H1N1 flu victim collapsed on way to hospital [Latest H1N1 updates downthread]

Within minutes, six-year-old Rubjit Thindal went from happily chatting in the back seat of the car to collapsing and dying in her father's arms.

"If we had known it was so serious, we would have called 911,'' Kuldip Thindal, Rubjit's distraught mother, said in Punjabi yesterday. "She just had a stomach ache -- she wasn't even crying.''

Rubjit was pronounced dead at hospital barely 24 hours after showing signs of a fever. Later, doctors told her parents she had the H1N1 influenza virus. She is believed to be the youngest person in Canada with the virus to have died.

2 more Utahns die from H1N1 flu
http://www.deseretnews.com/article/1,5143,705312630,00.html

Two more Utahns have died as the novel H1N1 flu continues to spread throughout the Beehive State at a rate that is “well above the epidemic threshold,” for the reporting period June 14-20.

The Utah County Health Department reported a woman between the ages of 18 and 39 has died, and the Davis County Health Department reported the death of a boy between the ages of 5 and 17. As with several other Utah victims, both had underlying medical conditions, health officials said, adding no other information on either victim will be released.

The deaths bring the Utah total for novel H1N1 flu fatalities to 10.

The Utah Department of Health released new statistics Wednesday afternoon showing 81 more people have been hospitalized in the past week, bringing the total of hospitalized cases to 210.

Confirmed cases of the virus have now been identified in all of Utah’s local health districts, though not all of those districts have seen patients hospitalized. Officials said the majority of cases, hospitalizations and deaths have occurred along the heavily populated Wasatch Front.

Most of those hospitalized have risk factors including chronic lung, heart or kidney disease.

“Families should begin preparing for what they would need if they are asked to spend a week away from school, work or other activities. Now is the time to update, or create, your emergency stockpile. Items like food, water, tissue, sanitizers, over-the-counter medications and prescription medications are all useful items to have on hand in the event you become ill and are confined to your home,” officials said in a press release.

The Centers for Disease Control and Prevention is now estimating the virus will be a “Category 2,” which means it has the following characteristics:

Case fatality ratio of 0.1 percent to less than 0.5 percent.

Between 90,000 and 450,000 deaths in the U.S. (compared with estimated 36,000 deaths during a typical influenza season).

Excess death rate of between 30 to less than 150 per 100,000 people.

Illness rate of between 20 percent and 40 percent.

Similar to the 1957 flu pandemic.

State health officials have released an online set of guidelines for employers who are trying to determine how best to deal with the outbreak. Details may be found online at health.utah.gov/epi/h1n1flu/Q&As_Employer_061609_Final.pdf.

U.S. state of Oregon confirms second A/H1N1 flu death

www.chinaview.cn 2009-06-25 05:39:45
http://news.xinhuanet.com/english/2009-06/25/content_11596349.htm

SAN FRANCISCO, June 24 (Xinhua) — Public health authorities in the U.S. state of Oregon have confirmed that a young child recently died from the A/H1N1 flu, the second such death in the state, local media reported on Wednesday.

The child, who had no known underlying medical conditions and a two-day history of fever, passed away on June 15, The Oregonian newspaper said.

The case was confirmed Tuesday by the Oregon State Public Health Laboratory.

An Oregon woman who had multiple underlying health conditions died on June 7 after eight days in a hospital, marking the first A/H1N1 flu-related death in the state.

Oregon’s two confirmed deaths of the new influenza, including the young child, both occurred in the state’s Marion County.

A total of 219 cases of A/H1N1 flu have been confirmed in Oregon since the beginning of the outbreak, the state’s health officials said, noting that the new flu continues to present similarly to seasonal flu in terms of severity.

H1N1 crisis deepens (Canada)
http://www.winnipegfreepress.com/local/h1n1-crisis-deepens-49080766.html

The Assembly of Manitoba Chiefs has declared a state of emergency over the H1N1 flu pandemic, a move it hopes will rattle the cages of the province and the federal government and cause them to spring into action to combat the potentially deadly virus.

AMC Grand Chief Ron Evans said he and his fellow chiefs want to ensure government officials are fully aware of the devastating impact the H1N1 virus is having in their communities throughout the province.

“The governments need to step up. There is no plan in place. Nobody wants to accept responsibility for First Nations. There is very little combatting the H1N1 pandemic. Our people are sick,” Evans said at a press conference at the AMC’s downtown headquarters Wednesday.

The AMC’s desperate call for action came as the province announced the number of confirmed H1N1 cases in Manitoba jumped by 163, bringing the total to 458. As of Monday, 37 patients with the most severe flu-like symptoms have been put on ventilators in intensive care units.

Evans and 11 other chiefs decried the province’s inability to complete even the most simple of tasks on a timely basis — getting hand sanitizers into the communities that needed them — describing it as “a political and bureaucratic nightmare.”

Part of the problem is that commonly used hand sanitizer products can contain upward of 60 per cent alcohol and there was concern among health officials as well as some First Nations chiefs, that the sanitizers could be misused for intoxication.

Anne-Marie Robinson, assistant deputy minister of Health Canada’s First Nations and Inuit health branch, told a Senate committee of discussions between chiefs and public health officials about sending alcohol-based products into communities with addiction problems because there have been “rare” cases where it has been problematic. Robinson would not disclose which reserves had been involved in the discussions and never linked the talks with the “difficulty” she acknowledged was experienced in getting hand sanitizer to some of the chiefs who had asked for it.

David Harper, chief of the Garden Hill First Nation, which is located about 600 kilometres northeast of Winnipeg on Island Lake, said he has heard before of people ingesting hand sanitizer to get intoxicated and that his own band council talked about the alcohol-based products because Garden Hill is a dry reserve where alcohol isn’t allowed. He said they quickly identified alternative products and there’s no excuse for the delay in getting supplies to Garden Hill when so many people were getting sick.

Harper said he waited for more than two weeks for hand sanitizer and other supplies to arrive, by which point he had already purchased $15,000 worth of merchandise.

A shipment of 2,500 bottles of sanitizer did arrive in Garden Hill last week from the federal government — they were alcohol-based. Some has been distributed to families and some of the stock is being kept at the school and a police station. Harper said the federal government has shown a willingness to get off its wallet when it comes to other catastrophes in the past. For example, it doled out $425 million in aid after southeast Asia was hit by a tsunami in 2004 and it partnered with the province to bail out Manitoba hog producers, who have been suffering an economic backlash because H1N1 was originally called “swine flu,” with another $37.7 million. Harper said aboriginal leaders would welcome Canadian soldiers with open arms if the federal government opts to deploy them to reserves to help fight H1N1.

“If Canadian forces are being sent all over the world to help out, why not in our communities? We need help,” he said.

Health Minister Theresa Oswald said the province didn’t have a specific response to the AMC’s plea because it has effectively been in a state of emergency since April. The province calls it incident command status, instead.

Oswald said she and members of the province’s health incident command team have taken a number of measures to deal with the pandemic, including invoking an emergency provision in the collective agreements of doctors and nurses to reassign them where they’re needed, postponing elective surgeries to build capacity in the hospital system for intensive care patients and having First Nations leaders participate directly in its pandemic response structure.

Oswald said she spoke to Evans Wednesday afternoon and asked for a list of areas where the province hasn’t delivered and he wasn’t able to provide any specific shortcomings.

Britain set for “explosive outburst” of swine flu as numbers rise

Jun 25, 2009, 12:44 GMT
http://www.monstersandcritics.com/news/health/news/article_1485844.php/Britain_set_for_%26quotexplosive_outburst%26quot_of_swine_flu_as_numbers_rise_

London - Britain expects an ‘explosive outburst’ of swine flu infections in the autumn and winter of 2009, the government’s chief medical officer said Thursday.

Liam Donaldson said that in three areas - Scotland, London and the West Midlands - the spread of the virus had ‘moved beyond containment, leading the authorities to adopt a policy of ‘outbreak management.’

He said the authorities had been unable to prevent the spread of the infection in those areas, where ‘sustained community-based transmission’ had now taken hold.

Health Secretary Andy Burnham said that 3,597 cases of influenza

A (H1N1) infections had been confirmed in Britain so far.

Royal Highland: ‘Swine flu’ outbreak could place serious strain on farmers (Scotland)
http://www.farmersguardian.com/story.asp?sectioncode=31&storycode=27177

A WINTER ‘swine flu’ (H1N1) pandemic could have major implications on food supply, the environment and animal welfare, according to new work from the Resilience Advisory Board Scotland’s (RABS) food group.

The Scottish Government’s advisory body has begun to draw up plans for how the food and farming industries would respond to a pandemic, warning at its peak up to 2.5 million Brits a week could be taken ill.

It raises concerns that such an outbreak would leave farmers struggling to fulfil labour requirements while consumers could run short on food.

NFUS chief executive James Withers, who sits on the RABS food group, said the predictions were ‘dire’ and if large numbers of people were taken ill it would have serious implications for businesses across all sectors.

He said: “We are talking about things that may never come to pass, but we have to be prepared as an industry because the impact of a widescale pandemic would be huge.

“The implications for food production and for farming are massive and we have the summer months to prepare for something.

“RABS is looking at food production and how we would deal with shortages of food and labour in the industry.”

He said while the worst case scenarios may not come to pass, it was vital to begin planning for a resurgence of the H1N1 virus this winter.

Within the contingency plans will be preparations for relaxing certain legislation to allow the prioritisation of fuel and the movement of livestock.

There are also concerns around fallen stock if a pandemic causes disruption to disposal and collection routed.

Similarly, the potential loss of labour would also cause problems for slurry spreading and farm inspections raising concerns over farmers’ abilities to comply with NVZ or cross-compliance rules.

Mr Withers said: “We need the farming industry to get its thinking cap on. It might not emerge this winter but it just as well could do and we have to be prepared for every eventuality.”

Pathetic response to flu threat
4:00AM Wednesday Jun 24, 2009
By Brian Rudman
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10580293&pnum=0

So it’s official. The authorities have given up the fight. We’re to lie back and think of England as the dastardly swine ravages us all.

Even though upwards of 200 of us are likely to die - in the first wave anyway - all officialdom is offering is an 0800 free phone, and some Tamiflu anti-viral drugs left over from the bird flu scare a few years back.

As I heard a not-so-muffled cough rattle around the bus yesterday morning, I didn’t feel very much part of the 21st century. I want drugs and vaccines in return for all the taxes I pay, but all I get is advice to blow my nose in a tissue then store it securely in a plastic bag.

Chance would be a fine thing. In my workplace they recently removed our personal rubbish bags as a Green gesture - and to cut back on the cleaning staff. The creepy old nursery rhyme passed down from the years of the Black Death suddenly seem very modern: “Atishoo atishoo, and we all fall down.”

Staying in the dark ages, my local Ponsonby News is advising me to beat swine flu by shopping with Dr Ajit at Planet Ayurveda in Mt Eden. He’s touting a magic cure-all called Chywanprash, two teaspoons a day of which “gives good immunity against all viruses, hay fever, colds, coughs, fever and sinus headaches”.

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And if that doesn’t seem a bargain, he’s also promising wondrous healing properties after major surgery and chemotherapy as well. Nominate that man for one of National’s new knighthoods. Give him a Nobel prize. Shame I’ve already stocked up on garlic and red wine and shrunken heads.

These so-called pandemics do highlight what strange beasts we humans are. Ninety years ago, when a swine flu virus last jumped the species barrier into the human biosphere, at least 50 million people died worldwide - more than had died in the four years of World War I.

In New Zealand the second killer wave of the 1918 influenza epidemic killed almost 8600 people in less than two months, compared with the 18,000 New Zealand soldiers who died during the war.

So what did the humans do? Unite against this common enemy? No way. They rushed off and re-armed and set about killing each other in great numbers all over again.

Five years ago, after the Sars and bird flu scares, there was much talk about creating more vaccine factories worldwide so that when another wave of potentially killer-flu appeared, humanity had a fighting chance of standing up to it. Of course nothing happened. Here in New Zealand, we’re one of handful of rich countries that have advance purchase orders for vaccines for the latest pandemic strain. But we’re dependent on overseas-based commercial drug companies with no idea when supplies will start arriving, and how much we will get.

By the time the drug manufacturers’ home countries are supplied, the epidemic in New Zealand could be over and 200 dead.

This wave of the flu is seemingly mild, but who knows what it could transmogrify into and whether, when that happens, the vaccine we get will be successful against the by then, more deadly, mutated strain.

This year, $2.82 billion of tax dollars will be spent on our armed forces. Nearly $50 million of that will go on the running costs of the controversial LAVs, the 105 light armoured vehicles which cost $667 million to buy a few years back. Yet how many New Zealand lives has that money saved?

If good governance is about protecting the people from overseas threats, then maybe it’s time for a rethink of priorities. Why $2.82 billion on soldiers and sailors without an enemy in sight - or over the horizon, yet bugger all spent on protecting us from an invader, which even in its present benign form, the Ministry of Health says will kill up to 200 people.

At the very least, why are we not establishing a national vaccine manufacturing plant so we’re no longer dependent on the whims of the multinational drug lords?

Given our supremacy in fields of animal health, I’m presuming we have talented scientists capable of staffing such a facility - either on a full-time basis, or in times of crisis. If needs be, it could be a public/private partnership, if that made the present Government more ideologically comfortable with the concept.

We could connect with public health research facilities elsewhere in the world, taking the lead, but always with the interests of New Zealanders top of the list.

It might cost a bit, but compared with the $667 million spent on something named after the smallest room in the house, it would be money better spent, defence wise.

To sit around waiting for the disease to strike as we’re now being advised to do, is medieval.

The weapons to fight it are there, if our governors only got off their backsides and acted. But instead, all they have to offer are tissues and trips to Planet Ayurveda.
_________________
If you’re not living on the edge you’re taking up too much space.

Cytokine storm? Getting scary.

From an earlier thread:

ARD, Cytokine Storm, Swine flu

UPDATE: To clarify things, what researchers are trying to determine is an over the counter (OTC) formula that would prevent Acute Respiratory Distress (ARD). Sometimes called the “Cytokine Storm”, it is an overreaction of the body’s immune system that severely damages the lungs, resulting in oxygen deprivation to the internal organs.

However, a four-drug combination that inhibits some of the major inflammatory mediators, is now being suggested as a way to stave off ARD. All four of these drugs must be included.

1) 15,000 IU of Vitamin D (though prescription anti-hypertension drugs called ACE-2 inhibitors are preferred.)

2) Histamine-1 blocker. Benedryl or the equivalent.

3) Histamine-2 blocker. Tagamet or the equivalent (normally used to block acid reflux.)

4) Ibuprofen. Advil or the equivalent, a prostaglandin blocker.

In addition, it is also recommended to maintain just the MDAR of Vitamin A. Being short of Vitamin A is associated with having an excess of a very powerful inflammatory mediator called TNF-1. But it is easy to take too much Vitamin A, which is toxic.

Care should be taken with other “health foods” that can artificially enhance the immune system, something to be avoided when there is the prospect of ARD.

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