and
penetrating as far as the alveoli. The scientists speculate that this:

"might contribute to a viral pneumonia characterised by diffuse
alveolar damage that contributes to hospitalisations and fatal cases
where no underlying health issues exist."

This is animal work, but the models, particularly ferrets and
macaques, are those that best mimic flu infections in people. The
message should be pretty obvious. It's misleading to think of this as
a mild pandemic -- it's mild only in comparison to 1918, and
complacency is dangerous.

That said, however, and without questioning the rigour of the Nature
study, it's important to be aware of a couple of caveats. Speaking
this afternoon to Wendy Barclay, Professor of Virology at Imperial
College, London, she pointed out two factors that mean swine flu might
not be quite as bad in the field as it looks in the animal-testing
laboratory.

First, there are the doses involved. Kawaoka et al infected their
animals with between 104 and 106 particles of virus. Professor Barclay
said that most people who become infected with swine flu are exposed
to the order of just 10 viral particles -- several orders of magnitude
fewer -- and this may explain why symptoms are not generally serious.
Healthy people's immune systems can fight the virus off, and while
they do fall ill, they don't require hospital treatment and they don't
die. These experiments may be more representative of what happens when
immunocompromised people, or those with other underlying health
problems, get sick with swine flu.

The second issue is the comparison that's involved. In Kawaoka's
paper, and in the two papers published in Science last month, swine
flu's effects were compared to those of a seasonal H1N1 virus. But,
Professor Barclay said, it's been acknowledged for a while that H1N1
seasonal flu doesn't generally cause severe infections. H3N2 flu is
the type that causes more serious seasonal cases, and no comparison
has yet been made between it and swine flu.

None of this means that swine flu isn't serious, and that it isn't
capable of causing serious illness and death. It is. But the fact that
it's had these worrying effects in animal studies is not necessarily a
cause for especially grave concern. It's not a mild illness, but
neither does it seem especially severe. Perhaps "moderate" is the best
term.

Not obesity but insufficient dose of antiviral

http://www.reuters.com/article/healthNews/idUSN1053710520090711?sp=true

I got the clue from the research done by the manufacturer of the drug
into investigating the true dose for obese people.

It occurred to my child so many times. Doctors love to prescribe based
on body weight but my child is small for his age, so he is given given
a small child's dose despite his age just because he is light.

This under dose will easily create virus and bacteria that is immune
to the antibiotics or antiviral because insufficient dose is
administered to kill all the antigens.

I kept on arguing that the antibiotics is effective because his fever
subside but the rate is so slow that the bacteria has time to mutate
and adjust to the antibiotics.

These new doctors tend to under dose because this was recommended by
the doctors. Not sure how he knows because it is not shown on the
bottle. My rule is simple. One day of fever, will require at least 3
days dosage. 3 day fever, will require 9 days' dosage.

Experienced doctors will prescribe more than this dose. I met one case
where he prescribed 3 weeks of a strong antibiotic, (because my son
suffer a slight recurrence in fever,) Augmentin, a wide ranging
antibiotic. In Singapore it is routine to get 2 weeks dose of
Ampicilin.

Swine Ebola

Pork lovers should read it. It may not be dangerous, but pigs, as they
are, will allow the mutation of Swine Ebola into versions that allow
easy human-human infection.

http://www.scientificamerican.com/article.cfm?id=swine-ebola-discovered

If Swine Flu Weren't Enough, Now There's Swine Ebola
Scientists report that domestic pigs harbor Reston ebolavirus, the
only Ebola species that has not caused disease in humans

By Brendan Borrell

EBOLA IN PIGS: A cook roasts a baby pig at the Lydia Lechon restaurant
in Quezon City, Philippines
HELLOCHRIS/FLICKR
e-mail print comment

Don't worry, it can't hurt you—yet.

Scientists have identified Reston ebolavirus—a member of the deadly
Ebola group of hemorrhagic viruses—in domestic swine from the
Philippines.

The virus, which looks like a piece of yarn with a slight bend, is the
only Ebola pathogen not known to cause disease in humans. Even so, the
U.S. Centers for Disease Control and Prevention in Atlanta considers
it a biosafety level 4 pathogen, reserved for the most dangerous and
exotic diseases.

Ebola and the closely related Marburg viruses are highly contagious,
causing vomiting, diarrhea and bleeding with death rates as high as 90
percent. These viruses, originally from Africa, are thought to be
caught from close contact with monkeys and apes, their primary hosts,
although they have also been isolated from bats that show no symptoms.

Indeed, Reston ebolavirus was first identified in 1989 in crab-eating
macaque monkeys that were shipped from the Philippines for research in
Reston, Va. Human caretakers developed an immune response to the
virus, but they never came down with any symptoms.

The latest outbreak of the Ebola family was discovered in July 2008 as
the Philippine Department of Agriculture was investigating "blue ear
disease" in pigs, a respiratory condition that causes their ears to
turn blue from lack of oxygen. Investigators sent tissue and blood
samples to Michael McIntosh at the U.S. Department of Agriculture's
Foreign Animal Disease Diagnostic Laboratory at the Plum Island Animal
Disease Center in Greenport, N.Y.

McIntosh says he was surprised to find that the tissue samples also
contained the Reston strain, which had not been previously identified
in swine. His team also confirmed pig-to-human Ebola transmission by
identifying six pig handlers, whose blood tested positive for
antibodies to the virus, although they showed no symptoms. Manila had
announced preliminary findings in January, and McIntosh's study is
published in this week's Science.

McIntosh says there are still a lot of unknowns, including how the
virus was transmitted to the pigs and whether they show any symptoms
independent of blue ear disease. He worries that the virus's passage
through pigs could allow it to mutate into something more harmful.
The research also raises the possibility that pigs could be infected
with lethal Ebola strains. "What is the level of risk? We really don't
know," he says, "The fact that it shows up in domestic pigs raises
that risk."

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."

Reference

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.

Confirmed: swine flu infect pig, pig to pig

That is why it is called Swine Flu. It originated from Pigs, it surely
will return from pig.

It may have 1/3 of pig virus, but pigs can also catch bird flu as
well, just as humans can, but only pigs can produce flu, which allows
human-human transmission. Birds can't.

The fear had been that bird flu will infect pigs, and pigs produce
versions that allow human-human transmissible bird-flu. Note that the
name does not change despite it being DEVELOPED in pigs.

In fact you can say that all flu are SWINE FLU, because only pigs
allow mutations into human-human transmissible form from other
animals, whether bats, (nipah and encephalitis) or birds, as the
current swine flu is. Fortunately Swine flu is only 1/3 bird flu.

http://www.google.com/hostednews/canadianpress/article/ALeqM5hn-iJkF7GXKpqEhf-IM6bxe53Lpw

Scientists warn of pig pandemic after swine flu moves from human to
hog

By Steve Rennie – 16 hours ago

OTTAWA — German scientists are warning of a pig pandemic after tests
suggested the swine flu can pass from humans to hogs and then infect a
whole herd.

A team of virologists at Germany's national animal health research lab
recently infected five pigs with the human strain of the H1N1 virus
and put the sick pigs in a room with three healthy pigs.

Within four days, all the pigs had the flu. All of them recovered.

A research paper to be published Friday in the Journal of General
Virology warns "the high transmissibility of the virus observed in
humans also applies to pigs."

That increasingly puts pigs at risk as the virus spreads among humans.

"It must be assumed that this virus will spread fast and efficiently
if introduced into swine farms, possibly establishing endemic
infections," the paper says.

"With the increasing numbers of human infections, a spillover of this
virus to pigs is becoming more likely."

There is no evidence pigs are passing the swine flu virus to humans,
or that eating pork products poses an infection risk.

Dr. Thomas Vahlenkamp, who headed the team of virologists at Germany's
Friedrich Loeffler Institute, said the tests show how susceptible pigs
are to the virus.

"We would not claim that the virus can easily be transmitted to pigs,"
he said.

"But at least if the pig is infected, it can transmit it quite easily
between pigs."

The Canadian Pork Council says fears of a pig pandemic are overblown
since the animals are kept away from people.

"It's not like ... some of the other animals or livestock that are
just out in a field," spokesman Gary Stordy said.

"Since they are in enclosed structures with ventilation, there's very
minimal contact with unauthorized (people) or the general public.
There's generally very limited access to a farm just because of bio-
security measures."

This is not the first time researchers have shown pigs can catch the
human strain of the H1N1 virus. British scientists ran similar tests
in May with the same results.

But it's believed the German scientists are the first to publish their
findings in a scientific journal.

The Germans also added a twist to their experiment by throwing five
chickens into the mix to see if the birds would catch the virus from
the sick pigs. But the fowls stayed fit.

Researchers then tried to directly infect the chickens with the virus,
to no avail.

"We don't know whether chicken in general cannot catch the infection,
but at least in our hands with this isolate from a German patient we
could not infect chicken," Vahlenkamp said in an email.

Canada is only one of two places where the pandemic virus has been
found in pigs. The other is Argentina.

In April, swine flu appeared in pigs on an Alberta farm. At first,
health officials thought a farmhand who had been to Mexico and fell
ill upon his return infected the pigs. But blood tests showed the
worker didn't infect the herd.

The farmer who owned the pigs later culled his entire herd when he
couldn't sell the animals.

Two workers at a Saskatchewan hog farm recently caught a brand new
virus, and a third is thought to have been sickened by the same thing.
All three have fully recovered.

Health officials say the new virus is not connected to the current
swine flu pandemic that has infected thousands of Canadians and been
linked to 37 deaths across the country.

The 10,000 to 15,000 hogs on the Saskatchewan farm are all reportedly
healthy.

That's sure to have drawn a sigh of relief from the farm owner since
it's common to see influenza in pigs, and human transmission to pigs
is known to occur.

The German scientists say experiments are underway to see whether
there are any vaccines available for pigs that might stop the spread
of the swine flu.

Copyright © 2009 The Canadian Press. All rights reserved.

Interesting flu case fatality rate paper

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19255

It may be flawed but it is accompanied by lots of facts and estimates.

The highest estimate is based on the assumption that swine flu is
equally virulent as common flu so data for common flu is used,
especially that collected by CDC.

The latest CDC data on common flu uses various models to estimate flu
fatality rates so for a population of 10 million in developed nations,
i.e. fully developed health care systems:

case fatality rates for common flu and therefore swine flu is
estimated to be 120-1800

Interesting estimate is that of New York. It predicted that swine flu
is much lower at 60 - 90.

The conclusion is simple. Either the CDC estimate for common flu is
just too high, or Swine flu deaths in New York is the real fatality
rate for common flu.

It would help if there were comparisons with normal flu deaths in
order to confirm the New York telephone survey data. Then we can
determine the range of errors in the telephone sample surveys and the
assumptions made.

One thing is certain though. The school closures and treatments with
respirators have helped reduce fatalities.

Let us hope that the swine flu figure is the correct one instead of
the CDC estimates for flu.

Malaysia, with a population of 30 millioin, will have fatalities
ranging from 180 to 270 with actions taken such as closing of schools,
using Tamilflu and respirators. That telephone survey data was also
made in early May, in Spring, which is only slightly worse than
Malaysia's hot summer. Fatalities in Malaysia will be even lower.

You can argue that it is much lower than deaths due to dengue, but the
question is what would happen if we don't close schools? Will we
approach the fatality of Mexico in the early days or Argentina
currently?

One thing is certain. Fatalities due to common flu is vastly
exaggerated by CDC estimates. Even when we closely monitor Swine flu
with almost exhaustive tests, we don't detect that much flu causing
deaths, over that of Swine flu.

Interest flu trend statistics from Google

http://www.google.org/flutrends/intl/en_us/

It is based on google searches for flu symptoms.

It tend to correlate with the trends of flu in USA.

The trend is indeed worrying.

There is no increase in the activity of flu symptoms and yet the
number of deaths and intensive care unit admissions, is much higher.

It shows that Swine flu has taken over common flu but is more deadly
or serious.

Unless we have figures to prove that current swine flu deaths are
similar to previous year's flu deaths at the same time.

Flu only kills 257 in USA in 2001

Why are they lying about these flu deaths???

These data may look old but this is the only data available and most
reliable. It took time for these data to be analysed and published.

Our common sense should tell us about the real deaths due to common
flu. In my whole life, I had never heard any flu deaths but
malnutritions, yes, although I have not seen these deaths personally.

The fact that there are a lot of deaths already due to swine flu shows
how dangerous Swine flu is compared to common flu.

The total data for flu and pneumonia deaths are 60,000 but for those
confirmed with flu is only 257. It shows that there were attempts to
separate these cases. Come on, it is easy to diagnose flu, compared to
just pneumonia, and flu doesn't kill, it is the pneumonia that kills
as a result of the flu.

You can interpret the data, as those killed by pneumonia but some are
induced by flu. Not 30,000 as claimed. Maybe someone just want to give
the average figure thinking that these pneumonia deaths were not
tested for flu, but flu symptoms are obvious.

Even in the current Swine flu deaths, only those that exhibit flu
symptoms were tested. Not all pneumonia deaths are tested for flu.
Maybe it is a good idea to start now. Maybe we can determine who have
flu or not. I doubt it will be many given the mild nature of common
flu.

http://www.thinktwice.com/flu_lie.htm

Read the above which refers to this data from CDC.

http://thinktwice.com/cdc_2001.pdf

National Vital Statistics Reports NVSS CDC
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Volume 52, Number 3 September 18, 2003
Deaths: Final Data for 2001
by Elizabeth Arias, Ph.D.; Robert N. Anderson, Ph.D.; Hsiang-Ching
Kung, Ph.D.;
Sherry L. Murphy, B.S.; Kenneth D. Kochanek, M.A.; Division ofVital
Statistics
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Table 10. Number of deaths from 113 selected causes by age: United
States, 2001 National Vital Statistics Reports, Vol. 52, No. 3,
September 18, 2003 Pages 30-33
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Cause of death (Based on the Tenth Revision, All Under 1-4 5-14 15-24
25-34 35-44 45-54 55-64 65-74 75-84 85 years Not
International Classification of Diseases, 1992) ages 1 year years
years years years years years years years years and over stated
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
All causes ................................................ 2,416,425
27,568 5,108 7,094 32,252 41,683 91,674 168,065 244,139 430,960
701,929 665,531 422
Influenza and pneumonia (J10-J18) ........ 62,034 299 112 92 181 339
983 1,801 2,704 6,650 18,677 30,191 5
Influenza (J10-J11) ............................ 257 7 6 12 7 10 6 15
21 21 56 96 -
Pneumonia (J12-J18) ............................ 61,777 292 106 80 174
329 977 1,786 2,683 6,629 18,621 30,095 5
Malnutrition (E40-E46) ........................... 3,454 2 - 2 9 13 39
99 146 347 1,025 1,772 -
Asthma (J45-J46) ..................................... 4,269 10 31 99
140 233 455 603 553 634 802 709 -
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Note: This is an abridged version of the complete table.