Swine flu worse in Mexico than US, but why?

[The Mountains Voice]

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

Niman:
My guess is that they will soon be overwhelmed with swabs, which will yield sequences. I would think that there are cases in almost every state.


I agree. I think I'd be wasting their time. But it does bring up my earlier question - that of the 1918 early season exposure resulting in limited immunity. Becase IF that is a true scenario back then - it could very well hold for now. In that case I would be very interested in knowing whether my family had been exposed or not. Because IF my family was exposed (and we've obviously lived), and if this turns out to be just a minor 1st round, with a more intense/virulent 2nd round to follow in months to come - what are the odds / considerations involved in whether we would maintain a limited / complete immunity??

 

[HenryN]

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

It is likely that you would have some immunity. There will be many versions and one or a small number will emerge and teh strain that emerges will have acquired more virulence and may have also escaped from the immunity produced by the milder version. However, those exposed to the mild version will almost certainly do better with subsequent rounds (might just get sick, while those with no exposure will die).

At this point you are better off with the mild strain than without (but of course the mild strain is far from harmless, and the death toll will month for this version. The exiting sequences from California and Texas have differences and there are probably more such changes in fatal cases in Mexico.

 

[Into The Woods]

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

First, the US Healthcare Infrastructure will continue to convert life-threatening illnesses into "mild" illnesses.

It will continue to do so for as many and for so long as it has drugs, equipment, space and personnel to do so.

During that time, the comparative mortality will be less than other areas with less developed medical capabilities.

But when the tide comes fully in and the JIT supply-line starts to warp and buckle, the technical staff that wave our magic wands are home tending their own ill or in bed themselves, and our electric grid begins to flicker and dim, then our supposed greater level of genetic or environmental immunity may come into greater question.

Second, the US had a significantly lower average mortality rate in 1918 than the world-at-large but that's a far cry from saying that what our country experienced then was a "mild" flu.

So until the numbers give us more to work with, I'm thinking that making conclusory statements about "mild" or "severe" are premature and could create false foundations for future analysis and discussion.

 

[dr kockosh]

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

Niman
whats your opinion on tamiflu still being effective against this swine virus ? i guess it may not be long before we are only left with relenza?
can i get your opinion on the following scenerio - assuming tamiflu is still effective and an individual was taking the profolactic dose while being exposed to the virus for instance a health care provider - is exposure to the virus under this circumstance likely to confer any resistence for that individual

 

[The Mountains Voice]

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

INTO THE WOODS wrote:
First, the US Healthcare Infrastructure will continue to convert life-threatening illnesses into "mild" illnesses. It will continue to do so for as many and for so long as it has drugs, equipment, space and personnel to do so. During that time, the comparative mortality will be less than other areas with less developed medical capabilities. But when the tide comes fully in and the JIT supply-line starts to warp and buckle, the technical staff that wave our magic wands are home tending their own ill or in bed themselves, and our electric grid begins to flicker and dim, then our supposed greater level of genetic or environmental immunity may come into greater question.

Lots of stories coming out of Mexico where mortality rates are much greater than publicly announced. I believe I saw at least a couple where doctors & staff were exiting for various reasons. Hard to determine fact from fiction. Anyone with insider knowledge on exactly what is going on in the Mexican hospitals? Any substantial number of infected health providers? Regardless of the "Official" death count - I'm seeing crazy swings in "Rumour Death" reporting? Anyone here have credible estimate?

 

[Amish Country]

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

A serious lack of potable water may also be a factor that could effect health and sanitation. Please note the article is dated April 11th.


Dry Taps in Mexico City: A Water Crisis Gets Worse
Time.com
By IOAN GRILLO / MEXICO CITY Ioan Grillo / Mexico City – Sat Apr 11, 1:40 am ET

"The reek of unwashed toilets spilled into the street in the neighborhood of unpainted cinder block houses. Out on the main road, hundreds of residents banged plastic buckets and blocked the path of irate drivers while children scoured the surrounding area for government trucks.
......

About five million people, or a quarter of the population of Mexico City's urban sprawl, woke up Thursday with dry taps. The drought was caused by the biggest stoppage in the city's main reservoir system in recent years to ration its depleting supplies."

Link to entire article:
http://news.yahoo.com/s/time/20090411/wl_time/08599189062300

 

[Farmer]

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

A serious lack of potable water may also be a factor that could effect health and sanitation. Please not the article is dated April 11th.


Dry Taps in Mexico City: A Water Crisis Gets Worse
Time.com
By IOAN GRILLO / MEXICO CITY Ioan Grillo / Mexico City ? Sat Apr 11, 1:40 am ET

"The reek of unwashed toilets spilled into the street in the neighborhood of unpainted cinder block houses. Out on the main road, hundreds of residents banged plastic buckets and blocked the path of irate drivers while children scoured the surrounding area for government trucks.
......

About five million people, or a quarter of the population of Mexico City's urban sprawl, woke up Thursday with dry taps. The drought was caused by the biggest stoppage in the city's main reservoir system in recent years to ration its depleting supplies."

Link to entire article:
http://news.yahoo.com/s/time/20090411/wl_time/08599189062300

Good find Amish Country. The lack of potable water and interruptions in the sewage system could potentially be very relevant. Iowa State has a backgounder that reports H5N1 virus has been documented as being shed in human feces:

"Fecal shedding of the avian H5N1 virus has also been documented in a child with diarrhea." Page 3 - no specific refernce cited.
http://www.cfsph.iastate.edu/FactSheets/pdfs/highly_pathogenic_avian_influenza.pdf

Diarrhea and vomiting have been reported as a feature of this outbreak, and diarrhea has been a component of seasonal influenza particularly among infected children. It is possible that more severe illness in Mexico City is associated with a higher viral dose exposure.

 

[mixin]

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

Some are of the opinion that giving antibiotics as a preventative measure, as we do, helps guard against the development of pneumonia.

We also promote pneumococcal vax.

From: http://www.histopathology-india.net/Lobar_Pneumonia.htm
Pneumococcal pneumonia is an infection in the lungs caused by bacteria called Streptococcus pneumoniae (also called pneumococcus ).

Pneumococcal pneumonia is of diminishing significance because of prompt response to treatment, it is still a significant illness in industrialized nations. In the non-industrialized world it is still a major cause of mortality.

It is commonly a disease of healthy young to middle-aged adults, is rare in infants, and the elderly, and is considerably more common in men than in women.

Alcoholics appear to be particularly vulnerable.

Pneumococcal pneumonia is commonly seen in young adults after exposure to cold or after previous respiratory infection. It typically follows a viral infection, often influenza.

 

[JJackson]

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

Niman
whats your opinion on tamiflu still being effective against this swine virus ? i guess it may not be long before we are only left with relenza?
can i get your opinion on the following scenerio - assuming tamiflu is still effective and an individual was taking the profolactic dose while being exposed to the virus for instance a health care provider - is exposure to the virus under this circumstance likely to confer any resistence for that individual

I too will be interested in Niman's take on these questions. I assume, as your asking, that you are aware Dr. Niman is of the opinion that SNPs readily transfer by recombination and the closer the strains the more likely this is to happen. So a H1N1(seasonal) and H1N1(swine) coinfections in large numbers should provide the perfect opportunity for H274Y(NA) and A193T(HA) to jump ship and make the new pandemic strain oseltamivir resistant.
As to the second part of your question. Again no one knows but due to the MO of Neuriminidase inhibitors (and this should be true for Relenza too) they do not prevent infection but slow it down by causing clumping and preventing the new virons making a clean getaway. Given this and your being continuously challenged sustaining low level infections your adaptive immune system should be making B cells so gradually learning how to fight the virus. It is a nice theory - post back and let me know if it worked in practice.

 

[The Mountains Voice]

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

MIXIN wrote:
We also promote pneumococcal vax.

How long does this maintain effectiveness? I got one about 5 years ago during emergence of BF / SARS.

Also - Taking the hypothetical bad scenario, where health care breaks down to a degree at some point, respirators in short demand etc.... Wouldn't it be a prudent preventative step NOW for many people in ALL age groups to get the vaccination? I realize it is normally reserved/reccomended for older/weaker immune people - But considering the possibilities here, and the fact that it's only $20 +/-, and rather commonly available at the local doctor's office - IS THIS SOMETHING PEOPLE SHOULD CONSIDER?

 

[SophiaZoe]

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

Great points Mixin.

I've been thinking on the pneumonia issue since last night. I know that there are a few papers indirectly noting the statistically significant difference of pneumonia between human H1N1 (lesser) and human H3N2 (more). I'm wondering if we will see the same lesser tendency with Swine H1N1.

One of the papers I read specifically notes that the "synergism" is driven by the neuraminidase and its degree of activity.

 

[mixin]

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

MIXIN wrote:
We also promote pneumococcal vax.

How long does this maintain effectiveness? I got one about 5 years ago during emergence of BF / SARS.

Also - Taking the hypothetical bad scenario, where health care breaks down to a degree at some point, respirators in short demand etc.... Wouldn't it be a prudent preventative step NOW for many people in ALL age groups to get the vaccination? I realize it is normally reserved/reccomended for older/weaker immune people - But considering the possibilities here, and the fact that it's only $20 +/-, and rather commonly available at the local doctor's office - IS THIS SOMETHING PEOPLE SHOULD CONSIDER?

From: http://www.vaccineinformation.org/pneumchild/qandavax.asp

My elderly neighbor got a second pneumococcal shot. I thought just one was required.
Revaccination is not done routinely, but a single revaccination dose is recommended for groups of people at highest risk of serious infection. No one should receive more than two doses of PPV.

For example, persons who received a first dose when they were younger than age 65 years should receive a second dose at age 65 years if at least five years have elapsed since the previous dose. Likewise, persons age two years or older who are at high risk for pneumococcal disease due to certain long-term health problems, in particular immunosuppression, HIV infection, and not having a functional spleen (or having no spleen) should get a second dose five or more years after the first dose.
---------------------------------------------------------

As for the second part of your question, I'm not a health expert but it seems to me that getting a pneumonia vax pre-pandemic is a good idea. It was on my list of things to do when I got my flu shot this winter (and is still on my list unfortunately).

 

[flutrackers@cool.fr.nf]

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

Why is the virus worse in Mexico?

I do not believe it has much to do with the health care system, etc.

My personal belief is that as the virus spread through Mexico it mutated very slightly, one to two genes, hardly noticeable. The virus has a longer inncubation period than 24-48 hours. Maybe closer to seven days. This would explain why cases in the US are less severe. As they were infected with the early, less deadly virus. Again this is just a theory. However expect the virus to mutate as it continues to spread. This virus has already shown us it can mutate, and mutate quickly. We have been watching H5N1 for years for signs of a mutation that could allow human to human transmission, and for the most part the virus has been unsuccessful at doing so.

The other theory I have heard has been based on the epigenetics of the virus. Epigenetics is a relatively new field of study, especially with respect to virology. But in theory could explain to differences in severity of infection.

 

[AlaskaDenise]

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

My personal belief is that as the virus spread through Mexico it mutated very slightly, one to two genes, hardly noticeable.

Agreed - it took advantage of the crowds and lived below the radar, perfecting its H2H capabilities.

.

 

[flutrackers@cool.fr.nf]

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

Agreed - it took advantage of the crowds and lived below the radar, perfecting its H2H capabilities.

.

Yeup. And based on this theory (including the seven day inncubation period) the newer cases we will be seeing can be seperated in to two main groups those who have the newer more virtulent strain and those with older less virtulent strain.

 

[flutrackers@cool.fr.nf]

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

It is important to remember we are know a great deal about H5N1 and other flus and would be able to more clearly detect and understand the most minor of mutations. However we know nothing about this flu and it will take a good while before we are truly able to understand it.

 

[AlaskaDenise]

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

Yeup. And based on this theory (including the seven day inncubation period) the newer cases we will be seeing can be seperated in to two main groups those who have the newer more virtulent strain and those with older less virtulent strain.

However, I believe the stronger will survive, just as the earlier Ft. Dix novel H3N2 vs. H1SwN1 competition (with added H1SwN1 VAX) where the "stronger" novel H3N2 won - according to the less studied case.

.

 

[flutrackers@cool.fr.nf]

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

However, I believe the stronger will survive, just as the earlier Ft. Dix novel H3N2 vs. H1SwN1 competition (with added H1SwN1 VAX) where the "stronger" novel H3N2 won - according to the less studied case.

.

I agree. I believe the weaker will run its coure and die out as the flu season ends, and the stronger will push on. HOWEVER I feel it is EXTREMELY important to point out that in 1918 flu pandemic (again an H1N1 virus) the virus was first dected in March and became most virtulent in August. I hear alot of people, including the white house saying that it is almost the end of flu season. It is imporant everyone understands that the end of flu season could have little to absolutely no effect on the virus itself as we saw in 1918.

 

[AlaskaDenise]

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

It is imporant everyone understands that the end of flu season could have little to absolutely no effect on the virus itself as we saw in 1918.

Modern communications may take care of that problem.

It will be interesting to see if this will knock current seasonal H3N2 out of existance.

The WHO work in Mexico should paint a good picture.

.

 

[yielddude]

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

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?

Mountain, I know that I read in John Barry's "The Great Influenza" that there was definitely a milder version that first occurred in the spring, then came back in the late summer in a more virulent form. And I believe those that did have the spring version were better off than those that did not.