H5N1

Vietnam: A new human H5N1 death (updated)

Via Reuters: PRESS DIGEST - Vietnam newspapers - Dec 1. Excerpt:

The Health Ministry confirmed the H5N1 virus has killed a 23-year-old man last month in the northern province of Dien Bien, the fifth fatality in Vietnam so far this year. Vietnam currently has no outbreaks among poultry, the Agriculture Ministry said.

How current is "currently"? Vietnam News reported a bird-to-bird outbreak in Dien Bien on November 3. But this is the first report I've heard of a human death in Vietnam in some time. 

WHO's November 27 update on H5N1 cases shows only four H5N1 deaths this year in Vietnam. WHO hasn't had a flu-death update on Vietnam since May 6. I expect another one in the next day or two.

Update: Voice of Vietnam News has a report on the case.

US: Second H1N1 wave has peaked

The New York Times discusses today's CDC update: Fall Wave of Swine Flu Has Peaked, Data Confirm. Excerpt:

New swine flu infections continue to drop across the United States, confirmation that the pandemic’s fall wave has peaked, according to figures posted online Monday by the Centers for Disease Control and Prevention. 

But the number of children and teenagers killed by swine flu is still rising. An additional 27 deaths in lab-confirmed cases of it were reported among children and teenagers in the week ended Nov. 21, raising the total to 234 since April. In a typical flu season, there are fewer than 100 deaths among that segment of the population. 

And since the C.D.C. believes that there are actually two to three deaths for each fatal lab-confirmed case, the total is presumably creeping toward 700. 

But just 32 states, mostly in the Northeast and the West, reported “widespread” flu activity, down from 48 at the peak, in late October. 

Overall doctors’ visits for flu declined for the fourth week in a row. Hospitalizations dropped for the third straight week, and, for the first time, there appeared to be a clear drop in weekly deaths. 

That defied pessimistic warnings from officials at the disease control agency that hospitalizations and deaths might keep rising, since most people are hospitalized days after first falling ill and may be treated for weeks before dying. 

Experts at the agency have tentatively predicted that a new, but presumably smaller, January wave could emerge, brought on by students’ returning home for Christmas. Campus flu activity is declining but not gone. 

Further, cases of seasonal flu are now being found occasionally. Among the 420 samples the agency has tested since September, it has found three cases of H3N2 flu, the strain that tends to be most lethal to the elderly; four cases of influenza B, which normally arrives late in the season; and one case of seasonal H1N1.

I'm glad to see the drop in cases, but a third wave seems likely to result from more than just students going home: Millions of people travel internationally over the holidays. The hajj, just completed, had very few H1N1 cases and only five deaths. Let's hope other travelers are as fortunate.

Finland confirms human-to-pig transmission of A/H1N1 flu

Via Xinhua: Finland confirms human-to-pig transmission of A/H1N1 flu. Excerpt:

Finland has confirmed the country's first known human-to-pig transmission of A/H1N1 influenza, said Finnish Food Safety Authority and Finnish National Institute for Health and Welfare in a statement on Monday.     

According to the agencies, samples taken from some pigs of a pig farm in Southern Pohjanmaa region, west in the country tested positive for the A/H1N1 flu viruses.

These transmissions are happening pretty often, and similar transmissions have no doubt happened for centuries. 

I recall Christmas Eve 1983, when my wife and I wandered around a farm across the road from our institute in suburban Guangzhou. The owners, proud and prosperous, showed us their new brick pigsty, with some handsome residents, just a few steps from the farmhouse itself. 

The family was making money in those early years of China's takeoff, putting a new floor on the house, and living in cheerful intimacy with their pigs and poultry. Guangdong province has lived like that for centuries, and never more successfully than in the last 30 years.

Hong Kong: Swine flu fears spark pet dumping worries

Via The Standard: Swine flu fears spark pet dumping worries. Excerpt:

Pet owners are fretting over news that dogs in the mainland tested positive for the human swine flu (H1N1). 

The concerns have prompted the Society for the Prevention of Cruelty to Animals and Hong Kong Dog Rescue to warn pet owners not to abandon their pets because of the scare. 

Neither organization has received any urgent calls from owners looking to get rid of their pets, however. 

"They are sensible people and I don't see them panicking," said Sally Anderson of Hong Kong Dog Rescue of the average pet owner. 

Still, a woman named Mok called RTHK claiming she was infected by her cat, which caught flu from her brother's cat a floor below. "My brother did not tell me his cat was infected so I allowed mine to play with his," she said, claiming to have been ill for a week and "sneezing like my cat." 

But Secretary of Health York Chow Yat-ngok and Chinese University of Hong Kong respiratory medicine professor David Hui Shu-cheong said there is no scientific evidence to show humans could catch the H1N1 virus from pets. 

Chow did say, though, that there was "always an opportunity for the virus to spread from species to species." 

The main concern, he added, was determining exactly what happened to the two dogs in the mainland that tested positive for the virus and the question of whether it was transmitted from humans to dogs or between dogs.

CDC update

The CDC has published its Situation Update covering the November 15-21 period. Excerpt:

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week of November 15-21, 2009, influenza activity decreased in some key indicators and increased in others. Overall influenza activity remains high for this time of year.

Spain: Flu cases triple in Málaga

Via 20minuto.es: El frío triplica los enfermos por la gripe A en un mes. [Cold weather triples flu illnesses in one month] Excerpt, with my translation:

La bajada del termómetro trae, como cada año, un aumento de las enfermedades respiratorias. Y este año, el virus de la gripe A casi ha reemplazado al de la gripe estacional. Los últimos datos de la Junta indican que se registran 324 casos por cada 100.000 habitantes, frente a los 117 casos de finales de octubre. 

The fall of the thermometer has brought, like every year, an increase in respiratory illnesses. And this year the H1N1 virus has virtually replaced seasonal flu. The latest data from the Council indicate 324 cases per 100,000 inhabitants, compared to 117 cases at the end of October.

Indonesia: Suspected H5N1 patient in Padang

Via Bird Flu Information Corner, a translated report from Padang Today: Padang, West Sumatera ::: Duck farmer suspected to contract bird flu.

A resident of Tanjuang Durian, Nagari Baru Kecamatan Bayang Kabupaten Pesisir Selatan, Dasrizal (37), suspected to contract bird flu virus and admitted to M Djamil hospital. 

Patient is a duck farmer, and raising hundreds of ducks. He is reported to have found almost of all his ducks suddenly died. Subsequent to the finding, he buried the dead ducks. He developed high fever at noon of the same day, and his family gave him antipyretic drug, a kind of paracetamol. 

Dafrizal’s fever was getting higher in the afternoon and his family brought him to Pasa Baru public health center in the evening. Public health center was then referred Dafrizal to M Zein Painan hospital, where he was diagnosed as bird flu suspect. 

Patient was transferred to M Djamil hospital to receive better treatment as bird flu suspect patient.

Fear and swine flu in Bangladesh

Via BMJ Blogs, a wonderful article: Tracey Koehlmoos on fear and swine flu in Bangladesh. Excerpt:

They were waiting for me when I returned to Dhaka in late July. My office is not easily found, so the small group of older gentlemen must have been determined in their efforts. 

Without an appointment but bearing chocolate, the request was clear: surely I had access to the H1N1 vaccine and they wanted it for themselves. In July the vaccine was available only in trials in North America, Europe and Australia—not in South Asia. 

My attempts to provide the best information available on preventing illness through good respiratory hygiene and hand washing fell flat on these accomplished men. As one said, “I have COPD. If I get this disease, I will die.” 

The fear of H1N1 is real in Bangladesh, as we look across the border to India where schools have been closed and re-opened, the situation is viewed as a true public health emergency. 

Within Bangladesh, enterprising yet nefarious agents were reportedly selling “swine flu vaccine” in the informal market. I wonder what they were shooting into people? Saline? Another real vaccine like Hib or measles? Something potentially dangerous? Fortunately, there were no reported deaths from the fake vaccines. 

From June to September 2009, the number of identified H1N1 cases in Bangladesh was 604, and there were only three reported deaths. Further, most people without other risk factors will contract a mild form of the disease, and recover fully without the help of anti-viral treatment or medical care. 

In a country where more than 1000 children a day die of diarrheal disease and 83 children per day die of injuries, the panic itself seems disproportionate to the burden and risk of H1N1.

Canada: No time to let things slip

An unhappy editorial in this morning's Globe and Mail: No time to let things slip. Excerpt:

More than 300 Canadians have died of swine flu since last spring, including 30 between Wednesday and Friday morning. It killed more people from Nov. 16 to 23 than it did all last spring. No one knows where it is going, or if it will return in a more deadly third wave. Yet the public has lost its sense of urgency about being inoculated. The biggest-ever immunization campaign is turning out not to be nearly as big as it could, or should, be.

Only 1.3% of Israelis got H1N1 shot; 3 more people with swine flu die

Via the Jerusalem Post: Only 1.3% of Israelis got H1N1 shot; 3 more people with swine flu die. Excerpt:

An 11-year-old girl, and two women aged 25 and 77 - all suffering from serious chronic illnesses - died on Monday after being infected with H1N1 virus, the Health Ministry said. 

The first died at Haifa's Rambam Medical Center, the second at Tel Aviv Sourasky Medical Center and the third at Wolfson Medical Center in Holon. They were the 61st, 62nd and 63rd Israelis listed as victims of the H1N1 flu strain, even though in none of the cases could the deaths be blamed on the virus due to lack of autopsies. 

Meanwhile, although Prime Minister (and acting health minister) Binyamin Netanyahu has ordered 7.3 million doses of H1N1 vaccine - enough for every resident except for newborns - the average Israeli does not seem interested in getting the shot. 

According to the latest figures of the Center for Disease Control, only 1.3 percent of residents - or 96,772 people - have received the H1N1 vaccination about a month after the first 350,000 became available. Many of those who were vaccinated work in the health system.