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How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

tetano

Editor, Senior Moderator
I wonder if this wave should be considered truly unpredictable and if it was no possible to do more to alert many young victims of the risk linked to a new wave of H1N1 virus.
In my opinion the WHO statement of the end of the pandemic was too rushed and has led many people to underestimate the risks.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

August 2010

?We are now moving into the post-pandemic period, said WHO Director-General Margaret Chan on a conference call with reporters, citing the consensus of the organization?s Emergency Committee. ?The new H1N1 virus has largely run its course.?

That doesn?t mean the virus is gone, of course, just that it is expected to recede into the semi-anonymity of other circulating flu viruses. There may still be ?localized [H1N1] outbreaks of different magnitude,? Chan said, but out-of-season outbreaks are no longer being reported.


http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/index.html


The pandemic does not end with an official announcement, as well as we have seen in subsequent seasons until the last, with waves equal and sometimes higher than the initial one, not only "localized".

The reason why the WHO rushed to declare the end of the pandemic lies in the criticisms from many parts for a pandemic considered a false alarm and the pressure of many governments that did not want to create concern among the world's population who was facing a major and long lasting economic crisis.

In fact it was completely ignored the lesson of the previous pandemics, with the result that public awareness campaigns on the risks that fell on people in the middle of their life and health have not carried on.

People from different countries, many are listed in this forum, have paid with his life because someone who had responsibility for directing the public has decided to declare that the H1N1 virus " is expected to recede into the semi-anonymity of other circulating flu viruses".

I think that the WHO, the international health organizations and scientific societies should learn from the mistakes made so that they may be avoided in the future.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

pH1N1 is a nasty virus. I think that the powers that be expected it to ameliorate in severity after everyone was exposed, and at risk individuals got vaccinated. There is a lot to learn from this:- I suspect that multiple exposures are needed in those who do not have any innate immunity, and that each time there is an antigenic escape it will come back with a sting in its tail. The 1918 virus continued to cause major problems until at least 1933. There is no reason to suppose that this will be any different.

Mankind has been lulled into a false sense of security because our 'traditional' seasonal flu's have not been too severe for many decades.

pH1N1 is a reminder of what flu can do. Lets hope H7N9 does not complete its adaptation, because if it does, I expect it will cause problems for years in much the same way. It wont be a case of a single peak epidemic wave and then revert to a 'harmless' seasonal flu.

Lets hope that at least important lessons are being learned.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

pH1N1 is a nasty virus. I think that the powers that be expected it to ameliorate in severity after everyone was exposed, and at risk individuals got vaccinated. There is a lot to learn from this:- I suspect that multiple exposures are needed in those who do not have any innate immunity, and that each time there is an antigenic escape it will come back with a sting in its tail. The 1918 virus continued to cause major problems until at least 1933. There is no reason to suppose that this will be any different.

Mankind has been lulled into a false sense of security because our 'traditional' seasonal flu's have not been too severe for many decades.

pH1N1 is a reminder of what flu can do. Lets hope H7N9 does not complete its adaptation, because if it does, I expect it will cause problems for years in much the same way. It wont be a case of a single peak epidemic wave and then revert to a 'harmless' seasonal flu.

Lets hope that at least important lessons are being learned.

Risk Levels
and
Muted Warnings

We've been discussing the pH1N1 future risk level since 2009 with continual updates. The Warning System must have some mysterious, unknowable unknown, deleterious random mutation that prevents all communications from impacting citizens except the managed perceptions issued from the podiums of public health officials.

An entire framework placing concern ONLY with newly emergent strains is short-sighted. We've demonstrated for 5 years the genetic maturation of the pH1N1 strain from a 2009 virus that was only a "starter set" of human-infective genetics. The host-switching process was only beginning and transition markers from earlier human emergences were available as guides to researchers and policy makers.

Ah, but we forget that the mysterious deletion mutation must be at play also in the communication process TO the Influenza corporate research departments conveniently located at universities in your neighborhood.

Only very rarely have we found random mutation or a sloppy polymerase at work as pH1N1 has matured. What the reservoir has demonstrated is a careful march toward this s2013.

That march is based around a well-constructed Clade2: 188T platform now sound enough to accept constrained, high diversity crossing with quasi-species at key amino locations. Those ever-present quasi-species of avian polymorphisms continue to inform severe clinical outcomes and may be detected under proper examination.

An immunologically naive population is not the only factor in human suffering from Influenza. It's time for the medical and research infrastructure to accept that their 40 year old policies require an update. A virus is perfectly able to create High Intensity events at the start, the middle and the end of the reservoir's maturation cycle. pH1N1 was the perfect candidate for Post-Emergence surge, as we have predicted, and as the world is seeing today.

The avian-like pH1N1 virus appeared partially-formed, was blamed on swine though none were ever demonstrated, marched directly into wild diversity in humans, killed at astonishingly variant rates and then proceeded to carefully gather base genetics while today returning to the early High-CFR Upsilon subclade for "tried and true" accumulations.

Those facts would lead any thoughtful investigator to the conclusion that current models cannot explain today's surge of vaccinated, healthy young adults expiring by the dozens around the United States of America.

And pH1N1 has any number of flashfire scenarios waiting in the wings.

Time for the policy makers to put on a new hat . . . and start thinking.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

Pandemic has been completely off the radar of the US admin since 2009. The focus has been on passing the health care plan.

For instance, remember how we used to talk about the US stockpile of tamiflu? This has not been mentioned by anyone in the admin for years. It is probably all expired by now. It is my guess that the US is completely unprepared except for the new vaccine facility now located in the US and whatever is accidentally planned for in the broad terrorism category.

Does anyone know what is stored in those pandemic warehouses anymore? From 2006 - 8 years ago? Is that stuff still there?

No one has contacted me for 5 years about pandemic anything. 5 years.

All of the contacts I had are gone. And the admin has placed gate-keepers so the media has no direct access to any US officials.

So we are doing our own thing here. We are doing what we can.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

Pandemic has been completely off the radar of the US admin since 2009. The focus has been on passing the health care plan.

For instance, remember how we used to talk about the US stockpile of tamiflu? This has not been mentioned by anyone in the admin for years. It is probably all expired by now. It is my guess that the US is completely unprepared except for the new vaccine facility now located in the US and whatever is accidentally planned for in the broad terrorism category.

Does anyone know what is stored in those pandemic warehouses anymore? From 2006 - 8 years ago? Is that stuff still there?

No one has contacted me for 5 years about pandemic anything. 5 years.

All of the contacts I had are gone. And the admin has placed gate-keepers so the media has no direct access to any US officials.

So we are doing our own thing here. We are doing what we can.

Sounds like those gate-keepers are the Public Health Pandemic Plan and perhaps not a random mutation? Civil Affairs is now managing the situation.

Are none of your contacts any longer responding?
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

The gate keeper system was implemented a few years ago. Many journalists complained openly.

I have not tried to contact anyone but I know that Stephanie Marshall, who was the HHS pandemic media director, is gone. No one replaced her.

The former HHS media director is gone. I have no idea who is now in his place.

FT was dropped off the CDC/HHS media mailing list twice. About a year ago, after complaining publicly, the CDC put us back on the list.

From my viewpoint, it has all been about pushing the health care plan and since FT did not do that we were "out". We did not take a position on the plan: 1) Too politically charged, 2) Too complicated to understand all these years. So we stayed out of the debate. I feel we were punished for it by being cut off.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

Does anyone know what is stored in those pandemic warehouses anymore? From 2006 - 8 years ago? Is that stuff still there?

http://www.reuters.com/article/2013/11/22/us-glaxosmithkline-vaccine-pandemic-idUSBRE9AL14Q20131122
U.S. FDA approves GSK's bird flu vaccine for national stockpile
By Toni Clarke
Fri Nov 22, 2013 6:14pm EST
...
The approval comes amid some uncertainty over the safety of modern adjuvants such as the one used in GSK's bird flu vaccine.

However, there are no effective traditional vaccines against bird flu. Glaxo's super-charged product is the first to show it can confer protection in the event of a pandemic. European regulators have approved it under the brand name Pumarix.

Data shows that children in England who received a similar adjuvanted vaccine during the 2009-10 H1N1 swine flu epidemic had a 14-fold heightened risk of developing narcolepsy, a chronic and potentially debilitating sleep disorder that can cause hallucinations, daytime sleepiness and cataplexy, a form of muscle weakness precipitated by strong emotion.

I think NIH is investigating adjuvants further. (Hopefully)
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

A bride-to-be died from swine flu less than six weeks after an out-of-hours GP prescribed antibiotics, diagnosing her with a routine chest infection, an inquest has heard.

Joanne Oliver, 31, rang the out-of-hours service for medical advice after complaining of a severe cough, aches and pains and bouts of sickness.

The mother-of-one's condition was initially treated as urgent.

..


An inquest into her death heard the GP who treated Miss Oliver did not suspect she had swine flu because doctors had been given no direction to screen patients for a possible strain of the illness.

Five months prior to Miss Oliver's death on January, 17 2011, the World Health Organisation declared the notorious 2009 swine flu pandemic officially over.

But a week after her death, GPs were ordered to screen for the disease once more.



http://www.dailymail.co.uk/news/art...tml?ITO=1490&ns_mchannel=rss&ns_campaign=1490
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

PANDEMIC DEATHS IN THE WORLD AFTER THE FIRST SEASON

The following is a list only partial of deaths from influenza H1N1 in different areas of the world, based on data recorded in our forum. I invite other forum members or add or remove data if there are omissions or errors.
A part of the deaths reported here may be due to other influenza viruses. It is obviously incomplete and dependent on the surveillance systems in different countries. Only the deaths officially registered or reported by the press are considered, it is known that most of the deaths escape also the most advanced surveillance systems. During the first pandemic season in the USA 7 real dead to every death reported officially was calculated.
The purpose of my text is to testify to the impact of the pandemic in the years following the first pandemic year, proving that the pandemic virus do not exhaust its strength in a single season, as was declared by the WHO.
I would like to see from this Forum an appeal to international organizations and the main scientific societies to review the criteria that determine the beginning and the end of a pandemic, which should not take account of interests of a few individuals or states, but consider the message which is given to the population, in order to take the necessary measures to protect from the complications of the disease.
After the development of the flu season in South America during the spring and summer of 2013, a similar behavior was to be expected even in the countries of the northern hemisphere and a campaign aimed to the population should have been done in order to raise awareness so that the greatest number of people could be saved. In particular, those aged between 40 and 65 years, that are the target of the pandemic virus.
Unfortunately many people had no warning they were in danger from the recurrent wave of H1N1 flu.


New Zealand, in 2010 : 15 deaths, 700 hospitalized with pandemic influenza

http://www.flutrackers.com/forum/sho...d.php?t=158858


2010-11 northern emisphere


UK : 602 confirmed fatalities

http://www.flutrackers.com/forum/sho...d.php?t=156569

over 1700 cases of hospitalised severe acute respiratory infections (SARI) as of week 2 reported to ECDC from eight countries (Austria, Belgium, France, Ireland, Portugal, Romania, Slovakia and Spain).

http://www.ecdc.europa.eu/en/publica..._2010-2011.pdf

Greece : 179 victims of the flu and 368 people in ICU

http://www.flutrackers.com/forum/sho...d.php?t=161141

Poland: 141 total fatalities reported

http://www.flutrackers.com/forum/sho...d.php?t=159410

France: 127 fatalities

http://www.flutrackers.com/forum/sho...d.php?t=157429

Netherland : 654 hospitalizations, 38 deaths

http://www.flutrackers.com/forum/sho...d.php?t=157585

Spain: 1,409 hospitalized and 165 deaths due to influenza

http://www.flutrackers.com/forum/sho...d.php?t=158397

Portugal: 40 deaths

http://www.flutrackers.com/forum/sho...d.php?t=163524

Hungary: 88 deaths from flu

http://www.flutrackers.com/forum/sho...d.php?t=166829

Czech Republic: A H1N1 death toll reaches 101

http://www.flutrackers.com/forum/sho...d.php?t=141357

Denmark: Flu has claimed 22 lives

http://www.flutrackers.com/forum/sho...d.php?t=162911

Latvia: 15 fatalities confirmed

http://www.flutrackers.com/forum/sho...d.php?t=160435

Lithuania: 21 people died from influenza

http://www.flutrackers.com/forum/sho...d.php?t=164251

Georgia: 49 deaths

http://www.flutrackers.com/forum/sho...d.php?t=165696


Mexico: 235 deaths by influenza A H1N1

http://www.flutrackers.com/forum/sho...d.php?t=176623

India deaths from 10/06 to 10/12:

Maharashtra 474

http://www.flutrackers.com/forum/sho...d.php?t=124573

Karnataka 94

http://www.flutrackers.com/forum/sho...d.php?t=124422

Rajastan 109

http://www.flutrackers.com/forum/sho...d.php?t=129297

Gujarat 182

http://www.flutrackers.com/forum/sho...d.php?t=124613

Thailand : 112 deaths

http://www.flutrackers.com/forum/sho...d.php?t=157799



2011 southern emisphere

Venezuela: 15 dead, 77 ARI hospitalized

http://www.flutrackers.com/forum/sho...d.php?t=165183

Uruguay: 147 cases and 16 deaths

http://www.flutrackers.com/forum/sho...d.php?t=172440




Northern emisphere 2011-12

India 2012: 405 fatalities

http://www.flutrackers.com/forum/sho...d.php?t=184782


Southern emisphere 2012

Brazil: 348 deaths for flu H1N1

http://www.flutrackers.com/forum/sho...d.php?t=191173

Paraguay: 97 deaths for influenza

http://www.flutrackers.com/forum/sho...d.php?t=189938

Northern Emisphere 2012-13

Czech Republic: 532 ICU cases and 124 deaths

http://www.flutrackers.com/forum/sho...d.php?t=197807

Poland: 120 fatalities

http://www.flutrackers.com/forum/sho...d.php?t=193822

France: 506 in ICU and 67 deaths

http://www.flutrackers.com/forum/sho...d.php?t=194912

Sweden: 16 deaths from influenza H1N1

https://flutrackers.com/forum/forum...a/141175-sweden-16-deaths-from-influenza-h1n1



India 2013: 708 deaths

http://www.flutrackers.com/forum/sho...d.php?t=199861





Southern Emisphere 2013

Argentina 46 deaths from flu A at 31-07-2013, more deaths registered later

http://espanol.cri.cn/782/2013/07/31/1s285416.htm

Brazil: 595 deaths , Sao Paulo 354

http://www.flutrackers.com/forum/sho...d.php?t=205020

http://www.flutrackers.com/forum/sho...d.php?t=204899

Chile: 33 deaths

http://www.flutrackers.com/forum/sho...d.php?t=208412

Ecuador: 23 deaths

http://www.flutrackers.com/forum/sho...d.php?t=210393

Peru: 114 deaths

http://www.flutrackers.com/forum/sho...d.php?t=208880

Venezuela: 88 deaths, with much controversy

http://www.flutrackers.com/forum/sho...d.php?t=211630

http://www.flutrackers.com/forum/sho...d.php?t=206650

Costa Rica: 28 deaths

http://www.flutrackers.com/forum/sho...d.php?t=208820

Dominican Republic: 12 deaths

http://www.flutrackers.com/forum/sho...d.php?t=206993

Puerto Rico: 16 deaths

http://www.flutrackers.com/forum/sho...d.php?t=210170

Northern Emisphere 2013-14

Canada: 215 deaths

http://www.phac-aspc.gc.ca/influenza/flu-stat-eng.php

USA: unofficial count of 1347 deaths at week 5

http://www.flutrackers.com/forum/sho...d.php?t=216453

Mexico: 704 deaths

http://www.flutrackers.com/forum/sho...d.php?t=217471

Greece: 111 deaths, 287 in ICU at March, 26th

http://www.flutrackers.com/forum/sho...d.php?t=217957

Spain: 266 deaths, 2332 severe cases hospitalized

http://www.flutrackers.com/forum/sho...d.php?t=216689

Portugal: 113 in ICU, deaths ?

http://www.insa.pt/sites/INSA/Portug...nts/Gripe2.pdf

Egypt: 81 deaths

http://www.flutrackers.com/forum/sho...d.php?t=218422
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

My letter to Harvey Fineberg:

Dear Dr Fineberg,

My name is Stefano Prandoni and I am an italian pediatrician. I am interested in topics related to influenza, pandemic and preparedness. I greatly appeciated your last article published in the NEJM and your work at the head of the Committee of Experts appointed to review the last pandemic.
I am a member of the international Flutrackers forum, where in cooperation
with many other voluntary members keep track of influenza and other
potentially dangerous diseases in the world.
Much controversy has raised the topic of criteria which should determine the conditions for proclaiming the start of a pandemic, but this is not what I want to talk about.
On the forum I started a thread about the end of the pandemic and the
excessive haste with which the WHO said that the pandemic was over in August 2010 ( http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/).
In reality the lesson of the previous pandemics, such as that of 1957, was
forgotten and in different countries of the world, not only in restricted
areas, recurrent waves of H1N1 outbreak were recorded provoking a number not insignificant of severe hospitalized cases and deaths.
In the last season there were serious epidemics in North America and some
European countries. Since a similar trend was seen in the South America
countries during the spring and summer of 2013 ( especially Brazil, Venezuela, Peru) it would not have been difficult to foresee that this could happen even in the countries of the northern hemisphere. A campaign aimed to the population should have been done in order to raise awareness, so that at least a part of the complications and fatalities could be avoided, especially in people aged between 40 and 65 years, that is the target of the pandemic virus.
The thread that I started on the international forum is entitled "how many
people had no warning they were in danger from the recurrent wave of H1N1 flu" and you can read it at this web address:

http://www.flutrackers.com/forum/showthread.php?t=216540

I think that the criteria that determine when to declare the end of a
pandemic should be reviewed becouse the interest of the whole population, not of political and economical groups, should be the focus of the international health decisions and statements aimed at saving the greatest number of human lives.
A clearer message by WHO should be that the emergency phase is over (with its need to strengthen surveillance systems and to stockpile drugs and vaccines) not the pandemic and its burden on population.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

Dear Dr. Prandoni,

Thank you very much for your message and information about the flutrackers forum thread that you initiated on the declared "end" of a pandemic. You highlight a good point about the ongoing, annual burden of influenza.

With best wishes,

Harvey

Harvey V. Fineberg, M.D., Ph.D.
President, Institute of Medicine
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

Thank you Dr. Prandoni and Dr. Fineberg.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

I sent a similar letter to Michael T. Osterholm:

Dear Dr. Osterholm

My name is Stefano Prandoni. I am an italian pediatrician and a member of the Flutrackers forum.

I write to you because I know and greatly appreciate the interest on your part and of the Institute of which you are the director on topics related to influenza , pandemic and preparedness.

On the forum I started a thread about the end of the pandemic and the excessive haste with which the WHO said that the pandemic was over in August 2010:



http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/


In reality the lesson of the previous pandemics, such as that of 1957, was forgotten: it may take as many as 4 or 5 years for a recently emerging virus to assume the characteristics typical of a seasonal virus ( Mark A. Miller, Cecile Viboud, Marta Balinska, and Lone Simonsen. The Signature Features of Influenza Pandemics — Implications for Policy. N Engl J Med 2009; 360:2595-2598). In different countries of the world, not only in restricted areas, recurrent waves of H1N1 outbreak were recorded provoking a number not insignificant of severe hospitalized cases and deaths.
In the last season there were serious epidemics in North America and some European countries. Since a similar trend was seen in South America countries during the spring and summer of 2013 ( especially in Brazil, Venezuela, Peru) it would not have been difficult to foresee that this could happen even in the countries of the northern hemisphere. A campaign aimed to the population should have been done in order to raise awareness, so that at least a part of the complications and fatalities could be avoided, especially in people aged between 40 and 65 years, that is the target of the pandemic virus.
The thread is entitled "how many people had no warning they were in danger from the recurrent wave of H1N1 flu" and you can read it at this web address:

http://www.flutrackers.com/forum/showthread.php?t=216540

I think that the criteria that determine when to declare the end of a pandemic should be reviewed becouse the interest of the whole population, not of political and economical groups, should be the focus of the international health decisions and statements aimed at saving the greatest number of human lives.
A clearer message by WHO should have been be that the emergency phase was over (along with the need to strengthen surveillance systems and to stockpile drugs and vaccines) not the pandemic and its burden on population.

I would like to know your opinion.
 
Re: How many people had no warning they were in danger from the recurrent wave of H1N1 flu?

Unfortunately Dr. Osterholm did not respond to my email. It's a pity because it would have been interesting to know his opinion on a issue of such importance
 
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