Frowning takes 68 muscles.
Smiling takes 6.
Pulling this trigger takes 2.
I'm lazy.
Posted on 01/24/2011 1:57:41 PM PST by The Comedian
"consideration of antiviral treatment for any previously healthy, non high-risk symptomatic outpatient with confirmed or suspected influenza, based upon clinical judgment, if treatment can be initiated within 48 hours of illness onset."
The above comment is included in the recent CDC health alert on influenza antiviral treatment and diagnostic tests. This January 14, 2011 alert follows a significant outbreak of H1N1 in the UK and reports of increased H1N1 activity in the northern hemisphere.
Initial reports from the UK indicated most fatal cases were young adults without underlying conditions. Subsequent reports have focused on patients with underlying conditions, but the high frequency of fatal cases without underlying conditions raised concern.
A similar death cluster was reported in Lehigh, Pennsylvania and recently released sequences by the CDC demonstrated the presence of S186P in the identical HA sequences from the two Pennsylvania cases, which were closely related to UK sequences.
Moreover, one of the sequences, A/India/5103/2010, without changes at positions 156-159 was declared a low reactor, and this sequence had S186P and S188T. These two changes are widespread in the UK, with 22/41 cases having S188T and another 14/41 cases having S186P. In addition to the case in India, a sequence from Japan, A/KANAGAWA/74/2010, also had both changes, and the most recent sequence from Japan, A/NIIGATA/1581/2010 also had S188T.
Other combinations were seen in the UK and Bhutan. In the UK there were sequences with S188T combined with D190G (A/England/4640543/2010) and S186P combined with D190Y (A/England/4500186/2010). Similarly, A/Bhutan/72/2010 had S186P combined with A189T. These combinations are similar to the immunological escape of seasonal H1N1 associated with the fixing of H275Y in 2008/2009 which involved A193T combined with at least one change at positions 187, 189, or 196.
These genetic changes indicate the current vaccine, direct against A/California/7/2009 will have less than optimal efficacy as sequences with the above receptor binding domain changes emerge and dominate. As noted, 36/41 recent sequences from the UK had S188T or S186P, and these changes are rapidly spreading throughout the northern hemisphere.
The CDC alert does not mention these changes, but includes antiviral recommendations, which includes use in previously health young adults.
The current H1N1 vaccine target, A/California/2009, has remained unchanged since it was selected in the spring of 2009. It is currently recommended for the 2010/2011 season in the northern hemisphere, and is the target for the 2011 season in the southern hemisphere.
Recommendations for the 2011/2012 northern hemishere flu season will be made next month. A target change is long overdue.
I guess your perspective depends on where you live and how healthcare is rationed
In December 10% of intensive care beds in Britain were occupied by flu victims- a greater percentage of nation’s stock of ventilator systems (4,000) being used to keep flu victims alive
We have been treating Type B flu here for the last month..
So far no bad secondary problems except for one death in 15 year old.. suspect multiple medical problems may have been the problem with the death
Healthcare is NOT rationed in Maryland, thankfully.
You’ll note in the first article that 80% of the deaths were in “at-risk” populations, which is normal. (sad nonetheless) Also since the deaths generally occurred 2 weeks +/- after infection , one can medically conclude they did not die from the flu, but rather pulmonary and respiratory distress/ pneumonia/ edema. They (likely) died form complications and secondary infections AS A RESULT of POOR primary care. They were too sick by the time they were admitted. THAT *IS* is potential indictment of the NHS.
“Many of the newly recorded flu victims probably caught the illness two or three weeks ago when infection rates were at their highest, experts believe ... more than 80 per cent of the fatalities were in an ‘at risk group’, including pedes, pregnant women and those with conditions such as asthma, diabetes or Alzheimer’s. Infection rate figures show there are now 66.5 cases of flu per 100,000 people, down from 108 the previous week and well below the 124 at the beginning of this month.” THAT DROP mirrors the drop in the US. The CDC publishes data, shown the seasonal up and down of the flu season. IOW, what happened is to be expected in terms of infection rates. What’s sad is the deaths.
What’s my point? H1N1 is NOT a super bug or global killer. It kills those most susceptible to severe respiratory distress coupled with poor or late care. Don;t fear H1N1 unless you are in one of ‘those’ groups, but DO get out the plastic and duct tape if we have an H5N1 outbreak with an active human to human vector.
I encourage you to read the CDC’s Advice to Clinicians - Healthcare Professionals regarding H1N1 and treatment/prevention. It is eye-opening in terms of its blandness.
Mo
The second article again points to the real culprit - respiratory distress, since it features Extracorporeal Membrane Oxygenation units. These patients’ lungs are full of fluid (pneumonia) and they need help breathing effectively. The virus weakens them. They drown/asphyxiate from the edema/pneumonia associated with SRD. why are these people so sick? Again, they are in at-risk groups for H1N1, whether swine origin or not. what kills them is how they react to the viral infection AND THE TREATMENT THEY DON’T GET.
From the third artcle: “However health experts are concerned that the H1N1 virus could mutate into something more severe.”
That is pure scare mongering by the author, likely not any epidemiologist. EVERY “novel” virus, ie ‘this years’ strain is a mutation, sorta.
So let me net this out to try to stay on my points —
A. Sadly, ‘real’ influenza kills a FEW people in the US. complications from and secondary infections kill quite a few, sadly. This happened in all years past; it will happen in the future.
B. Swine origin H1N1A is not a fearsome bug for the majority of the human population.
C. the UK has it tough right now, for real, for the people dealing with secondary infections. But to state “66.5 cases of flu per 100,000 people” is still less than 1/10th of one percent. Stay objective. Read and follow the CDC’s advice to clinicians, NOT the hype on the news or in The Mail.
A friend of my daughter just died of this last Sunday. He was 18.
Another friend’s son died two summer’s ago of H1N1.
Seems to be lethal.
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