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Why the United States?

Hogweed

Well-known member
http://www.google.org/flutrends/

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Re: Why the United States?

We do have the same restriction in Canada...
Isn't a gradient from south to north? If it so the situation en Mexico should be worse.

WTB
 
Re: Why the United States?

As far as comparing Canada and the US, I believe part of it has to do with the fact that many American schools started this school year in August, several weeks before Canadian schools. Not sure when Mexican schools started back for this school year.
 
Re: Why the United States?

Maybe the difference is in surveillance data?

Google bases their rating on search trends for flu related treatment keywords and then calibrates that with historical ILI data. It does seem to match official ILI data fairly well but Google is usually 1-2 weeks in advance of official figures.
 
Re: Why the United States?

As far as comparing Canada and the US, I believe part of it has to do with the fact that many American schools started this school year in August, several weeks before Canadian schools. Not sure when Mexican schools started back for this school year.


Schools began the final 2 weeks of August in Mexico.
 
Re: Why the United States?


Just a guess...

Many schools starting in August in the US
Cooler temperatures than Mexico
The media here acts like the flu is not a big deal
I don't know about other contries' subculture, but there appears to be a great deal of selfishness here, i.e. lack or regard. Or maybe it is the portion of the U.S. I live I've noted in the last few weeks a 10 year old hacking awfully in pediatrics sitting next to his mother, right in front of a sign asking coughing patients to to cover their mouth (not covering his cough our wearing a mask), several hacking patients walking in drugstores not covering their coughs at all, etc.
 
Re: Why the United States?

I just came across the following which tentatively suggests that the common cold may have delayed the progress of swine flu in Europe.

Does viral interference affect spread of influenza?

EXTRACT - Full report at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19354

Eurosurveillance, Volume 14, Issue 40, 08 October 2009
Rapid communications
Does viral interference affect spread of influenza?
A Linde ()1, M Rotz?n-?stlund2, B Zweygberg-Wirgart2, S Rubinova1, M Brytting3

1. Department of Epidemiology, Swedish Institute for Infectious Disease Control, Solna, Sweden
2. Department of Clinical Microbiology, Karolinska University Hospital, Solna, Sweden
3. Department of Virology, Swedish Institute for Infectious Disease Control, Solna, Sweden

Citation style for this article: Linde A, Rotz?n-?stlund M, Zweygberg-Wirgart B, Rubinova S, Brytting M. Does viral interference affect spread of influenza?. Euro Surveill. 2009;14(40):pii=19354. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19354
Date of submission: 07 October 2009

This short communication hypothesises that rhinovirus epidemics occurring after start of school may interfere with the spread of influenza during the period when warm and humid climate decreases the influenza spread by aerosol. Limited laboratory data supporting this hypothesis are included in the article, but the report is written mainly to stimulate interest and research concerning the possibility that viral interaction may affect influenza epidemiology.

...

A simple but likely explanation for the sudden interruption of the spread of influenza could thus be the increase in the spread of above all rhinoviruses. It is well known that a major rhinovirus epidemic always occurs soon after school has started [7]. The virus is spread mainly by contaminated hands [8], and has not been reported to be climate-dependent. Thus the spread of rhinoviruses may have had an advantage over influenza due to the mild and moist climate. Once a rhinovirus infection has become established, infected cells start producing interferon and other cytokines, similar to those produced by influenza [9]. This immune reaction causes the cells to enter an antiviral state. Though double infections occur, they are probably not common enough to maintain high level spread of both rhino and influenza viruses in the population.

Influenza surveillance with sentinel reporting normally does not start until week 40, and respiratory sampling for viral diagnostics is usually scarce during early autumn. For week 40, most Swedish sentinel doctors usually report zero cases of influenza-like illness (ILI), and we do not know whether we the early autumn rhinovirus peak would have been reported as ILI in previous years even if reporting had been in place then. The reason for the large number of rhinovirus infections diagnosed in 2009 was most likely that people who got respiratory tract infections, who would not normally have visited a doctor, did so due to the fear of the pandemic influenza.

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In conclusion, we hypothesise that a rhinovirus epidemic that occurred after the end of the summer holidays may have interfered with the spread of pandemic influenza during a period with warm and humid climate that decreases spread of influenza by aerosol. Although the laboratory data supporting this hypothesis are limited, it may stimulate research into the possibility that the interaction between different circulating viruses may affect influenza epidemiology.

We therefore suggest the following:

1. The epidemiology of influenza should be related to that of other respiratory viruses for improved understanding of the true epidemiological situation.
2. Surveillance of respiratory infections should be conducted throughout the year to create reliable baselines for ILI and acute respiratory infections, which are useful when a pandemic virus occurs that does not follow the usual pattern of spread.
 
Re: Why the United States?

OK here goes w/ my conjectures as to why the US has the highest number of deaths. Possibilities include:

1. Other countries may be covering up, misnomering cases, ignoring all but the worst cases, and then writing down cause of death not as an infectious agent, but simply as 'pneumonia, etiology unknown'...plus 1/2 the world burns their dead by the same night as they die or bury them on the same day, so unless tests and bodily samples are/were taken before disposition, there's no further available corpus to ascertain real circumstances of fatal cases. RE: India has numerous infections going on, and one city alone was reporting over 30,000 ILI just in September, so the death rates/ CFR there may actually be higher than the US in confirmed cases, 3% vs 1 %, and there may be many more deaths unconfirmed there put down to pneumonia, meningitis, malaria, typhoid, etc.

2. People travel much more often and greater distances domestically and abroad...The US is sine qua non the center of globalization, the center of air traffic and truck and automobile traffic, and the borders are so porous that a far greater number of original infecteds' families went and are going back and forth to Mexico and points south, driving new variants into the heartland such that one might even come to expect the 1st emergence of a widespread pathogen in North America, even if the origination of the infectious carrier (person or swine) entered Mexico from Asia and the true situation in places such as China can NEVER IMO be accepted for truth without having realtime neutral inspections of hospitals and prisons made totally accessible (and that's unlikely to happen anytime soon).

3. The US may be simply catching more of the deaths from ILI and testing them, whereas others may only be catching a lesser fraction. Simply put, better technology and better 'best practice' methodologies in ICU and coroners offices.

4. The previous poster's Eurozone report that rhinovirus infections may have curtailed transmission early on for H1N1. Perhaps so many Euro's caught colds that they were already practicing good social distancing skills and not shaking hands and they were too obviously ill sneezing into their Kleenex that less transmission chain links occur.

5. Colder weather doesn't seem to be a bellweather as far as the maps indicate, since Texas and areas nearest Mexico are still warmer than temps down here in NZ, and yet we've not seem a second wave yet, but Texas and Mexico sure have. Since few have immunity other than those infected during the 1st wave, one scientist was opining that a vaxx for the H1N1 going around may just spur a more highly pathogenic variant into becoming the primary pandemic virus if and when one evolves sufficient variance to escape the vaxx target genotype.

6. Schools...classes are still more overcrowded than most Eurozone schools, but more like the rest of the Americas, the crowded cities and schools and transport methods complicate any attempts to keep kids far enough away from one another...or perhaps it's more a matter of how many in one place or another are practicing good prevention skills, social distancing, regular handwashing. But if that were the case, then the undeveloped world will soon be facing a very serious situation.

7. Personally I think there's another possibility...that there's some new strain/variant of H1N1 an HPHIN1--- a High pathogenic H1N1 influenza capable of sustaining production of higher viral loads more easily penetrating the lungs of more patients...that this variant is already in N. America, and perhaps not yet described, but just on the verge of global dissemination, but not yet sequenced and exposed to public information...and even with the best meds and best practices, we simply couldn't keep a greater number than in the first wave from presenting with more serious illnesses and thus we can't prevent a greater number perishing.

8. Timeliness in medicating 'suspect' cases...any delays involved in providing Tamiflu to persons presenting with ILI may result in greater numbers with poor outcomes. Or lack of insurance and fears of financial costs for those already in economic-limbo may dissuade a large enough percentage from seeking medical help even when they feel symptoms.

9. And lastly, perhaps it's all just scalar. There are more cases of the serious stuff because there are also more cases out there of the mild infections, and thus the US has the distinction of having the most cases already from the second wave and will have the higher death counts too.

OK, those are my perspectives, sorry just speculation.
 
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