http://www.nationalpost.com/news/canada/story.html?id=1769452
Swine flu virus unpredictable, scientists warn
Life Threatening; Starts like regular flu, then lungs stop functioning
Sharon Kirkey, Canwest News Service
Published: Wednesday, July 08, 2009
Anyone who develops serious flu-like symptoms should seek immediate medical attention, because no one can predict when the H1N1 flu virus, or swine flu, will turn life-threatening in otherwise healthy people, infectious disease experts are warning.
Severe cases are occurring, in which the infection starts off like regular seasonal flu, with fever and cough, but then the lungs rapidly become inflamed and stop functioning.
“It looks to most of us like a primary viral pneumonia that deteriorates five or six days into therapy,” says Dr. Allison McGeer, director of infection control at Toronto’s Mount Sinai Hospital. “It’s really severe illness.”
“If you’re young and healthy, you can recover from that severe lung injury. People do. But it takes a very long time,” Dr. McGeer said.
“Sometimes we’re talking about a month, five weeks on a ventilator before you are breathing on your own. Some people can be left with so much residual lung damage, they will have abnormal lungs for their lifetime.”
Scientists are scrambling to understand why otherwise healthy people are becoming seriously ill with swine flu.
But Dr. McGeer said attempting to identify whom this happens to “is the same as trying to pick out people who, faced with Group A [streptococcus], get necrotizing fasciitis — flesh-eating disease — when most of the rest of us get nothing, or minor illness,” she said. “The parallel is, I think, identical.
“If you have underlying illness, if you are pregnant, there are things we know are risk factors,” Dr. McGeer said.
“But I don’t think there’s anything that labels these people any more than there’s something that labels people who get necrotizing fasciitis.”
As of July 3, there had been 8,883 confirmed cases of the H1N1 flu virus across Canada, 663 of which have led to hospitalization, and 29 of which have ended in death.
And as the number of cases climb, H1N1 is showing signs that it can move outside the respiratory tract to other parts of the body, something regular flu viruses normally do not do.
Researchers from the Centers for Disease Control and Prevention in Atlanta found H1N1 virus in the small intestines of ferrets infected with HIN1 isolates taken from three people who developed mild, severe and fatal flu.
The finding could explain why swine flu is causing vomiting and diarrhea in about 40% of cases, symptoms that are not typical of garden-variety flu.
“That’s not normal. Influenza should just be in the lung,” said Earl Brown, an influenza expert at the University of Ottawa. “This is the first time a human flu has done this in a ferret. The question is: How does it get there? You don’t like to see a flu virus move outside the lung.”
The virus did not spread to other organs, such as the kidney or brain. But it suggests H1N1 influenza A is hardier and can survive in the environment longer than normal flu.
High amounts of the virus were also found in lung tissue, “which we don’t typically see with seasonal strains,” said Terrence Tumpey, a microbiologist at the Centers for Disease Control’s influenza division.
They also found significant weight loss in the ferrets infected with the new swine virus.
“It tells us that this virus has the capability of causing more illness in mammals, in comparison to the seasonal strain,” Dr. Tumpey said.
The ferret is considered the best model to study flu in humans. “Generally, the disease you get in the ferret mirrors the disease you get in humans,” Dr. Brown, of the University of Ottawa, said.
Meanwhile, new, non-pandemic influenza has been found in two hog-farm workers in Saskatchewan, and a third case is under investigation. The affected workers have fully recovered.
Yesterday, the World Health Organization said it has received more than 98,000 reports of laboratory-confirmed cases of pandemic H1N1 from 120 countries, including more than 440 deaths.
Argentine businesses struck by swine flu
By Oliver Balch in Buenos Aires
Published: July 8 2009 04:18 | Last updated: July 8 2009 04:18
http://www.ft.com/cms/s/0/835fd8e8-6b01-11de-861d-00144feabdc0.html
An uncharacteristic quiet hangs over Buenos Aires’s usually bustling commercial districts as swine flu grips the Argentine capital.
Restaurants, shopping centres, hotels and theatres all report falling sales as deaths from H1N1 infection across the country reached 65.
“We are seeing a jump in telephone inquiries, but footfall in the shop is dead,” said Florencia Paulet, an assistant in the aptly named furniture store Me Quedo En Casa (I stay at home), located in the trendy Palermo district.
Local businesses fear that emergency health measures unveiled by the Buenos Aires health ministry last week could result in similar economic losses to those that occurred in Mexico City at the start of the swine flu outbreak.
Trade has halved over recent days, representing a weekly loss of around $150m, according to Luis María Peña, president of the association of hotels, restaurants, confectionary shops and cafés.
Businesses geared towards children are reporting the most severe impact. Cinemas reported a fall in ticket receipts of more than 33 per cent in a week. Internet cafés, sports centres, discotheques and theatres have seen a similar fall-off rate.
In the district of San Isidro, children under 18 have been banned from entering shopping centres until July 9. Nightclubs and gymnasiums have also closed their doors temporarily.
Provincial governments are now following suit. Mendoza, San Juan and Corrientes have ordered casinos and cinemas to remain shut for a fortnight. Argentina’s theatre association has also decided to close box offices for 10 days.
“I’ve had two children’s parties and a baptism cancelled at the last minute. The flu is terrible for business because parents are terrified and prefer to stay at home,” said Justina Maiz, a specialist children’s photographer.
Travel companies are also reporting widespread cancellations as an increasing number of countries issue health warnings against visiting Argentina.
Argentines themselves are holding off travelling as well. School graduates are being requested not to travel to the ski town of Bariloche, a popular end-of-term destination, for at least a fortnight.
Pharmacies are one of the few industries to see sales on the rise. Stocks of masks and alcohol gel are almost sold out across the country, leading some consumers to cross into neighbouring Chile and Uruguay to obtain them.
The antiviral Tamiflu medicine is the top seller. “Supplies are still available, but the problem is that we sell out in a flash,” said a pharmacist in Buenos Aires’s busy Palermo neighbourhood.
Business leaders have criticised the government for responding too slowly to the H1N1 outbreak. An estimated 100,000 people have contracted swine flu since the first cases appeared in Argentina in May, according to the national health ministry. Laboratory results put the figure at 2,485.
If the flu epidemic lasts for a month, the impact on the economy could amount to 0.5-0.6 per cent of GDP, equivalent to over 6.1bn pesos ($1.6bn, £990m), according to estimates by local analyst firm Orlando Ferreres. Other analysts put the figure at anywhere between 4bn and 10bn pesos.
Last week, health minister Graciela Ocana resigned, allegedly due to her frustration at not being able to introduce nationwide prevention measures earlier.
Cristina Fernandez de Kirchner, the president, has so far preferred to leave provincial and municipal governments to determine their own responses to the outbreak. To date, 11 of the country’s 23 provinces have declared a state of emergency, in addition to Buenos Aires.
The health ministry finally unveiled a 1bn-peso package of measures at the end of last week, most of which was meant for the distribution of Tamiflu.
Other measures include the introduction of paid leaves for pregnant women. Civil servants with young children have also been granted time off as schools close their doors on Wednesday, a week ahead of scheduled holidays.
Around 45,000 civil servants are off work in Buenos Aires, while private companies are reporting absentee levels of up to 15 per cent.
Congress is due to debate on Wednesday whether or not to bring forward parliament’s winter recess.