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Same old flu, same old flu stories.

Although Fujian did make at brief appearance at the end of last season, it is quite new, although it does have some of the mutations seen in human isolates after the 1968 pandemic (those born after 1968 should be paying attention).

There are some old flu stories that go back to 1918, but Fujian is quite new and there will be many more stories.

What are the chances it was Fujian, as it was articularly nasty?

If you look at last year's CDC flu summary, you will see that 100 H3N2 were subtyped. 93 were Panama and 7 "had reduced titers". Those that had reduced titers were Fujian. Thus, Fujian was running at about 7%, but it came up late, so the percentage of later cases was higher.

Everything about Fujian was classic. It came up late in the season and was gaining strength. It also had mutations in key positions (matching sequences of pigs and ducks as well as human isolates from just after the 1968 Pandemic).

The science was a no-brainer. The early appearance and severity this season was NOT unexpected (to anyone paying attention). The vaccine wasn't working well and the virus was beginning to take off last season.

If you had Fujian last year you will be much better off you would be from getting a Panama flu shot this year.

The Media is drumming this up into a panic.

Modesto Police Officer May Have Become Victim of Flu Outbreak Sue McGuire for KCBS-740 AM

(KCBS)--A Modesto Police officer, who had been suffering from flu type symptoms, died suddenly Saturday, apparently becoming the latest victim of the flu outbreak affecting California.

Modesto Police Detective Doug Ridenour says 32-year-old Officer Michael DuFour's family found him unconscious on the floor early Saturday morning. "The fire department got notified by the emergency response crews after they responded to a home here in Modesto that one of our officers, he had apparently collapsed and stopped breathing. They started CPR, the family did, but once the medical folks got there, they pronounced him dead a short time later at the house," said Ridenour.

DuFour had called in sick the past two days.

The Stanislaus County Coroner's office is conducting an autopsy to determine the exact cause of death.

The number of deaths with suspected links to the flu outbreak have continued to climb in the state.

A 16-year-old boy who tested positive for the flu has died in a San Diego county hospital. Two other deaths in the county may also be related to the flu. County officials confirm a 56-year-old San Diego man died December 3rd of flu induced pneumonia and it's suspected in the death Tuesday of a 13-year-old girl. A seven-year-old Bakersfield boy died Sunday and an elderly San Luis Obispo resident died of the flu last week.

People concerned about the flu are crowding Bay Area emergency rooms but many of the cases involve people with the common cold that easily can be treated at home.

Amy Nichols, the infection control manager at Alta Bates Summit Medical Center in Oakland and Berkeley says it's important to know the difference between a cold and flu because it could save your life. "It stays with you longer and there are other things that can occur in the wake of being infected with the influenza virus that can put you at risk for a more severe disease like pneumonia," she said.

Knowing the difference between the flu and the cold could also ease the burden placed on emergency rooms in the area.

Nichols says the flu is a respiratory infection that leaves victims with high fevers and low energy for more than a week. A cold does not last nearly as long and the fever isn't as bad. For people who have a fever for more than three days, they should seek medical care.

Might be a different strain than what I'm seeing in Oklahoma.

Nationwide Fujian / Panama ratios are about 3/1. I think it was 50/50 in Oklahoma. The season is still pretty early. When Fujian arrives, you will know it. Many of the fatalities had been immunized.

Usually we give flu shots to the elders and sick in October

The vaccine has Panama for the fourth year in a row, which won't do much for Fujian. This year's vaccine is just to let everyone think they are doing something constructive.

Fujian left its calling card last season and as expected, it has returned with a vengeance and the vaccine will do little.

actually the flu is no worse than usual, it just came earlier than usual.

Not even close. Fujian is very nasty. It started earlier, but will make for a very difficult winter.

WHO and the FDA chose the wrong strain, so they will downplay the epidemic until it becomes too obvious. January and February will be much worse.

The Media is drumming this up into a panic

Flu Shuts Down School System in Wayne County

Nicole Skelton and her friend Sarah Staggs attend Wayne County High School. Like many students, they spent Friday at home.

"We had nothing to do. We decided to get together," explains Sarah Staggs.

The flu outbreak shut down schools across Wayne County. Over 200 students called in sick Monday. From there, the numbers grew.

"We had a growing percentage of students out because of the sickness," says Wayne County Superintendent Jerry Pigg. "By yesterday evening, we had somewhere around 205 of student population absent."

"There were a lot of my classmates that were out sick. There was 60 people out yesterday," said Nicole Skelton.

Luckily, Skelton and her friend aren't sick. But trying to keep themselves busy has been hard.

Wayne County schools will be closed Monday and Tuesday. This is the first time the school system has had to shut down because of the flu.

The Media is drumming this up into a panic.

Flu Outbreak

MOSCOW (MT) -- A seasonal flu outbreak has started spreading across the country, hitting children in Moscow, St. Petersburg and seven regions the hardest, health officials said Friday.

The State Committee for Sanitary and Epidemiological Surveillance said the outbreak is well over the epidemic level in Moscow and recommended that schools disband classes in which half of the children are sick, Ekho Moskvy radio reported. In St. Petersburg, students from about 500 classes were told to stay home, the station said.

Most of those suffering the flu are children between the ages of 3 and 14.

I believe that determines the frequency of animal-to-human transmission.

The number of animal to human transmission has been on the rise. There have been at least 3 incidents in the past 10 months.

The transcript of the vaccine selection committee mentions signature changes at amino acid positions 155 and 156 in HA. The change of H155T actually involves two mutations (C463A and A464C). Interestingly, the same changes are found in pigs and ducks. They are also found in human isolates collected just after the 1968 Pandemic. The other change also involves two mutations to produce Q156H. In Fujian it is A468T and in the other Fujian-like isolates it is A468C. It looks like the virus was pretty serious about changing those two amino acids.

Unfortunately, I suspect the "signature" will be Peter Palese's vote on the science and everyone else's focus on expediency or cost cutting (using the same old Panama strain for the 4th year in a row).

I think it will be a VERY long winter.

Quick, open the borders!!!

Viruses do not require Visas. They are equal opportunity killers.

Here is one media interpretation of the transcript:

FDA balked at riskier, but better, flu shot
By David Migoya and Marsha Austin
THE DENVER POST

Federal regulators could have approved a flu vaccine that protected the public against the deadly strain sweeping across the country, but would have had to use a controversial and risky method to do it.

A leading national expert on infectious diseases told a Food and Drug Administration committee in February and again in March that it would be a mistake if this year's vaccine didn't guard against a potentially lethal strain of flu that was beginning to emerge in the Southern Hemisphere.

Dr. Peter Palese warned that the flu strain - known as A-Fujian/411/2002 - seemed likely to hit the United States and that drastic measures were required to protect public health. Creating a vaccine that offered only moderate safeguards against the new strain was a bad idea, he warned, according to official transcripts of FDA meetings earlier this year.

"I feel that it is better in the long run to have a good vaccine or a better vaccine … than having just a potential (for protection)," Palese, director of microbiology at Mount Sinai School of Medicine in New York, told the FDA panel in March.

http://www.dailystar.com/star/today/31214NFLU-VACCINE-DEN.html

voted to keep using the 5-year-old Panama Flu Strain--which has a 50-50 record about helping against Fujian Flu.

Unfortunately, Panama is nowhere near 50/50 against Fujian. At their earlier meeting they were shown ferret data which showed that ferrets immunized with Panama had titers of 640 to 1280 against Panama, but only 80 against Fujian (and the Panama vaccine doesn't even work that well against Panama - in spite of being used worldwide for the past 4 years, 1/4 of the US cases are still Panama).

Their choices were not ideal, but there was only one correct vote, which was to passage the virus once in MDCK cells and then grow it in eggs. MDCK cells were already in registration for vaccine production so pathogen free cell lines existed.

Making Fujian THIS year was very doable.

do you have any idea how long it could take to hit the U.S.?

The Korean virus has not been shown to infect humans yet. The Hong Kong virus has infected at least one person and contacts are being monitored.

Like SARS, infectious agents in people are just one airline flight away.

The real deal on the flu vaccine:

MEETING ON INFLUENZA VIRUS VACCINE
FORMULATION FOR 2003-2004

+ + + + +

TUESDAY,

MARCH 18, 2003

+ + + + +

The meeting was held in Conference Room A on the 11th Floor, 5515 Security Lane, at 10:30 a.m., Dr. David Stephens, Committee Chair, presiding.

http://www.fda.gov/ohrms/dockets/ac/03/transcripts/3941t1.doc

PAST POST: 1918
Rise in Flu Cases, Deaths Alarm District



Sunday, December 14, 2003; Page C02



Spreading in the District at an alarming rate, Spanish influenza increased more rapidly yesterday than since the disease became epidemic. Thirty-seven deaths were reported to the health department for the 24-hour period up until last midnight. More than 1,300 new cases were reported under treatment.

With this record number of deaths came announcements that the George Washington and Georgetown universities had closed classes. With fair weather promised for today, all church services will be held outdoors in compliance with the commissioners' orders.

Late reports were that many employees of the Chesapeake and Potomac Telephone Company were suffering with the disease. The city post office faces a serious shortage of manpower in face of heavy mails. . . . High school boys, idle since the schools were closed, are urged to apply for work at the post office, until the schools reopen.

-- Oct. 6, 1918

http://www.washingtonpost.com/ac2/wp-dyn/A62649-2003Dec13?language=printer

This is a little too close to our military in South Korea for comfort if it gets bad.

The military played a major role in the 1918 pandemic (and the flu may have played a role in ending WWI).

Here's more on bird flu:

Flu Virus From Bird Infects Boy in Asia
Experts Worried About Global Pandemic

By Rob Stein
Washington Post Staff Writer
Sunday, December 14, 2003; Page A03


While the start of this year's flu season has been especially wretched, flu experts say it is not the killer pandemic they have been worrying about for years. They are more anxious about a little-noticed case that emerged last week in Hong Kong, where a 5-year-old boy was infected with a bird flu virus, because that is the sort of event that could spark a long-feared global health emergency.

The child recovered, and so far no one else appears to have been infected. But experts say they are monitoring the situation closely because whenever a new animal flu virus infects a person it has the potential to create an entirely new virus against which humans would be defenseless.

"Every transmission of an avian influenza virus to humans raises the possibility for a pandemic. So we immediately have a red alert," said Klaus Stohr, a top flu specialist at the World Health Organization in Geneva. "The concern is that a new virus with high transmissibility and high pathogenicity could emerge."

The Hong Kong boy's family is in isolation, and officials are anxiously awaiting the results of tests on them and other children who attend the same kindergarten for signs that the virus had spread or mutated. Three family members had a mild cough.

As soon as WHO officials learned of the case, the agency issued a global alert for scientists to be on the lookout for any flu cases caused by viruses that could not be identified, and they rushed samples of the Hong Kong virus to laboratories around the world to begin deciphering its genetic code and developing tests that could identify it quickly if it were to spread.

"We have to treat it seriously," Stohr said. "Fortunately, so far it looks like an isolated case with no human-to-human transmission. But we are concerned."

http://www.washingtonpost.com/ac2/wp-dyn/A62620-2003Dec13?language=printer

Isn't this better suited for posting on PETA's website?

H5N1 has produced fatal infections in humans.

This report might be clearer:


DEC 13, 2003
S. Korea tests poultry farm for bird flu
Up to 19,000 birds have died, and a highly contagious flu that can be deadly to humans is suspected

SEOUL - South Korean veterinary experts are carrying out tests on chickens at a farm near Seoul for suspected cases of a highly contagious type of bird flu that can, in the case of certain strains, be deadly to humans.

The Agriculture Ministry said in a statement yesterday that the results of final tests would be released next week.

If its suspicions are confirmed, it would be the first cases of highly pathogenic (HP) avian influenza in South Korea.

'The National Veterinary Research & Quarantine Service test showed suspected cases of avian influenza in chickens,' the statement said.

'According to the quarantine experts, it is highly possible for this case to be highly pathogenic influenza.'

As a precautionary measure, the authorities have destroyed all the remaining 5,000 chickens at the affected farm, which is about 80km south-east of Seoul, according to the statement.

Between Dec 5 and 11, some 19,000 chickens had died out of a total of 24,000 birds, it added.

'It is too early to say it is HP avian influenza, but if it is, it would be Korea's first case,' an official at the ministry said.

http://straitstimes.asia1.com.sg/storyprintfriendly/0,1887,225143,00.html?