Eideard

An unusual study done in 49 remote Hutterite farming colonies in western Canada has provided the surest proof yet that giving flu shots to schoolchildren protects a whole community from the disease.

Although previous studies have demonstrated what scientists call “herd immunity,” none have been so incontrovertible, because they were done in less isolated places with more sources of flu passing through. Also, only one other study, done 42 years ago, immunized over 80 percent of a community’s children, as this one did. Success repeated in many separate communities with very high vaccination rates implies that the shots themselves — rather than luck, viral mutations, hand-washing or any other factor — were the crucial protective element…

“Not only was that clearly needed to protect the kids, but they probably wound up protecting the older people, too,” Dr. Fauci said…

Although they frown on television and radio, Hutterites drive cars and modern tractors. More important from a medical point of view, they live in communities of up to 160 people, own everything jointly, attend their own schools, eat in one dining hall and have little contact with the outside world. Each community governs itself, but, in Dr. Loeb’s words, “after one very with-it Alberta bishop recognized the study’s benefit to the rest of the world and backed it,” almost 50 communities voted to participate.

Hutterites have no religious objections to Western medicine, that very “with-it” bishop, John K. Stahl, 76, said in a telephone interview. While deliberately cut off, they perform acts of generosity — for example, many donate blood frequently…

There was a 60 percent “protective effect” for the whole community, the study concluded. It implies, Dr. Bridges said, that giving flu shots only to schoolchildren would protect the elderly just as well as giving flu shots to the elderly themselves.

The C.D.C. would never recommend that, she cautioned, “because you still should vaccinate high-risk people.”

Anyone who ever worked in an office setting populated by folks with schoolkids in their family knows what happens even with the common cold – much less the flu. Everyone brings it to work after they catch something from their kids.

RTFA. The study was fortunate to connect with religious communities that aren’t anti-science from the gitgo. Down here in the lower 48, we’re still hampered by political winds blowing out the butts of pundits, demagogues and populists who use every excuse in the book to hinder ordinary medical science.

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As many as 80 million Americans have been infected with H1N1 swine flu, up to 16,000 have been killed and more than 360,000 hospitalized, the U.S. Centers for Disease Control and Prevention said on Friday.

But 90 percent of the most vulnerable people remain unvaccinated, with only about 61 million Americans having received shots, the CDC said…

The pandemic, which began in March, is on the wane but health officials stress that influenza is unpredictable and could come back or mutate.

And this new virus, while it has not caused more deaths than seasonal influenza, has killed younger people than seasonal flu does.

About 90 percent of deaths in an average year are among people over 65, while 90 percent of those seriously ill or killed by the new virus are much younger and include as many as 1,730 children.

Health experts say vaccination is by far the best way to ensure the virus does not come back or mutate into a new and more dangerous form, but the vaccine rolled out slowly and the public is now skeptical of the need to be vaccinated…

More pregnant women than usual have been vaccinated — 38 percent as compared to between 15 percent and 25 percent in an average year. Pregnant women are always at high risk from any flu and they accounted for an unusually high percentage of those sickened and killed by H1N1…

The usual anti-science brigade continue their agitprop: religious anti-vaccine nutballs, right-wing Republicans and neolithic libertarians both of whom hate government as strongly as any middle-class undergraduate anarchist.

I don’t especially mind their lockstep march into Darwinian risk; but, I have only contempt for the effect their blathering has on the general public, skeptical enough after eight years of spooky anti-intellectualism from Bush League conservatives.

Daylife/AP Photo used by permission

Seasonal flu, which annually kills 30,000 Americans, may not appear in the U.S. for the first time in more than 40 years, crowded out by the swine flu pandemic and mass vaccination campaigns.

Seasonal strains are almost nonexistent in reports from countries where swine flu, or H1N1, has taken hold. In the U.S. and Europe, 99 percent of influenza cases tested last week were H1N1, according to government reports. Seasonal versions of virus that usually arrive in December and peak in February may not emerge at all, said Marc Lipsitch, a flu tracker at the Harvard School of Public Health, in Boston.

“I would bet against a seasonal flu this year,” said Lipsitch, a professor of epidemiology, in a telephone interview. “But I wouldn’t bet very much money.”

One of the seasonal strains most likely to appear this year, known as type B, was responsible for 7 of 478 positive cases in a testing sample for the week ended Dec. 5, according to the U.S. Centers for Disease Control and Prevention. A second form, H3N2, hasn’t been spotted at all.

Neither seasonal strain emerged after H1N1 struck in the Southern Hemisphere, where the winter flu season ended in September, according to the World Health Organization in Geneva…

Scientists aren’t sure exactly how some flu strains can crowd out others, said William Schaffner, chairman of the department of preventive medicine at Vanderbilt University in Nashville, Tennessee, and an outside adviser to the CDC on vaccine policy…

The last time seasonal flu strains were crowded out entirely in the U.S. was during the Hong Kong flu pandemic of 1968, Lone Simonsen [researcher at GWU] said. She predicted that swine flu will return in January and may circulate simultaneously with seasonal flu strains, potentially attacking both the young and old.

“It’s probably still a very good idea to get vaccinated, because this is not over,” Lone Simonsen said in an interview on Dec. 8. “I don’t have a crystal ball, but we had two historical pandemics where there was an early fall wave — 1918 and 1957 — and both of those were followed by a winter wave.”

RTFA. Lots of interesting detail to theories. And like Ms. Simonsen says – none of us has a crystal ball. The details may yet kill a bunch of us.

Thanks, Mr. Fusion

In fatal cases of 2009 H1N1 influenza, the virus can damage cells throughout the respiratory airway, much like the viruses that caused the 1918 and 1957 influenza pandemics, report researchers from the National Institutes of Health (NIH) and the New York City Office of Chief Medical Examiner.

The scientists reviewed autopsy reports, hospital records and other clinical data from 34 people who died of 2009 H1N1 influenza infection between May 15 and July 9, 2009. All but two of the deaths occurred in New York City.

A microscopic examination of tissues throughout the airways revealed that the virus caused damage primarily to the upper airway—the trachea and bronchial tubes—but tissue damage in the lower airway, including deep in the lungs, was present as well. Evidence of secondary bacterial infection was seen in more than half of the victims…

“This study provides clinicians with a clear and detailed picture of the disease caused by 2009 H1N1 influenza virus that will help inform patient management,” says NIAID Director Anthony S. Fauci, M.D. “In fatal cases of 2009 H1N1 influenza, it appears the novel pandemic influenza virus produces pulmonary damage that looks very much like that seen in earlier influenza pandemics.”

The new report also underscores the impact 2009 H1N1 influenza is having on younger people. While most deaths from seasonal influenza occur in adults over 65 years old, deaths from 2009 H1N1 influenza occur predominately among younger people. The majority of deaths (62 percent) in the 34 cases studied were among those 25 to 49 years old; two infants were also among the fatal cases…

“This pattern of pathology in the airway tissues is similar to that reported in autopsy findings of victims of both the 1918 and 1957 influenza pandemics,” notes Dr. Taubenberger.

You’ll find a range of support info about influenza over here.

It’s not like we have too many regular readers here at Eideard.com – please get your flu shot!

There wasn’t any such thing as flu vaccine in 1918

President Barack Obama declared the swine flu outbreak a national emergency, giving his health chief the power to let hospitals move emergency rooms offsite to speed treatment and protect noninfected patients…

Health authorities say more than 1,000 people in the United States, including almost 100 children, have died from the strain of flu known as H1N1, and 46 states have widespread flu activity. So far only 11 million doses have gone out to health departments, doctor’s offices and other providers, according to the Centers for Disease Control and Prevention officials…

Health and Human Services Secretary Kathleen Sebelius now has authority to bypass federal rules when opening alternative care sites, such as offsite hospital centers at schools or community centers if hospitals seek permission…

The national emergency declaration was the second of two steps needed to give Sebelius extraordinary powers during a crisis.

On April 26, the administration declared swine flu a public health emergency, allowing the shipment of roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually needed them. At the time, there were 20 confirmed cases in the U.S. of people recovering easily. There was no vaccine against swine flu, but the CDC had taken the initial step necessary for producing one.

”As a nation, we have prepared at all levels of government, and as individuals and communities, taking unprecedented steps to counter the emerging pandemic,” Obama wrote in Saturday’s declaration.

The most contemptible political contradictions in this process come from conservatives and libertarians who started out fear-mongering over vaccines and have now switched to finger-pointing, trying to blame the government for the inability of producers in the U.S. to come up with an adequate supply to match demand.

RTFA to understand how the regs mostly concern quarantine and treatment centers.

The influenza-like illness that we track with our ILInet sentinel provider system is showing higher levels of illness than we saw last week. Again, these are unprecedented levels of illness. The national average is about 6.1% of doctors visits, for purposes of influenza-like illness that’s very high at any time particularly in October. We also track mortality around the country. Through something called the pneumonia and influenza mortality survey with 122 cities. And for the first week this fall, we’re seeing that the amount of influenza and pneumonia mortality is above the epidemic threshold. All of these things may suggest it’s a very busy and difficult flu season and we are seeing very high levels of activity around the country. We are also having updates on the pediatric deaths. Unfortunately those are going up as well…

We hope that the continuing deaths in children will be as few as possible but this is a very brisk number, usually in a whole season that lasts from going to September all the way to may, you would only have about 40 or 50 deaths so in just one month’s time we’ve had that many…

Overall, fewer than half of Americans (47%) say that they would get the swine flu vaccine if it was available to them; an identical percentage says they would not get the vaccine. A clear majority of Democrats (60%) say they would get the swine flu vaccine if it was available, compared with 41% of Republicans and the same percentage of independents.

It might seem like Democrats are more inclined to trust this government, and that the anti-Administration bent of right wing nutters is taking a toll. After all, there’s a partisan edge to this:

More than half of Republicans (54%) say news reports are overstating the swine flu’s danger, compared with 42% of independents and just 35% of Democrats…

Sometimes, it’s true, those concerns go beyond any appeal to reason. They grow out of a visceral mistrust of authority in general – and of government, regulatory agencies, medical researchers and multinational pharmaceutical companies, in particular. A sophisticated anti-vaccine movement has emerged that plays on this wariness, and helps to feed the conspiracy theories about the H1N1 vaccine that are circulating on the Internet and in viral e-mails…

If you’re still on the fence and are too lazy to check any of the peer-reviewed science, here’s a decent editorial piece about the myths and reality.

My own seat of the pants reckoning – just following the stats in New Mexico and Texas communities – is that the death rate among children is running 4 to 8 times higher than the usual flu season. Does killing your own kids qualify you for a Darwin Award?

The solution offered by pundits instead of physicians

Suspicion of government and public unease about vaccines has resulted in a flood of misconceptions about the U.S. swine flu program, experts say…

“There’s a lot of misinformation out there,” Gregory Poland, a flu vaccine expert at the Mayo Clinic, told the newspapers. “Then you mix into that people’s concerns about conspiracy theories and government misbehavior and conflicts of interest and all of that, and the average layperson has a difficult time discerning what to do…”

Experts stressed that the vaccine was made the same way it is every year and that there is no reason to think it will pose any greater risk. Serious side effects involving the seasonal vaccines are extremely rare…

Although the new H1N1 virus generally causes mild illness, most people have no immunity against it, meaning far more people will probably become infected, sick, end up in the hospital and possibly die than during a usual flu season. Most disturbingly, children, young adults and pregnant women appear to be especially vulnerable…

At least 87 percent of a national sample of adults, which included health care workers, said they agreed or strongly agreed in a vaccination requirement for health care workers…

The poll also found health care workers were more likely than other adults to say they planned to not receive the H1N1 flu vaccine because they believed the seasonal flu vaccine would protect them from it and believed they could easily get medication if they did get sick.

“That’s simply not correct. This finding indicates there needs to be more education among health care workers,” Davis said.

Anyone surprised to learn that someone in a healthcare job needs more education about their own job?

I expect the superstitious to be fearful. Same goes for the ignorant.

I reserve my contempt for those who know something about science, double-blind studies and peer-reviewed analysis. They prefer the ideology of hating government more than anything else, hating those who choose preventive medicine instead of relying on a private hoard of Tamiflu [yes, I know one of those]. So-called libertarians who prefer anarchy over good will.

They are as guilty of superstitious behavior as your neighborhood personal psychic.

Just about every political decision in this story requires stupidity.

It is unlikely anyone has ever come to this city and commented on how clean the streets are. But this litter-strewn metropolis is now wrestling with a garbage problem so severe it has managed to incite its weary residents and command the attention of the president…

But the crisis should not have come as a surprise.

When the government killed all the pigs in Egypt this spring — in what public health experts said was a misguided attempt to combat swine flu — it was warned the city would be overwhelmed with trash.

The pigs used to eat tons of organic waste. Now the pigs are gone and the rotting food piles up on the streets of middle-class neighborhoods like Heliopolis and in the poor streets of communities like Imbaba…

What started out as an impulsive response to the swine flu threat has turned into a social, environmental and political problem for the Arab world’s most populous nation.

It has exposed the failings of a government where the power is concentrated at the top, where decisions are often carried out with little consideration for their consequences and where follow-up is often nonexistent, according to social commentators and government officials.

“The main problem in Egypt is follow-up,” said Sabir Abdel Aziz Galal, chief of the infectious disease department at the Ministry of Agriculture. “A decision is taken, there is follow-up for a period of time, but after that, they get busy with something else and forget about it. This is the case with everything.”

The reasons for decisions like this are as phony as the excuses. I doubt if the pigs would have been slaughtered the way they were – if they were owned by Arabs. But, since custom only allowed Christians to raise swine, it was easy as pie to get the Ehyptian public to agree with the decision.

Foolishness in every corridor of government.

A new iPhone application, created by researchers at Children’s Hospital Boston in collaboration with the MIT Media Lab, enables users to track and report outbreaks of infectious diseases, such as H1N1 (swine flu), on the ground in real time. The application, “Outbreaks Near Me,” builds upon the mission and proven capability of HealthMap, an online resource that collects, filters, maps and disseminates information about emerging infectious diseases, and provides a new, contextualized view of a user’s specific location – pinpointing outbreaks that have been reported in the vicinity of the user and offering the opportunity to search for additional outbreak information by location or disease.

“We hope individuals will find the new app to be a useful source of outbreak information – locally, nationally, and globally,” says HealthMap co-founder John Brownstein, PhD. “As people are equipped with more knowledge and awareness of infectious disease, the hope is that they will become more involved and proactive about public health.”

The new application also features an option for users to submit an outbreak report. This will enable individuals in cities and countries around the world to interact with the HealthMap team and participate in the public health surveillance process. Users may take photos – of situations and scenarios of, and/or leading to, disease – with their iPhone and submit them to the HealthMap system for review and eventual posting as an alert on the worldwide map…

The HealthMap Web site averages 10,000 unique visits a day, including regular users from the World Health Organization, the CDC, and the European Centre for Disease Prevention and Control. During the peak of H1N1 swine flu this spring, visits to the site rose substantially, with as many as 150,000 visitors coming to the Web site to search for information.

First time I recall bumping into the term “participatory epidemiology”. Makes good sense. One of those times where being “connected” doesn’t sound like a sophomoric daydream even to a hermit like me.

Yes, an App funded and aided by Google.

A group of rabbis and Jewish mystics have taken to the skies over Israel, praying and blowing ceremonial horns in a plane to ward off swine flu.

About 50 religious leaders circled over the country on Monday, chanting prayers and blowing horns, called shofars. The flight’s aim was “to stop the pandemic so people will stop dying from it”, Rabbi Yitzhak Batzri was quoted as saying in Yedioth Ahronoth newspaper.

The flu is often called simply “H1N1″ in Israel, as pigs are seen as unclean.

So they can’t say the fracking word, “swine”.

According to Israel’s health ministry, there have been more than 2,000 cases of swine flu in the country, with five fatalities so far.

“We are certain that, thanks to the prayer, the danger is already behind us,” Mr Batzri was quoted as saying.

Next time, spend the cost of the fun air trip on providing medical care for the sick. It will do a lot more good.