The Discovery of the 2009 A/H1N1 Pandemic - Mexico: April 17 New Respiratory Illnesses - Including Mexico City & Oaxaca

[sharon sanders]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

per PAHO -


"...Acute respiratory diseases: The cumulative incidence of pneumonia and influenza was 184 per 100,000, 1997-2000. Registered mortality from respiratory diseases, including pneumonia and influenza was 43 cases per 100,000, 1999...."


http://www.paho.org/English/DD/AIS/cp_484.htm

 

[terrafirma]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

We are very alarmed, and have had alerts issued by our Ministry of health regarding a respiratory outbreak in mexico, describing several deaths, many in previously healthy young adults, and health care workers affected. We are including Mexico in our Febrile Respiratory illness screening of all pts in ER and admissions.
Why hasn't this hit the Major news yet?????????????

http://www.countyweeklynews.ca/ArticleDisplay.aspx?e=1502177

ONTARIO, CANADA
Cornwall Crown Attorney contracted unknown illness on Mexico trip


Simard on life support, family member says

Posted By David Nesseth and Michael Peeling, The Cornwall Standard Freeholder

CORNWALL ? Acting city Crown Attorney Guy D. Simard, 47, is in a coma after he contracted an unknown illness during a recent trip to Mexico, a family member said.

Simard is in Ottawa General Hospital, where he admitted himself after gradually feeling worse since he returned from the trip on March 22.

?We don?t know, the hospital doesn?t know (what he contracted),? said Lise Lavictoire, Simard?s aunt.

Lavictoire confirmed that Simard is on a respirator and awaiting a blood transfusion.

?They?re doing other tests today,? she added. ?They said he?s very strong, so they have hope.?

Simard is surrounded by family at the hospital, she said, including his mother, wife and son.

Murray MacDonald, director of prosecutors for eastern Ontario, said he will be monitoring Simard's health before deciding on a course of action about his duties.

Simard, a graduate of the University of Ottawa, took on the position of Acting Crown Attorney in January after MacDonald, Cornwall?s former Crown Attorney, took on a contract position in Ottawa.

"He is very ill right now," said a colleague of Simard at the Ministry of the Attorney General. "We're hoping he can pull through this illness."

Article ID# 1502177

 

[sharon sanders]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Welcome Terrafirma!

Do you think that Canada is extra cautionary due to the SARS episode?

 

[HenryN]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

We are very alarmed, and have had alerts issued by our Ministry of health regarding a respiratory outbreak in mexico, describing several deaths, many in previously healthy young adults, and health care workers affected. We are including Mexico in our Febrile Respiratory illness screening of all pts in ER and admissions.
Why hasn't this hit the Major news yet?????????????

http://www.countyweeklynews.ca/ArticleDisplay.aspx?e=1502177

ONTARIO, CANADA
Cornwall Crown Attorney contracted unknown illness on Mexico trip


Simard on life support, family member says

Posted By David Nesseth and Michael Peeling, The Cornwall Standard Freeholder

CORNWALL ? Acting city Crown Attorney Guy D. Simard, 47, is in a coma after he contracted an unknown illness during a recent trip to Mexico, a family member said.

Simard is in Ottawa General Hospital, where he admitted himself after gradually feeling worse since he returned from the trip on March 22.

?We don?t know, the hospital doesn?t know (what he contracted),? said Lise Lavictoire, Simard?s aunt.

Lavictoire confirmed that Simard is on a respirator and awaiting a blood transfusion.

?They?re doing other tests today,? she added. ?They said he?s very strong, so they have hope.?

Simard is surrounded by family at the hospital, she said, including his mother, wife and son.

Murray MacDonald, director of prosecutors for eastern Ontario, said he will be monitoring Simard's health before deciding on a course of action about his duties.

Simard, a graduate of the University of Ottawa, took on the position of Acting Crown Attorney in January after MacDonald, Cornwall?s former Crown Attorney, took on a contract position in Ottawa.

"He is very ill right now," said a colleague of Simard at the Ministry of the Attorney General. "We're hoping he can pull through this illness."

Article ID# 1502177

Crown attorney Simard's condition improving



Posted By MICHAEL PEELING

Posted 15 days ago

<table style=""> <tbody><tr> <td style="width: 521px;">
</td> <td style="vertical-align: top;">
</td> </tr> </tbody></table>

Crown attorney Guy Simard is making a strong recovery from a life-threatening illness.
Simard was the area's head legal prosecutor for only a few months when a serious respiratory infection that turned into pneumonia sent him to the hospital in his home of Hawkesbury two weeks ago.
His condition took a turn for the worse after spending the night in the hospital, prompting doctors to have him airlifted to an Ottawa hospital.
Simard is still in the intensive care unit, but his colleague Murray MacDonald, director of prosecutors for Eastern Ontario, said his successor as Cornwall Crown attorney is expected to be moved out of the ICU any day now.
"He is awake and anxious to get back on his feet," MacDonald said. "He wants to extend his deep appreciation for the words and letters of support he has received from friends and family."
MacDonald said Simard won't be returning to work anytime soon as he needs time to recover.
There are currently measures in place to cover for Simard's absence, but MacDonald will be naming an acting Crown attorney for the Cornwall office later this week.


http://www.standard-freeholder.com/ArticleDisplay.aspx?e=1514728

 

[terrafirma]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Certainly that's where the turning point was, but I don't believe we are doing anything other than what is prudent and safe. (We routinely perform Febrile Respiratory illness screening on all ER and admitted patients, and have just added Mexico to the list of travel "hot zones"). Apparantly our Government has been notified by the Mexican authorities of the situation. Here is part of the MEMO issued:

" THE MOHLTC and the "OAHPP were contacted April 20 by the PHAC (Public Health Agency Canada) regarding a number of sever respiratory illness (SRI) cases occurring in various locations of south and central mexico. The cases in Mexico presented with influenza-like symptoms that rapidly progressed to severe respiratory distress in about 5 days, with many requiring mechanical ventilation. Some patients have died. most cases have occurred in previously healthy young adults aged between 25-44 years old. Some health care workers have been affected.. Some specimens have teste d positive for influenza A and B viruses; however it is not clear at this stage whether these cases represent isolated events or whether they are linked. Furthermore, there is no evidence at present to suggest infection with an unusual pathogen, including a novel strain of influenza.
Recommended Actions for Ontario Health Care Providers:
- given the severity of cases, it is prudent for front line providers to actively look for cases of SRI, particularly in persons recently returned (within 2 weeks) from Mexico, and report information to your local Medical officer of Health". ...

 

[terrafirma]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0421a1.htm

Swine Flu (H1N1) Infection in Two Children Southern California March - April, 2009
... unique combination of gene segments that previously has not been reported among swine or human influenza viruses...

 

[sharon sanders]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Certainly that's where the turning point was, but I don't believe we are doing anything other than what is prudent and safe. (We routinely perform Febrile Respiratory illness screening on all ER and admitted patients, and have just added Mexico to the list of travel "hot zones"). Apparantly our Government has been notified by the Mexican authorities of the situation. Here is part of the MEMO issued:

" THE MOHLTC and the "OAHPP were contacted April 20 by the PHAC (Public Health Agency Canada) regarding a number of sever respiratory illness (SRI) cases occurring in various locations of south and central mexico. The cases in Mexico presented with influenza-like symptoms that rapidly progressed to severe respiratory distress in about 5 days, with many requiring mechanical ventilation. Some patients have died. most cases have occurred in previously healthy young adults aged between 25-44 years old. Some health care workers have been affected.. Some specimens have teste d positive for influenza A and B viruses; however it is not clear at this stage whether these cases represent isolated events or whether they are linked. Furthermore, there is no evidence at present to suggest infection with an unusual pathogen, including a novel strain of influenza.
Recommended Actions for Ontario Health Care Providers:
- given the severity of cases, it is prudent for front line providers to actively look for cases of SRI, particularly in persons recently returned (within 2 weeks) from Mexico, and report information to your local Medical officer of Health". ...

Thank you for this. As a public health site we are very cautionary and appreciate the attention given to this by Canada Public Health.


http://www.phac-aspc.gc.ca/index-eng.php

 

[sharon sanders]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0421a1.htm

Swine Flu (H1N1) Infection in Two Children Southern California March - April, 2009
... unique combination of gene segments that previously has not been reported among swine or human influenza viruses...

Link to thread about Swine Flu in Southern California on FluTrackers -

http://www.flutrackers.com/forum/showthread.php?t=99824

 

[HenryN]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

C Some specimens have teste d positive for influenza A and B viruses; however it is not clear at this stage whether these cases represent isolated events or whether they are linked. Furthermore, there is no evidence at present to suggest infection with an unusual pathogen, including a novel strain of influenza.

At this point, the nature of the lack of evidence for a novel strain of influenza is remains unclear. If it just means that there is no evidence for H5N1, then something related to the H1N1 swine flu in southern California is a possibility. If it means that the associated flu was seasonal flu (B, H1N1, or H3N2) then swine flu is unlikely because it does not sub-type as seasonal flu (unless the samples are a mixture of seasonal and swine flu, which of course would be a VERY bad combination).

Any details on the "lack of evidence"?

 

[terrafirma]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Sorry, nothing further to offer!

 

[HenryN]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0421a1.htm

Swine Flu (H1N1) Infection in Two Children Southern California March - April, 2009
... unique combination of gene segments that previously has not been reported among swine or human influenza viruses...

Just to clarify the above statement, all sequences released at GISAID (HA, NA, M) are clearly swine H1N1. The "unique combination" is in reference to the fact that NA and M are Eurasian swine sequences, while HA (and sequence of other gene segments which have not been released) is North American swine.

Thus, the isolates from southern California have 8 swine gene segments, but the combination of swine genes from North America and Europe is unique and has never been reported previously (in humans or swine).

 

[Shiloh]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Source: http://www.cbc.ca/health/story/2009/04/23/respiratory-illness-flu-mexico.html

Canadians returning from Mexico urged to be on alert for flu-like symptoms
20 die from severe respiratory illness in Mexico
Last Updated: Thursday, April 23, 2009 | 9:30 AM ET
CBC News

Canadians who have recently returned from Mexico should be on alert for flu-like symptoms that could be connected to a severe respiratory illness, according to an advisory sent to health services across Canada.

The Public Health Agency of Canada contacted health and quarantine services on April 17 to inform them that Mexican health authorities had advised Canada to be on alert for possible infections.

A severe respiratory illness appears to have infected hundreds in south and central areas of Mexico, according to Mexican health officials.

The illness has killed at least 20 people in Mexico, mostly men between the ages of 25 and 44, according to a public advisory sent out by Canadian health authorities.

Hundreds of people have also reportedly been hospitalized and health-care workers have also been infected.

Officials said there are not yet any reports of the illness outside of Mexico.

The cause of the illness has not been confirmed. Mexican health officials said samples so far have tested positive for influenza A and B.

People infected with the virus initially suffer flu-like symptoms that include fever, cough, sore throat, muscle and joint pain and shortness of breath. The illness then elevates to a severe respiratory illness within about five days.

Anyone who has returned from Mexico within the last two weeks and is suffering similar symptoms is being asked to contact a physician.

Mexican health authorities said that many of those diagnosed with the illness have had to be put on ventilators.

 

[jasonfoster]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

In post #112 it mentions it is sensitive to Tamiflu. If this source is to be believed, is there any sense in listing the possible flu strains still sensitive to Tamiflu in that area?

 

[Blue]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Do we know what part of Mexico that Acting city Crown Attorney Guy D. Simard had travelled to? I do not see that information listed anywhere in the media. I am sure that the health authorities did ask.

Also, are they testing his contacts? No symptoms in family members?

 

[tropical]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

#132:
"influenza-like symptoms that rapidly progressed to severe respiratory distress in about 5 days, with many requiring mechanical ventilation"


The researchers knows better, but seems to me that ordinary seasonal flu could not do that.

This is more like to the China/Russia/... recent strange outbreaks.

The ressembling of SARS or BF "one week to mechanical ventilation" shape seems to point to an serious agent.

 

[Laidback Al]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

And one more.

http://www.eluniversal.com.mx/nacion/167414.html

The Ministry of Health issued a national alert, the infuenza recorded 20 deaths in the first three weeks of April, which is considered atypical or unusual.
. . .

En constraste, en seis meses, de octubre del 2008 a marzo de 2009, fallecieron sólo 30 personas por influenza, según cifras de la dependencia. By contrast, in six months, from October 2008 to March 2009, only 30 people died from influenza, according to the agency. . .

From the above post-
<o> </o>
Average number of deaths per week October 2008 to March 2009: 1+
<o> </o>
Average number of deaths per week since April 1, 2009: 6+

Keep in mind that the mention of SARS here is a mistranslation of atypical pneumonia.

http://www.exonline.com.mx/diario/n.../influenza_atipica_mata_a_10_en_un_dia/578187

Atypical influenza kills 10 in one day

. . . .Yesterday, only in the Instituto Mexicano del Seguro Social (IMSS) ten people died from SARS presumably caused by seasonal influenza virus, and six deaths were recorded in the Federal District.

If 10 people died in Mexico yestersday (6 in the Federal District), the death rate is increasing. Futher immediate official clarification of the number of deaths, number infections, locations of infections, and results of testing are critical.

 

[jasonfoster]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

#132:
"influenza-like symptoms that rapidly progressed to severe respiratory distress in about 5 days, with many requiring mechanical ventilation"


The researchers knows better, but seems to me that ordinary seasonal flu could not do that.

This is more like to the China/Russia/... recent strange outbreaks.

The ressembling of SARS or BF "one week to mechanical ventilation" shape seems to point to an serious agent.

I have no doubt this is not seasonal flu.

What I was getting at is that as far as I know, most seasonal flu is not sensitive to Tamiflu. H5N1 has more resistance at this time. Some initial tests suggest influenza A involvement but it hasn't been typed yet indicating that it is a novel strain (if flu). If the strain has come from H1N1 seasonal flu, wouldn't you have thought that it would be Tamiflu resistant? That was the reason for the question.

If it is not resistant to Tamiflu, it "might" have evolved from H5N1.

 

[HenryN]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

I have no doubt this is not seasonal flu.

What I was getting at is that as far as I know, most seasonal flu is not sensitive to Tamiflu. H5N1 has more resistance at this time. Some initial tests suggest influenza A involvement but it hasn't been typed yet indicating that it is a novel strain (if flu). If the strain has come from H1N1 seasonal flu, wouldn't you have thought that it would be Tamiflu resistant? That was the reason for the question.

If it is not resistant to Tamiflu, it "might" have evolved from H5N1.

The swine flu H1N1 in southern California is Tamiflu sensitive.

 

[Shiloh]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Source: http://www.elmanana.com.mx/notas.asp?id=117125

Reportan 500 casos en la Ciudad de México
Jueves, 23 de Abril de 2009
El contagio de trabajadores ha afectado ya a empleados de los principales hospitales públicos de la Capital , tales como el Hospital Juárez, el Hospital General, el Instituto Nacional de Enfermedades Respiratorias, y los hospitales de la zona de Tlalpan

Google translation:

500 cases reported in Mexico City
Thursday, April 23, 2009
The contagion has affected workers and employees of major public hospitals in the Capital, such as the Juarez Hospital, General Hospital, National Institute of Respiratory Diseases, and hospitals in the area of Tlalpan

MEXICO CITY .- At least 500 employees of the Health sector in Mexico City are infected with influenza virus, reported Antonio Sanchez Arriaga, general secretary of the National Independent Union of Health Workers.

The contagion has affected workers and employees of major public hospitals in the Capital, such as the Juarez Hospital, General Hospital, National Institute of Respiratory Diseases, and hospitals in the area of Tlalpan, where the National Institute Cardiology, the National Nutrition Institute and the Hospital Manuel Gea González, in addition to the Red Cross Polanco.

The union leader warned that the number of infections could triple this week not to take necessary health measures

"Last Friday we learned of the infection and ask our representatives in the various hospitals who send us reports of patients, and found that the focus of infection and reached 500 partners," said Sanchez Arriaga.

The leader of the guild said that the authorities are overcome by the presence of influenza in hospitals and only palliative measures have been implemented to try to prevent further infections.

"Right now we are being vaccinated and are taking a week leave to employees who are sick, but this is already an epidemic, and again we believe that if this continues this week we could have more than 1,500 infected," he said.

Sanchez Arriaga explained that it is essential to vaccinate personnel working in the areas of neonatology, pediatrics, gynecology and pulmonology, and who have the most potential for spreading infection in high risk populations.

(Imelda Garcia / Agency Reform)

 

[Laidback Al]

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

Re: Mexico: Respiratory Illnesses - Including Mexico City & Oaxaca

This comment needs to be emphasized; its implications are overwhelming.

Right now we are being vaccinated and are taking a week leave to employees who are sick, but this is already an epidemic, and again we believe that if this continues this week we could have more than 1,500 (mil 500 contagiados) infected," he said.