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Aso calls for calm response as new flu infections exceed 5000 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Hi pjie2

No. 37.1 degrees C is correct.

I call
37.0-37.9 Fever
38.0- High fever

Osaka Prefecture reported 17% of novel flu patients had a fever between 37.0-37.9.

________________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Confirmed cases of Novel flu in Hyogo

Date of confirmation

Blue bar: Daily number of confirmed cases
Red line: Accumulated number of confirmed cases
Beige bar: Daily number of confirmed cases related to schools
Pink line: Accumulated number of confirmed cases related to schools

20090525Hyogo.webp


___________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Hi pjie2

No. 37.1 degrees C is correct.

I call
37.0-37.9 Fever

Not to be rude, but that's simply wrong. 37 degrees is NORMAL body temperature, and there's at least ~0.5 degrees variance around this. You can't really call it even a low fever till you get to 38 degrees. 39 degrees is a moderate fever, while 40 is high.
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

No severe case reported
May 23, 2009
Source: http://idsc.nih.go.jp/disease/swine_influenza/2009idsc/clinical_epi_osaka.html

The Infectious Disease Surveillance Center (IDSC), National Institute of Infectious Diseases (NIID), published a report on clinical aspects of Novel flu in Osaka.

According to the report, no severe case was found among 69 patients; 5 primary school pupils and 64 junior high and senior high school students.

Of 64 students, 18 patients were hospitalized according to the Infectious Diseases Prevention Act. However, hospitalization was not medically necessary for none of the hospitalized cases.

Tamiflu and relenza were effective.
**********************************************************
The above report in English will be ready shortly. I will post it.

No severe case has been reported from any novel flu patient in Japan.
It may be an example of WHO?s comment that the same disease cause different damage to different population.

A report on 61 novel flu patients in Hyogo states 18 patients (10-20s of age) had fevers between 37.1 and 37.9 degrees C and a teenage high school student had no fever.

In Japan (and elsewhere in the world, I believe), we say flu patients typically have fevers of 38 degrees and higher. And younger patients tend to have higher fevers while elderly patients sometimes have fevers less than 38 (when they are too old).

This flu looks very different.

_____________________________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Hi pjie2

No. 37.1 degrees C is correct.

I call
37.0-37.9 Fever
38.0- High fever

Osaka Prefecture reported 17% of novel flu patients had a fever between 37.0-37.9.

________________________
SN1987A

It would be interesting to know if during this period of symptoms there are also an alternating pattern of daily periods by temperature sub-lowering:

low to higher 37-39

than lowering to sub-temperatures: 36-36.3

and than renewed higher.
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Interesting observation, Tropical. My experience with raising two children and one grand-child is that fever seems to peak in the late afternoon and early evening.

Which time do medical professionals choose to report? Is there a standard time of day when a med-pro would record fever for the record?
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

...
37 degrees is NORMAL body temperature
...

Hi pjie2,

maybe you are a "hot" person ... :)

Mine normal temperature is about 36.5 C.

When it starts to rise near the 37 level, it is a signal that some "warming" started.

The usualy words: "below 38 C is not temperature", is from the inf. ward or ER folks, when triaging.

Aknowledging that there were many pneumonias without 37 C, or under, without temperature, and the fact that this novel flu have many (a third presumed, written) asymptomatic (so without temperatue) folks, than some temperature near 37, or slightly more, is already a red flag, and could be filtered as suspected from the mega-fluxes of airplain passengers, at their screening points at the hubs, or on the plains.
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

...
Which time do medical professionals choose to report? Is there a standard time of day when a med-pro would record fever for the record?

Hello Snicklefritz.

Usualy they likes twice daily, but it could be reinforced:
morning / early afternoon / evening.

But for pandemic purposes they probably watch the cases more frequently ...
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Hi, pjie2

I understand your point. ?High Fever? and ?Fever? were just to make a distinction between ?38 degrees and higher? and ?below 38 degrees?. And you are right in saying that 38 degrees is not a ?High Fever?. But, whether ?37 degrees is Normal body temperature? or not would vary with the individual. Anyway, Hyogo report uses ?Fever? for 37 degrees.

Reported body temperatures were taken when the patients visited the hospital for consultation. ?Upon arrival? so to speak.

The point is some novel flu patients (17% in Osaka and 31% in Hyogo) had body temperatures lower than 38 degrees.

It is surprising to me. But, you can find a similar observation in a WHO report on cases in Mexico, USA, Canada, Spain and UK.

Quote
Some confirmed cases did not have fever; it is likely that there are asymptomatic and
very mild cases of infection -- as occurs with seasonal epidemics of influenza.
Unquote
(Source: http://www.who.int/csr/resources/publications/swineflu/Report_20_05MayTeleconferencex.pdf)

___________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 346 in Japan

Re: Aso calls for calm response as new flu infections reach 346 in Japan

Update of Novel flu in Japan
May 26, 2009

Status of infection
Kansai area (western Japan)
Hyogo prefecture (including Kobe) 180 confirmed cases [Today 1]
Osaka prefecture 152 confirmed cases [Today 1]
Shiga prefecture 2 confirmed case
Kyoto prefecture 2 confirmed case

Kanto area (eastern Japan)
Tokyo prefecture 3 confirmed cases
Kanagawa prefecture 1 confirmed case
Saitama prefecture 2 confirmed case

Kyushu area (south western Japan)
Fukuoka Prefecture 1 confirmed case [Today 1]

Narita airport 8 confirmed cases [Today 2]

Total 8 prefectures 351 confirmed cases [Today 5]

Note: [Today #] shows an increment from yesterday's number and does not mean the infection was confirmed or reported "Today".

20090526.webp
Note: Due to differences in cutting times, daily numbers and daily accumulated numbers may be different from other reports.

Fukuoka Prefecture
May 25, 2009
Source: http://www.nishinippon.co.jp/nnp/item/97974
An American male (38) from San Francisco visiting his relatives living in Shime-cho, Fukuoka from May 22. This is the first confirmed case in Fukuoka prefecture in Kyushu area, south western region of Japan.
The patient is hospitalized and the relatives are requested to stay home.
He arrived at Fukuoka airport via Narita Friday night, had a fever of 39 degrees C Sunday, visited a High-fever consultation center Monday afternoon and infection was confirmed by PCR test Monday night.
He is hospitalized in Fukuoka infectious disease center. Body temperature has dropped to 37 degrees and his condition is stable.
Fukuoka prefecture confirmed that he contacted only his relatives and some friends. Schools in Fukoka will not be closed.

Narita airport
May 26, 2009
Source: http://www.nishinippon.co.jp/nnp/item/98062
Two Americans, a father (30s) and a son (under 10), from Los Angeles to Narita on board a Singapore airline’s flight were confirmed infected with the novel flu Monday afternoon and hospitalized in Narita red cross hospital.

School closure
May 26, 2009
Source: http://www.nishinippon.co.jp/nnp/item/98057
40 schools in Kyoto resumed class on Tuesday.
Schools in Yao-city, Osaka also reopened on Tuesday.


___________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

Schools, kindergartens reopen in Hyogo, Osaka
The Yomiuri Shimbun

DY20090526114538917L1.jpg

Students at a primary school in Kobe
on Monday listen to their teacher using
a puppet to explain how to fit a mask
correctly.


KOBE--About 4,700 schools and kindergartens in Hyogo and Osaka prefectures reopened Monday after having been temporarily closed due to the spread of a new strain of influenza.

Ninety-seven schools where a number of students have been confirmed as infected, including Kobe and Hyogo high schools and Kansai Okura Middle and High schools in Ibaraki, Osaka Prefecture, remain closed.

Kindergartens, primary, middle and high schools and special needs schools were closed after the nation's first case of new flu infection was confirmed in Kobe on May 16, with the infection then spreading around Hyogo and Osaka prefectures.

The Hyogo prefectural government decided to reopen schools Friday, while the Osaka prefectural government reached the same decision Saturday.

According to related boards of education, in Hyogo Prefecture, 2,152 schools reopened while 14 remain closed, while in Osaka Prefecture, 2,580 schools reopened and 83 remained closed.

At Hyogo prefectural Mikage High School in Higashi-Nada Ward, Kobe, students started arriving at school around 8 a.m. About 30 percent of them were wearing masks.

Some students greeted each other with high fives.

Although none of the students or teachers of the school have been infected with the new flu, liquid soap was provided at each of the school's about 50 basins. Students gave homeroom teachers notes of their temperature records during the last week.

A 15-year-old female student, who belongs to a volleyball club, said: "I couldn't practice so I've got out of shape. We've got an upcoming meet so I have to start practicing again from today."

There seemed to be far fewer passengers wearing masks on the morning commuter trains compared to the period when the nation's first flu case was confirmed.

(May. 26, 2009)


________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

Health checks, makeups ahead
The Yomiuri Shimbun

OSAKA--Schools that resumed classes Monday after closing for a week to prevent mass infection of the new strain of influenza now face the challenge of scheduling makeup classes as well as handling further possible infections.

Since more than 80 percent of the people infected with the new flu in the nation were young people, schools have been considered among the riskiest locations for infection.

The boards of education of Osaka and Hyogo prefectures as well as other bodies have therefore instructed the schools to pay special attention to their students' physical condition.

The schools are also required to detect signs of a wider outbreak by keeping track of the number of absent students.

In addition to being urged to instruct students to thoroughly wash their hands and gargle, the schools have been advised to avoid scheduling large gatherings of students. Instructing students absent due to flulike symptoms to go to a fever consultation center immediately is also seen as an important part of the prevention efforts.

The schools may reduce summer vacations days or increase class hours per day to make up the lost school days.

Teachers at the schools have been asked to help reduce the overall burden on students caused by the outbreak and to support students who have been infected.

(May. 26, 2009)


____________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

#110:
"Some confirmed cases did not have fever; it is likely that there are asymptomatic and very mild cases of infection ..."

And some asymptomatic cases without fever could be more serious and have pneumonia.


#112-113:

picture of pupils obediently hearing their teacher woring surgical masks ...

Could we named the above depicted teaching way as an "infection safe"?

Obviously not, because it is known that such surgical masks could not shield from exhausted particles, to not mention the absence of the eye protecting famous additional "lateral closed glasses".

But the top of the nonsense, are the surface contaminations.

Obviously no permanent usage of gloves.
Additional contaminations by closet rooms.
Surface viral lacings of the school working surfaces and chears ...

But the human educational effort must be heroicaly done ..., obviously by the physical pupils presence, in the internet era with enormous quantities of web based educational data, and many web based teaching educational programs.

So why it is neccessary to retain the pupils at schools - from previous news data from the USA: because of the impossibility of them staying put at homes for 10 days or 2 weeks on internet learning, or even simpler, on internet surfing ...

The suceeding of worldwide collective behaviour shaping instead of infection control measures.
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

Mother-Child Infection: Disarmingly few
May 27, 2009
Source: http://www.cabrain.net/news/article/newsId/22243.html

?Cases of mother-child infection were disarmingly few.? Yoshinori Yasui, chief researcher of the Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, stated Tuesday in an explanatory meeting held in the center, discussing the interim report* of the epidemiological investigations on mass infection of novel influenza in Osaka. (* Note: this is the report I discussed in the previous post #105. Unfortunately, English version is not published yet.)

The researcher Yasui visited Osaka from May 16 to 24 to perform the epidemiological investigations on 64 confirmed cases in the junior and senior high school (Note: Kansai Okura, the same as the below article) and 5 confirmed case in a primary school in Yao-city.

The researcher Yasui said: ?Usually, it is anticipated that the mother in a family will be the first to be infected. However, such cases were disarmingly few. Brothers and sisters got infected. But few mothers got infected even in very close mother-child relationship cases. We will do further analysis on this.?
As students in their teens were predominantly patients of the spread, school closures were effective in reducing the infection.?

-snip-


?Morbidity is NOT high?, Novel flu in Kansai Okura
May 27, 2009
Source: http://www.asahi.com/kansai/news/OSK200905270015.html

National Institute of Infectious Diseases published an interim report of the epidemiological investigations on the mass infection in Kansai Okura junior and senior high school in Ibaraki-city, Osaka.

The main cause of the infection is considered to be school busses. As there were few infections other than between students, NIID stated: ?morbidity would not be so high.? The symptoms were mild in each case.

So far, more than a hundred cases were confirmed among students and teachers of Kansai Okura junior and senior high school. In the epidemiological investigations, 61 students and 3 teachers were interviewed about their symptoms and the situation of contacts with others.

Three students in a class of 2nd grade of the senior high school did not attend the class on May 11 because they had been diagnosed with A type flu. On May 13, 36 students including other classes were absent from school and the school closed the entire grade. Therefore, the possibility is high that the infection started and spreaded from this grade. However, as earlier students were not diagnosed with the novel flu*, the real starting point of the infection could not be investigated and remains unknown.
(* Note: PCR tests were not conducted for those students because the government?s diagnosis guideline then required PCR test only for suspected patients who had contact with a confirmed patient of the novel flu or who had traveled abroad within ten days.)

There were also infections between close friends and infections through club activities. However, a major cause of widespread infection beyond classes and grades is considered to be school busses which about 1500 students or 80% of the entire school of 1900 students use for both going to and from the school. Busses were always full of students in a situation where droplet infections easily occur. At home, the infection to parents was less than that between brothers and sisters for unknown reasons.

Judging from the fact that infections in a class gradually spreaded from students who were sitting nearer to the first patient, Yoshinori Yasui, chief researcher, who conducted the investigations, stated: ?people who had closely contacted a patient for a relatively long time got infected. Distant relationship didn?t cause the infection. It is impossible that you will be infected only by going to Osaka.?

Rergarding bashing of the school people, Yasui called for a calm reaction. ?Anybody can contract influenza. Infected people are no different from others and this is not their fault. Please stop the bashing.?
************************************
As far as I know, this is the first time, an expert of influenza clearly states: ?morbidity would not be high.? (In a govermental scientist case, this sounds a complete affirmative to me.)

Please correct me if I am wrong. No passengers sitting around a patient got infected in transocean flights. No hotel guests of the hotel where a patient stayed got infected. In SARS'case, multiple infections are reported in a flight and a hotel.

Morbidity is NOT high. (as far as Hyogo and Osaka are concerned.)
THIS IS NOT A WOLF BUT A SHEEP IN PIG?S CLOTHING.

What troubles me is that commuter trains in Japanese big cities are in the same situation as the school bus.

_________________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

Sheeps, pigs, poultry or x, I see that even their researcher admited it:
"school closures were effective in reducing the infection".

No schools, no parties.

When pupils did not gone to schools, their school buses don't drive (to not mention the non-going at higher schools by subways).


#115:
"The researcher Yasui said: “Usually, it is anticipated that the mother in a family will be the first to be infected. However, such cases were disarmingly few. Brothers and sisters got infected. But few mothers got infected even in very close mother-child relationship cases. We will do further analysis on this.”
As students in their teens were predominantly patients of the spread, school closures were effective in reducing the infection.”"
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

The same thing happened in 1918: citizens wore masks which were nearly useless against the flu. We saw it in Mexico too, where lots of people wore fashionable, loose-fitting masks which provided very little protection.
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

Update of Novel flu in Japan
May 27, 2009

Status of infection
Kansai area (western Japan)
Hyogo prefecture (including Kobe) 185 confirmed cases [Today 5]
Osaka prefecture 155 confirmed cases [Today 3]
Shiga prefecture 3 confirmed cases [Today 1]
Kyoto prefecture 2 confirmed cases
Wakayama prefecture 1 confirmed case [Today 1]

Kanto area (eastern Japan)
Tokyo prefecture 3 confirmed cases
Kanagawa prefecture 2 confirmed cases [Today 1]
Saitama prefecture 2 confirmed case

Kyushu area (south western Japan)
Fukuoka Prefecture 1 confirmed case

Chubu area (central Japan)
Shizuoka Prefecture 2 confirmed cases [Today 2]

Narita airport 8 confirmed cases

Total 10 prefectures 364 confirmed cases [Today 13]

Note: [Today #] shows an increment from yesterday's number and does not mean the infection was confirmed or reported "Today".

20090527.webp


Note: Due to differences in cutting times, daily numbers and daily accumulated numbers may be different from other reports.

Hyogo Prefecture
2 high school students in Kobe. The mother (41) and a younger brother (12, junior high) were also infected. The high school of the students which reopened Monday will be closed again for a week.
Another was confirmed in Amagasaki. Details not available.

Osaka Prefecture
No information available.

Shiga Prefecture
A businessman (36) living in Otsu, Shiga and working in Kyoto. The first rapid test on Monday was negative. The second rapid test on Tuesday was positive and PCR test gave positive this morning.

Wakayama Prefecture
A businessman (28) returned from Oahu, Hawaii to Kansai International Airport on May 23. He went to his office Tuesday, had a fever and hospitalized Tuesday evening.

Kanagawa Prefecture
A housewife (30s) in Kawasaki returned at Narita Airport from New York on May 24 and was hospitalized Tuesday.

Shizuoka Prefecture
A boy (7) and his sister (4) arrived at Chubu International Airport from Philippines on May 22. He had a fever Monday and she had a fever Tuesday.

Daily number of confirmed cases in rise again.
4 school-related cases and 4 overseas travel-related cases.
4 overseas travel-related cases passed the airport gate and later had symptoms.

School Closure
Remaining schools in Osaka and Kyoto resumed classes.
Only schools where all students are not fully recovered are still closed.

___________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 351 in Japan

Re: Aso calls for calm response as new flu infections reach 351 in Japan

The same thing happened in 1918: citizens wore masks which were nearly useless against the flu. We saw it in Mexico too, where lots of people wore fashionable, loose-fitting masks which provided very little protection.

Hi Siegfried X

Please take a look at a new thread in The Pandemic Discussion Forum > Deliberation Room > I wear a mask because I feel better.

Thank you

___________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 364 in Japan

Re: Aso calls for calm response as new flu infections reach 364 in Japan

Update of Novel flu in Japan
May 28, 2009

Status of infection
Kansai area (western Japan)
Hyogo prefecture (including Kobe) 185 confirmed cases
Osaka prefecture 156 confirmed cases [Today 1]
Shiga prefecture 3 confirmed cases
Kyoto prefecture 2 confirmed cases
Wakayama prefecture 1 confirmed case

Kanto area (eastern Japan)
Tokyo prefecture 3 confirmed cases
Kanagawa prefecture 2 confirmed cases
Saitama prefecture 2 confirmed case

Kyushu area (south western Japan)
Fukuoka Prefecture 1 confirmed case

Chubu area (central Japan)
Shizuoka Prefecture 2 confirmed cases

Narita airport 8 confirmed cases

Total 10 prefectures 365 confirmed cases [Today 1]

Note: [Today #] shows an increment from yesterday's number and does not mean the infection was confirmed or reported "Today".

20090528.webp


Note: Due to differences in cutting times, daily numbers and daily accumulated numbers may be different from other reports.

Osaka Prefecture
A male (25) had a fever of 38.1 degrees C + ILI Tuesday, was treated with Tamiflu, staying home.

School Closure
42 colleges and universities reopened today.
The high school in Kawasaki of which two female students were confirmed infected after returning from New York, reopened today.

Kobe city Mayor made a declaration of ?safe for now.? No case was confirmed in the city today.

___________________
SN1987A
 
Re: Aso calls for calm response as new flu infections reach 365 in Japan

Re: Aso calls for calm response as new flu infections reach 365 in Japan

Quarntine officer criticized Waterside measures
May 28, 2009
Source: http://www.nikkansports.com/general/news/f-gn-tp0-20090528-500114.html

Ms. Moriyo Kimura, an active quarantine officer at Haneda international airport and a medical officer of the Ministry of Health, Labor and Welfare, attended today?s budget committee meeting of Upper house as a witness. Kimura severly criticized the Ministry for unduly emphasizing the quarantine work. ?As quarantine officers in full PPE running up and down the ailes were easy demonstration of ?the Ministry is trying very hard?, I suspect we, quarantine officers, might be exploited (by the Ministry).?

Kimura pointed out problems of the Waterside measures that delay responses to domestically infected patients. ?Novel influenza action plan was prepared without sufficient discussions and information.? she emphasized. Even after the quarantine work was scaled down, ?we are still imposed human sacrifice.?

?The Ministry are considerably trying by adding 10 quarantine officers this year.? Minister Masuzoe explained.

Hiroshi Suzuki of the Democratic Party on Japan (Note: an opposition party) stated that they should listen to voices from the site, and requested attendance of Kimura who wrote a book about problems of infectious disease measures. The Liberal Democratic Party (Note: ruling party) refused the request Tuesday saying that she was not in a position to represent the administration. The refusal temporarily embroiled the committee.

******************************
The quarantine work detected 8 novel flu patients at Narita airport by spending hundreds of thousand of manhours. Many more infected people went through the gates without being detected. At an early stage of the global infection, very few infected people actually flew to Japan. But hundreds of quarantine officers and doctors from several major university hospitals worked around the clock to find inexistent infected people.

The real problem was the Health Ministry didn?t change their emphasis on the quarantine work even when a rapid spread of infection in Hyogo and Osak nearly ruined the medical system in the area. I wrote in May 20?s post: ?Note: Somebody said ?the Ministry of Health and Welfare won?t give up the quarantine easily because it falls under the Ministry?s direct responsibility. Health officials fear of being criticized for failing to screen infected travelers. So, they don?t want to let doctors working on the quarantine to go back to their hospitals to work on the treatment of novel flu patients which is under the responsibility of prefectures and municipalities. I hope this is not the case.?

Well, it was exactly the case.

Moreover, the Health Ministry bureaucrats convinced LDP, the ruling party, to refuse the request for Kimura?s attendance to the committee. Knowing that Kimura is always critical, bureaucrats wanted to stop her at any cost. Fortunately, somebody realized in LDP that it was against the democracy not to let a government official testify at the Diet and agreed on her attendance.

Then, she did criticize the Ministry. I hope everything will be better especially for this brave lady standing up against her own Ministry to speak up on her belief. No retaliatory attempt shall harm this whisteblower.

___________________________
SN1987A
 
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