INFLUENZA A (H1N1) VIRUS, SWINE, HUMAN - NORTH AMERICA

Pro Med ^ | 4-25-09

[Mother Abigail]

It turns out this virus is highly unusual, a quadruple reassortant. The genes of a flu virus are packaged in eight discrete segments. When two flu viruses infect the same host cell, the segments of each are copied and repackaged, 8 at a time, in new viral particles which then bud off from the infected cell. They then may infect a new host cell. In this repackaging process the segments of the two different viruses may mix and match, so that new virus particle will have segments from two different viruses. The new virus is, in a sense, not just a swine flu virus. It does have viral segments characteristic of two different families of swine flu, one typical of North America, where swine flu is endemic, and one typical of pig flu viruses from Europe and Asia. But we learned today that it also has viral segments seen in North American birds and in human seasonal influenza. Which of the segments is a bird segment and which is humans wasn't discussed in today's briefing, but the fact that the genetic sources comprise widely different geographies and species is highly unusual -- unusual at least as far as we know. We have little systematic information on swine viruses, so how common this really is we don't know for sure, nor do we know how recent. The virus is resistant to the older adamantane antivirals but sensitive to both oseltamivir (Tamilfu) and zanamivir (Relenza).

Whatever this is, it isn't seasonal influenza. The reported cases range from 9 years old to 54 years old, 3 females, 4 males. All have recovered and only one required hospitalization. The earliest case is from late March, the most recent just days ago. Symptoms are typical for influenza-like illness except that there seems to be a greater prominence of gastrointestinal symptoms (nausea, vomiting, diarrhea) along with the respiratory symptoms and fever. CDC emphasized they were in an active investigation mode and will keep sharing information as it develops. Clearly there is a lot more to learn about this.

[Mother Abigail]

Alert Issued After Serious Mystery Ailment Affects Canadians Returning From Mexico
Thursday April 23, 2009
CityNews.ca Staff
It’s supposed to be a place where you can get away from it all. But now Canadian travellers to Mexico may be bringing something back with them that’s far more serious than just a souvenir.

Experts are becoming increasingly concerned about a mysterious illness that’s recalling the frightening days of SARS in Toronto. The Public Health Agency of Canada is looking into a growing number of reports about Canadians returning from the south and central parts of the country with a severe respiratory illness.

The mystery malady has puzzled experts both here and in Mexico, who have yet to identify exactly what it is. The ailment seems to primarily affect young adults who went on their trips healthy but failed to return in the same condition.

The symptoms begin as a flu-like illness and rapidly deteriorate to respiratory distress and breathing difficulties.

http://www.citynews.ca/news/news_33963.aspx

[MHGinTN]

Has anyone discerned whether a bout with this multistrained variety offers an immunity factor to more virulent strains of non-combinant varieties? ... Does an infection with this variant do what chicekn pox did to stave off small pox?

[Mother Abigail]

The World Health Organization convened an emergency meeting of experts in Geneva on Saturday to advise on whether to escalate the global pandemic alert in response to outbreaks of swine flu in people in Mexico and the southwestern United States.

WHO Director General Dr. Margaret Chan said the group would counsel her on whether the worrying disease outbreak, which is reported to have claimed at least 20 lives so far, should be deemed a public health emergency of international concern.

It is also expected to recommend on whether the global pandemic alert level should be raised from the current Phase 3 to Phase 4 or higher. Phase 6 means a pandemic has been declared.

[aruanan]

Does an infection with this variant do what chicekn pox did to stave off small pox?

Wasn't that cow pox that was used first to immunize against small pox?

[tiki]

We have a customer who does business in Mexico, he recently spent 5 days in bed he was so sick, he said he had never been so sick and wondered if he had had the Bird flu. Of course, this happened before all the news and he didn’t go to the doctor.

[MHGinTN]

You are correct, I stand corrected. The girl who was a milkmaid lead the researcher to the idea of a scratch infection with cow pox to immunize for small pox.

[Mother Abigail]

CDC Media Advisory - Teleconference Sat. 1:00

For Immediate Release
April 25, 2009
Contact: CDC Media Relations
(404) 639-3286

Media Availability on CDC Investigation of Human Cases of Swine Influenza

WHAT: Media availability for press with questions related to the
investigation of cases of swine influenza.

WHO: Anne Schuchat, M.D., Interim Deputy Director for Science and Public
Health Program

Daniel Jernigan, M.D., Ph.D., Medical Epidemiology, Influenza Division

WHEN: Saturday April 25, 2009 at 1 p.m. ET.

DIAL-IN:
Media: 888-798-0855
Listen Only: 800-779-9078
INTERNATIONAL: 1-630-395-0068
PASSCODE: CDC Media

Important Instructions: If you would like to ask a question during the call,
press 1 on your touchtone phone. Press 2 to withdraw your question. You
may queue up at any time. You will hear a tone to indicate your question is
pending.

LISTEN-ONLY AUDIO WEBCAST
This press briefing media will also be available via listen-only audio web
site at www.cdc.gov/media. We strongly encourage non-media participants to
use the webcast.

TRANSCRIPT
A transcript of this media availability will be available following the
briefing at the CDC web site at www.cdc.gov/media.

[Mother Abigail]

http://twitter.com/mpoppel
There will likely be another press conference (via phone) later tonight after the emergency meeting.

2 minutes ago from TweetDeck I will continue to update you throughout the day on the swine flu situation, as well as @BreakingNewsOn.

2 minutes ago from TweetDeck Transcript of this press briefing will be available soon.. WHO man apologies for the technical issues.

4 minutes ago from TweetDeck Chan says reports that many health care workers fall ill to this virus are false.

4 minutes ago from TweetDeck 2 health care workers were infected with swine flu

5 minutes ago from TweetDeck Especially young adults fall ill to this disease, similar to the 1918 pandemic

6 minutes ago from TweetDeck @tenspider I think it will be impossible to track down the first, original source but.. I don’t see why it would be terrorism-related.

7 minutes ago from TweetDeck Chan says they will discuss changing the pandemic alert level today

8 minutes ago from TweetDeck WHO will hold 4pm emergency meeting

9 minutes ago from TweetDeck CHAN SAYS NEED TO WAIT BEFORE RECOMMENDING WHETHER TO SWITCH VACCINE PRODUCTION TO NEW STRAIN

9 minutes ago from TweetDeck WHO may have recommendations within days

10 minutes ago from TweetDeck there is an information gap because of the size of the outbreak*

10 minutes ago from TweetDeck there’s an information gasp

11 minutes ago from TweetDeck back on the call

11 minutes ago from TweetDeck @Todzilla It does seem to evolve quicker than other diseases.

12 minutes ago from TweetDeck in reply to TodzillaReally annoyed by the conference center the WHO is using. “Please wait for operator”, waiting 10 mins now

14 minutes ago from TweetDeck CHAN SAYS MAIN WHO RECOMMENDATION TO OTHER COUNTRIES IS TO ENHANCE SURVEILLANCE FOR UNUSUAL DISEASE PATTERNS

17 minutes ago from TweetDeck Reuters bulletin: CHAN SAYS PREMATURE TO ISSUE TRAVEL ADVISORIES, TO BE ADDRESSED BY EMERGENCY COMMITTEE LATER TODAY

17 minutes ago from TweetDeck The WHO seems to be experiencing technical problems, likely hundreds of journalists on the call. Awaiting..

[Dallas59]

What will Obuma do? Blame Americans for this virus?

[Mother Abigail]

Viral gene sequences to assist update diagnostics for
swine influenza A(H1N1)
25 April 2009

WHO published a Guidance to influenza laboratories on response to swine influenza
A(H1N1) infections1. Due to the fact that it is a new reassortant virus, diagnostics has to
be updated accordingly.

The full genome sequence of the newly identified swine influenza virus
A/California/04/2009 A(H1N1) has been made available by the WHO Collaborating
Center in CDC, Atlanta, USA on the GISAID sequence database2 and has the following
accession numbers.

Further update on availability on other public sequence databases will be provided when
available.

• HA:
SequenceID: EPI176470
SequenceName: 2009712049_seg4
Length: 1701
Isolate: A/California/04/2009
• NA:
SequenceID: EPI176472
SequenceName: 2009712049_seg6
Length: 1410
Isolate: A/California/04/2009
• M:
SequenceID: EPI176471
SequenceName: 2009712049_seg7
Length: 972
Isolate: A/California/04/2009
• PB2:
SequenceID: EPI176486
SequenceName: 2009712049_1
Length: 2280
Segment: PB2
1 http:// …. Link to the first

Proteins: N/A
Isolate: A/California/04/2009
• PB1:
SequenceID: EPI176485
SequenceID: 2009712049_2
Length: 2274
Segment: PB1
Proteins: N/A
Isolate: A/California/04/2009
• PA:
SequenceID: EPI176484
SequenceName: 2009712049_3
Length: 2151
Segment: PA
Proteins: PA (716aa)
Isolate: A/California/04/2009
• NP:
SequenceID: EPI176482
SequenceName: 2009712049_5
Length: 1497
Segment: NP
Proteins: N/A
Isolate: A/California/04/2009
• NS:
SequenceID: EPI176483
SequenceName: 2009712049_8
Length: 838
Segment: NS
Proteins: N/A
Isolate: A/California/04/2009

http://www.who.int/csr/disease/swineflu/swineflu_genesequences_20090425.pdf

[Judith Anne]

Thank you very much for your post, and a personal note, nice to see you on FR today.

[silverleaf]

seems to be slightly different disease in Mexico and US, more virulent in Mexico?

Could perhaps the US version with vomiting etc purge virus more rapidly from the body?

[SE Mom]

Thanks for your informative thread.

For anyone who hasn’t seen this- a link to some firsthand accounts from people in and around Mexico City:

http://news.bbc.co.uk/2/hi/talking_point/8018428.stm

[silverleaf]

The too-silent zerO is laying low, will be under close medical watch- he just got back from Mexico

So did Hillary

[dsc]

“What will Obuma do? Blame Americans for this virus?”

Most likely the “Christian right.”

You know: His blood enemies.

[CGASMIA68]

praying for specific out come

[RegulatorCountry]

What will Obuma do? Blame Americans for this virus?

The virus traveled from the US to Mexico, on the barrels of all those evil guns we're forcing them to smuggle. Evil, pork-eating, bird hunting gun shooters in Texas are to blame for this, those right wing terrorists. < /Napolitano>

[SE Mom]

And now she’s in Iraq meeting with our GI’s...

[fatima]

Listen here live.Taking questions now.

http://www.videonewswire.com/cdc/58388/event.html