WHO warns of severe form of swine flu

[Treyfish]

Re: WHO warns of severe form of swine flu

2 very different statements.

[somebodyoutthere]

Re: WHO warns of severe form of swine flu

Those statements don't seem contradictory to me. The severe form has been reported from the beginning in Mexico, and it occurs in a small percentage of cases.

[Treyfish]

Re: WHO warns of severe form of swine flu

so then Malaysia is certain they don't have a severe srain that is goin straight to the lungs.. defining it as a seperate strain ...No cases of the new severe strain of the Influenza A(H1N1) have been reported in the country but the Health Ministry is taking no chances.

[Rwilmer]

Re: WHO warns of severe form of swine flu

Those statements don't seem contradictory to me. The severe form has been reported from the beginning in Mexico, and it occurs in a small percentage of cases.

Yes that is it. I have just reached this conclusion. We have been misinterpreting this statement and so has the media. That "new form" has been happening all along. It is just in a small number of people. We have interpreted this to mean a new varient of the virus. It should say "In this small number of patients, the virus directly infects the lung, causing severe respiratory failure." Because they say this in the article. "The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, also in young and healthy people, the number of such cases remains small."

[Mamabird]

Re: WHO warns of severe form of swine flu

The World health organization has some explaining to do then. They say this in the same article:

-Snip-
Close monitoring of viruses by a WHO network of laboratories shows that viruses from all outbreaks remain virtually identical. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.

Likewise, the clinical picture of pandemic influenza is largely consistent across all countries. The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, also in young and healthy people, the number of such cases remains small.
-Snip-

and then in the SAME article they say this:

-Snip-
Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.
-Snip-

They are saying two completely different extremes here.

http://www.who.int/csr/disease/swine.../en/index.html

The reports from clinicians since April have all been pretty much the same. As the virus hits, everyone is surprised at its affects on the population, and the tragedy of so many young people getting sick and some dieing. The story is the same in Sao Paulo (that claimed the virus had mutated), in Rio, in Argentina, Australia, etc.

And when the sequences roll in, they fall within three of five known variants that have been around since March (two of the variants have virtually disappeared). The virus has not changed in any material way. The story is consistent, and is repeated over and over again. And the total deaths attributed to the virus are surprising low. When you see the death count go through the roof, then you will know we have a rogue virus that has turned really ugly.

[Niko]

Re: WHO warns of severe form of swine flu

The World health organization has some explaining to do then. They say this in the same article:

-Snip-
Close monitoring of viruses by a WHO network of laboratories shows that viruses from all outbreaks remain virtually identical. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.

Likewise, the clinical picture of pandemic influenza is largely consistent across all countries. The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, also in young and healthy people, the number of such cases remains small.
-Snip-

and then in the SAME article they say this:

-Snip-
Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.
-Snip-

They are saying two completely different extremes here.

http://www.who.int/csr/disease/swine.../en/index.html

I don't see a contradiction. The first section is regarding "laboratory" studies of novel H1N1. The 2nd is about clinical observations when comparing novel flu with seasonal flu.

[Rwilmer]

Re: WHO warns of severe form of swine flu

I fugured out shortly after I posted that, I figured out that was not a contradiciton and now I understand what they meant.

[Niko]

Re: WHO warns of severe form of swine flu

Swine flu spreading at 'unbelievable' rate: WHO

(AFP) ? 1 day ago

PARIS ? Swine flu spreads four times faster than other viruses and 40 percent of the fatalities are young adults in good health, the world's top health official warned in an interview appearing Saturday.

"This virus travels at an unbelievable, almost unheard of speed," World Health Organisation Director General Margaret Chan told France's Le Monde daily in an interview.

"In six weeks it travels the same distance that other viruses take six months to cover," Chan said.

"Sixty percent of the deaths cover those who have underlying health problems," Chan said. "This means that 40 percent of the fatalities concern young adults -- in good health -- who die of a viral fever in five to seven days.

"This is the most worrying fact," she said, adding that "up to 30 percent of people in densely populated countries risked getting infected."

Chan's warning came a day after the WHO said the virus had overtaken others to become the most prevalent flu strain.

"Evidence from multiple outbreak sites demonstrates that the A(H1N1) pandemic virus has rapidly established itself and is now the dominant influenza strain in most parts of the world," the UN agency said in a statement.

"The pandemic will persist in the coming months as the virus continues to move through susceptible populations," it added.

Chan underlined that emergency and healthcare services in several countries had come under strain and stressed that resources allocated for cancer patients and those suffering from heart disease should not be diverted.

"One must not rob Peter to pay Paul," she said. "All governments must prepare for the worst."

She said the most important thing in the battle against the virus was "political leadership."

More than 2,180 people around the world have died from the virus since it emerged in April, according to the latest WHO figures.

Chan also said that it could be months before sufficient vaccine is available to combat the pandemic.

She put world production capacity at 900 million doses a year, for a global population of 6.8 billion people.

Even if this was an unprecedented effort, and authorities were speeding up procedures for getting vaccines to the market, there should be no question of compromises on their safety and effectiveness, Chan said.

Britain and France received their first batches of swine flu vaccine this week. Australia on Friday said a massive swine flu vaccination programme would start in October and Turkey hopes the first supplies of the vaccine will come by that time.

While 90 percent of severe and fatal cases occur in people aged above 65 in seasonal flu, most of those who die from swine flu are under the age of 50.

A "very severe form of disease" affecting the lungs and causing severe respiratory failure among young and healthy people was being reported, WHO said Friday, adding that highly specialised care was required.

Large numbers of such patients could therefore "overwhelm" intensive care units and disrupt the provision of care for other diseases, it warned.

In the southern hemisphere where the flu-prone winter season is tailing off, the WHO said cities in several countries had reported that nearly 15 percent of hospitalised cases required intensive care.

http://www.google.com/hostednews/afp/article/ALeqM5hYCBp4bPYUGtZwMUlvNaMJxSlOng

[Roehl_JC]

Re: WHO warns of severe form of swine flu

I agree. The H1N1/swine flu virus out there has got to be primarily the original h2h strain, and the samples sequenced must indicate little or no variance so far, but why don't WHO give any evidence to back up the "15%" figure they're saying are having the serious sudden severe respiratory symptoms? Probably it's only an attempt to prep the general public for what they anticipate to be a second strain (such as the ones we're hearing about that are Tamiflu-resistant?) .... gut feeling, the WHO is simply covering their ar**s by making certain that the general public understands that there are severe cases among otherwise healthy persons as well as those who are at increased risk due to pregnancy, asthma, & pre-existent conditions, so that later on, when a really severe wave develops, they can claim to have given due warning to one and all.
I think the current situation also bodes trouble, simply because as the sheer increase of numbers of those with the swine flu reaches a certain threshhold level even a low percentage of severe cases presenting to hospitals at the same time will have impacts on their abilities to handle them all.
So perhaps the real test to come will be when hospitals are congested and there are reports of more folks dying in waiting rooms and....all the while the virus will have an increasing chance of recombining with other avian and seasonal flu viruses, and let's all keep our fingers crossed that it doesn't mix with H5N1 or we could see a truly severe situation. Odds favor continued co-infections with other influenza viruses such as the H3N2 currently in Hong Kong as well, so I see this as a matter of when rather than if a more severe wave will occur.
In conclusion, if WHO with certainty KNOWS that there's a variant form of H1N1 out and about that's causing severe direct attacks on the lungs in upwards of 15% of persons, they need to let the public KNOW where these outbreaks are, whether it's a consequence of ethnicity, poverty, poor healthcare availability, or whether it's a consequence of a new perhaps Tamiflu-resistant, or has the ability to replicate itself in greater numbers in the upper nasopharyngeal tract so it easily can move quickly to the lower respiratory tract....otherwise we're all just left guessing. I'd say there's a combination of things going on here, and the sooner we hear from WHO officials as to WHY they've issued the statement, which some might see as 'alarmist' if there is no underlying changes....the sooner the better to get them to tell us.
But over the short term, if we all had a crystal ball, WHO's statement may be proven totally appropriate.

[Roehl_JC]

Re: WHO warns of severe form of swine flu

Margaret Chan's latest statement about the extremely rapid spread of H1N1 helps me understand the 15% figure they've trotted out a bit more. I think she's saying that among those few (less than 5% thus far) who are needing hospitalization, about 15% of that group are developing the severe ARDS complications....so that's still a low CFR overall, and that would support an analysis that the main concern of WHO right now is warning govs that a sheer rapid increase in cases would cause severe shortages and that the healthcare facilities in the Northern Hemisphere are likely to be sorely tested to breaking point in the coming weeks/months.

[Niko]

Re: WHO warns of severe form of swine flu

The original post in this thread contains excepts from Le Monde's interview with Margaret Chan. I couldn't find the actual interview here at FT, so here it is... (google translation French to English)

http://www.lemonde.fr/archives/article/2009/08/29/le-virus-h1n1-voyage-a-une-vitesse-incroyable_1233257_0.html

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"Le virus H1N1 voyage ? une vitesse incroyable"

"The H1N1 viruses travel at incredible speed"

LE MONDE | 29.08.09 | 14h52 ? Mis ? jour le 30.08.09 | 18h04

LE MONDE | 29.08.09 | 14h52 ? Updated 30.08.09 | 18h04


According to the overall published Friday, August 28th by the World Health Organization (WHO), influenza A (H1N1) has killed "at least 2 185 people. The number of people infected at that date amounted to at least 209 to 438, in over 177 countries. The H1N1 became the predominant flu virus worldwide. It supersedes that of seasonal influenza. <table style="float: left; clear: both; padding-right: 6px;" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td><center><script language="JavaScript">OAS_AD('Middle1');</script></center></td></tr></tbody></table>

On April 24, WHO issued a global alert, announcing that hundreds of cases of influenza were reported in Mexico and the United States.
On June 11, its director general, Dr Margaret Chan, said influenza A (H1N1) pandemic of the twenty-first ^century.

.

In an exclusive interview to Le Monde, she takes stock of the situation and explained the strategy of WHO.

The current pandemic defies our benchmarks. So far, the word was synonymous with millions of dead, which is far from being the case ...

This is the first time in history we see a pandemic evolve before our eyes. Formerly, the world was always taken by surprise, without having had time to discuss ways to tackle the disease. Since the emergence of a few years ago, the virus of avian influenza H5N1, which results in an extremely severe disease, with 50% to 60% of fatal cases, the health ministers have discussed with the WHO how to plan the preparation for the pandemic threat, with reference to the Spanish flu of 1918.
The 2009 virus A (H1N1) is totally different. It is new, and hardly anyone is immune against him. It spreads very easily, but does not cause severe disease in most people. These elements do not fit with the plans prepared, and require them to adapt. No wonder, then, that people wonder why the current pandemic does not match what they expected, and found that it actually much. But I do not agree with this view.

What threats posed by the pandemic now?

Firstly, the virus travels at a speed incredible, unprecedented. In six weeks, he traveled the same distance as other viruses in six months! The number of infected people is also unprecedented. Up to 30% of people in countries with high population density may be infected. Without preparedness plans, we would be unable to have an organized response. It is a kind of return on investment.

60% of deaths occur in people with poor underlying health. This means that 40% of deaths are in young adults - healthy - who die in five to seven days of viral pneumonia. This is perhaps the most worrying. Treating these patients is very heavy and difficult.

In many countries, emergency services and intensive care are extremely busy, or overloaded. In our world of 6.8 billion people, that will happen if the infection affects 20% to 30% of the population? What happens if the disease became more severe unless we're prepared? Many resources will be consumed at the expense of people affected by cancer, cardiovascular disease ...

Exactly, what do you say to those who fear that the fight against H1N1 to the detriment of the other cons deadliest diseases?

The question is legitimate. It is necessary to raise additional resources. Do not rob Peter to pay Paul. Any responsible government must prepare for the worst and hope for the best. He is accountable for how it protects its citizens. By definition, pandemic influenza are highly unpredictable. True, the disease is benign, and we hope it will remain when the second wave will arrive this fall. If not, how governments that have not done enough to prepare can they justify themselves to their public?

The race to the vaccine against influenza A (H1N1) has been launched. The first strain sent by WHO to manufacturers has yielded disappointing returns. Risk Is there a delay on the schedule?

We said it would take five to six months to develop the first batches of vaccine. For now, we're on schedule.

Will we have time and enough of these vaccines?

Not in the coming months. Before the implementation of the plan against the virus of the H5N1 avian influenza, the annual production capacity of influenza vaccines worldwide was 450 million doses, primarily in developed countries. It rose to 900 million doses. Even if this is not enough, this never happened in past pandemics.

What will it take to developing countries?

We have received pledges of donations totaling 150 million doses. We are continuing dialogue to increase this quantity, but also to negotiate the purchase of additional doses. But we must not lose sight of the non-pharmacological interventions: washing hands, staying home if one is sick ... I just returned from Uganda. I visited a village where the only communication medium is radio, where volunteers participate in health interventions. The village chief is the only one with a mobile phone. We must consider how to disseminate information via SMS.

Questions remain about the quality and safety of future vaccines against the H1N1 ...

The regulatory authorities accelerate the process leading to authorization of marketing, but only as regards administrative procedures. There is no question of compromising on safety and efficacy of vaccines. Clinical trials will give us answers about the possible side effects of these vaccines, but it must be clear: because of the limited number of people tested, extremely rare side effects are not always.The Guillain-Barre syndrome (a neurological complication possible) occurs at a frequency of one case per one million people vaccinated. We may therefore see.

Even with quality products, there are always side effects. That is why WHO has issued recommendations for health surveillance to ensure, once the vaccines used. But we must distinguish between the effects really related to the vaccine and those that coincide in time without cause and effect. If we find specific effects related to the vaccine, we will share, and governments will do the same. The media must play their role: to bring the most important information to public attention, and they must monitor our work.

What we need most in the fight against H1N1?

We need political leadership, good plans against the disease, proper coordination and smooth implementation. This is not the only health ministers. Some interventions have strong economic and social implications, such as school closures.

We must consider all aspects of the issue. Finally, support of public opinion is vital. The best investment for a government is "communication pandemic": identifying appropriate communication mechanisms in each country so that people receive information in a timely manner, and seamlessly.

Propos recueillis par Paul Benkimoun

Interview by Paul Benkimoun

Article paru dans l'?dition du 30.08.09

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[Treyfish]

Re: WHO warns of severe form of swine flu

WHO warns of severe form of swine flu
(Agencies)
Updated: 2009-08-31 09:12
2009-08-31 09:12:51.0WHO warns of severe form of swine flu</title><keyword>WHO,swine flu,warning

http://www.chinadaily.com.cn/life/20...nt_8636088.htm
Same story again, getting a lot of coverage. I also believe the chinese dr Zhong Nanshan is THE main man in China and therefore the WHO. Here are 2 recent stories mentioning him and H1N1 developements. http://www.flutrackers.com/forum/sho...d.php?t=123157
http://www.flutrackers.com/forum/sho...d.php?t=123001