The plague shall not be upon you to destroy you, when I smite the land of Egypt.
April 25, 2009 9:32 AM   Subscribe

Experts at WHO and elsewhere believe that the world is now closer to another influenza pandemic than at any time since 1968. WHO uses a series of six phases of pandemic alert... The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans. The outbreak of a variant of swine flu led federal officials to close Mexico City-area schools indefinitely - the first such shutdown since a devastating 1985 earthquake.

At least 62 people have died from severe pneumonia caused by a flu-like illness in Mexico, according to WHO. Some of those who died are confirmed to have contracted a type of swine flu known as A/H1N1. That particular flu variant has not previously been seen in pigs or humans, though other types of H1N1 have.

H1N1 is a subtype of the species Influenza A virus. H1N1 has mutated into various strains including the Spanish Flu strain (now extinct in the wild), mild human flu strains, endemic pig strains, and various strains found in birds.

Pandemic concern: The virus appears to infect by human-to-human transmission, and has spread within Mexico and into the United States. Investigations of infected patients indicate no direct contact with swine, such as at a farm or agricultural fair. In contrast, for example, disease transmission in the last severe outbreak of influenza, the bird flu that peaked in 2006, was determined to be almost entirely from direct contact with birds.

Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S. in San Diego County and Imperial County, California as well as in San Antonio, Texas.

The majority of these cases have occurred in otherwise healthy young adults...Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.

Mexican virus could throw wrench into North America's pandemic planning: Preparations based on assumption outbreak would surface in Asia, and take three months to arrive

According to the tin foil hat brigade, there are solid reasons to suspect that this new Mexican Swine Flu is NOT a naturally occurring event but instead is an Advanced Biological Warfare recombination DNA genetically engineered virus.

Google Flu Trends has no data yet on this latest threat.
posted by KokuRyu (297 comments total) 57 users marked this as a favorite

 
Human-to-human transmission? Time to hunker down in my bunker town.
posted by smackfu at 9:37 AM on April 25, 2009 [2 favorites]


That's it, I'm going to Madagascar.
posted by The Whelk at 9:39 AM on April 25, 2009 [43 favorites]


This is what happens when IHOP mixes bacon and eggs in Tijuana.
posted by stbalbach at 9:41 AM on April 25, 2009 [1 favorite]


So how long until the vacine is developed for this strain?
posted by humanfont at 9:45 AM on April 25, 2009 [1 favorite]


Obviously God is angry about the US turning to socialism.
posted by Thorzdad at 9:48 AM on April 25, 2009 [7 favorites]


Like when he was pissed about all the debauchery in New Orleans.
posted by gman at 9:49 AM on April 25, 2009


The Whelk: "That's it, I'm going to Madagascar."

As long as you get there before they close their port.
posted by dunkadunc at 9:52 AM on April 25, 2009 [17 favorites]


Remember the last time 'swine flu' was a household catchphrase? Background, more.

Not suggesting that the current outbreak will or won't be serious, we don't know yet. It is a minefield for anyone who's a decision-maker, though.
posted by gimonca at 9:53 AM on April 25, 2009 [3 favorites]


Obviously God is angry about the US turning to socialism

You mean it's not just a little hint about getting healthcare fixed fast?
posted by dilettante at 10:02 AM on April 25, 2009 [10 favorites]


I for one welcome our new pneumococcus overlords.

Or, at least, whatever deity or terrorist organization bioengineered them.
posted by XMLicious at 10:02 AM on April 25, 2009


Remember the last time 'swine flu' was a household catchphrase?
Only second-hand. The health care professionals who are still bitter about that overreaction are close to retirement, now. In a certain sense we're fortunate that the last swine-flu scare was more than 30 years ago, because otherwise people would be more reluctant to take this latest outbreak very seriously.

Talking to first-responders, the impression I get is that their big concern and worry is not about the next terrorist attack. They're worried about the next pandemic, specifically pandemic flu.
posted by deanc at 10:11 AM on April 25, 2009


Mexican virus could throw wrench into North America's pandemic planning: Preparations based on assumption outbreak would surface in Asia, and take three months to arrive

I've observed that during outbreaks we often proceed to vaccinate the elderly and sick, leaving the kids to fend for themselves. Nobody minds very much, until the thought enters that this might be the way it is when the big one hits. It's will probably be less of a scientific decision than a political one. Any notion of "pandemic planning" has its dark side, and as it attempts to reduce the randomness of the outbreak, it would probably first protect those who are government insured, reflecting current trends, lobbying and political clout.
posted by Brian B. at 10:11 AM on April 25, 2009


So how long until the vacine is developed for this strain?


Tamiflu is supposed to be effective, but the challenge is that there are only enough doses for 1 million of Mexico City's 20 million inhabitants, for example, and I'm sure there is the same problem in other parts of the world.
posted by KokuRyu at 10:12 AM on April 25, 2009


humanfont: So how long until the vacine is developed for this strain?

“The egg method isn’t very flexible if you need to rapidly ramp up vaccine supply,” says Jonathan Seals, director of Process Development at ID Biomedical Corporation of Northborough, MA. “Vaccine manufacturers need to arrange for egg supplies months in advance — and you can’t tell a chicken to lay more eggs.”

Sounds like it won't be anytime before Summer is ended, at the earliest.
posted by hippybear at 10:13 AM on April 25, 2009 [1 favorite]


This is very frustrating, because I have already learned the dance the Bird Flu, and, to the best of my knowledge, there currently is no Swine Flu dances. How did we allow ourselves to get painted into such an unfortunate Terpsichorian corner?
posted by Astro Zombie at 10:18 AM on April 25, 2009 [1 favorite]


So the mortality rate in Mexico (with poor health care access) is 7%, and in the US is 0%. Why do I need to be buying guns and holing up, exactly?
posted by crapmatic at 10:19 AM on April 25, 2009 [2 favorites]


My Dad is a GP and for the last year or two he has had a lot of pandemic-related literature lying around. I think that health services are rather concerned about stuff like this, but I'm reasonably happy that there's been some forward planning.

Dystopian literature/cinema has given me a morbid fascination with watching these stories develop. Anyone else?
posted by knapah at 10:20 AM on April 25, 2009


I have a mild dose of summer flu myself, and my mood is swinging between "OMG this is it I'm going to die" and "OK this is probably the mild strain that gives me resistance to the deadly strain and leaves me picking through the deserted city streets on my own after everyone is dead". Either way, get well soon Mexico.
posted by WPW at 10:23 AM on April 25, 2009 [2 favorites]


Why do I need to be buying guns and holing up, exactly?

If that is your takeaway message, you were likely watching coverage of the teabagging tax day tea party events. I'm not sure anyone is calling for full-on 12 Monkeys panic quite yet.
posted by hippybear at 10:27 AM on April 25, 2009


Dystopian literature/cinema has given me a morbid fascination with watching these stories develop. Anyone else?

I grew up on The Triffids, The Stand, Threads, Survivors ... good times!

posted by WPW at 10:27 AM on April 25, 2009 [1 favorite]


My gf plans responses to threats like this. People don't see the planning, but she looks at cases like "where do the tents go?" when you're considering a mass decontamination scenario. In her opinion: 1) WHO will go to level 4 today; 2) the 7% mortality in Mexico is worryingly high for influenza; 3) if this is a pandemic it should be in full swing by June.
posted by jet_silver at 10:27 AM on April 25, 2009 [7 favorites]


Dear lords I feel like Cassandra must have. I said about a year and change ago that the way this economic down turn would be MUCH worse would be if a large scale influenza pandemic hit.

I'm going to be hiding and disinfecting everything I own.
posted by strixus at 10:30 AM on April 25, 2009


I understand disinfecting your stuff, but why hide it?
posted by Astro Zombie at 10:32 AM on April 25, 2009 [6 favorites]


So the mortality rate in Mexico (with poor health care access) is 7%, and in the US is 0%. Why do I need to be buying guns and holing up, exactly?

The diagnosed cases of swine flu are only the ones we know about - all of these cases have been confirmed by lab tests. Not everyone who has been infected by (or died due to) swine flu has been by lab tests. Tip of the iceberg.

Plus, people are highly mobile, which means the disease will spread more easily, and the virus affects healthy younger folks, rather than the elderly and children.
posted by KokuRyu at 10:33 AM on April 25, 2009


Astro Zombie:

*spews coffee all over iMac and computer desk*

Oh, thanks. shit. Now I have to find my AppleCare numbers again.
posted by hippybear at 10:35 AM on April 25, 2009


So the mortality rate in Mexico (with poor health care access) is 7%, and in the US is 0%. Why do I need to be buying guns and holing up, exactly?
The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. [...] The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%.
So while you seem to be implying that a mortality rate of 7% in Mexico is low, it's actually shockingly high for an influenza. And given that there have only been a tiny handful of cases in the U.S. (that we know of so far), it's entirely premature to draw the conclusion that its mortality rate in the states will stay at 0%.

Moreover, the problem with these types of influenzas (unlike the usual annual strains) is that they tend to kill young, healthy adults.
The leading theory on why so many young, healthy people die in pandemics is the “cytokine storm,” in which vigorous immune systems pour out antibodies to attack the new virus. That can inflame lung cells until they leak fluid, which can overwhelm the lungs, Dr. Moscona said.

But older people who have had the flu repeatedly in their lives may have some antibodies that provide cross-protection to the new strain, she said. And immune responses among the aged are not as vigorous.
Of course, no one is actually suggesting that you need to stockpile guns, crapmatic. I would suggest, however, that you put down the ill-informed snark and actually use some critical thinking skills to read the links. Unless you think that there's some benefits to your immune system to be gained by looking like a jerk in a public forum.
posted by scody at 10:36 AM on April 25, 2009 [11 favorites]


I'm not freaking out about this; the disease is already in the US. Things haven't blown out of proportion yet.

What I AM concerned about is the supply of medication to deal with the flu and Mexico's ability to handle its own cases. Flu is the best population-killer I know of. Do we know who died?
posted by kldickson at 10:47 AM on April 25, 2009


Actually the Wikipedia article on the 1919 outbreak gives 2 to 20% mortality rate, not 2.5%, but I do see your point; I thought the 1919 outbreak was closer to 40 or 50%.

I would suggest, however, that you put down the ill-informed snark and actually use some critical thinking skills to read the links. Unless you think that there's some benefits to your immune system to be gained by looking like a jerk in a public forum.

I asked about the 0 to 7% mortality rate as a serious question. If you are having problems taking comments personally, you probably don't need to be on here.
posted by crapmatic at 10:48 AM on April 25, 2009


I find 7% mortality shockingly and disturbingly high. How many of your friends and family got the flu last year? Imagine that for every 15 of them one died from the disease. Horrible.
posted by grouse at 10:50 AM on April 25, 2009 [8 favorites]


I asked about the 0 to 7% mortality rate as a serious question.

You don't actually expect anyone to believe that "Why do I need to be buying guns and holing up, exactly?" is indicative of a sincere, serious question asked in good faith, do you?

If you are having problems taking comments personally, you probably don't need to be on here.

You are free to take it to metatalk if you have a problem with me, but until then, I'll continue to post wherever I like, thanks. I would point out that I'm not the one who came in to shit on the thead -- which, despite your protests to the contrary, is exactly how your comment reads.
posted by scody at 10:54 AM on April 25, 2009 [11 favorites]


I wonder what a 1918 class pandemic will do to unemployment numbers in the US.

One one hand you'd have all that temporary employment providing the vaccine. And if the vaccination plan isn't executed effectively or the vaccine doesn't work you'd have ~1 million deaths concentrated in the young adult demographic which would remove those who were unemployed from the rolls and provide openings for others. Plus the temporary surge in the death industries.

One the other hand you'd have a lack of productivity from those who merely got sick rather than dieing and you'd experience some depression from people in key positions dieing. Plus it'd hit the already struggling insurance industry pretty hard to have to pay out all those life insurance policies.

Sure wish there was some way to find out that didn't involve killing a 100 million people or more across the globe.

Most disturbing for me is that it is pretty warm in Mexico already isn't it? Influenza spreads best during the winter. If this thing spreads around with relatively low infection rates until October and then explodes it's going to be pretty messy.
posted by Mitheral at 10:55 AM on April 25, 2009 [1 favorite]


So the mortality rate in Mexico (with poor health care access) is 7%, and in the US is 0%.

The numbers of confirmed swine flu cases are too low to be statistically useful, whether in the US or Mexico. Of the 1000+ cases of illness attributed to swine flu in Mexico, 150 have died. The number of total swine flu cases and deaths in the US is unknown, but probably because health authorities haven't yet been making the link between unexplained flu deaths and this new strain. Over the next week you'll probably see more reporting of 'suspected' swine flu cases coming out of the southern US.

The problem for California is that is has a significant population of people with poor or cramped living conditions which makes contagion easier (I think the homless population is something like 200,000); also there are several million (?) without health insurance and so more likely to 'sweat it out' than go to hospital. If this swine flu really is as contagious and deadly as it is made out to be, it could be terrible for the people there.
posted by Sova at 10:59 AM on April 25, 2009 [4 favorites]


Sorry, 68 dead in Mexico, not 150.
posted by Sova at 10:59 AM on April 25, 2009 [1 favorite]


I wonder what a 1918 class pandemic will do to unemployment numbers in the US.

You assume the economy would continue to function normally. The world is far more interconnected than it was in 1918. A pandemic would mean the effective shutdown of global trade, and vast logsitical problems distributing goods and resources. Shutdowns of industry and commerce would be inevitable, if they weren't already shut down by government order to prevent infection spreading, or unsaffed because public transport had been shut down. What the long-term consequences for unemployment might be is anybody's guess, but in the short term almost everybody would be unemployed.
posted by WPW at 11:00 AM on April 25, 2009


unsaffed = unstaffed
posted by WPW at 11:01 AM on April 25, 2009


So, on top of the wars, the economy, and all the other bullshit, now I have to worry about getting Captain Trips? Fuck you, world.
posted by Optamystic at 11:06 AM on April 25, 2009 [20 favorites]


It may be fortunate that this flu is appearing now, on the brink of summer, as the influenza virus appears to be more easily transmissible in cold, dry weather.
posted by vibrotronica at 11:07 AM on April 25, 2009


So, on top of the wars, the economy, and all the other bullshit, now I have to worry about getting Captain Trips? Fuck you, world.
posted by Optamystic


I wouldn't think you worry about shit.
posted by gman at 11:09 AM on April 25, 2009


M-O-O-N, that spells "wash your hands".

Clearly not enough people have seen "The Stand".
posted by mrbill at 11:10 AM on April 25, 2009 [5 favorites]


Meh... those army dudes will get them little blue masks passed out pronto and everythings gonna be fine.

Little blue masks fix everything.
posted by Baby_Balrog at 11:10 AM on April 25, 2009


You assume the economy would continue to function normally.

Actually, no. If this really is a pandemic, you're going to see curtailment of public gatherings, including work. And that will reduce GDP. If the flu gets severe enough, the reduction in GDP could be quite stark.
posted by dw at 11:15 AM on April 25, 2009


> So, on top of the wars, the economy, and all the other bullshit, now I have to worry about getting Captain Trips? Fuck you, world.

Life sucks. And then...
posted by you just lost the game at 11:18 AM on April 25, 2009


Pandemic 2 has no options for virus to be spread by pigs.
posted by mrmojoflying at 11:19 AM on April 25, 2009 [1 favorite]


You know, they said that global disaster would befall us as soon as we elected a black president, but I'd hoped it would at least be something cool like an asteroid or an alien invasion, not some piddlin' swine flu. Maybe it's all being saved up for 2012?

gimonca: "Remember the last time 'swine flu' was a household catchphrase?"

At least it's not Salmonella Fitzgerald.
posted by Rhaomi at 11:19 AM on April 25, 2009 [1 favorite]


We just did a tabletop at work over a pandemic flu event. The one big takeaway from it was that in such an event the "chain of command" isn't as clear as it could be, and those who would be in it kept saying they'd look to people outside the chain to make decisions and follow them.

While this is good for a pandemic on a macro-basis (e.g. the health department says "close all schools"), it's bad on a micro-basis (e.g. how are we going to handle payroll?)

The frightening thing is that over the last 30 years American public health budgets have been obliterated by successive Republican and Democratic leaderships. It was easy to cut, and hey, who really needs epidemic surveillance when it's mostly HIV/AIDS anyway and abstinence/condoms fix that? And now they will reap what they (didn't) sow.

The fact this could be coming from Mexico is going to be a major political football. That border is so long and porous it's impossible to keep the virus out, even with some hastily built 50 foot high triple fence from California to El Paso, the Rio Grande being stocked with crocodiles and piranhas, and Minutemen being given "shoot on sight" orders by Glenn Beck. And the focus really has been on Asia. APEC has a detachment working on pandemic surveillance. I'm not sure there's a pandemic surveillance group handling Central America.
posted by dw at 11:27 AM on April 25, 2009 [2 favorites]


Most disturbing for me is that it is pretty warm in Mexico already isn't it?

Mexico City is at a pretty high altitude and because of its latitude stays pretty temperate all year. I will often go down there in August because the temps are in the mid 70s when in central Texas it is about 100. I'm no epidemiologist but I believe the spread of influenza happens in the colder months because more people are sharing indoor closed quarters without fresh air. A sick person on a subway train, school room, or airplane can infect tons of people.

What I hate about this situation is the BUILD THE BORDER FENCE people are in a frenzy (just read any newspapers' comment section on these articles for a taste) in a similar manner as they are over the drug wars are "spilling over" the border. My guess is a Mexican immigrant suffering from this strain of flu is going to go from Cd Mexico to Matamoros on foot and then swim over the border. If this does turn out to be a pandemic, it will be by planes (possibly via American business people) so we'll need to BUILD THE BORDER FENCE higher than airplanes can fly. Seriously, I hope the anti-latino wingnuts don't make this about fearing Mexicans.

A humorous note: when I was reading about this this morning a google.com.mx search allowed me to discover an Yahoo! Answers Mexico question: Can you get the swine flu by eating ham and cheese sandwiches? Answer: jajajaja. Nice to see Yahoo! Answers is so awesome worldwide.
posted by birdherder at 11:30 AM on April 25, 2009 [5 favorites]


The carrying capacity for the world is circa 2 billion people at a US middle-income standard of living. There are currently over 6 billion people on the planet.
posted by five fresh fish at 11:31 AM on April 25, 2009


Looks like Tamiflu and Relenza are working against it. This is good and bad at the same time. It means we have two drugs on hand that can reduce mortality and potentially slow the spread of the virus, instead of one (or none). But there will not be enough to go around if we hit pandemic levels, and you can imagine how a drug shortage will play out.
posted by dw at 11:32 AM on April 25, 2009


One of the reasons that the 1918 pandemic was such a huge killer was that there were so many people in hospitals due to WWI injuries and illness. With so many people lying around acting as a hosts, the disease was able to spread quickly. Without a lot of bodies around in close enough proximity to each other for the disease to spread between them, highly virulent forms of the flu (or whatever) can't spread very far, because they knock out their hosts too quickly.

It's the less virulent forms that are able to spread quickly, that leave people able to walk around and infect others. If someone gets really sick these days, they stay home for a while (unless they're bad enough to go to the hospital) where they don't infect anyone. So the less virulent forms end up swamping out the more virulent forms.

It isn't like these pandemics just have random virulence, and a 1918 style thing is just waiting to happen like a big earthquake or flood, it was the result of specific conditions that existed at the time.
posted by delmoi at 11:36 AM on April 25, 2009 [3 favorites]


DW, my entire point was that the economy isn't going to continue to function normally. I was answering Mitheral.
posted by WPW at 11:36 AM on April 25, 2009


You may have seen it before, but if you'd like a nice, gripping read about what severe, pandemic flu would mean for a medium-sized Canadian community, the CanadaSue series of articles at fluwikie are still available. IIRC, the author has a nursing background and the fictionalized setting is based on Kingston, Ontario.
posted by gimonca at 11:36 AM on April 25, 2009 [1 favorite]


That border is so long and porous it's impossible to keep the virus out, even with some hastily built 50 foot high triple fence from California to El Paso,

Air travel is a bigger issue than the physical border
posted by KokuRyu at 11:38 AM on April 25, 2009


The fear reponse will be a factor as well, even if this does not get as bad as it could. Our already polarizied society will get nastier, and that's when you need to have the guns and food stockpiled, I guess.

And what knapah said.
posted by vrakatar at 11:41 AM on April 25, 2009


"To some the sermon simply brought home the fact that they had been sentenced, for an unknown crime, to an indeterminate period of punishment. And while a good many people adapted themselves to confinement and carried on their humdrum lives as before, there were others who rebelled and whose one idea now was to break loose from the prison-house."
posted by ageispolis at 11:43 AM on April 25, 2009 [1 favorite]


I'm no epidemiologist but I believe the spread of influenza happens in the colder months because more people are sharing indoor closed quarters without fresh air.

This 2007 study implicated "low relative humidities produced by indoor heating and cold temperatures as features of winter that favor influenza virus spread."
posted by Knappster at 11:44 AM on April 25, 2009


So, let's say a pandemic does break out, and steps are taken to prevent its spread...

How much participation in enforcing those measures will we see from this crowd?
posted by hippybear at 11:46 AM on April 25, 2009


One of the reasons that the 1918 pandemic was such a huge killer was that there were so many people in hospitals due to WWI injuries and illness.

not to mention that they were on average less healthy and people, especially soldiers, were living a lot more closely than they do now - also medical knowledge was not as advanced then

i don't think this flu will be anywhere as bad, at least in the u s
posted by pyramid termite at 11:48 AM on April 25, 2009


Thing is, your classic disaster preparedness kit -- food, water, batteries, flashlights, masks, etc. for at least three days -- will get most of us through any major disaster, even a pandemic.

And those Oath Keepers and remaining militia types, they probably still have water and MREs from the Y2K panic. They're in better shape than most Americans.
posted by dw at 11:57 AM on April 25, 2009


I suspect that since Mexico and the US are separated by desert, as long as there is sufficient border control between the two countries until the epidemic decreases, there will be less of a chance for influenza to cross the border, though the cases in the US and Mexico are related.

If border towns can make sure they're prepared to deal with the flu, border control can step up their activity, and towns on the way to the border can prepare themselves for a possible influx of people who may be trying to get to the border so they can both quarantine the illness and treat people (Guadalajara, Monterrey, and Torreon are in an ideal position, being situated along major interstates). The US and Mexico need to cooperate on this.
posted by kldickson at 12:04 PM on April 25, 2009


I'm no epidemiologist but I believe the spread of influenza happens in the colder months because more people are sharing indoor closed quarters without fresh air.


Dry, cold air in winter makes it easier for the lining of the throat to dry out, lowering its ability to protect against viruses. It's kind of like how if you are prone to squeezing zits or habitually scratching scabs you can get colds more easily.
posted by KokuRyu at 12:07 PM on April 25, 2009


How do you know when to start worrying about the new Swine Flu threat?
posted by homunculus at 12:12 PM on April 25, 2009 [3 favorites]


birdherder, if I'm right, swimming is one of the things border control deals with.

I'm pretty much diametrically opposed to what the nativists want, but border control has its uses - for situations such as this where it's to human benefit to keep disease in one place. Let them stay there; Mexico is not totally third-world and does have functioning hospitals and medical professionals, and I would suspect the US and Canada have an interest in making sure their Latin American buddy is secure. We would have a much easier time fighting disease there than we would in Africa.

Let's not shit our pants yet.
posted by kldickson at 12:15 PM on April 25, 2009


Here's an aspect of the story the American media, unsurprisingly, isn't touching: the outbreak has been linked to industrial pork production.
posted by gerryblog at 12:22 PM on April 25, 2009 [10 favorites]


Well, this should make the Zero Population Growth people ecstatic...until somebody theycare about dies.
posted by happyroach at 12:23 PM on April 25, 2009


So, on top of the wars, the economy, and all the other bullshit, now I have to worry about getting Captain Trips? Fuck you, world.

I don't know, I always kind of had this feeling that I'd at least be a lackey in the hero's group in a post-apocalyptic scenario. Like, I wouldn't be Stu Redman, but I might be the dude guarding the gate to Boulder that told him Fran had the baby when he returned from Las Vegas. That would be okay with me.
posted by DecemberBoy at 12:26 PM on April 25, 2009 [5 favorites]


happyroach, who pissed in your cereal?
posted by kldickson at 12:31 PM on April 25, 2009


I suspect that since Mexico and the US are separated by desert, as long as there is sufficient border control between the two countries until the epidemic decreases, there will be less of a chance for influenza to cross the border, though the cases in the US and Mexico are related

And thank goodness nobody ever travels by air between Mexico and the US!
posted by hippybear at 12:40 PM on April 25, 2009 [5 favorites]


but border control has its uses...

Far too late. There are hundreds, perhaps thousands of carriers in the US already, and most of them are US tourists returning. Hard to keep those out with a fence.
posted by rokusan at 12:51 PM on April 25, 2009 [2 favorites]


if you'd like a nice, gripping read

I see what you did there.
posted by oaf at 12:51 PM on April 25, 2009 [2 favorites]


the outbreak has been linked to industrial pork production.

Because of mad cow's rise, that's the first thing I guess now for any weird surprise disease. The standards used in factory farming are so crazy-obviously-wrong that this sort of thing seems inevitable.
posted by rokusan at 12:53 PM on April 25, 2009 [4 favorites]


NYT now reports that it may be infecting a population of schoolchildren in NYC.
posted by felix betachat at 1:01 PM on April 25, 2009


even with some hastily built 50 foot high triple fence from California to El Paso

Yes, but why not between El Paso and Brownsville, too? Or were you under the impression that El Paso is in eastern Texas? It's in the west.
posted by marble at 1:07 PM on April 25, 2009 [1 favorite]


After watching the right-wingers stockpile guns and ammo for the apocalypse, I decided that they were right. So I made preparations of my own. I just checked my family's supply of food, antibiotics and tamiflu and everything looks ship-shape.

It's a lovely day outside, I think I'll take my family to the park today to fly kites.
posted by double block and bleed at 1:07 PM on April 25, 2009


hippybear, air travel is just a tad more regulatable.
posted by kldickson at 1:10 PM on April 25, 2009


Yes, but why not between El Paso and Brownsville, too? Or were you under the impression that El Paso is in eastern Texas? It's in the west.

You did read the part about the crocs and piranhas in the Rio Grande, right?
posted by dw at 1:12 PM on April 25, 2009


I see what you did there.

Hah! It was totally unconscious and unintentional. Or maybe I'm feeling feverish. Good catch.

posted by gimonca at 1:13 PM on April 25, 2009


birdherder, if I'm right, swimming is one of the things border control deals with.

I'm pretty much diametrically opposed to what the nativists want, but border control has its uses - for situations such as this where it's to human benefit to keep disease in one place. Let them stay there; Mexico is not totally third-world and does have functioning hospitals and medical professionals, and I would suspect the US and Canada have an interest in making sure their Latin American buddy is secure. We would have a much easier time fighting disease there than we would in Africa.

Let's not shit our pants yet.


My point was the illegal immigrant sneaking across the border will get the brunt of the blame from certain groups within the US, when really a much larger group -- those that legally enter the US via land, sea and air -- are a larger vector for disease. Hence my BUILD THE FENCE HIGHER snark.

Like I mentioned in my original comment, read the comments section of almost any newspaper article on the subject and you're already seeing the BUILD THE FENCE people blaming immigrant as if this magical fence would solve anything. We don't know how those in San Diego and San Antonio contracted this strain of the flu, but I'm thinking patient zero entered the US legally.
posted by birdherder at 1:30 PM on April 25, 2009


via gerryblog's link, a detailed timeline of events from March 30 to April 24. The timeline appears to be generated by the Veratect Corporation.

The corporate site is pretty vague. I'm trying to discern how legitimate Veratect is.

Their employment page has some interesting listings. Of course, if you're just starting in the field you may want to try "Civil Unrest Intern."
posted by werkzeuger at 1:32 PM on April 25, 2009 [4 favorites]


Wikipedia's article on cytokine storms mentions that treatment with synthetic OX40 immunoglobulin might attenuate the fatal reactions:
"Experiments in mice have demonstrated that OX40-Ig can reduce the symptoms associated with an immune overreaction while allowing the immune system to fight off the virus successfully."
Hey, awesome!
"The drug, to be made by a company called Xenova Research...was supposed to be in phase I clinical trial in 2004, but its status is currently unknown."
Somewhat less awesome. What's keeping you guys?
"Xenova has sold the rights for OX40 development to down-regulate against, for example, a cytokine storm caused by an influenza infection...While neuraminidase inhibitors like Tamiflu can be used against all manner of flu types and hence have a market even when there is no pandemic the OX40 blockers probably do not have much utility against influenza under normal conditions. So OX40 blocker development probably isn't going to get much funding against flu unless governments step in (and my guess is governments are probably not smart enough and prudent enough to do that)." (FuturePundit, November 12, 2005)
As of last January, Genentech is still in Phase 1 clinical trials of OX40 blockers...as an asthma treatment. So much for all that.

FuturePundit does go on to suggest that Statin drugs (think Lipitor) might help against cytokine storms. Commenter also suggest leukotriene modifiers, vast amounts of Omega-3 fatty acids (while curtailing Omega-6), NSAIDS, Vitamin-D3, and smoking. (Most of those would need a few weeks' head start to have any moderating effect on the immune system, so begin now if you're paranoid.)
posted by Iridic at 1:41 PM on April 25, 2009 [2 favorites]


A nice listing of world public health news resources.
posted by werkzeuger at 1:47 PM on April 25, 2009


...a detailed timeline of events from March 30 to April 24.

That's a really good find, and well worth reading. It makes clear that despite potential cases in Mexico dating back to March 13, this outbreak only started getting everybody's attention on 20/21 April. As mentioned above, there are potentially already thousands of carriers with this in the US, and it is more a case of lessening the impact and not containing it to Mexico.
posted by Sova at 1:48 PM on April 25, 2009


So, how do you obtain Tamiflu before you get sick?
(The only info on their website says that you can go to a doctor once you're already sick and ask for a prescription. Not Useful.)
posted by -harlequin- at 1:52 PM on April 25, 2009 [2 favorites]


Here's an aspect of the story the American media, unsurprisingly, isn't touching: the outbreak has been linked to industrial pork production.

They've also been ignoring the spread of antibiotic-resistant bacteria in the pork supply.
posted by homunculus at 1:56 PM on April 25, 2009 [1 favorite]


Reports of quarantine in Montreal.
posted by KokuRyu at 2:10 PM on April 25, 2009


So, how do you obtain Tamiflu before you get sick?

You're not supposed to.
posted by Justinian at 2:11 PM on April 25, 2009 [7 favorites]


Another more technical summary of the situation. (via the International Society for Infectious Diseases' Pro-Med-mail.)
posted by werkzeuger at 2:11 PM on April 25, 2009


Werkzeuger--

Veratect appears to be at least marginally legitimate. They're incorporated in the state of Washington, and they're registered in Virginia as well and Illinois as well.

Though, for what it's worth, the major principle in Veratect, a guy named Scot Eldon Land, has about 9 billion other entities in Washington. That could mean that he's a busy, well-connected, generally entrepreneurial sort, or it could mean other things, not all of which are positive.
posted by palmcorder_yajna at 2:18 PM on April 25, 2009


From the discussion on Reddit:

New and virulent strains of flu have the potential to cause a cytokine storm (an overreaction of the body's immune system). Younger adults have stronger immune systems and thus this overreaction can be deadly.

Also:

My wife is a doctor in a hospital in Mexico city and just told me that the deaths in Mexico have been linked to the swine flu....
She told me that retro-viral treatments seem to be effective and that the people who died (she knew 4 of them) died, because they weren't treated properly, since they assumed that it was just a "normal" flu.

posted by Huplescat at 2:19 PM on April 25, 2009


Cases confirmed in Kansas.

On preview, thanks palmcorder_yajna.
posted by werkzeuger at 2:22 PM on April 25, 2009


Here's an aspect of the story the American media, unsurprisingly, isn't touching

Is it really the media? My impression has been that popularly-held EU concerns about food production methods are popularly pooh-poohed in the USA, where there just seems to be (culturally) significantly less interest in food supply caution. Take the FDA for example - thoroughly corrupt, inept, and spineless from top to bottom, yet it enjoys the same kind of public trust here as genuine and successful regulatory agencies do in other countries.

I don't know that coverage of pork production could get much traction here. Judging by the Mad Cow stuff, no-one gives a shit until the house has been on fire for so long that it's no-longer possible to look the other way.
posted by -harlequin- at 2:24 PM on April 25, 2009 [1 favorite]


The Veratect Corporation? Xenova Research? Are you shitting me?

The fact these companies all sound like dystopian sci-fi zaibatsus is not reassuring.
posted by rokusan at 2:25 PM on April 25, 2009 [4 favorites]


Director of goverment lab in Winnipeg, Canada speculates Tamiflu and Relenza will be ineffective.
posted by werkzeuger at 2:30 PM on April 25, 2009


The fact these companies all sound like dystopian sci-fi zaibatsus is not reassuring.

As are the "venture capital+one guy+template" websites.
posted by werkzeuger at 2:32 PM on April 25, 2009 [1 favorite]


So, how do you obtain Tamiflu before you get sick?

You're not supposed to.



So officially, everyone's Plan A should be to wait until they're sick and now have a deadline of mere hours to find some - then try to get some in the midst of a pandemic that exhausted all supplies of it weeks ago.

Plan A doesn't appeal to me much. :-/

"First-in-first-served While Supplies Last, provided you're already sick" may be fair, but allowing ahead-of-time purchases would increase the market, spurring greater production, meaning that in the event of a pandemic, a greater number of people can be treated.

Damnit, I guess I'll have to brace myself for another interaction with the US healthcare system.
posted by -harlequin- at 2:35 PM on April 25, 2009


I get the impression, based on the cases in the US, that this isn't going to be a very deadly strain. What is somewhat disturbing to me is the fact that the WHO and CDC are already throwing up their hands and saying there is nothing they can do about stopping the spread.

What is this were a highly virulent flu, for example bird flu? What makes anyone think the WHO, etc. could do anymore to stop that then they've been able to stop swine flu? That's what kind of scary.
posted by elder18 at 2:47 PM on April 25, 2009


So, how do you obtain Tamiflu before you get sick?
(The only info on their website says that you can go to a doctor once you're already sick and ask for a prescription. Not Useful.)


I've been wondering about this too. Particularly since I'm told I'm should consider flu vaccination risky (had something that might have been Guillain-Barré when I was a kid).

I considered stocking up via online pharmacy a few years ago, but I wasn't entirely comfortable with this route at the time...
posted by weston at 2:49 PM on April 25, 2009


Tamiflu is not worth getting. If everyone takes it but not everyone takes it properly, then it will not longer be effective because the virus will adapt.

You want a Plan A? Wash your hands with soap and water.
posted by dw at 3:02 PM on April 25, 2009 [5 favorites]


Well, this can't be good:

The first case was seen in Mexico on April 13. The outbreak coincided with the President Barack Obama’s trip to Mexico City on April 16. Obama was received at Mexico’s anthropology museum in Mexico City by Felipe Solis, a distinguished archeologist who died the following day from symptoms similar to flu, Reforma newspaper reported. The newspaper didn’t confirm if Solis had swine flu or not.
posted by Rhaomi at 3:04 PM on April 25, 2009 [4 favorites]


Can I also get some Vicodin in case I hurt myself in the future?
posted by snofoam at 3:12 PM on April 25, 2009 [9 favorites]


elder18, most of the cases were in children. Once we see our first young adult cases, there's a possibility they may die from cytokine storm.
posted by kldickson at 3:14 PM on April 25, 2009


"First-in-first-served While Supplies Last, provided you're already sick" may be fair, but allowing ahead-of-time purchases would increase the market, spurring greater production, meaning that in the event of a pandemic, a greater number of people can be treated.

And again, Tamiflu would lose its effectiveness as people incorrectly use Tamiflu, giving the virus an opportunity to adapt to it. Pretty soon the "magic bullet" becomes an abandoned drug, just as first and second generation antibiotics have been.

Good hygiene is far more effective. Wash your hands. Cover your mouth when you cough/sneeze. When you're sick, stay home.

In an event like this, there will be a lot of sick people, but not every sick person needs hospitalization or even an antiviral like Tamiflu or Relenza. And if we do have an epidemic, anyway, the hospitals will be in triage mode. Most people will be told to stay home, drink fluids, and only head for the hospital if the situation is dire.

And the people who show up at the hospital then will be given Tamiflu. Unless, of course, people run out and demand prescriptions for it, take it for two days, and completely wreck its effectiveness. In that case, they'll just tell the people who show up they'll do what they can but hope you have your affairs in order because the drugs that would have worked aren't effective anymore.
posted by dw at 3:24 PM on April 25, 2009 [4 favorites]


snofoam:
Most experienced hikers that I know (and myself) do carry Vicodin or similar heavy-duty painkillers in their first-aid kits. Accidents in the mountains can happen, help is sometimes a long way (or time) away, and staying put is not always an option.

DW: Prevention is definitely better than cure, but washing your hands doesn't help make you better once infected. It helps save other people from sharing your fate :-)
posted by -harlequin- at 3:32 PM on April 25, 2009


Wow, I just spent a week with 16,000 conventioneers in San Diego. I have not found anything on the time between exposure and onset for this strain, only how long you are contagious after onset. Anyone seen a number or is it the same as normal flu in that way?
posted by cgk at 3:32 PM on April 25, 2009


Damnit, I've been reading up on Tamiflu resistance. Seems that like antibiotics, we're at the mercy of Stupid People again.

And stupid always wins.
posted by -harlequin- at 3:36 PM on April 25, 2009 [1 favorite]


Anyone seen a number or is it the same as normal flu in that way?

If it's typical of most other flu viruses, onset can take up to 96 hours.
posted by dw at 3:36 PM on April 25, 2009


Further speculation about ties between confined animal feeding operations and swine flu in Mexico. via HuffPo.
posted by werkzeuger at 3:39 PM on April 25, 2009


About the tamiflu: all three of my children have major medical problems. My wife and I are in the very fortunate position of being extremely close with our children's pediatrician (he gave us his home number years ago). He was willing, after I politely asked, to write prescriptions for tamiflu and antibiotics for us as an emergency backup. He knows that we are not the kind of people who will give the kids half a run of antibiotics for a hangnail. Over the period of a few months, I filled and refilled the prescriptions.

The point of my previous comment wasn't so much, "Fuck y'all, MY family is safe", although I could certainly see how it could be taken that way. The idea that I was really trying to get at is that stockpiling weaponry against something like this is stupid.
posted by double block and bleed at 3:47 PM on April 25, 2009


The outbreak coincided with the President Barack Obama’s trip to Mexico City on April 16. Obama was received... by Felipe Solis, a distinguished archeologist who died the following day from symptoms similar to flu.

I forgave Obama for the double homicide, but I don't think I can forgive him for wiping out Mexico, Twelve Monkeys-style.
posted by rokusan at 3:56 PM on April 25, 2009 [2 favorites]


washing your hands doesn't help make you better once infected.

The point of washing your hands is to do so before you move that virus you picked up from the subway turnstile or shopping cart handle from your hands to your eyes, nose or mouth. Or to seventy-five other surfaces in your own house.

Honestly, if parents would just teach their kids to wash their hands as soon as they get home it would have a huge generational impact.

A lot cheaper than ruining the whole point of antibiotics and vaccines, too.
posted by rokusan at 3:59 PM on April 25, 2009 [1 favorite]


Felipe Solis, a distinguished archeologist who died the following day from symptoms similar to flu

Actually, babelfish tells me that both of these pages say he died from cardiac failure. There is no mention of flu-like symptoms at all.

(Not saying that isn't the case, just seems like jumping to conclusions to get too excited about Obama shaking his hand.)
posted by hippybear at 4:02 PM on April 25, 2009 [1 favorite]


OK, so it's nothing to shut down the schools, right. Oh, yeah, that'll stop it in its tracks.
Why don't you shut down the frikkin' airports so it doesn't spread all over??!?
posted by Drasher at 4:02 PM on April 25, 2009


The outbreak coincided with the President Barack Obama’s trip to Mexico City on April 16. Obama was received... by Felipe Solis, a distinguished archeologist who died the following day from symptoms similar to flu.

Y'know, I gotta think the president travels with a big ol' drum of hand sanitizer.
posted by dilettante at 4:14 PM on April 25, 2009


cardiac failure.... not saying that isn't the case, just seems like jumping to conclusions to get too excited about Obama shaking his hand.

My heart might fail.
posted by rokusan at 4:22 PM on April 25, 2009


Bush was a big fan of hand sanitizer, maybe he passed that on to #44.
On his first meeting at the White House, [Obama] remembers shaking the hand of [President Bush], who turned to “an aide nearby, who squirted a big dollop of hand sanitizer in the president’s hand.”

“Not wanting to seem unhygienic,” the senator writes, he also “took a squirt.”
Source
posted by rokusan at 4:27 PM on April 25, 2009 [1 favorite]


Case suspected in Minnesota.

Story by regional news station oddly devoid of detail and featuring possible alarmist stock photo.
posted by werkzeuger at 4:27 PM on April 25, 2009


That MN story says cases are also reported in Massachusetts. Anyone heard that elsewhere? Or have more information?

really, really, really. really wish my wife wasn't at a conference in MA this weekend. mainly for the hell that air travel is going to be tomorrow.
posted by felix betachat at 4:30 PM on April 25, 2009


That MN story says cases are also reported in Massachusetts. Anyone heard that elsewhere? Or have more information?


MSNBC is also reporting suspected cases in MN and MA.
posted by werkzeuger at 4:33 PM on April 25, 2009


Wait - that MSNBC link doesn't mention MA, but it's Google result does. ???
posted by werkzeuger at 4:37 PM on April 25, 2009


This is the way the world ends
This is the way the world ends
This is the way the world ends
Not with a bang but a sniffle.
posted by five fresh fish at 4:40 PM on April 25, 2009 [3 favorites]


possibly alarmist stock photo
posted by hattifattener at 4:45 PM on April 25, 2009


In other news, i'm a young adult and I've definitely got the flu coming on.
posted by dunkadunc at 4:49 PM on April 25, 2009


Usually with the flu it doesn't "come on". It his you like a freight train. One minute you feel fine and an hour or two later you don't want to walk to the next room unless you really have to.

Colds, on the other hand, can be quite gradual.
posted by Justinian at 4:57 PM on April 25, 2009 [1 favorite]


In other news, i'm a young adult and I've definitely got the flu coming on.
posted by dunkadunc


Shit! It's in this thread! Evacuate the blue!

*shoves black-market Tamiflu into USB ports*
posted by Krrrlson at 5:10 PM on April 25, 2009 [2 favorites]


8 New York Students Likely Have Strain of Swine Flu
posted by oaf at 5:23 PM on April 25, 2009


While at the gym I noticed on Fox News they said that 8 kids in NYC had it. Then by the time I was in front of the TV again, it was saying they're suspected of having it. I think in these early hours/days anyone that has a cough will be "suspected" of having the killer Mexican swine flu. Fox News also showed b-roll of pigs as it introduced the story and on of the rotating FOX ALERT chyrons would say that eating pork products was not dangerous. Alternating with "CDC believes it is too late to stop the spread." Then they'd show people handing out masks in the Mexico City Metro and many Chilangos wearing masks. In other words, the mainstream media has something to talk about other than the boring "the economy sucks" stories. This story seemed to get pushed to the back once news of Bea Arthur's passing crossed the wire.
posted by birdherder at 5:23 PM on April 25, 2009


Here's a last-updated-12-hours-ago google map.
posted by wearyaswater at 5:35 PM on April 25, 2009 [1 favorite]


Obit (Spanish) for Felipe Solis Olguin. "El arqueólogo murió a las 07:00 horas de hoy de un paro cardiaco. El Instituto Nacional de Antropología e Historia expresó su pesar por el deceso del funcionario y afirmó que con ello México pierde a uno de los hombres más destacados de la arqueología moderna."

My Spanish is so rusty the only parts of it that are recognizable squeak and shed brown flakes when flexed, but I'm thinking this says the dude (who was a for-real bigwig in his field) had a heart attack. Which is peculiarly appropriate for a scholar of the Aztec, I suppose.

Found, of all things, via Twitter.
posted by mwhybark at 5:39 PM on April 25, 2009


oo-er, lurvely newsmap reboot over 'ere
posted by mwhybark at 5:48 PM on April 25, 2009


At this point in the thread (and after my washing my hands and keyboard), it's time to make the ineluctable tasteless joke about viral marketing for the season series of Survivors airing later this year.
posted by Doktor Zed at 6:06 PM on April 25, 2009


Mexico City, 81 dead, 1324 infected. In 24 hours a substantial terror thread will unfold.
posted by wallstreet1929 at 6:11 PM on April 25, 2009


What was it Biden said?

"It will not be six months before the world tests Barack Obama like they did John Kennedy. The world is looking. We're about to elect a brilliant 47-year-old senator president of the United States of America. Remember I said it standing here if you don't remember anything else I said. Watch, we're gonna have an international crisis, a generated crisis, to test the mettle of this guy." -- Joe Bid
posted by wallstreet1929 at 6:15 PM on April 25, 2009 [1 favorite]


It's in Montreal, too.
posted by five fresh fish at 6:29 PM on April 25, 2009


Globe & Mail says it's not in Montreal. Well, not yet, anyway.

I'm choosing to believe that everything will fall just the right way and that this won't be even as bad as 1968. But 81 dead now in Mexico? Shit. That's not a good trendline.
posted by maudlin at 6:41 PM on April 25, 2009


One of the reasons that the 1918 pandemic was such a huge killer was that there were so many people in hospitals due to WWI injuries and illness.

Movement was a big part of the problem. The flu was introduced into New Zealand by soldiers returning from WW I. Seriously - the country was under a lockdown, but the Prime Minister of the time had promised to bring the troops back home, so he breached the quarantine for troop ships.

For some reason he wasn't burned alive as punishment for the near one in ten New Zealanders who died, a fact which surpasses all understanding.

Anyway, mobility has only improved since then, and special interests, particularly in tourism and "just in time" manufacturing that rely on relatively unfettered cross-boarder travel will likely lobby against any life-saving measure that cost the a few pennies.

Well, this should make the Zero Population Growth people ecstatic...until somebody theycare about dies.
happyroach, who pissed in your cereal?

five fresh fish certainly appeared to be popping in to do a happy dance at the prospect of mass die-offs.
posted by rodgerd at 6:42 PM on April 25, 2009


I'm not going anywhere CNN on Monday; Lou Dobbs is going to be frothing-at-the-mouth howling-at-the-moom batshit insane. And I mean even more than he usually is.
posted by Ber at 6:43 PM on April 25, 2009 [2 favorites]


Does my only having caught 1 cold/flu in the last, oh, 4 years mean my immune system is going to turn me inside out if I get this?
posted by Decimask at 6:44 PM on April 25, 2009


Does my only having caught 1 cold/flu in the last, oh, 4 years mean my immune system is going to turn me inside out if I get this?

Karma's a bitch.
posted by -harlequin- at 7:11 PM on April 25, 2009 [1 favorite]


Decimask, this blog post, linked earlier in the thread, says, "It is also notable that this flu affects those who are most likely to be immune or resistant to the more run of the mill flu viruses." So, perhaps.
posted by des at 7:13 PM on April 25, 2009


> Karma's a bitch.

Would you feel better if I told you it's probably because I have no social life to speak of?

posted by Decimask at 7:30 PM on April 25, 2009 [2 favorites]


In 24 hours a substantial terror thread will unfold.

Oh, oh, oh... let me start!

I'm going to need a lot more tinfoil.
posted by rokusan at 7:31 PM on April 25, 2009


I want this fantastic thread in my Recent Activity.
posted by iamkimiam at 7:31 PM on April 25, 2009


This is indeed a great thread. Thanks for all the resources, everybody.
posted by vacapinta at 7:37 PM on April 25, 2009


kldickson: happyroach, who pissed in your cereal?

Five Fresh Fish, for a start.

But there's going to be others. These sort of tragedies always bring out the assholes who gloat about how there's too many people in the world, how epidemics are natures way of correcting itself, and related misanthropic crap.

Personally, I'd be happy to help them put their money where their mouths are, and take up a collection to send the lot of them down to Mexico's influenza wards.
posted by happyroach at 7:40 PM on April 25, 2009


Speaking of resources (pdf).
posted by felix betachat at 7:43 PM on April 25, 2009


that's scary...
posted by lithiummind at 7:49 PM on April 25, 2009


AskMeFi question from August 2005 about obtaining Tamiflu online.
posted by Asparagirl at 7:54 PM on April 25, 2009


happyroach, is it entirely relevant to the thread?

And there are, in fact, too many people in the world.
posted by kldickson at 8:06 PM on April 25, 2009


AskMeFi question from August 2005 about obtaining Tamiflu online.

o.O So uh, how many boxes of Tamiflu you holding on to Aspara?
posted by cavalier at 8:09 PM on April 25, 2009


homunculus: "How do you know when to start worrying about the new Swine Flu threat?"

Christ, that kind of article is the very worst kind of journalism/scaremongering there is.

Step 1: Potentially Dangerous New Thing that could kill people emerges somewhere in the world.
Step 2: Authorities who know their shit about this Potentially Dangerous New Thing say that it is indeed potentially dangerous but not to freak out.
Step 3: People like Greg Laden tell people TO FREAK THE FUCK OUT MAN!!!

After which the ultra-paranoids out there in society essentially begin bunkering up and don't emerge for years while life goes on as normal for the vast, vast majority of humans.

Yeah, OK, Swine Flu is a Potentially Dangerous New Thing, sure. But so was Bird Flu in 2004, 2005, 2006 and 2007 and before that it was Mexican Killer Butterflies and before that there was probably something else that was going to kill us all. Far as I can tell, the world's population size is still growing in size.

Basically, yeah, let's be cautious about this Potentially Dangerous New Thing, but until Swine Flu starts knocking off half your neighbors and half your friend and the WHO has pushed the notch up to Level 5 or 6, people like Greg Laden need to shut the fuck up and stop with all the scaremongering.
posted by Effigy2000 at 8:09 PM on April 25, 2009


Happyroach: Putting your money where your mouth is just means having one child instead of two or more.
posted by -harlequin- at 8:11 PM on April 25, 2009 [1 favorite]


Industrial pork production was the name of my band in high school.

What's kind of off putting about this is the statistical likelyhood of it. At some point 'X' is going to occur. We WILL get hit by a meteor big enough to take out a city that will - eventually - take one out.
Doesn't mean it's now. Doesn't mean that this swine flu is THE pandemic.
But given the numbers, how about having a, y'know, contingency plan? And letting people know about it so they cooperate instead of scatter and try to go it alone?
Just a thought. Maybe because I'm well stocked with firearms already I'm on to phase 2 - shooting people isn't going to solve the problem.
People have skillz. Numchuck skillz. But doctorin' skillz as well. And communication skillz. Which is also pretty important.
I dunno. Maybe Mexico isn't that sophisticated. Their government does have plenty of other irons in the fire.
But damnit, anyone there on the opposite side of that equation really think drug money, all the other bullshit is going to save them from puking their guts out?
(Reminds me of a bit from the film "Conspiracy" - taking about disease in the Jewish ghettos and the realities of it vs. the ideology.)

Whether it's a heavyweight or not - it would just be good practice to go through the motions. Do some trial and error. See what works, what's efficient, where we need more cooperation, all that.
posted by Smedleyman at 9:18 PM on April 25, 2009


I'm glad I don't support the swine industry.
posted by MaryDellamorte at 9:35 PM on April 25, 2009


what happened in 1968?
posted by wayofthedodo at 9:42 PM on April 25, 2009


What a useless, pontificating, alarmist thread. Everybody knows something, but nobody knows anything. It's a train wreck of OMG'ness and half-assed assumptions.

Check back in a month. If you're all dying, then MAYBE this thread will have some merit.
posted by matty at 9:55 PM on April 25, 2009


But the thread will be closed in a month! It's now or never people!
posted by ryanrs at 10:08 PM on April 25, 2009 [4 favorites]


The Hong Kong Flu happened in 1968. It was the third pandemic of the twentieth century and generally seen as the mildest.
This 1968 Hong Kong influenza pandemic of 1968 caused fewer deaths than the previous two pandemics. The virus subtype that caused this pandemic was somewhat analogous to the 1957 influenza virus because it had the same NA antigen, N2. but a different HA antigen.

The first case of Hong Kong flu was detected in September 1968, just 11 years after the last flu pandemic. The outbreak developed rather slowly, becoming widespread in early December, and with the mortality rate peaking in December and January 1969. Similar to the previous pandemic, schoolchildren suffered the highest attack rate. By the time the pandemic waned it had caused about 700,000 deaths worldwide, including about 34,000 deaths in the U.S. Many fewer people died during this pandemic than the other two pandemics for three reasons: (1) improved medical care that gave vital support to the very ill; (2) the availability of antibiotics that were more effective against secondary bacterial infections; and (3) the severity the illness probably was reduced among many people because they retained antibodies against N2 in their systems from the 1957 influenza pandemic.
With 700,000 dead worldwide and about 34,000 dead in the States, "mild" may seem like an understatement, but compared to 40-50 million dead from the Spanish flu in 1918, you can see a pretty damn large difference.

I'm not certain how the 1968 flu numbers compare to the death rates from flu in a non-pandemic year, because the CDC doesn't seem to track deaths among the general population. Most years, about 1500 Canadians die from the flu, so I'd guesstimate that 15,000 people die from flu in the States every year. If this is the right estimate, then the 1968 flu was probably about twice as lethal as a typical year's strain. But as far as I can see, there was no overwhelming panic or major economic disruption in 1968-1969. There's a fairly serious report from the CBC here: they sound worried, but not freaked.
posted by maudlin at 10:20 PM on April 25, 2009 [1 favorite]


For the conspiracy minded among us, Baxter recently admitted that they shipped vaccines contaminated with multiple strains of live H3N2 (standard flu) and H5N1 bird flu viruses. This would allow the strains to swap DNA, setting the stage for a lethal pandemic-class flu. According to people in the field, it's incomprehensible how this could have been accidental given the stringent safeguards in place for this kind of research and manufacture. Mainstream reports of this story are virtually non-existent. This was the only reference I could find that wasn't someone's blog or Alex Jones.
posted by gngstrMNKY at 10:51 PM on April 25, 2009 [3 favorites]


Woooo-eeee. San Francisco, New Orleans, Rio de Janeiro, Rome, Kinshasa, Karachi, Bangkok, Peking!
That's some trip you're taking, sir. All in one week!
posted by Durn Bronzefist at 10:51 PM on April 25, 2009 [12 favorites]


Step 3: People like Greg Laden tell people TO FREAK THE FUCK OUT MAN!!!

Huh? He says "even at level 4, you should probably not worry too much. Rather, you should be concerned about the possibility that you will have to start worrying soon, maybe." That's a far cry from freaking the fuck out, man.
posted by homunculus at 10:54 PM on April 25, 2009 [1 favorite]


The world is far more interconnected than it was in 1918. A pandemic would mean the effective shutdown of global trade, and vast logsitical problems distributing goods and resources. A pandemic would mean the effective shutdown of global trade, and vast logsitical problems distributing goods and resources.

Fortunately, we have an actual case-study with current interconnectedness conditions in the SARS epidemic, which caused an estimated 3.8% contraction in Singapore's GDP for Q2 2003. This is minus other factors then the uncertainity leading into the Iraq war, and when US growth was fast chugging into life after the dot-com recession.
posted by the cydonian at 11:12 PM on April 25, 2009


What a useless, pontificating, alarmist thread. Everybody knows something, but nobody knows anything. It's a train wreck of OMG'ness and half-assed assumptions.

Check back in a month. If you're all dying, then MAYBE this thread will have some merit.
posted by matty at 9:55 PM on April 25 [+] [!]


See, that's the whole point.The links from the OP KNOWS something, dw has contributed the most important (albeit cheap) way to stop spreading this and other virii. And yet -harlequin- kept pushing for info on TREATMENT even thoug he's not even sick and backpedaled after who knows what hit him, blaming it on stupid people®. An then you came to inform us that pearl of wisdom.Bravo.

Snark aside, please wash your hands regularly and thoroughly. Can't be emphasized enough.
posted by youhavetoreadthistwice at 11:14 PM on April 25, 2009 [1 favorite]


Happyroach: Putting your money where your mouth is just means having one child instead of two or more.

Or no children.

And as if stating a fact is in any way doing a happy dance. Kiss my asshole, twit.
posted by five fresh fish at 11:27 PM on April 25, 2009


That, btw, was directed at rogerd and Happyroach, not kldickson.
posted by five fresh fish at 11:33 PM on April 25, 2009


I'm glad we're doing Metafilter Circular Argument #234: Overpopulation.

Bea Arthur died, and now we have pig flu, and all you can talk about is who's poppin' outta what vagina. There may not even be a vagina! Have you ever heard of test tube babies?!
posted by dirigibleman at 11:34 PM on April 25, 2009


I just want to point out that reading this at 3:27 am when you've been sick for two days with something that makes you feel like you've been hit with a freight train isn't the best choice.
posted by anastasiav at 12:28 AM on April 26, 2009 [2 favorites]


Just for basic understanding, about 60,000 Americans died in 2004 from influenza and pneumonia. Most of these are elderly and/or immunocompromised, but you do see a very small number of younger people die of influenza and pneumonia every year.

What makes this virus unusual is that it seems to be attacking the young more fiercely than the old, sparking fears of a Spanish Flu like scenario (the cytokine storm mentioned upthread). But right now that's a bit of an unknown, since no one has published any ages for the 86 dead. Word out of Mexico is no new deaths in the last day, which might be a sign that the aggressive treatment doctors are using on the flu is working.

We really don't know how this is all going to play out. We are on the back side of the Northern Hemisphere's flu season, given the warmer weather and the end of school years coming. While containment may be impossible, this might buy the US and Europe enough time to whip up a vaccine to roll out during the fall. Whether there will be enough doses to go around will be a question mark, and the flu could burn itself out much as the '76 swine flu epidemic did. OTOH, it could also rage all summer and reach pandemic levels the moment the snow starts falling.

But right now it really is just a worry, and it should be a reminder to all that handwashing, covering your mouth when you cough/sneeze, and staying home when you're sick are the best ways to prevent this from becoming the pandemic everyone is afraid of. And if it does become a pandemic, having a disaster kit that includes food and water will be essential if food shipments are disrupted or grocery stores are shuttered. This is all common sense stuff, not panic mode stuff. Keep calm and be prepared, but get prepared like this is any other potential disaster, not like The Stand -- Live! is coming to your town.
posted by dw at 12:54 AM on April 26, 2009 [1 favorite]


homunculus: "Huh? He says "even at level 4, you should probably not worry too much. Rather, you should be concerned about the possibility that you will have to start worrying soon, maybe." That's a far cry from freaking the fuck out, man."

Let's review what he says then, shall we? First he says that at some level, we should already be worried now. Never mind that everyone who knows anything about this stuff is telling us not to worry and that this thing only has a potential to become a pandemic. No, worry now? Why? Well he never really says. Just cos', apparently.

Then he tells us this;

"The World Health Organization (WHO) has a threat level system. The lowest threat level is 1, the highest is at 6. The good news is that we are currently only at level 3, which means you should not be worried."

So far, so factual. But then, after telling us what the experts (WHO) say, he writes;

"The bad news is that some experts think we should be at level 4 already, and as far as I can tell they are correct. Which may make us worry about WHO more than it does about the flu..."

This is the second bit of scaremongering Mr. Laden does in his article. Here he tells us that some nameless 'experts' say that we should be at Level 4 already, which should make us worry about the reliability of advice WHO gives us.

The whole crux of Mr Laden's article essentially is "If you aren't worried yet, start worrying god dammit, because someone (I won't say who) said that we should be more worried than we are and that contradicts what the WHO said and that essentially means we possibly can't trust them!"

It's all well and good to question things, but when you contradict the worlds foremost experts with the opinions of nameless apparent experts and unsubstantiated facts, this is the worst kind of scaremongering a journalist can engage in.

Like I said, let's start worrying when the WHO ramps up the threat level to Level 5 or 6, and even then, only when your next door neighbors and half your circle of friends have started dying from this thing. In the meantime, ignore armchair pundits like Laden, who were probably telling us to freak out when Avian Flu, SARS and killer butterflies were making the news as the next big thing to kill us all.
posted by Effigy2000 at 1:19 AM on April 26, 2009


man such hysteria. I hope our good citizens have duct tape and syran wrap ready.

on a flight coming back from peru, a few missionaries -no kidding- on board had told they drank hotel water, which was beyond stupid even for american missionaries. a-and they got real sick on the flight, emesis out both ends, taking up the bathroom for hours and hours etc, so much so we had to make an emergency landing in mexico, where we waited 7 hours for the sickest to be removed. on coming back into houston, every airport worker greeted us with giant 9/12 style gas masks, claiming they'd heard of a epidemic on a plane from mexico.

it took me a few seconds to realize.. oh that's our plane. I imagine the lengths taken for this will be even more reactive.
posted by sarcasman at 1:31 AM on April 26, 2009 [1 favorite]


Here he tells us that some nameless 'experts' say that we should be at Level 4 already, which should make us worry about the reliability of advice WHO gives us.

Just to be clear, here are the official definitions of the pandemic phases, defined in the WHO Global Influenza Preparedness Plan [54pg PDF]. I think it's clear, from this and from statements by Dr Chan (Director-General of WHO) in the briefing yesterday afternoon (EDT), that the main uncertainties lie in the virus's transmissability. Comparing what we already know (1300+ probable cases in 3 countries, now that the NZ cases are confirmed as Influenza A) to the given examples, the only link we haven't yet seen is confirmed human-to-human transmission. Maybe everyone was just hanging around some pigs; maybe every pig in Mexico is infected. We don't know for certain, but if tests do indicate definitively that the virus can successfully hop between people, I suspect we'll see Phase 5 declared by the WHO's emergency committee very very quickly after.

It's not, however, a matter of WHO "holding back information". They're very clear: they don't know yet.
Phase 4. Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.
Rationale. Virus has increased human-to-human transmissibility but is not well adapted to humans and remains highly localized, so that its spread may possibly be delayed or contained.
Examples:
• One or more clusters involving a small number of human cases, e.g. a cluster of <25 cases lasting <2 weeks.
• Appearance of a small number of human cases in one or several geographically linked areas without a clear history of a non-human source of exposure, for which the most likely explanation is considered to be human-to-human transmission.


Phase 5. Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).
Rationale. Virus is more adapted to humans, and therefore more easily transmissible among humans. It spreads in larger clusters, but spread is localized. This is likely to be the last chance for massive coordinated global intervention, targeted to one or more foci, to delay or contain spread. In view of possible delays in documenting spread of infection during pandemic phase 4, it is anticipated that there would be a low threshold for progressing to phase 5.
Examples:
• Ongoing cluster-related transmission, but total number of cases is not rapidly increasing, e.g. a cluster of 25–50 cases and lasting from 2 to 4 weeks.
• Ongoing transmission, but cases appear to be localized (remote village, university, military base, island).
• In a community known to have a cluster, appearance of a small number of cases whose source of exposure is not readily apparent (e.g. beginning of more extensive spread).
• Appearance of clusters caused by same or closely related virus strains in one or more geographical areas without rapidly increasing numbers of cases.


Pandemic period
Phase 6. Increased and sustained transmission in the general population.
Rationale. Major change in global surveillance and response strategy, since pandemic risk is imminent for all countries. The national response is determined primarily by the disease impact within the country.
posted by Super Hans at 2:34 AM on April 26, 2009 [2 favorites]


While I'm spamming info here, there's a lot of data on the plans of both federal and state governments in the US at pandemicflu.gov, which I have never seen before.

Most interesting tidbit so far was this chart of Federal Response Stages, and how they correspond to WHO pandemic plan phases -- unfortunately they were working on the assumption of an overseas outbreak, not one next door. The fact that it's already in the US makes pretty much all of their stages up to stage 5 (the "oh shit, it's here" stage) useless. Containment is impossible, as various officials have already stated.

Hope it doesn't suck too much!
posted by Super Hans at 2:40 AM on April 26, 2009


A combination of double pneumonia, bronchitis, and the Hong Kong flu almost killed me back in 1968, when I was four years old. I vaguely remember getting sick, then puking, then fever setting in. My family was worried but thought it was just a standard childhood illness until they checked my temperature -- 108 degrees! The doctor had them throw me in the tub with ice cubes while he ran over (house calls, remember those?). I was only semi-conscious by then, but I do recall my sisters dumping ice cubes into the tub with me. After the doc arrived and checked me out, it was straight to the hospital.

I remember wheezing and fighting for each breath, under an oxygen tent at the hospital. After struggling to get in one breath, I recall thinking, boy, this breathing shit is just SOOO HARD, and it's be SOOO EASY to just...stop breathing. But then I'd exhale and restart the process of breathing all over again, unwilling to let go of life, just too freaking stubborn to give up. Of all various times in my life where I've come close to death, I don't think I was ever as close to death as I was in the winter of '68. I looked Death itself in the eyes that year, and there's been a part of me that's been heartily thankful for every day I've lived since then.
posted by jamstigator at 2:47 AM on April 26, 2009 [9 favorites]


The BBC this morning quote an eyewitness doctor in a Mexico City hospital as saying the death toll is now over 200 and the current vaccine doesn't work effectively.

Usual warnings about salt, pinches thereof, apply: but the authorities would never try to prevent public panic by understating the casualty figures, would they?
posted by cstross at 3:04 AM on April 26, 2009 [2 favorites]


From the BBC:
In France, a top health official told Le Parisien newspaper there were unconfirmed suspicions that two individuals who had just returned from Mexico may be carrying the virus
posted by fcummins at 3:17 AM on April 26, 2009 [1 favorite]


Wow, cstross, thanks for the BBC link. Those reports from people in Mexico City - and there are a lot of them, and they're agreeing with each other very well - are something...

I've also been checking out this blog - it's a bit scattered but it seems to be a good aggregator of news related to the outbreak, and has been collecting flu-related news since last November. I think it's updated by a Henry L. Niman, who has 6 publications in Nature, but I don't know anything more about him -- and I could be wrong -- but anyway. The blog, which may or may not be run by Niman (and/or friends), excerpts a post from "Recombinombics", which is explicitly Niman's:
The above comments leave little doubt that the H1N1 swine flu is being efficiently transmitted human to human in southern California. The unique constellation of swine genes has not been reported previously and the two cases do not have swine contacts. Moreover, family members had symptoms before and after the confirmed cases, indicating the H1N1 spread efficiently within each family. [Wednesday, April 22]
Niman is behind the Google Maps flu spread map that wearyaswater posted in an earlier comment.
posted by Super Hans at 3:52 AM on April 26, 2009


Some informed comments on flu pandemics and their social consequences. (So far he seems to be right on the money.)
posted by cstross at 3:57 AM on April 26, 2009


cstross: your BBC link seems to indicate those are unsolicited emails. I would assume some level of vetting and checking, but it's not quite "quoting an eyewitness doctor."
posted by werkzeuger at 6:06 AM on April 26, 2009 [1 favorite]


werkzeuger: your point is noted — but if there is a full-dress panic in progress, the Minister for Health is inevitably going to be dragging his heels about announcing a higher death toll, for fear of being blamed for encouraging the panic.

And so rumours circulate, and the lagging public official death toll sets up a dissonant note with what the folks on the ground can see and report, which encourages fear, uncertainty and doubt, and the whole thing escalates. This isn't exactly rocket science: it reminds me somewhat of the original news about SARS back in 2003, and the way panic was provoked by the official denials that there was anything to be afraid of.
posted by cstross at 6:50 AM on April 26, 2009


isn't this just bird flu all over again? -ie all hype no action?
posted by mary8nne at 7:20 AM on April 26, 2009


mary8nne: in a word, no.

That H5N1 was dangerous is beyond question -- but it didn't cross the species barrier easily; you had to live in a hut with a flock of infected chickens before you stood much chance of being infected.

This A/H1N1 strain of pig flu, in contrast, appears to readily spread from one human being to another -- so it's far more contagious than bird flu. It's showing signs of a high mortality/morbidity ratio, which is also worrying. It's too early to tell if it's contagious enough to go pandemic, but the early signs aren't good.

Once a new flu strain goes pandemic, it's only a matter of time before it cross-infects someone with a different flu virus load. At which point it hybridises -- in effect mutating to produce a happy fun new and improved strain. This happens numerous times; the more people are infected, the higher the probability of new strains emerging. The real risk of which is the possible emergence of vaccine or antiviral drug resistance.

NB: don't write off bird flu yet. It was contained (by mass slaughter of chickens on an epic scale) and hasn't hybridised with a contagious human influenza strain -- yet. If it hybridises with this pig flue strain, though, we're all in for a world of hurt.
posted by cstross at 7:33 AM on April 26, 2009 [2 favorites]


Interesting. This article from the AP quotes a CDC representative saying that the reason why cases in Mexico appear so much more lethal than those in the US is that their infection rate is probably much, much higher. It seems artificially deadly in Mexico because we are only hearing about the most virulent cases. Perhaps these are people whose immune systems are compromised because of poor nutrition, or who have preexisting respiratory conditions because of the air quality in Mexico City.
posted by felix betachat at 7:36 AM on April 26, 2009


Oddly enough, the post 9/11 hysteria led to the creation of lots of disaster plans, including some that would cover this kind of thing. There was considerable attention to smallpox, for instance, and some vaccination was actually done. As I recall, medical staff go pretty high up on the vaccination priorities. And they may possibly be required to report for work, as happens sometimes during hurricanes.

(Oddly, because it was terrorism, not bird flu, that led to the planning).
posted by dilettante at 8:02 AM on April 26, 2009


The U.S. cases are in addition to the outbreak in Mexico, which has caused as many as 60 deaths and more than 1,000 infections. U.S. tests on virus samples from 14 Mexican patients confirm that about half of them are swine flu.

The problem in identifying swine flu is that its symptoms are virtually indistinguishable from regular influenza, said Dr. Anne Schuchat of CDC. The only way to be sure an infection is swine flu is through a laboratory test, which takes time.

Because the virus has popped up in so many locations, there is likely to be a larger outbreak if the virus proves to be highly transmissible -- something that has not been demonstrated yet.
LA Times
So the CDC tested 14 samples from Mexico and found half of them to be swine flu. That means half of the people died from something else.
On Saturday, as word spread that city health officials had determined that at least eight students at St. Francis Preparatory School in Fresh Meadows, Queens, probably had human swine flu, students and their families, along with teachers and administrators, reacted with varying degrees of anxiety, alarm and aplomb.
NY Times
The story about the high school kids in Queens troubles me because a) the kids are "suspected" of having the strain and b) the link to Mexico is based on other students saying many kids went to Cancún on spring break.

Here's a map (en español) from El Universal in Cd Mexico that shows where the cases are popping up across Mexico. The Minutmen and Lou Dobbs will be in even more of a tizzy about the cases in the border states. But since you can fly nonstop from Mexico City to Narita, Hong Kong, Frankfurt, London, and dozens of major airports in the US and Latin America. Airplanes make great disease carriers as they quickly travel across the globe with people sitting in close quarters with recycled air. Since influenza can live on surfaces like filthy airplanes for hours, the next people on that flight can get it. The bug is already global at this point. So people everywhere need to cover their mouths when they sneeze, wash their hands, and stay home or seek treatment if they're sick.

Of course, a lot of these are suspected cases and death, not confirmed cases. And just because you are showing "flu-like symptoms" doesn't mean you have the killer Mexican Swine Flu of 2009. We need to be careful of any strains of flu and pneumonia but not freak out.
posted by birdherder at 8:28 AM on April 26, 2009 [1 favorite]


Damn. If we could just remove all the people from the airplanes it would be so much safer. Fewer people would die when there's a crash, too.
posted by XMLicious at 8:54 AM on April 26, 2009


XMLicious, now you understand why the CEOs of failing companies did not want to give up their private jets. They'd have to share the air with sick people!
posted by birdherder at 9:13 AM on April 26, 2009


Smithfield Farms Link?

Timeline of events

Personally I think this will turn into a full-bore pandemic. You usually don't get bits and bobs popping up all over the world at the same time unless a fuckton of people already have it...

I'm less concerned about the lethality and more concerned about the reaction people will have to this. I figure by Monday afternoon people in the US will be in full-bore tizzy mode. What does that mean? Dunno. I assume random stockpiling and bizarre behaviour for a bit, especially as germaphobic as people are nowadays.

Also for the doctors out there, does the germaphobe culture/rise in allergies amongst younger generations raise the chance of a cytokine storm? Or is it just luck of the draw?

I expect I'll get sick, especially considering that I'm smack-dab in the middle of what you could classify as a big petri dish. 10 minutes from LAX, living in West LA. No possible way to get away from this, unless I get on a boat and float away, never interacting with another human being or animal..

I'm preparing though.. I'm going to go buy apple juice and I'm cooking chicken soup to freeze. Which now that I think of it, feels like a good, measured approach to the incoming pandemic.. heh
posted by Lord_Pall at 9:42 AM on April 26, 2009


I bought my own house a few months ago and have been remodeling it. I'm low on funds and have had to reduce my socializing, as well as being a bit depressed by the whole move and living alone, feeling socially isolated. I've thrown myself into the remodeling and have slowly been adapting to living alone and starting to feel good about myself again. I also happen to work for myself, so I'm basically home alone all day and night, unless I need to run out and meet a client, or have dinner with friends. All of a sudden, I'm grateful to have my own place and work for myself LOL. I'm not worried at all about this flu, except I did just fly home from a week's vacation in Las Vegas on April 22, just as all of this started to hit the news... LOL So far no flu symptoms that I'm aware of and I'm hitting that 96 hour mark after my flight! Oh heavens.

In all seriousness, it seems to be that we've had lots of potential pandemic threats pop up only to fizzle out over the last 20 odd years. I truly think technology, communications, and medical advances are giving us a leading edge on such things. I would never dare to say the world has seen its last pandemic, but I think it's a legitimate question to ask ourselves how many pandemics we've avoided that we might not have 50 years ago... Let's hope this is just another!
posted by PigAlien at 10:10 AM on April 26, 2009


NYT's reporting that the Queens cases are indeed swine flu.
posted by oaf at 10:13 AM on April 26, 2009


Swine flu identified in Canada
posted by oaf at 10:20 AM on April 26, 2009


(Some possibly helpful links.)

http://crofsblogs.typepad.com/h5n1/

http://scienceblogs.com/effectmeasure/

(google maps tracker)

http://maps.google.com/maps/ms?ie=UTF8&hl=en&t=p&msa=0&msid=106484775090296685271.0004681a37b713f6b5950&ll=24.527135,-97.734375&spn=146.410171,360&z=1
posted by loquacious at 10:23 AM on April 26, 2009


Mad cow, bird flu, swine flu... Is our livestock taking revenge for something? We should eat them faster before they are able to hatch out these nefarious plans.
posted by bigmusic at 10:33 AM on April 26, 2009


NYT's reporting that the Queens cases are indeed swine flu.

So that's what jonmc has been up to!
posted by The Whelk at 10:40 AM on April 26, 2009


Well, at least pigs can't fly.
posted by carter at 10:41 AM on April 26, 2009 [2 favorites]


US Govt has just declared a public health emergency, according to the NYT.
posted by felix betachat at 10:50 AM on April 26, 2009


gerryblog wrote: Here's an aspect of the story the American media, unsurprisingly, isn't touching: the outbreak has been linked to industrial pork production.

Swine flu..trichinosis. Trichinosis..swine flu.. Hmm. Tough question.
posted by wierdo at 11:26 AM on April 26, 2009


Sorry, what's the question, wierdo?
posted by grouse at 11:32 AM on April 26, 2009


I hate FluMist because I took it as an alternative to the flu shot once and it basically gave me a mild but still miserable case of the flu (they deny it does this, but when you read the side-effect list, it is a classic description of flu symptoms).

Nevertheless, the FluMist technology allows for really rapid 'vaccination' of any type of flu.

What they basically do is take a really mild 'cold adapted' flu strain and bioengineer it somehow so the outside of it looks like another flu--any flu type that you want to protect against. It is kind of like putting a scary halloween mask on a little child.

Your immune system reacts to the mask and creates antibodies to the monster it sees, the result being you become immune to the more dangerous flu.

I mention this because the flumist technology can be used to quickly provide immunity to the world if it becomes necessary. No need to wait for growing anything on eggs like traditional flu vaccines.

There's also a universal flu vaccine in the works.
posted by eye of newt at 11:43 AM on April 26, 2009


What's the story with flu in Hawaii, where it lights up Google Flu Trends?
posted by Blazecock Pileon at 11:54 AM on April 26, 2009


What's the story with flu in Hawaii, where it lights up Google Flu Trends?

Maybe Hawaiians still have relatively poor flu immunity, at least compared to people of European or more recent Asian descent?

Having just finished Guns, Germs and Steel, I wonder if the fatal flu cases in Mexico City disproportionally involve people with more native american/mexican ancestry. I have no idea if 600 years is long enough to mix up the genes enough to give everyone uniform resistance to livestock based diseases.
posted by b1tr0t at 12:05 PM on April 26, 2009


I know the situation's not going to get that bad, but the constant references to the handful of cases popping up around the country make me think of The Stand, specifically the parts discussing how the virus spread early on:

He had a slight cold, an allergy cold, maybe, and he kept sneezing and having to spit. In the course of the meal he infected Babe, the dishwasher, two truckers in a corner booth, the man who came in to deliver bread, and the man who came in to change the records on the juke. He left the sweet thang that waited his table a dollar tip that was crawling with death.

* * *

That night they stayed in a Eustace, Oklahoma, travel court. Ed and Trish infected the clerk. The kids, Marsha, Stanley, and Hector, infected the kids they played with on the tourist court's playground -- kids bound for west Texas, Alabama, Arkansas, and Tennessee. Trish infected the two women who were washing clothes at the Laundromat two blocks away. Ed, on his way down the motel corridor to get some ice, infected a fellow he passed in the hallway. Everybody got into the act.

* * *

Sarah Bradford and Angela Dupray walked back to their parked cars together (infecting four or five people they met on the street), then pecked cheeks and went their separate ways. Sarah went home to infect her husband and his five poker buddies and her teenaged daughter, Samantha. Unknown to her parents, Samantha was terribly afraid she had caught a dose of the clap from her boyfriend. As a matter of fact, she had. As a further matter of fact, she had nothing to worry about; next to what her mother had given her, a good working dose of the clap was every bit as serious as a little eczema of the eyebrows.

The next day Samantha would go on to infect everybody in the swimming pool at.the Polliston YWCA.


I still think
posted by Rhaomi at 12:15 PM on April 26, 2009 [1 favorite]


...that that book is the most terrifyingly realistic example of a pandemic in literature.

(sorry)
posted by Rhaomi at 12:16 PM on April 26, 2009


I bet Janet Napolitano will use the fact that there are now at least six cases in Canada as "proof" that our border with Canada as much scrutiny as the one with Mexico.
posted by oaf at 12:21 PM on April 26, 2009


needs
posted by oaf at 12:22 PM on April 26, 2009


So, ahh, if I had a flu shot this past winter, will it be effective against the current strain?
(Trying not to be paranoid and embrace the wtf-ness of the whole thing.)
posted by wowbobwow at 12:26 PM on April 26, 2009


the virus affects healthy younger folks

Coming back to this earlier statement... I'm not seeing evidence of this being anything like the Spanish Flu. Two of the cases near San Antonio are 16 year old boys, and they're reported to only have mild cases. The only other confirmed "younger" person who died is a 39 year old woman in Mexico who was already immunocompromised.

Right now, of the 1500 or so cases we've seen, as many as 81 have died, which does look bad (a 7% kill rate). But every death so far has been in Mexico. In the rest of the world there have been zero deaths and only a handful of hospitalizations among the confirmed cases. And it looks like there still haven't been any confirmed deaths since Friday.

I feel like I'm repeating myself over and over here -- stop panicking already, be prepared, and understand we're still very early in this situation. It could go pandemic. It could just be a bad flu. But this isn't someone's wet dream of a world-ending plague. One thing my wife mentioned to me this morning is how many of the Spanish Flu victims might have survived if penicillin or sulfa were available in 1918 -- many died from opportunistic pneumonia.

We're in a Health Emergency now, so the National Stockpile is going to start shipping out masks and drugs to state health departments today, just in case, just as they did during the anthrax scare. The public health system, threadbare and underfunded as it is, is deploying what it has. So long as we stick to the things I keep going back to over and over about prevention, most of us will never even get sick, and the drugs that will work will be ready to help those in most serious need.

And PS: It doesn't appear to have entered the US food chain yet, and even if it had, you're fine so long as the pork is cooked. Enjoy your bacon.
posted by dw at 12:37 PM on April 26, 2009


So, ahh, if I had a flu shot this past winter, will it be effective against the current strain?

No. This is strain is something new.
posted by sbutler at 12:40 PM on April 26, 2009


So, ahh, if I had a flu shot this past winter, will it be effective against the current strain?

No. This is strain is something new.


Actually, it just might grant some protection.
The dominant form of flu circulating in the U.S. in the most recent flu season was an H1N1, said Frederick Hayden, professor of clinical virology at the University of Virginia Health Sciences Center in Charlottesville. That suggests that people who got this year’s flu vaccine, which gave protection against the H1N1 virus, might also have some protection against the swine flu, he said.
But this is still conjecture, and so far no one has been able to corroborate a relationship between being vaccinated and complete/partial immunity.
posted by dw at 12:46 PM on April 26, 2009


What's the story with flu in Hawaii, where it lights up Google Flu Trends?

I don't know, but if you click on the HI state outline to see just the historical data for Hawaii, you see that its "flu-googling season" is a bit atypical in all years — longer and delayed compared to the rest of the country — and it's not a whole lot different this year from last. I'd guess that the Hawaii flu season varies with tourist activity, rather than with local weather.

I'm a bit interested since I just got back from Hawaii, but if we assume a typical incubation period for this flu I already know I didn't catch anything there or on the flights…
posted by hattifattener at 1:46 PM on April 26, 2009


...The public health system, threadbare and underfunded as it is, is deploying what it has...

And PS: It doesn't appear to have entered the US food chain yet, and even if it had, you're fine so long as the pork is cooked. Enjoy your bacon.


Just don't let the teabaggers hear you say that.
posted by fontophilic at 2:13 PM on April 26, 2009


Another reason to be pissed off at Congressional Republicans. via
posted by nax at 3:37 PM on April 26, 2009


I keep telling myself that I'm not going to obsessively read about the latest swine flu news on the internet, yet I keep doing exactly that.
posted by diogenes at 4:25 PM on April 26, 2009 [4 favorites]


If this thing does go pandemic, you can bet your last healthcare dollar that the religionuts are going to claim that God is punishing America for [insert nuttery here].
posted by five fresh fish at 4:53 PM on April 26, 2009


Well, there's your problem. You're not supposed to insert the nuttery. It's purely decorative.
posted by maudlin at 4:56 PM on April 26, 2009 [2 favorites]


∀x, good(x), ∃y: the religious nuts believe god is using x to rewarding you for doing y.
∀x, bad(x), ∃y: the religious nuts believe god is using x to punish you for doing y.
posted by b1tr0t at 5:01 PM on April 26, 2009 [3 favorites]


s/rewarding/reward/
posted by b1tr0t at 5:01 PM on April 26, 2009


Welp, okay, all you guys convinced me: I'm going to actually care about washing my hands regularly now.
posted by Ms. Saint at 5:13 PM on April 26, 2009


E(x)∃

augh, math goatse!
posted by ryanrs at 5:14 PM on April 26, 2009 [12 favorites]


If this thing does go pandemic, you can bet your last healthcare dollar that the religionuts are going to claim that God is punishing America for [insert nuttery here].

I'm sure the people at NOM can make another gem of a video.
posted by MaryDellamorte at 5:18 PM on April 26, 2009


In relation to the title of the post. The dietary laws prohibiting swine would have come after the Israelites left the land of Egypt, no?
posted by ericales at 5:21 PM on April 26, 2009


In addition to the religious wingnuts doing their thing, the conspiracy theorist paranoics are just shitting themselves at the thought that this might — nay, must! — be a manufactured virus.
posted by five fresh fish at 6:12 PM on April 26, 2009


five fresh fish: Or no children.


And as if stating a fact is in any way doing a happy dance. Kiss my asshole, twit.


Oh really. So you crept into a thread on an epidemic, to innocently drop a non sequitur about your OPINION (not fact, opinion) that there's far too many people in the world. Which has nothing to do with anything except that people shouldn't have children.

Yeah right. Tell us another one, buddy.

You don't need to have had all that much contact with radical ZPG types to know what the subtext of your sentence is going to be, and I've had plenty. I'verown seen the words said often enough to know the words that went unsaid in your one-liner were "therefore an epidemic that kills off lots of brown people is a good thing."

But hey, if you're really just all about the no babies thing, it's still not too late for postnatal autoabortion. Go ahead and be a good example.
posted by happyroach at 6:27 PM on April 26, 2009


Happyroach is not a happy roach.
posted by dirigibleman at 6:53 PM on April 26, 2009


There's plenty of resources for everyone on the planet. Instead of focusing on how overpopulation is the problem, we should be focusing instead on overconsumption, which is the real problem, not people.
posted by KokuRyu at 7:06 PM on April 26, 2009 [1 favorite]


Come on people, keep it civil. Stick to infectious bacon paranoia.
posted by Merik at 8:13 PM on April 26, 2009


Flu Manual
There's a non-profit out there called InSTEDD (Innovative Support to Emergencies, Diseases, and Disasters).
The page in the first link has a link to a .pdf of a 'Citizen's Manual' for pandemic flu.
It's a good read, fairly clear and mostly lingo-free.
Another InSTEDD site, TrackerNews provides an aggregate of information from all over the globe.
Docs I know say we should be 'very concerned.'
posted by dbmcd at 8:33 PM on April 26, 2009 [4 favorites]


[Some comments removed. Less of the fuck-you parade or take it elsewhere.]
posted by cortex at 9:30 PM on April 26, 2009


Carrying capacity of earth. Happyroach: [deletia].
posted by five fresh fish at 9:42 PM on April 26, 2009


@dw: the Chicago Tribune is reporting that the CDC says differently:
There is no vaccine against swine flu, but the CDC has taken the initial step necessary for producing one — creating a seed stock of the virus — should authorities decide that's necessary. Last winter's flu shot offers no cross-protection to the new virus, although it's possible that older people exposed to various Type A flu strains in the past may have some immunity, CDC officials said Sunday.
For what it's worth, though, I agree that it's probably too early to be speculating on such things. There's a lot of information out there, some of it contradictory. I would, however, operate under the assumption that this years flu vaccine offers no protection since that's the most cautious course.
posted by sbutler at 10:24 PM on April 26, 2009


i am not very excited about this because now trying to get on an airplane is going to involve some kind of invasive medical testing or something.

air travel is the biggest reason for global pandemics because people can get to the other side of the world before they know they're even sick. so now we're going to quarantine mexico and institute virus testing before you can get on a plane, all in the name of safety and security.

or, maybe not. we have a sane man in the white house now, but if my dystopian fiction has taught me anything, it's that people freak the fuck out and do stupid things.
posted by misanthropicsarah at 10:38 PM on April 26, 2009


if my dystopian fiction has taught me anything, it's that people freak the fuck out and do stupid things.

If my dystopian ficton has taught me anything, it's that any minute now people are going to start trying to eat me.
posted by dersins at 12:11 AM on April 27, 2009 [1 favorite]


Might be time for a re-read of Connie Willis's Doomsday Book for some Black Death/2050 flu pandemic tips.
posted by harriet vane at 3:28 AM on April 27, 2009


CBC now reporting cases in Mexico, the U.S., Canada, and Spain.
posted by Durn Bronzefist at 4:42 AM on April 27, 2009


DON'T PANIC BUT YOU ARE GOING TO DIE.
posted by MrMustard at 5:34 AM on April 27, 2009


When do I worry? Cause I'm not worried and don't plan on worrying, but just to be on the safe side, what's the 'oh crap oh crap oh crap?'. Threshold? I mean , my car is still more dangerous, right?

Is that the threshold? Or is it when it superseeds ladder, or slipping in the bathtub? And how quickly could it reach those types of numbers? Thanks for all the other good info upthread.
posted by From Bklyn at 7:16 AM on April 27, 2009


just to be on the safe side, what's the 'oh crap oh crap oh crap?'. Threshold?

Likely this is different for everyone. Myself, I'd be more, um... concerned (or whatever it is I'm feeling) if I lived in an area like southern CA or NYC or someplace with more people likely to travel directly between the US and Mexico. Or if I had a lot of traveling to do myself in the next month.

Would I be wearing a mask on the NYC subway at this point? I don't know. I might if I had some on hand, but I don't know if I'd go out and buy some. Yet.
posted by hippybear at 7:25 AM on April 27, 2009


The worry comes from feeling helpless. If you are in a car or on a ladder and see an accident about to happen you can take defensive action to prevent it. So most of the time we feel in control of our lives. With the flu, these timy invisible things make you really sick, maybe kill you or someon you love and washing hands just doesn't feel as proactive. Add in the worry about lost/losing their jobs and a lot of people are feeling emotionally fragile and not in control of their lives.

I remember during SARS in Toronto how people would FREAK whenever someone coughed, even if was obvious they were choking on food.
posted by saucysault at 8:43 AM on April 27, 2009


Reasons to feel secure:

Lessons from SARS: the SARS epidemic earlier in the decade helped governments learn a lot about how to deal with a flu-like disease. However, from what I recall, SARS was much more deadly and dangerous than the current swine flu.
posted by KokuRyu at 9:06 AM on April 27, 2009


As Nax mentioned above the Republicans cut flu outbreak preparation in the recent budget.

There's only one thing the GOP would hate more than warning people about than volcano eruptions or flu pandemics: the eruption of a volcano filled with swine flu.
posted by dances_with_sneetches at 9:14 AM on April 27, 2009


i am not very excited about this because now trying to get on an airplane is going to involve some kind of invasive medical testing or something.

In Chile they set up no-contact body temperature scanners for the immigration line at the airport.
posted by signal at 9:16 AM on April 27, 2009


When do I worry? Cause I'm not worried and don't plan on worrying, but just to be on the safe side, what's the 'oh crap oh crap oh crap?'. Threshold?

Having read the excellent WHO flu manual linked above, I would say it's too early to "panic" but certainly not too early to prepare. If this isn't it, then there's likely to be another. Really, I'm not sure what it is about human nature that makes a person think: "well sure, it's happened every 30 to 50 years.... until now".
posted by Durn Bronzefist at 9:21 AM on April 27, 2009


Just want to chime in that people making comments about how industrial farming led to this are goddam morons. The Asian/Avian/Hong Kong pandemics were the direct result of "sustainable" farming in rural China -- that is, small farms with pigs, chickens, and humans all co-mingling. This always creates the largest infectious threat. I'll take this "industrial" swine flu over the other any day.
posted by FuManchu at 10:09 AM on April 27, 2009 [1 favorite]


The two cases in Kansas are thisclose to me. I'm not one to panic (after all, we just had a tornado warning last night and those are much more immediate dangers at this time of year) but it's hard not to be nervous with the "EVERBODY PANIC!" tone of some of the news reports.

I've read through several flu-related threads on various sites within the last few days, and this thread is by far the most sane and informative, so thanks to everyone who is contributing.
posted by amyms at 10:42 AM on April 27, 2009


Just want to chime in that people making comments about how industrial farming led to this are goddam morons.

I disagree, it's entirely possible that both environments are breeding grounds for different types of bugs. It may very well turn out that this strain originated within a modern commercial farming/ranching concern and it may very well turn out to be that practices or procedures within industry enabled this particular strain of influenza to adapt and mutate rapidly. At this point it's probably too early to have a definitive AH HA! type moment for where it made the jump.
posted by iamabot at 10:46 AM on April 27, 2009


Just want to chime in that people making comments about how industrial farming led to this are goddam morons. The Asian/Avian/Hong Kong pandemics were the direct result of "sustainable" farming in rural China -- that is, small farms with pigs, chickens, and humans all co-mingling. This always creates the largest infectious threat. I'll take this "industrial" swine flu over the other any day.

Amen.

You know what they found at the beginning of the 20th century after pathologists had tracked down the mycobacteria that cause tuberculosis? People were getting it from the milk they drank. That's right, bovine tuberculosis is communicable to humans. It was treating animals for disease that wiped out TB in the U.S. more than treatment of humans.

Just one of the many reasons for the "pumped full of drugs" part of industrial agriculture, so that you don't find yourself washing down the homeopathic vanilla bean Trader Joe's Oreos with tuberculosis milk.
posted by XMLicious at 10:55 AM on April 27, 2009 [1 favorite]


I am finding that my usual cynical ability to pooh-pooh the latest health panic is being severely dampened by the fact that I'm pregnant. The CDC website didn't do all that much to assuage my low-grade worry, either.
Because of the unknown effects of influenza antiviral drugs on pregnant women and their fetuses, these four drugs [Oseltamivir (Tamiflu), zanamivir (Relenza), amantadine (Symmetrel), and rimantadine (Flumadine)] should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus; the manufacturers' package inserts should be consulted. However, no adverse effects have been reported among women who received oseltamivir or zanamivir during pregnancy or among infants born to such women.
Yay? I guess?
posted by shiu mai baby at 11:22 AM on April 27, 2009


Just want to chime in that people making comments about how industrial farming led to this are goddam morons.

Nice. Did you read the link? If the connection is bogus then it should be debunked, but ignoring the evidence doesn't disprove it. It's a possibility which should be investigated.

The Asian/Avian/Hong Kong pandemics were the direct result of "sustainable" farming in rural China -- that is, small farms with pigs, chickens, and humans all co-mingling.

Small rural farms are certainly an easy place for a virus to jump to humans, but there's still some reason to believe that industrial poultry also contributes to the spread.
posted by homunculus at 11:46 AM on April 27, 2009


It was treating animals for disease that wiped out TB in the U.S. more than treatment of humans.

Are you certain that it wasn't the widespread adoption of pasteurization that led to that reduction in human disease? My understanding was that animal antibiotics were introduced to reduce weight loss and keep animals producing the meat or milk we desire rather than wasting energy fighting off infection.
posted by hippybear at 11:50 AM on April 27, 2009


It seems as though we were, at one point, thinking about pandemic spread as something we needed to spend money on. Apparently, now, not so much.
posted by hippybear at 12:06 PM on April 27, 2009


Did you read the comments to the link? Anyone with understanding about how the virus forms was skeptical.

Now, look: Let's be clear on what we are and are not saying. When a virus exists in a population, it will spread faster if that population is denser. No one really objects to that. With any given virus, it is best that the populations are spread thinly and don't mix. Viruses would spread fastest in an industrial setting.

What is special about the mixing of the bird-swine-human populations is the mutation of the virus, the creation of the deadly strain. The worst strains, those most lethal to humans, have come from that combination. Therefore the actual creation of deadly viruses is most common in the backyard setting.

There is obviously a trade-off. My claim is that the benefits of industrialization (feeding more people, greatly reducing number of death-strains) outweigh the costs (quick spread of viruses which do appear). China has been a great example of non-industrialized farming for centuries, and it has been the epicenter for multiple pandemics in the last 100 year. I put if to the critics of industrialization to prove otherwise.
posted by FuManchu at 12:14 PM on April 27, 2009


Evidently, a 6.0 earthquake just hit mexico city...
posted by 445supermag at 12:14 PM on April 27, 2009


It was 5.6, and though it was felt in Mexico City, it was centered 250 kilometers away.
posted by dersins at 12:22 PM on April 27, 2009


FYI, CDC Emergency Preparedness and Response has a Twitter stream.
posted by dersins at 12:51 PM on April 27, 2009 [1 favorite]


I am finding that my usual cynical ability to pooh-pooh the latest health panic is being severely dampened by the fact that I'm pregnant.

Don't worry too much about it. People who spend a lot of time flying (travel + airplane environment + exposure to masses of people from all over the world) have the most to fear from this illness.

Just wash your hands and you'll be fine.
posted by KokuRyu at 12:59 PM on April 27, 2009


The WHO has raised its flu alert to level 4.
posted by hippybear at 2:03 PM on April 27, 2009 [1 favorite]


So this seems not much worse than SARS, so meh.

However, I hear that a large serving of civet will prevent catching swine flu.
posted by GuyZero at 2:15 PM on April 27, 2009


"Swine Flu" + Madagascar = 29,000 hits

Also seems to be a popular joke on twitter:
http://search.twitter.com/search?q=madagascar

I'm kind of amazed that such an obscure joke about an obscure web-game has gotten so widespread.
posted by empath at 2:22 PM on April 27, 2009 [1 favorite]


James MacDonald at Making Light has come through with another link-filled, sensible post on prepping for flu season and possible pandemics. Also, Bruce Sterling.

I'm in Toronto. I lived through SARS (sadly, 44 neighbours did not), the city's economy recovered, and we even got a festival with AC/DC, loads of genuine American barbeque and Justin Timberlake getting bottled into submission at the end of it. More importantly, public health agencies learned a LOT from SARS. We could get a really bad pandemic some day, and it's still possible that this could be it, but right now, we're still waiting for the shoe to drop. It seems as if there must be something odd going on in Mexico if there are 100 deaths so far from this and nothing but relatively mild cases elsewhere. The most plausible theory seems to be that the Mexican authorities are vastly underreporting non-hospitalized cases, which means that the death rate is actually significantly lower than reported, plus the rest of the world hasn't had enough cases yet to yield the first few deaths.

(Only 26 Mexican deaths have been officially attributed to swine flu, but given how this seems to be striking relatively young people rather than the elderly, it seems plausible that just about all of those deaths must be from this strain.)
posted by maudlin at 2:27 PM on April 27, 2009


The large number of deaths reported in Mexico City is the confusing/scary part. I can't understand why people seem to be dying in Mexico but not in other cases. I live in Southern California and to be frank, am currently more worried about our mental health than our physical health! This is the potential stuff of my nightmares.
posted by pazazygeek at 2:40 PM on April 27, 2009


Surprised to see a BBC "have your say" thread on swine flu, but it makes for interesting reading from those reporting in from Mexico, some of them claiming to be health practitioners. Content unverified, of course, but scary.
posted by Durn Bronzefist at 2:52 PM on April 27, 2009


five fresh fish:Carrying capacity of earth. Happyroach: [deletia].

It's worth noting that even that site with it's one-sided and simplistic look at population, points out that the carrying capacity of Earth is not a fixed number. It states that more efficient resource consumption can raise the carrying capacity of Earth beyond the 8 Billion person limit. So the problem is, once again, not one of population, but of politics, and it's not good evidence for your case.

And beyond that, there's still the big question: WHY did you bring the whole population limits thing up in this thread of all places, if you weren't doing the standard "Disease is a good thing by bringing down the brown person population" taking point?

Have you gotten to the point where you think that simply saying "overpopulation" is enough to get your talking point across? Or were you trying to hide your attitude?
posted by happyroach at 3:11 PM on April 27, 2009


the standard "Disease is a good thing by bringing down the brown person population" taking point

I've said for years, the proliferation of tanning salons is going to be the end of us all.
posted by hippybear at 3:30 PM on April 27, 2009


Just want to chime in that people making comments about how industrial farming led to this are goddam morons.

Yes. And no.

Yes, the instant "HURF DURF PIG FARM" attitude of the Grist post is absolutely ludicrous. For one thing, we're not even clear if the disease even began in that town, only that the earliest reported cases were there. To jump to these sorts of conclusions is not just unscientific, it's anti-scientific, and it puts on display the problems not only with modern science writing but also with modern environmental writing. There's a lack of fact and a whole lot of yellow journalism in there.

No, because we know that if you put a bunch of animals in a confined space with questionable hygiene you will get disease. Since influenza is a virus that loves to share its genes with other influenza viruses, this is what you get. And given that Mexican hog farm disease monitoring isn't on the level of American hog farm monitoring, this could have been stewing for quite a while. All it'd take is for a swine flu infected human to get some human flu virus in them, the viruses have a key, er, gene party, and voila, a new virus with swine components and a human targeting system. And an intensive hog processing facility is the perfect place for humans to contract swine flu. Add in a poorly maintained facility with lots of waste and pollution, and you are playing with fire.

Does this mean the pig plant in Veracruz state is the cause of our problems? We really, honestly don't know. But to lay the blame at their feet is like blaming video games for school shootings. You need to show better cause and effect than "they played Doom a lot."

I was at a lecture on swine flu today, and it was mentioned that this H1N1 actually consists of parts of two swine viruses -- one common in North American hog farms, one common mainly in Asian pig farms. How the Asian hog virus got mixed in is unknown; the virus hasn't been seen in the US pig population at all.
posted by dw at 3:40 PM on April 27, 2009


Can we please not do this derail, happyroach?
posted by ryanrs at 3:41 PM on April 27, 2009


Level 4 is a critical juncture in the pandemic alert system. Basically, we're saying this stuff is human-to-human transmissible and so it's time to start mobilizing the response teams and thinking about how to handle quarantines, social isolation, and travel bans.

But note: It's not TIME for quarantines, social isolation, and travel bans. It just means it's time to get ready just in case it happens.

One other thing from the lecture I was at: It appears this swine flu virus, for the moment, is responding to treatment from front-line antivirals like Tamiflu and Relenza, which is odd considering that most common human influenza viruses don't.
posted by dw at 3:55 PM on April 27, 2009


Yea, dw, I don't think we disagree at all. There are definitely farming practices that need to be questioned. But using the term 'industrial' in regards to farming is usually done to compare it with 'sustainable' farming. And in the century we've had with both types of farming, one has produced multiple pandemic strains, while the other has not (though yea, it may only be a matter of days now). I think someone who was serious about the issues you raised would use different terminology. So yea, I just got mad at the HURF DURF.

for my own amusement:
Yes, the Manpig beast virus is a threat, and always has been. This may be the first time it has grown from industrialized farming. But sustainable farming allows Bird to bring in his power ring to join with Manpig's, which summons the horror that is Manbirdpig virus. Manbirdpig has been a proven threat at even small scales. So to call out Manpig when the other option is Manbirdpig is downright silly.
posted by FuManchu at 4:04 PM on April 27, 2009 [1 favorite]


I was at a lecture on swine flu today, and it was mentioned that this H1N1 actually consists of parts of two swine viruses -- one common in North American hog farms, one common mainly in Asian pig farms. How the Asian hog virus got mixed in is unknown; the virus hasn't been seen in the US pig population at all.

That's interesting... did anyone see Half Yard Productions' Pig Bomb docu-thingie on the Discovery Channel about the recent explosion in the wild pig population in North America? (online clips, Animal Planet rebroadcast schedule) It asserted (relevant clip) that the reason the behavior and appearance of wild pigs has changed is due to cross-breeding of feral domestic pigs - the original North American wild pig population - and Eurasian wild boars which were intentionally and illegally imported by hunters during the past few decades and released with the idea of providing hunting stock. Connected, perhaps?

Here's the producer/director's resume, since I came across it Googling for the other stuff.
posted by XMLicious at 4:54 PM on April 27, 2009


It asserted (relevant clip) that the reason the behavior and appearance of wild pigs has changed is due to cross-breeding of feral domestic pigs - the original North American wild pig population - and Eurasian wild boars which were intentionally and illegally imported by hunters during the past few decades and released with the idea of providing hunting stock. Connected, perhaps?

I'm pretty sure that the original North American wild pig was also imported to the Americas by Europeans, before the more recent Russian pigs that this show talks about.

Hawaii provides a small microcosm of what happens when wild pig populations get out of control.
posted by eye of newt at 5:06 PM on April 27, 2009


This Times article is attempting to trace the flu back to a village beside an industrial pig farm. They actually name the four year old who perhaps patient zero. Isn't that a rather crappy thing to do to a kid?
posted by saucysault at 6:16 PM on April 27, 2009


I'm pretty sure that the original North American wild pig was also imported to the Americas by Europeans,

Sorry, I used confusing punctuation there, that's exactly what I was said: that the original North American wild pig population before the introduction of boars was made up of feral domestic pigs.
posted by XMLicious at 6:21 PM on April 27, 2009


er, "exactly what I said", that should be
posted by XMLicious at 6:24 PM on April 27, 2009


Happyroach, I care about and on occasion rant about overpopulation, and race has nothing to do with it. In fact I usually think of overpopulators as white evangelicals.

You are barking up the wrong, and a very troll-ish, tree, sir.
posted by vrakatar at 7:59 PM on April 27, 2009


They actually name the four year old who perhaps patient zero.

She's killed us all.
posted by hippybear at 9:25 PM on April 27, 2009 [6 favorites]


re: Director of goverment lab in Winnipeg, Canada speculates Tamiflu and Relenza will be ineffective.
(posted by werkzeuger at 2:30 PM on April 25)

This article confuses the idea that existing vaccines will not be effective, with the idea that Tamiflu and Relenza will not be effective:
"The viruses are so different we think it's unlikely (existing vaccines) would provide much protection. So if we need a vaccine, which we probably do, we'll have to make one," Plummer said, noting it would take at least six months to make a new vaccine.
The reporter incorrectly infers from that, that the doc was saying that Tamiflu would be ineffective. He wasn't.
posted by memebake at 5:13 AM on April 28, 2009


An op-ed by John Barry, who wrote The Great Influenza. He says that this wave may be mild outside of Mexico, but successive waves could be more virulent, so we have to get hopping on a vaccine ASAP.

This is interesting:
The first wave in 1918 was relatively mild, many experts speculate, because the virus had not fully adapted to humans. And as it did adapt, it also became more lethal. However, there is very good evidence that people who were exposed during the first wave developed immunity — much as people get protection from a modern vaccine.
If the non-Mexican cases stay mild, and few or no deaths result, I wonder if some people will try to immunize themselves by deliberately trying to get sick now. Didn't families used to have chicken pox parties for their kids for the same reason?
posted by maudlin at 8:34 AM on April 28, 2009 [1 favorite]


It hasn't been confirmed yet, but we're potentially looking at the first two American flu deaths down in Los Angeles. Both were men, aged 33 and 45.

68 total confirmed cases in the U.S., although the NYC health commissioner claims "many hundreds" of schoolchildren there are infected.
posted by Rhaomi at 11:55 AM on April 28, 2009


Wow, that health commissioner sure knows how to make scary soundbites. I'm sure the next sentence was something about how the swine flu the kids have is no worse than the normal flu, but that won't make the headlines.
posted by smackfu at 11:58 AM on April 28, 2009


maudlin: "Didn't families used to have chicken pox parties for their kids for the same reason?"

People still do.
posted by The corpse in the library at 12:03 PM on April 28, 2009


Incidentally, the CDC has a pretty ominous-looking headquarters. A strange hodgepodge of smokestacks and antennas and concrete blocks rising up out of the streets. Creepy.
posted by Rhaomi at 12:27 PM on April 28, 2009


Memebake, thanks for that clarification. I wondered why that article seems to contradict so much other reporting.

For the scientifically (genetically?) minded, the National Center for Biotechnology Information has the gene sequences of many US cases online.

Finally, the Veratect Corporation, mentioned upthread, has a twitter feed which is very interesting, albeit unconfirmed.
posted by werkzeuger at 12:50 PM on April 28, 2009 [1 favorite]


The reporter incorrectly infers from that, that the doc was saying that Tamiflu would be ineffective. He wasn't.

Yeah, he's definitely confused. OTOH, I was just reading a WHO report the other day about rates of Oseltamivir (Tamiflu) resistance. Through 2008 into 2009, of H1N1 cases tested, 100% of (52) Canadian cases and 98% of (241) U.S. cases were Oseltamivir-resistant.

WHO FAQ on this issue here.

That's not to say that this would apply to the current strain. As the FAQ concludes (published in Feb 2008, mind, with regard to the first sentence):

"The current H1N1 viruses are not a threat to cause a pandemic, and the cause and timing of the next influenza pandemic cannot be accurately predicted. Existing neuraminidase inhibitors, including oseltamivir, are useful against a range of influenza viruses, and oseltamivir resistance has been very uncommon in H5N1 viruses to date. WHO and its partners will continue to carefully monitor antiviral susceptibility patterns in seasonal and animal influenza viruses. WHO is not making changes to its general advice on antiviral stockpiling for the time being."
posted by Durn Bronzefist at 12:57 PM on April 28, 2009


It hasn't been confirmed yet, but we're potentially looking at the first two American flu deaths down in Los Angeles. Both were men, aged 33 and 45.

Tests are incomplete, but the L.A. coroner doesn't think it was swine flu.
posted by Iridic at 2:35 PM on April 28, 2009 [1 favorite]


I've posted an alignment of the hemagglutinin sequences that werkzeuger linked to. Interesting that there is so much variation already.
posted by grouse at 2:45 PM on April 28, 2009 [1 favorite]


grouse: that's really interesting. Flus recombine a lot, right, I wonder if this is a strain that's somehow more apt to recombine? It would explain the high variation between cases already... the oh no 1918-style deaths in Mexico being a couple of switches flipped the other way, the highly spreadable version being something else...

This is all wild, insane speculation, of course. Glad you posted that though.
posted by Super Hans at 3:28 PM on April 28, 2009


I'm excited you guys actually made use of that link! Can you translate into layman?
posted by werkzeuger at 4:00 PM on April 28, 2009


werkzeuger: Looks like there are at least four distinct but very closely related sequences, three in California, and one in Texas. There are only changes at three residues: lysine/methionine, proline/serine, and alanine/threonine. Of course there are probably changes in the other genes as well. What do these mutations mean? I can't say what the implications of the individual changes are specifically, but HA is important in binding to host cells during flu infection, and little changes can cause big differences in effectiveness.

Lots of info about hemagglutinin.
posted by grouse at 4:10 PM on April 28, 2009 [1 favorite]


The large number of deaths reported in Mexico City is the confusing/scary part. I can't understand why people seem to be dying in Mexico but not in other cases.

Solve that mystery and you'll have a Nobel Prize for Medicine coming. This Slate article lays out most of the main possibilities, which include:

Some sort of genetic vulnerability peculiar to Mexicans. Not likely. "This isn't like the smallpox situation of 500 years ago, when American Indians were decimated by a virus they'd never encountered while Europeans carried it easily because centuries of exposure had selected them for resistance. This strain of swine flu virus is apparently new to everyone...There seems no reason any human population should resist its effects substantially better or worse than any other. "

Two different viruses or strains are at play. Apparently discounted for now; "the completed assays appear to show that the fatal Mexico cases match closely the 40-plus milder cases confirmed in the United States."

A subset of the above that I've seen: The virus is evolving into a less virulent form as it travels outward. The problem with this hypothesis is that it assumes the virus has moved uniformly outward. The map of the outbreak isn't a series of concentric circles centered on Mexico City, delineating gracefully degrading virulence as the bug ripples farther away, but a big patch of severe cases in Northern Mexico and smaller patches of mild cases scattered throughout the world.

The Mexicans are dying from coinfection.
Though the CDC team in Mexico has apparently ruled out most of the more likely candidates, it's possible that some sort of subtle endemic bug, abetted and masked by the swine flu, is at work. Too soon to know for sure.

Certain environmental factors exacerbate the flu.
Take your pick: elevation or air pollution. Certainly possible, and we have no way of discounting environmental factors until we see the flu's effects in a broader range of geographical areas.

Poor Mexican health system/nutrition. By all accounts, Mexican hospitals and clinics are underfunded and overburdened by red tape - but are they really so far behind the rest of the world as to let dozens of people die from a mild flu? As for nutrition, I've seen some suggestions that undernourishment is to blame, but that wouldn't match the facts: the main nutrition problem in northern Mexico these days is actually obesity.

The numbers from Mexico are flawed in such a way as to make the situation seem worse. Certainly a factor, though we don't know yet if it's the main factor.

This excellent blog lays out the calculation of the swine flu CFR (Case Fatality Ratio), a measure of virulence:
"What is CFR? Again, in simplest terms we can estimate it by using as the numerator the number of swine flu deaths in Mexico (or the US) and divide it by the total number of cases. That proportion is an estimate of dying of swine flu. Simple. Unfortunately a little too simple, because we have great difficult ascertaining both the numerator and the denominator."
That's the key issue of the day. It's clear that the total number of cases is greater than the ~2,000 cited by the media, but as yet we don't know how much greater. It's possible that a correct CFR might actually resolve the disparity between the Mexican statistics and the global numbers, especially if, as Slate suggests, the true total number of cases is around 1 million.
...It's also possible that Mexico is missing, undercounting, or badly underreporting deaths. But if this virus really does spread rapidly, its kill rate is fairly low; and if its kill rate is anywhere near as high as the 100-out-of-1,600 suggests, then it doesn't spread very easily.
Reason to feel a little better. But we should maintain our caution until we know for sure. There's still too much we don't know about the flu.
posted by Iridic at 4:11 PM on April 28, 2009 [8 favorites]


"In another development, the UN's Food and Agriculture Organisation is sending a team to investigate claims that industrial pig farms in Mexico were the source of the outbreak in humans. The agency's chief veterinary officer, Joseph Domenech, told the BBC that the FAO had to act following rumours that people had been falling ill last month near some intensive pig farms."

So maybe now we'll get a definitive answer on that.
posted by homunculus at 4:29 PM on April 28, 2009


Some in Mexico are starting to doubt the existence of swine flu deaths. For example, I received a chain email that's been floating around Mexico City asserting that the G20 dreamed up this flu to distract the world from the financial crisis. It's titled The Flu: A Big Lie, and it questions why there hasn't been any coverage or interviews with the family of the dead. One would expect photos of grieving families, but it all seems to be photos of people in mouth covers, so people there are now comparing this to Chupacabra.

A cursory glance at the comments sections on Mexican newspapers shows a similar phenomenon.
posted by mosessis at 5:12 PM on April 28, 2009 [1 favorite]


mosessis: is the contention of the chain email that there is no illness, period, or that the flu is manmade, or....?
posted by werkzeuger at 7:56 PM on April 28, 2009


grouse and super hans: you might like this information about the swine flu gene sequence.
posted by werkzeuger at 8:03 PM on April 28, 2009 [1 favorite]


Uh-oh. A Mexican national, but first confirmed swine flu death in the US.
posted by Happy Dave at 8:59 AM on April 29, 2009


Bacon's Revenge
posted by homunculus at 10:27 AM on April 29, 2009


Swine Flu Genes From Pigs Only, Not Humans or Birds
posted by homunculus at 1:08 PM on April 29, 2009


The Swine Flu Is All In Your Head: Is Anyone Awake At the Huffington Post?
posted by homunculus at 1:22 PM on April 29, 2009


Ok, without the snide blink tag, the WHO raised us to alert level 5 which means governments are supposed to activate their emergency preparation plans, not just uh, prepare them.
posted by Justinian at 1:44 PM on April 29, 2009


WHO raises influenza epidemic level from 4 to 5
posted by Rhomboid at 2:15 PM on April 29, 2009


FYI new flu thread here.
posted by dersins at 2:17 PM on April 29, 2009


werkzeuger - the contention is that the flu does not exist or it's fatality is being extremely overhyped. I talked to another source in Mexico City last night who said some people wonder if it isn't just regular flu deaths or even overdoses from club drugs.
posted by mosessis at 6:42 PM on April 29, 2009


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