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  • Swine flu worse in Mexico than US, but why?

    Source: http://www.google.com/hostednews/ap/...dr2EAD97PPGU00

    Swine flu worse in Mexico than US, but why?

    By MIKE STOBBE

    ATLANTA (AP) ? Why has the swine flu engulfing Mexico been deadly there, but not in the United States?

    Nearly all those who died in Mexico were between 20 and 40 years old, and they died of severe pneumonia from a flu-like illness believed caused by a unique swine flu virus.

    The 11 U.S. victims cover a wider age range, as young as 9 to over 50. All those people either recovered or are recovering; at least two were hospitalized.

    "So far we have been quite fortunate," said Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention on Saturday, just hours before three new U.S. cases were confirmed.

    Health experts worry about a flu that kills healthy young adults ? a hallmark of the worst global flu epidemics. Deaths from most ordinary flu outbreaks occur among the very young and very old.

    Why the two countries are experiencing the illness differently is puzzling public health experts, who say they frankly just don't know.

    It may be that the bug only seems more deadly in Mexico.

    And while experts believe Mexico is the epicenter of the outbreak, they're not certain if new cases are occurring or if the situation is getting worse. They also don't know if another virus might be circulating in Mexico that could be compounding the problem.

    A big question is, Just how deadly is the virus in Mexico?

    The seasonal flu tends to kill just a fraction of 1 percent of those infected.

    In Mexico, about 70 deaths out of roughly 1,000 cases represents a fatality rate of about 7 percent. The Spanish flu pandemic of 1918-19, which killed an estimated 40 million worldwide, had a fatality rate of about 2.5 percent.

    The Mexican rate sounds terrifying. But it's possible that far more than 1,000 people have been infected with the virus and that many had few if any symptoms, said Dr. Michael Osterholm, a prominent pandemic expert at the University of Minnesota.

    U.S. health officials echoed him.

    "In Mexico, they were looking for severe diseases and they found some. They may not have been looking as widely for the milder cases," said Schuchat of the CDC.

    The U.S. health agency sent two investigators to Mexico on Saturday to help, she said.

    Currently, even the counted illnesses are problematic. Only a fraction have been lab confirmed. Severe penumonia-like illness happens all the time, so it's challenging to figure out which ones are really tied to the outbreak, U.S. health officials said.

    "These numbers need to be confirmed," said Dr. Richard Wenzel, the immediate past president of the International Society for Infectious Diseases.

    Other ideas about the difference include:

    _Genetic analysis of virus samples in the two countries is continuing. The CDC says tests results show the U.S. and Mexican viruses are essentially the same, but some experts have not ruled out the possibility that the virus is changing as it leaks across the border to the north.

    _Perhaps nutrition levels are worse in some Mexican communities ? poor nutrition can degrade a person's immune defenses, and make them more susceptible to illness.

    _Air quality in Mexico City is considered terrible. That too may have affect patients confronted with a novel respiratory disease.

    _Access to medical care has been an issue in Asia, where a rare bird flu ? which does not spread easily from person-to-person ? has killed more than 200 over the last several years. Maybe Mexican patients have also had trouble getting medical care or antiviral drugs, some have speculated ? even though the government provides health care.

    All that is speculation at this point.

    "The question of why the virus appears to be more virulent in Mexico is one that we are looking intensively into," the CDC's Schuchat said. "Rather than speculate, it's important for the science to lead us on this."

  • #2
    Re: Swine flu worse in Mexico than US, but why?

    If someone can locate the recent paper by HK researchers on what makes an influenza highly H2H - I believe that may explain some of this issue. I did look and couldn't locate it - IOH probably has it readily available.

    I believe the jist of that paper is that successful H2H mutations occur in humans, so Mexico with various ideal environmental factors supplied this opportunity.

    It's also a function of keeping the RO low - crowding supplies the opportunity for higher ROs, which is a prerequisite for pandemic influenza.

    I prefer to view Mexico's austere actions to stop the spread as being less indicative of how bad it is, and more indicative of how they are committed to keeping this disease at a more manageable level of transmissability.

    .
    "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

    Comment


    • #3
      Re: Swine flu worse in Mexico than US, but why?

      From USAID: Infectious Diseases 2008 Report http://www.usaid.gov/our_work/global...o_profile.html


      Tuberculosis (TB) is a public health problem in Mexico and remains of great interest to the United States, given the shared borders and immigration flow between the two countries. According to the World Health Organization’s (WHO’s) Global TB Report 2008, Mexico had an estimated 22,473 TB cases in 2006, with an estimated incidence rate of 21 cases per 100,000 population. The National TB Control Program (NTCP) began implementing DOTS (directly observed treatment, short course) in selected demonstration areas in 1996, and, according to WHO estimates, DOTS population coverage reached 100 percent in 2005. Multidrug-resistant (MDR) TB is a concern, with 2.4 percent of new cases being drug resistant. Mexico received approval from the Green Light Committee (GLC) to expand access to second-line TB drugs. Extensively drug-resistant TB also was confirmed in Mexico in February 2007.
      ...........................................

      Comment: Many cases of TB go undiagnosed in Mexico. This has weakened the ability of many to develop stronger immune systems.

      Comment


      • #4
        Re: Swine flu worse in Mexico than US, but why?

        Most of the scientists are saying that this flu kills via cytokine (similar to pandemic flus) - this plays a large role.

        There are much more sick people in Mexico - that means more young adults - that means more mortalities.

        Almost all of the sick in the US are outside of the 20+ young adult group - they're almost all kids.

        Comment


        • #5
          Re: Swine flu worse in Mexico than US, but why?

          1st I have a comment about the 1918 Pandemic. I believe that prior to the beginning of that outbreak in the early Fall of 1918, there was a mild outbreak of a Spring Cold. I've seen that in several accounts. I've also seen indication that those that had the earlier mild version that year had developed a degree of immunity, and did not succumb when the eventual Pandemic broke out. Anyone have comments / references regarding that?

          2nd, I question the fact that the cases in the U.S. are "Mild". I was just watching an interview with the County Health Head in one of the San Diego Counties where 3 people were confirmed. The reporter asked him about the "mild" cases, and he specifically stated that 2 of the 3 had been hospitalized, but were recovering. Required hospitaliztion from Flu is NOT MILD. In that one county it is a 66% hospitalization rate (admittedly a small sampling). But I've also seen interviews with one Texas case & one New York case where family or friends referenced their friend/son being ADMITTED to the hospital for some period. Same point applies as above. This brings me to my 3rd concern -

          I've been following this board since the inception. The Leaders here do a fabulous job tracking individual suspect cases of Avian Influenza in out-of-the-way places like Indonesia, Vietnam and Egypt / China. Heck, some of the work done to track down exact details involved individuals in locations that you probably had to take a friekin donkey just to get to the local village. WHY am I not seeing individual case details on the cases right here in the U.S.? Granted it is happening fast, but am I missing a thread here?

          Again, I am not convinced that the cases here are mild. My only evidence is what the news Media keeps parroting. And this is the same media that continually refers to the NYC cases as if it is just 8. Everyone involved in this to any degree knows darn well that if it is 8 - it's probably 75+.

          How about some hardcore data on the individual confirms? Because my definition of a mild flu strain does not involve large percentages of hospitalizations. As one Moderator said "We tell it like it is here". So let's do that. Any comprehensive individual data on these cases???????

          Comment


          • #6
            Re: Swine flu worse in Mexico than US, but why?

            As an afterthought, in regards to the exact question mentioned in the Thread, "Swine flu worse in Mexico than US, but why?", I'd like to pint out that they have over 1300 cases with 81 dead (a 6.2% Mortality Rate). We have "11" cases. Statistically speaking, we've got a few more cases to go before we can expect a death - which brings us back to the question: ARE we experiencing Mild cases here in the U.S.? or is there a high rate of hospitalizations? Because if there are hospitalizations going on - then we might start experiencing mortalities within the next 10 or so official cases - statistically speaking.

            Comment


            • #7
              Re: Swine flu worse in Mexico than US, but why?

              We are dealing with both HIPPA regulations as well as information on minors.

              The specifics on the cases will have to come from parents and the press will have to figure out how to track them down.

              May I ask why you are interested in the minutia? Is it somehow relevant? We, in the US, are not denying the fact that we have an outbreak of a novel human transmissible virus, nor are we trying to puzzle out whether we have such. The names and ages of H5N1 victims in far away places help track relationships which helps inform about clusters or possible clusters.

              Flublogia does not demand this information, but puts the information to good use when it is available. Perhaps when the shock and illness wears off parents will begin to speak publicly about the ordeal, but right now, I imagine there is a lot of concern and confusion to deal with.

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              • #8
                Re: Swine flu worse in Mexico than US, but why?

                Originally posted by The Mountains Voice View Post

                I've been following this board since the inception. The Leaders here do a fabulous job tracking individual suspect cases of Avian Influenza in out-of-the-way places like Indonesia, Vietnam and Egypt / China. Heck, some of the work done to track down exact details involved individuals in locations that you probably had to take a friekin donkey just to get to the local village. WHY am I not seeing individual case details on the cases right here in the U.S.? Granted it is happening fast, but am I missing a thread here?

                Again, I am not convinced that the cases here are mild. My only evidence is what the news Media keeps parroting. And this is the same media that continually refers to the NYC cases as if it is just 8. Everyone involved in this to any degree knows darn well that if it is 8 - it's probably 75+.

                How about some hardcore data on the individual confirms? Because my definition of a mild flu strain does not involve large percentages of hospitalizations. As one Moderator said "We tell it like it is here". So let's do that. Any comprehensive individual data on these cases???????
                Is this what you are looking for? Names have been omitted on purpose, I assume. Case Listing - USA Swine Flu
                "In the beginning of change, the patriot is a scarce man (or woman https://flutrackers.com/forum/core/i...ilies/wink.png), and brave, and hated and scorned. When his cause succeeds, the timid join him, for it then costs nothing to be a patriot."- Mark TwainReason obeys itself; and ignorance submits to whatever is dictated to it. -Thomas Paine

                Comment


                • #9
                  Re: Swine flu worse in Mexico than US, but why?

                  Thanks Niko - that was exactly what I was looking for.

                  Comment


                  • #10
                    Re: Swine flu worse in Mexico than US, but why?

                    SOPHIAZOE WROTE:
                    May I ask why you are interested in the minutia? Is it somehow relevant? We, in the US, are not denying the fact that we have an outbreak of a novel human transmissible virus, nor are we trying to puzzle out whether we have such.

                    Well, I am one of the WE in the U.S.,, and yesterday I sent out a broadcast email alerting all of my friends and family that this was most likely not a drill, and that they needed to follow this story. One of my greatest points of guidance was to get prepared, and make at least some investment in preparatory supplies. Well, like most of John Q. Public, they tuned into the News Media, and almost unilaterally got back to me that "Oh, it's nothing David - it's only "MILD" here", and basically scoffed at me a a chicken little. So I don't consider it "Minutia" when it is giving the public the impression that the situation is less than it is. As a matter of fact, I never consider the truth vs. Spin to be "Minutia". I think my points are very much geared towards important points. Again, I have seen 3 interviews on the local news channels that indicated hospitalization for 4 of the 11 confirmed U.S. cases. And I will repeat that this is not Mild if it is true. I am also still very interested in anyone's comment on the earlier Mild Spring Case Immunity from 1918. Any truth to that to anyone's knowledge?

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                    • #11
                      Re: Swine flu worse in Mexico than US, but why?

                      I didn't know that crossing borders might cause viruses to mutate
                      I'm interested in expert panflu damage estimates
                      my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

                      Comment


                      • #12
                        Re: Swine flu worse in Mexico than US, but why?

                        Originally posted by Niko View Post
                        Is this what you are looking for? Names have been omitted on purpose, I assume. Case Listing - USA Swine Flu
                        No, the names haven't been omitted on purpose. The reason they are not listed relates to the comments above by SophiaZoe regarding HIPAA privacy. The names and personal information from H5N1 infected individuals in China, Egypt, Indonesia, etc. are obtained from local news media articles and occasionally from official sources. Because of privacy issues, scientific research and lab results are almost always based on some kind of arbitrary numbering sequence, so the names are never publicly associated with test results, clinical description, etc. Because of legal and privacy issues local news media in the United States will usually not report personal information about infected individuals.
                        http://novel-infectious-diseases.blogspot.com/

                        Comment


                        • #13
                          Re: Swine flu worse in Mexico than US, but why?

                          In Mexico they are only counting pneumonia cases. There are probably 10-100X that number of mild cases, so there are 10,000 to 100,000 cases in Mexico (maybe more).

                          The numbers in the US are fewer, so the pneumonia and deaths have not appeared yet.

                          Comment


                          • #14
                            Re: Swine flu worse in Mexico than US, but why?

                            67 from 10000 would still give 40M deaths worldwide
                            I'm interested in expert panflu damage estimates
                            my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

                            Comment


                            • #15
                              Re: Swine flu worse in Mexico than US, but why?

                              I was just looking at the onset dates in U.S. Interesting, because I have been under the impression that all of this has just exploded in a short time. My 5 year old had all of these symptoms around the 10th? of April. On the 12th (a Sunday) we took him to the emergency room. His symptoms fit the profile. They specifically mentioned that we hadn't had any flu cases recently in our area. I got it a day later, mine was similar symptoms, but of very short duration. My oldest son's friend was with us that weekend, and he got it the day after me. All the symptoms fit - and there was no seasonal flu activity in the 2 county area. I'm wondering now if we could have had it. Would there be antibodies detectable?

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