• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

novel A/H1N1 changes - symptom/outcome tracking

AlaskaDenise

AlaskaDenise

In Memoriam
While the researchers are monitoring the genetic sequences for changes, the first awareness of those changes may come from "boots on the ground", i.e., knowledgeable HCW, "flubies", or media reports - days or weeks before any sequence test can define & confirm any changes.

What symptoms/outcomes will the various highly-probably changes produce?
Compiling a list may prove useful.

---------------------------------------------------

PB2/627K (replication temperature switch):
- more agressive infections - fewer "mild cases"

NA/274Y or 294S - (anti-viral oseltamivir-tamilfu- resistance)
- no response to anti-viral therapy, with more serious infections & deaths

(for now, I won't list the high-path NS1 or poly-basic cleavage site, as hopefully they're less probable in the near future)

Are there any other specific symptom or outcome changes?

---------------------------------------------------------

Specific changes to watch for:

1 - non-response to anti-viral therapy.

2 - increase in % of cases with serious illness

3 - increase in expected death rates

others?

.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

I think a quicker progression to severe disease and death is worth watching...

This is from May 4th quoting Marc-Alain Widdowson, a medical epidemiologist from the U.S. Centers for Disease Control and Prevention

http://www.salon.com/wires/ap/scitech/2009/05/04/D97VNVAO0_med_swine_flu/print.html

""""We've seen in many of the cases in Mexico, there's been sometimes five to seven days of being mildly ill with increasing respiratory distress and then being hospitalized, and then spending five days or a week in hospital, so that's a timeline of two weeks," he said."""
 
Re: novel A/H1N1 changes - symptom/outcome tracking

AlaskaDenise said:
While the researchers are monitoring the genetic sequences for changes, the first awareness of those changes may come from "boots on the ground", i.e., knowledgeable HCW, "flubies", or media reports - days or weeks before any sequence test can define & confirm any changes.

What symptoms/outcomes will the various highly-probably changes produce?
Compiling a list may prove useful.

---------------------------------------------------

PB2/627K (replication temperature switch):
- more agressive infections - fewer "mild cases"

NA/274Y or 294S - (anti-viral oseltamivir-tamilfu- resistance)
- no response to anti-viral therapy, with more serious infections & deaths

(for now, I won't list the high-path NS1 or poly-basic cleavage site, as hopefully they're less probable in the near future)

Are there any other specific symptom or outcome changes?

---------------------------------------------------------

Specific changes to watch for:

1 - non-response to anti-viral therapy.

2 - increase in % of cases with serious illness

3 - increase in expected death rates

others?

.
Click to expand...
I did a quick look at PB2 sequences at GISAID which were not at Genbank and failed to find E627K. So far it is only in the one sequence from Shanghai/71T.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

AlaskaDenise said:
While the researchers are monitoring the genetic sequences for changes, the first awareness of those changes may come from "boots on the ground", i.e., knowledgeable HCW, "flubies", or media reports - days or weeks before any sequence test can define & confirm any changes.

What symptoms/outcomes will the various highly-probably changes produce?
Compiling a list may prove useful.

---------------------------------------------------

PB2/627K (replication temperature switch):
- more agressive infections - fewer "mild cases"

NA/274Y or 294S - (anti-viral oseltamivir-tamilfu- resistance)
- no response to anti-viral therapy, with more serious infections & deaths

(for now, I won't list the high-path NS1 or poly-basic cleavage site, as hopefully they're less probable in the near future)

Are there any other specific symptom or outcome changes?

---------------------------------------------------------

Specific changes to watch for:

1 - non-response to anti-viral therapy.

2 - increase in % of cases with serious illness

3 - increase in expected death rates

others?

.
Click to expand...
Death clusters. I am still suspicious of the two on Long Island (Brookhaven). Salt Lake city area also has 8 recent deaths.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

niman said:
Death clusters. I am still suspicious of the two on Long Island (Brookhaven). Salt Lake city area also has 8 recent deaths.
Click to expand...

Three in Waterbury, CT. Two of them last week I believe.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

(revised list)

What symptoms/outcomes will the various highly-probably changes produce?
Compiling a list may prove useful.

---------------------------------------------------

PB2/627K (replication temperature switch):
- more agressive infections - fewer "mild cases"

NA/274Y or 294S - (anti-viral oseltamivir-tamilfu- resistance)
- no response to anti-viral therapy, with more serious infections & deaths


(for now, I won't list the high-path NS1 or poly-basic cleavage site, as hopefully they're less probable in the near future)

Are there any other specific symptom or outcome changes?

---------------------------------------------------------

Specific changes/outcomes to watch for:

1 - non-response to anti-viral therapy (any or all)

2 - increase in % of cases with serious illness

3 - quicker progression to severe disease and death

4 - increase in death rates

5 - death clusters
Click to expand...
 
Re: novel A/H1N1 changes - symptom/outcome tracking

AlaskaDenise said:
5 - death clusters
Click to expand...

My money is on the above as the main indicator that will finally raise the red flag. You see a sudden grouping of deaths all with common infection chain - and absent some sort of genetic similarity/predisposition - that's where you're going to find your mutation.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

The Mountains Voice said:
My money is on the above as the main indicator that will finally raise the red flag. You see a sudden grouping of deaths all with common infection chain - and absent some sort of genetic similarity/predisposition - that's where you're going to find your mutation.
Click to expand...
Exactly right.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

The Mountains Voice said:
My money is on the above as the main indicator that will finally raise the red flag. You see a sudden grouping of deaths all with common infection chain - and absent some sort of genetic similarity/predisposition - that's where you're going to find your mutation.
Click to expand...

The question is which mutation will cause which symptom/outcome?

Some mutations could increase virulence, but not necessarily death. Those types might indicate a need for procedural changes - more PPE in health care settings, more school closures, more cleaning of public surfaces, more anti-viral distribution, etc.

Death clusters would indicate the need for rapid containment - strict quarantines, etc. The speed at which they are identified will directly relate to their success.

Boots on the ground reports might be the decisive factor - IF people are aware of the implications.

.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

The above has me convinced that death clusters will be the most obvious and verifiable epidemiologic clue. Unfortunately, some areas, like Florida, there is a lag of almost a week from death to confirmation of H1N1. The media will need to search for clusters of hospital deaths with or without the diagnosis.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

Thornton said:
.......... there is a lag of almost a week from death to confirmation of H1N1. The media will need to search for clusters of hospital deaths with or without the diagnosis.
Click to expand...

And they need to know exactly what all to look for!

.
 
Re: novel A/H1N1 changes - symptom/outcome tracking

Rev. #2...


Specific changes/outcomes to watch for:

1 - non-response to anti-viral therapy (one or more)

2 - increase in cases without underlying medical conditions

3 - more credible "leaks" from HCW that conflict with mild "official" statements

4 - increase in % of cases with serious illness

5 - quicker progression to severe disease and death

6 - increase in death rates

7 - death clusters
Click to expand...

.
 
Last edited:
Re: novel A/H1N1 changes - symptom/outcome tracking

I'm watching for the increasing incidence of public heath officials and physicians going 'off the reservation' and making statements about the reality on the ground - that contradict the 'talking points' of higher officials.

Biology will lead genetics.

Emergent Properties Regards,

Snick
 
Re: novel A/H1N1 changes - symptom/outcome tracking

Do we have a place to post the death clusters? Putting the State/Province at the top of each post for easier identification....One place....one thread?
 
Re: novel A/H1N1 changes - symptom/outcome tracking

Commonground said:
Do we have a place to post the death clusters? Putting the State/Province at the top of each post for easier identification....One place....one thread?
Click to expand...

Posting total deaths per state/province won't give us a "picture". They need to be located on a map for instant identification of close proximities - just like we've done for Indonesia (within a thead). Google would be nice, but who has the time to collect it all and do it throughout the day? Unfortunately, this time with death clusters, there will be no waiting to see IF it will go H2H. :( At that point, any mapping may be quickly overwhelmed - again.

Hopefully, any death clusters will be in the far future.

Given the Shanghai acquisition, increased infectivity and virulence cases may show up soon. That might be identified by hospital admissions numbers and anti-viral demand. Hospitals might postpone elective surgery and pharmacies will be out of antivirals. Given Mamabird's concern that this stage would overwhelm resources, ordinary people will be impacted fast enough to generate lots of red flag news reports. The news reporters need to be knowledgeable.

.
 
You must log in or register to reply here.
Back
Top Bottom