*The* Swine Flu (Cat 6 Pandemic) Thread

[lady-t]

he looks and acts much better.  he seems to feel much better.  his color and apetite is good.  his oxygen saturation is good as well as his blood pressure and other such medical stuff.  maybe we will get him home a day early.  although i am not happy about it.  i want him in the hospital and monitored 24/7  til he is FOR SURE out of the woods.  but the doc won't let him come home this time without that being the case ( i hope )  i think they let him out too soon last time and it developed into a worse case as a result. 

but anyway.  i have to go do a field trip with a basketball team today so he can't come home til later at any rate.

[Jackson]

I got an idea lady-t, maybe you should say you have developed a bad cough and cold and tell the doc you don't want to expose him for another day or two.  I hate lying- but I think I could manage it as concerned as you are

[seawitchllc]

http://www.recombinomics.com/News/02051003/H1N1_Duke_Mix.html

H1N1 D225G D225N H274Y Mixtures in Duke Death Cluster
Recombinomics Commentary 15:58
February 05, 2010

4 oseltamivir-resistant pandemic (H1N1) 2009 viruses emerged at Duke University Hospital in Durham, North Carolina, United States. One male and 3 female patients, ranging in age from 43 years to 67 years, with severely immunocompromised status, were admitted to the same ward. The onset of influenza illness occurred in a 2-week period between mid-October and early November.

While 3 of the cases were fatal, the role of H1N1 infection in contributing to the deaths is uncertain.

In 3 of the 4 cases, the H275Y mutation was identified before oseltamivir was administered.

The above comments from today’s WER still fail to comment on D225G and D225N in the sequences from the above cluster and still maintain that the role of the H1N1 in the deaths is still unclear.  However, the demographics help sort out the sequences from five isolates placed on deposit at GISAID by the CDC.  All five isolates match the demographics and timeframe detailed above.  Two of the isolates, A/North Carolina/39/2009 and A/North Carolina/49/2009, have the same demographic information (43F) and are likely to have been collected from the same patient. The sequence from the earlier collection is a mixture with D225G and wild type, while the later collection is D225G only. 

However, the sequences from other samples collected in mid-October are also mixtures. One sequence has a mixture of D225N with wild type, while the other isolate was cloned and one clone has H274Y, while the second clone is wild type at NA position 274.

Since all of the samples have NA with H274Y and HA with Y233H, it is likely that all three patients linked to the October collections had all three markers (D225G, D225N, and H274Y) and the collection site and time, as well as virus cloning and growth conditions, determined which combinations were in the sequences placed on deposit.

These data raise concerns that the levels of D225G/N and H274Y in the sequence databases under-represents these polymorphism in patients.  Moreover, host factors, including immunological status may influence which sequences become dominant to impact the clinical picture.

The low reactor status published by Mill Hill raises concerns that immune response to wild type may select these variants, leading to more severe and fatal cases in the new wave which is beginning to emerge in the northern hemisphere.

Detailed sequence data on recent H1N1 is schools and hospitals in North Carolina would be useful.

>>>>>>>>

www.recombinomics.com/News/02051004/H1N1_Reg4_W3.html

US Wave 3 Start Confirmed By H1N1 Increases in Region 4
Recombinomics Commentary 23:03
February 05, 2010

Region 4: AL, FL, GA, KY, MS, NC, SC, TN;

The latest CDC report shows an overall rise (from 8.9% to 13%) in samples positive for H1N1 in Region 4 in the week 4 report, providing additional evidence for the start of wave 3 in the United States.  Earlier media reports had described increases in various states in region 4.  Le Boehner children’s hospital in Memphis had seen an increase in hospitalized patients and a high frequency were being admitted to the ICU, where at least 2 of the 7 died.  One was from MS while then other was from TN.  University of North Carolina hospital also reported an increase in confirmed H1N1 in college students, and the North Carolina website showed an increase in samples testing positive for H1N1 to 25%, the  highest level since mid-November when wave 2 was declining.

These sharp increases in region 4 raise concerns that these cases will spread.  Region 4 led the nation at the beginning of the fall wave, which largely followed school openings.  Many of the schools in region 4 opened in August.  The rise in positive patients in region 4 raises concerns that wav 3 will be more severe, with an associated increase in deaths.

Tamiflu resistant H1N1 with D225G/N was found in the Duke fatal cluster in October/November increased concerns for more fatalities. The three fatalities at Duke were in the same ward and infected with the same H1N1, which had H274Y in NA and Y223H in HA.

Release of sequences from the severe cases in TN and NC would be useful.

[Jackson]

Re: Nimans Region 4 comments,
I live in AL, it was very obvious in October that we had a bad wave occuring.   I have seen and heard of 0 since before Christmas.  In October all the kids got it, work associates, church friends, I have seen 0 cases in a very long time.  Here is to hoping he is wrong, he probably ain't, but I still hope. 

[suburban_junkscape]

also re: nimans region 4 comments

yesterday they had an article on either msnbc or cnn saying the epidemic is almost over since as much as 40% of the country has immunity due to either infection or vaccination. I'm putting my swine flu fears off until September. We need to watch in the spring and summer to see if that D225G strain starts taking hold and also see how much the vaccine protects against it.

[Tropicalgirl]

lady-t - sorry to hear about your DH, but good news that he is getting better.  Hope he continues on the path to being well!

Btw, I was reading an article this week in Natural News about asthma being related to being linked to dehydration, wouldn't that be a miracle, drink more water, heal the asthma! http://www.naturalnews.com/001965.html

[EyesWideOpen]

I think this will be the week we find out if the mutation Niman is watching becomes a deadly 3rd wave, too. So this may still be Breaking, at least for another week.

[seawitchllc]

http://www.recombinomics.com/News/02081001/H1N1_MS.html

More Severe H1N1 Increases In Mississippi
Recombinomics Commentary 16:38
February 08, 2010

All their temperatures were in the 103-104 F degree range and they exhibited the classic picture of "aching-all-over-like-I've-been-run-over-by-a-semi" with uncontrollable dry cough and extremely depressed energy levels.

These folks were dramatically sicker than anyone I saw with H1N1 which I described in an earlier column as "Flu Lite." The typical case of swine flu I treated in the office struck me as being about a third as debilitating as seasonal flu.

I treated these recent patients with Tamiflu and they all got better but it took longer than in previous years. I have always told flu victims in the past that, once they started on Tamiflu, they would feel better within 24 hours. Most would tell me they felt brand new the next day. This year that advice didn't work. Most of these unfortunates were in bed for three or four days and didn't feel a bit better until the third day.

The above comments of a General Practitioner in Mississippi raise concerns that the increasing severity in recent flu patients in Region 4 is widespread.  Although this practitioner thinks his patients have seasonal flu, there have been no significant influenza A seasonal flu reports in MS or elsewhere in the US this season.  Seasonal H1N1 has not been reported in 7 weeks, and H3N2 was reported at minimal levels, which were less than 1% of swine flu levels.

Earlier reports described more severe cases in Memphis, TN as well as UNC University Hospital in Chapel Hill, NC.  Moreover, the per cent positive rate for swine H1N1 has increased to 25% for NC and 13% for Region 4 in the latest update.  Region 4 also reported the first upward swings in swine H1N1 in the fall, which began in August in the south, where schools began the academic year weeks earlier than school districts in other regions in the United States.

Although widespread disinformation campaigns have been discounting the current pandemic, these anecdotal reports suggest H1N1 cases are increasing and more severe.  Anecdotal reports also indicate school absenteeism is on the rise, but swine flu symptoms are being reported as bronchitis, allergies, stomachs flu, or seasonal flu, as happened during the swine flu outbreak in the fall.

Details on rising school absenteeism, which appears to be approaching 10% in some schools districts in the south, as well as sequence data from the more severe cases, would be useful.

>>>>>>

http://www.recombinomics.com/News/02091001/H1N1_Fake.html

WHO's Fake H1N1 Pandemic
Recombinomics Commentary 15:58
February 09, 2010


4 oseltamivir-resistant pandemic (H1N1) 2009 viruses emerged at Duke University Hospital in Durham, North Carolina, United States. One male and 3 female patients, ranging in age from 43 years to 67 years, with severely immunocompromised status, were admitted to the same ward. The onset of influenza illness occurred in a 2-week period between mid-October and early November.

While 3 of the cases were fatal, the role of H1N1 infection in contributing to the deaths is uncertain.

In 3 of the 4 cases, the H275Y mutation was identified before oseltamivir was administered.

The above comments for a February 5 WER describe a Tamiflu resistant fatal cluster at Duke University Hospitail that involved the transmission of H274Y as well as D225G/N.  However, more than three months after the fact the role of the H1N1 in the three deaths is still characterized as “uncertain”.  The same claim was made in the December 2 announcement, even though H274Y had been identified in the NA sequences and the HA sequences had almost certainly been generated since samples from three of the cases were collected on October 15 and 16 (sample from the fourth case was collected Nov 2), and included the three HA sequences with D225G/N.  The HA sequences also included a rare marker (Y233H) confirming that all patients were infected with the same H1N1.

Thus, although the three deaths were in patients on the same ward infected with the same virus at the same time, the official updates claim that the role of H1N1 in the deaths is unknown, which is the type of information used to create a fake pandemic which is based on negative data and serious downplaying of significant events in the evolution of the virus and pandemic.

The outbreak at Duke was serious.  Not only was h274Y being transmitted, but the virus was killing the patients, WHO disclaimers notwithstanding.  The death cluster led to conerns that the outbreak would involve D225G/N. which was recently confirmed in the sequences released by the CDC at GISAID.

However, the presence of D225G/N was not disclosed in the February 5, 2010 release or the December 2, 2009 release.  Similarly, the association of D225G/N in this cluster was not noted in the December 28 report or the January 21 report on D225G and in fact statements were meade denying transmission, even though the report stated that there were 3 examples of D225G in association with H274Y (but the examples were not detailed, so the specific link to this cluster was not made).

These deliberate omissions are used to create press releases that are factually correct, but extremely misleading.  These statements rely heavily on negative or excluded data to make the statement factual and creating a fake pandemic that appears to markedly less severe or ominous.

These types of official statements helped create an atmosphere that have been exploited by politicians who claim the very real and dangerous pandemic has been manufactured, which will reduce the effectiveness of the vaccination program leading to unnecessary deaths in those who avoided vaccination, was well as those infected by those who avoided vaccination.

Moreover, the denial of the significance of D225G/N will likely lead to the absence of the changes in the recommended swine H1N1 target for the seasonal flu vaccine for 2010/2011 as was done for the 2010 vaccine for the southern hemisphere.

The denial of the D225G/N importance is also linked to the role of recombination in the movement of these polymorphisms from one genetic background to another.  As was seen in the Duke cluster, even though all isolates had Y233H on HA and H274Y on NA, the detection of D225G/N varied.  In one patient D225G was initially identified as a mixture with wild type, while a clean sequence was obtained from the same patient in a sample collected a day later.  Similarly, the D225N was also identified as a mixture with wild type, while samples with from two other patients were wild typw without either D225G or D225N.  These variations clearly reflect different rations in different collections, raising concerns of false negatives for these markers.  WHO has already claimed that these markers do not transmit and do not cluster in time, space, or phylogenetically, yet both markers appeared in the same transmitting cluster at Duke, and similar results have been noted many times over in Ukraine and Russia, which include find D225G and D225N in the same sample (11 examples in fatal cases in Ukraine).

Thus, the distortions on reporting of test results and implications has created a fake pandemic, which has been exploited by politicians and internet fatansy bloggers to deny the serious H1N1 pandemic (as well as H5N1 clusters), which is hazardous to the world’s health.

[NYLongBow]

Yeah Niman appears to be getting quite aggressive with his comments.

Not that takes away from the issues he is reporting.

Cant see the next wave being the middle of the road. Expecting dramatic numbers in one direction or another. Effectively petered out due to vaccination %s or dramatic new reports due to mutation and resistance to current vac formulas.

Its clear though, that MSM and WHO are just as guilty of under-reporting and minimizing as Niman is for dramatizing.
Somewhere in the middle is a whole world hoping to role a lucky seven :-(

[EyesWideOpen]

While I'm not a cult member, I do think Niman, with a very good record so far on this thing, is at all over dramatizing. He's been right, been ahead of everyone else, and has my attention as a consequence.

[seawitchllc]

http://www.recombinomics.com/News/02111001/H1N1_MI_13.html

13 Recent H1N1 Deaths In Michigan Raise Concerns
Recombinomics Commentary 10:24
February 11, 2010

Cumulative deaths associated with any influenza strain since Sept 1, 2009: 79

The above comment in the most recent Michigan update describes a dramatic spike in H1N1 fatalities in the past 2 weeks in Michigan.  This recent rate of approximately 1 death per day is in marked contrast to deaths between December 12, 2009 and January 19, 2010 when only 2 fatalities were reported.  The spike in Michigan coincides with a spike in Pneumonia and Influenza deaths in the US, but in Michigan the spike was in lab confirmed H1N1, raising concerns that a new wave has begun in the US and is more lethal than the wave which largely ended in December and early January.

The start of a new wave is not unexpected.  Multiple waves within one pandemic seasonal have been noted previously, and the likelihood of a wave in early 2010 was increased by the early appearance of the fall wave, as well as the absence of seasonal influenza A.  Moreover, the decline in wild type H1N1 provides an opportunity for the emergence and dominance of a new strain.  Recent increases in the reporting of H1N1 sequences with D225G and D225N have raised concerns that this lethal strain could become more common leading to more severe and fatal cases.

There has also been a recent surge in H1N1 confirmed fatalities in Mexico, raising additional concerns for the spread of D225G.  In a recent series of 10 HA sequences from fatal cases in Mexico, 5 had D225G, D225N, or both.  The two sequences with both were collected within a day of each other in San Luis Potosi, raising concerns of H225G/N transmission, which was recently seen in a death cluster at Duke Medical Center in North Carolina.

Sequence data from the fatal cases in Michigan and Mexico would be useful.

>>>>>>>

http://www.recombinomics.com/News/02111002/H1N1_Mexico_Spike.html

Spike In H1N1 Deaths In Mexico Raise Concerns
Recombinomics Commentary 12:45
February 11, 2010

The recently released update from the Ministry of Health in Mexico lists 1026 lab confirmed fatalities, which is markedly higher than the 880 reported a month earlier.  Although there is a delay in lab confirmations of fatal cases, a comparison of confirmations in the four weeks prior to each report has 44 fatalities for the February 8 report, compared to 9 for the January 6 report.  Moreover, the total number of cases confirmed has been declining, leading to an increase in the apparent case fatality rate.

Recent sequences, including those from Mexico have shown an increase in D225G and D225N in samples from fatal cases.  These increases have raised concern that a new wave of infections could have a higher frequency of this two receptor binding domain changes, leading to more severe and fatal cases.  Comments on more severe cases have been made by physicians in Tennessee and North Carolina, and the recent spike in H1N1 confirmed fatalities in Michigan has increased those concerns.

The increases in Mexico could be due in part to an emphasis on confirmation of fatal cases, but media reports have also described increases in fatalities in patients with H1N1 symptoms, indicating the increases in recently confirmed cases represent a spike in fatal cases, and not an increased focus on testing fatal cases.

However, sequences from these recently confirmed cases and any information in changes in confirmation procedures or emphasis would be useful.

[NYLongBow]

Yep.. just read about the MI spike.

Seems like an odd time for a new wave spike though. Was expecting this in the fall. Suppose it could also be good news on timing as the flu season will start losing grip soon and the wave (should it be one) be mitigated by time of year.

perhaps thats too hopeful though.

[wordnerd]

Just saw this:
http://insightbb.com/reuters/default.aspx?doc=2010-02-12T233532Z_01_N12235797_RTROPTT_0_USREPORT-US-FLU-USA.XML
Swine flu has killed up to 17,000 in U.S.: report
Feb 12, 06:35 PM EST

WASHINGTON (Reuters) - H1N1 swine flu has killed as many as 17,000 Americans, including 1,800 children, the U.S. Centers for Disease Control and Prevention reported on Friday.

[Biminim]

Trying to get to bed early for once, so I'm just bopping in quickly to bump this thread to the front page, as it looks like H1N1 is back to its tricks in the U.S.

http://www.recombinomics.com/News/02251001/H1N1_Wave3_Signals.html

Courtesy of Dr. Niman's www.recombinomics.com:


More Signals On H1N1 Wave 3 Start in United States
Recombinomics Commentary 02:02
February 25, 2010



Some of the nation's emergency departments are noting increases in flu-like illness cases that appear to be pandemic H1N1, and colleges are reporting the first increase in flu-like illness since the end of November, but it's not clear if these are early signs of a third pandemic flu wave.

The American College of Emergency Physicians (ACEP) said today in a Twitter post that some of its members were anecdotally reporting a new wave of pandemic H1N1 patients coming to emergency departments and asked if other physicians were seeing similar patterns.

Carl Schultz, MD, professor of emergency medicine at the University of California at Irvine, told CIDRAP News that the increase in the number of influenza-like illnesses appears to be real, but he cautioned that many of the cases have not been confirmed as the pandemic H1N1 strain, because many departments stopped specifically testing for it because of low flu activity. Schultz chairs ACEP's disaster preparedness and response committee.

The above comments provide additional data that a third wave in the United States has begun.  Reports on flu at universities has increased 52% over last week, which is supported by anecdotal reports from emergency room physicians.  The largest number of new student cases was again in North Carolina.

These developments parallel the start of the fall wave.  The initial cases were in region 4 and this area has had the highest percent of samples being H1N1 positive.  Similarly, state reports showed recent increases in North Carolina and Alabama, while earlier reports describe more severe cases in hospitals in Tennessee and North Carolina.

The initial reports from region 4 may signal the emergence of a more evolved H1N1 since the time between the current outbreak and cases reported in the fall would be greatest.  A recent report on Allegheny County, location of metropolitan Pittsburgh found H1N1 antibody in 45% of patients age 10-17.  If this population is again being targeted, it is likely that there are re-infections and the new virus has escaped the immune response generated against the fall wave.

Recently released sequences from low reactors indicated that a single nucleotide change could move a sequence into the low reactor category, and recombination was creating new sequences with multiple low reactor polymorphisms, which if additive would lead to widespread vaccine failure and frequent infections of patients infected last year.

Sequence data on new cases, including severe and fatal cases would be useful, as would H1N1 history of these new patients.

[sweeks]

One of my co-workers just came in and said his daughter has swine flu. He came in and warned all of us because he's been around her quite a bit the past few days. The hospital is requiring him and all family member get the SF shot and to suggest all co workers/contacts etc get it as well.

She is severely handicapped, 6 years old in a wheel chair, has a feeding tube, can't talk, requires 24/7 care, etc.. She was born that way and we won't go into the expense/health care/moral issues of dealing with that.

He said she has been sick for a few days slight cough, mild fever and then his ex called this morning from the hospital. His ex said that his daughter just stopped breathing and they rushed her to the ER early this morning. They ran some tests and determined it was SF.

They were preparing to life flight her to Childrens Mercy in Kansas City, since our local hospital can't handle all of her needs, but they are full and can't accept her. They have a 6 hour backlog! What's going on that they can't accept a life flight patient for 6 hours.

He's afraid that if they don't get her up there pretty quick she won't make it.

I was up all Sunday night and Monday morning puking. I assumed it was just a 24 hr stomach bug that is going around but I have started to develop a cough. I really can't afford to be sick right now. And all right before I have Lasik on my eyes this Friday.