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Swine flu and panic in Ukraine
Alanna Shaikh - November 18, 2009 - 12:58 am

Health
There are a lot of rumors coming out of Ukraine right now about a new form of swine flu, a brand new illness, or some kind of virulent pneumonia. I suspect it’s no more than swine flu with complications, but it’s causing some major panic in Kiev.

Britain’s Daily Express newspaper has the terrified tabloid version. They report that “A cocktail of three flu viruses are reported to have mutated into a single pneumonic plague, which it is believed may be far more dangerous than swine flu. The death toll has reached 189 and more than 1 million people have been infected.” The New York Times has a slightly more nuanced report. They identify the mystery illness as swine flu and quote a WHO official who says that “Early findings are that serious cases mounted because the sick avoided hospitalization until their illness was dangerously advanced, stockpiles of Tamiflu were locked in centralized locations and the supply of ventilators fell short.”

I suspect that the WHO and the New York Times have it right. There are a lot of barriers to access to health care in Ukraine, under-the-table payments being one of the biggest. I can well imagine people refusing to go to a doctor until their lungs were past saving. Avian Flu diary agrees, attributing the unusual severity to viral hemorrhagic pneumonia as a complication of swine flu. They also have an enlightening comment at the bottom of their post from a commenter in Ukraine watching the situation unfold.

Secrecy is not helping the government of Ukraine here. In a nation with a history of cover-ups – Chernobyl being the most famous – the population is quick to panic when they sense that they’re not getting the real story. Getting the real story out as fast as possible and backing it up with access to medical care – is the only way to stop the panic.

http://www.undispatch.com/node/9160

Ukraine Dead Increase to 328 - Still No Sequences
Recombinomics Commentary 19:17
November 17, 2009

1,457,564 Influenza/ARI

83,526 Hospitalized

328 Deaths

The above numbers are in the latest update from the Ukraine Health Department and include 13 more deaths.* Although the number of deaths has decline slightly from the prior two days, the increase in cases and hospitalizations suggest the decline in deaths may be temporary.* The largest increase in cases was again in Kiev (5522 to 109,676) and two other eastern oblast (see map) had daily increases of more than 4000 cases (Dnipropetrovsk and Denetsk).* The steady rise in deaths continues to increase concerns over an H1N1 genetic change leading to an increase in lung disease such as those described earlier.

WHO came out with a situation update which provided little specific information beyond earlier reports that the H1N1 did not have large changes.* However, the new update did indicate that WHO regional centers in London and Atlanta were still investigating isolates, suggesting there have been sequences changes that are not fully characterized.

Recently released swine H1N1 from other locations have included receptor binding domain changes at position 225 (D225E, D225N, D225G) as well as 226 (Q226R) raising concerns that similar changes in Ukraine cold lead to the high frequency of fatal lung infections (Q226R has been seen previously in human H5N1 as well as H3 isolates from swine, ducks, and seals).* The new update did not address receptor binding domain changes or other SNPs that could have significant effects on the pathogenicity of the virus.

Therefore, the release of sequences and comments on receptor binding domain changes would be useful

http://www.recombinomics.com/News/11170902/Ukraine_328.html