Monday, April 27, 2009

Swine Flu and Virus Mutations

I've received several emails over the weekend asking me why I haven't brought up the swine flu subject -- ie. "Why aren't you writing about this?!?"

Long time readers of this blog know that I have already written about it...

Or at least, I wrote about what could happen.

Back on May 7, 2006, I wrote:
"How do low pathogenic avian viruses become highly pathogenic?"

And now, 3 years later --- here we are --- with a swine flu virus that CDC Officials say they cannot contain.

According to the WHO and CDC websites, there are 20 official laboratory confirmed cases in the United States of the new mutant virus they call "swine influenza A/H1N1" and they also state "the Government of Mexico has reported 18 laboratory confirmed cases of swine influenza A/H1N1."

The number above is already low, as 20 new cases were just reported today in New York (versus the original 8 that reported when the above WHO/CDC numbers were made public) and an afternoon broadcast has indicated there are a total of 40 confirmed cases in the USA now.

Thus far, the confirmed cases have been found in the following states:
  • California
  • Kansas
  • New York City
  • Ohio
  • Texas
The numbers of confirmed cases in the USA and Mexico will most likely go up before the end of the day today once lab tests are completed on several suspected cases across both countries.

The WHO website states:
"On Saturday, 25 April, upon the advice of the Emergency Committee called under the rules of the International Health Regulations, the Director-General declared this event a Public Health Emergency of International Concern." [link]

Concern but not Alarm

Meanwhile, according to President Obama, the swine flu situation is a cause for "concern but not alarm."

As of this morning -- "WHO is not recommending any travel or trade restrictions."

Meanwhile, in Europe today -- "The European Union's health chief advised travelers on Monday not to go to areas affected by swine flu." [link]

While here in the USA -- although they had no travel advisory on their site when I was posting this blog item, the CDC was just now on Fox News recommending people avoid non-essential travel to Mexico at this time.

Sixteen deaths from this particular swine flu strain have been reported in Mexico but no deaths at this time have been reported here in the U.S.A. (all of the original 20 diagnosed-case patients have recovered with only one of those infected hospitalized).

UPDATE: Just now Reuters is reporting that the Govt. of Mexico is raising the number of suspected deaths relating to this virus to 149.
One school has been shut down in New York (St. Francis in Queens) where some cases have been reported and they are now scrubbing the school down.

Meanwhile, in Texas, a string of 20 schools have been shut down for the week to hopefully prevent any spread of the virus.

And in Mexico, all schools have been shut down until May 6, 2009.

What Makes This Swine Flu Unique?

For starters, keep in mind that this particular strain spreads from human to human. (You don't need to get it from contact with pigs.) That's a red flag as my previously referenced blog post indicated.

But what truly makes this virus mutation unique is that it was morphed from 4 different virus strains. ANNE SCHUCHAT, MD, Director for the National Center for Immunization and Respiratory Diseases states:
"We know so far that the viruses contain genetic pieces from four different virus sources. This is unusual. The first is our North American swine influenza viruses. North American avian influenza viruses, human influenza viruses and swine influenza viruses found in Asia and Europe.

That particular genetic combination of swine influenza virus segments has not been recognized before in the U.S. or elsewhere. Of course, we are doing more testing now and looking more aggressively for unusual influenza strains. So we haven't seen this strain before but we haven't been looking as intensively as we are these days.

The viruses are resistant to amantadine and rimantadine anti-viral drugs but they are sensitive or susceptible to oseltamivir and zanamivir, the newer anti-viral drugs for flu. And at this time we don’t know exactly how people got the virus. None of the patients have had direct contact with pigs.

You can get swine influenza without direct contact but it's a bit more unusual. And we believe at this point that human-to-human spread is occurring. That's unusual. We don't know yet how widely it's spreading and we certainly don't know the extent of the problem." [link]

Now if you read my earlier blog items on influenzas and how they can mutate, this quite possibly poses quite a mystery for health officials as the the source -- the original mutation -- from whence this particular strain came.

Was it first mixed through a combination of avian and swine which then morphed in a human that had contact with the animals? Or, was it first in a human which was in contact with swine? Or...

The possibilities are mindboggling -- not because it has morphed and is being spread human to human -- but because it is so scattered, without any apparent concentration to any specific localized source.

When you consider the distances between reported cases, it really is remarkable IMHO that it has stretched so far and wide.

No Cause for Alarm or Something to Fear?

Frankly, based on what I've seen/heard/read thus far, I personally think (my humble opinion only) that the Bird Flu H5N1 was (could still be?) far more serious with a potential for higher devastation (owing to its human kill rate)... BUT ...what does concern me at this point is what if this particular strain of swine flu morphs one more time?

It truly is alarming to me that there are 4 different segments/sources for this strain.

And such a diverse mix of 4... Europe, Asia, North American swine, North American avian... consider the odds of the four segments coming together, mixing and eventually mutating into a human to human spread virus.

What if, for example, someone sick with something else entirely contracts the virus and it mutates just one more time?

As it stands right now for this current form of swine influenza A/H1N1, the survival rate is quite high here in the USA as of today.

But what if it morphs...??

Just one more time...??

The bottom line here is this.

I find myself in the very unusual position of being in full agreement with President Obama on this one. I agree with him in that yes, it is a cause for concern but not alarm.

So, don't panic.

At least, not yet.

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