Saturday, May 2, 2009

Only 24 cases of H1N1 flu in CA

The latest update from the California Department of Public Health shows only 24 confirmed cases of swine flu in the state. Although another 77 "probable" cases are under investigation, the key message here is that lots of people have been tested... And very few people actually have been sick. -- Post From My iPhone

Thursday, April 30, 2009

Spreading facts, common sense instead of germs

The government public health experts have a lot of different flyers and other useful guides that help explain what really prevents the spread of swine flu or other infections, and hopefully debunks some of the alarmist or fake advice popping up seemingly everywhere.

Here are a few flyers that I think convey clear messages:

The federal government also has developed an outstanding central site for all of its swine/H1N1 flu information - Everything from clinical recommendations to video chats can be found there. Many local health departments have created flyers with specific information about local resources, such as procedures for getting tested for possible flu. Unfortunately, good information has been hard to find in the major media. Even publications or broadcasts that have had accurate and helpful content have been illustrating their coverage with alarming -- and in many cases, misleading -- images, such as reporters or others wearing surgical masks, which is at best a dubious measure of protection.

Swine Means No Wine for Some Catholics | NBC Chicago

Back in the early 1990s, I reported on evidence that Catholic Communion practices -- specifically sharing the same cup of wine -- posed viral infection risks. Any time you share a glass, spoon or fork with another person, you are trading germs. That also happens when you touch another person's body (especially eyes, nose and mouth, but other parts, too, including skin.)

For those of us who dine out often, this is yet another reason why restaurant staff need to be careful to handle silverware only by the end that doesn't go into your mouth. Bartenders who serve drinks handling a glass by the rim also put you at risk. I like to watch how people handle dishes before I am comfortable in many restaurants.

And again, this is just another reason people should follow common sense infection control practices every day. The same things recommended now to avoid swine flu (or "H1N1 flu") are things we should do anyway to avoid other forms of flu, hepatitis, and other widely spread infections.

Just as health care workers learned in the 1980s, "universal precautions" work best because you cannot tell that someone is infectious just by how they look.

Swine Means No Wine for Some Catholics | NBC Chicago

Not pandemic yet, says WHO

"WHO's Fukuda says nothing WHO sees today suggests should go declare a
pandemic now. #swineflu"
- Helen Branswell (@diseasegeek)

Sent from my iPhone

Good resources from Harvard

Sent from my iPhone

Wednesday, April 29, 2009

Good blog post: Swine flu: I beat a dead horse

Here is an interesting post on a public health blog questioning whether health officials or the media are "hyping" the swine flu outbreaks. Read more: Swine flu: I beat a dead horse : Effect Measure

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Pandemic near, now what?

Do not get alarmed as the number of confirmed swine flu cases grows in the next several days. It will grow -- by a lot, and quickly, because people are being tested widely and those tests can be performed without sending samples to the CDC. Keep in mind that most of the cases have been relatively mild. In many, people have recovered before testing was even complete.

The precautions being taken -- like closing a school at the first sign of infection -- may seem severe, but keeping possibly infected individuals isolated (such as at their home) is the most effective and practical way to thwart person-to-person spread. Some communities in Texas and a few schools in Northern California have canceled classes already while suspected or confirmed cases are investigated and the schools can be disinfected.

Should things get much worse in any community, major public events may be curtailed and many people will be urged to work from their homes temporarily. This is why having a supply of food and other essential supplies is a good idea.

Do you need to wear a mask? Probably not. If you are sick, wearing a handkerchief or surgical mask is probably a good idea to keep from spreading your germs. If a family member gets sick, the CDC recommends that the individual stay in one room and that only one family member enters to provide care. Surgical masks do not provide sufficient protection from the flu for a non-infected person, by the way.

Can I get swine flu on an airplane? Maybe, but probably not. Contrary to popular belief, the flu virus doesn't circulate very well, especially through many air conditioner filters. Although airplane air may be stale, it is not likely to carry the flu. However, if you are seated next to someone with the flu, your risk is considerably higher. The flu is transmitted through little fluid droplets that don't travel far, but airplane seats are pretty tight. Best advice: carry some alcohol wipes and swab your audio-video controls, your tray table and other surfaces before touching them. Use a tissue to open and close lavatory doors. And, wash your hands frequently. -- Post From My iPhone

The Canadian Press: Swine flu: From nowhere to pandemic Phase 5 in less than a month

Here is an excellent timeline on the swine flu outbreak. It shows how rapidly an infectious agent can spread in the world of global travel. The Canadian Press: Swine flu: From nowhere to pandemic Phase 5 in less than a month

Swine flu officially a "pandemic"

This should be no surprise given the large number of cases being
investigated around the world and now that we have evidence of
transmission to people who were not in Mexico.

It remains to be seen whether these second generation infections are
as virulent. But expect to see more school closings and other mass
events postponed as cases emerge.

"URGENT -- World Health Organization to declare swine flu a pandemic,
BNO News confirms:"
- BNO News (@BreakingNews)

Sent from my iPhone

California swine flu update

"We've confirmed 14 cases of swine flu, 17 more probable. Remember to
wash your hands frequently and stay home if you have symptoms."
- Gov Schwarzenegger (@schwarzenegger)

Sent from my iPhone

Updated swine flu count from CDC

"SwineFlu case count in U.S.-AZ 1, CA 14, IN 1, KS 2, MA 2, MI 2, NV
1, NY 51, OH 1, TX 16 & 1 death. Total 91 #swineflu"
- CDC Emergency (@CDCemergency)

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Evidence of 2nd generation swine flu infections

If the school outbreaks in NY and elsewhere are confirmed as swine
flu, that info plus this news from Spain suggests we may be
approaching pandemic stage.

Remember that this disease is not typically fatal, but it is highly
contagious. If you feel sick, stay home. Wash hands often. Cough into
a tissue and discard the tissue, or cough into your arm--not your
hand. Hands spread germs.

"Reuters :Spanish Health Ministry confirms case of swine flu in person
who did not travel to Mexico."
- BNO News (@BreakingNews)

Sent from my iPhone

Fwd: WSJ NEWS ALERT: U.S. Confirms First Swine-Flu Death


> News Alert
> from The Wall Street Journal
> The U.S. confirmed its first swine-flu death since the outbreak. The
> CDC said a 23-month-old child in Texas has died from the virus.
> The number of confirmed cases rose to 66 in the U.S., including five
> people in California and Texas being treated at hospitals. More
> evidence of the global spread of a deadly flu emerged Wednesday, as
> an eighth country confirmed the disease's presence.

> ______________________________
> Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved.

Tuesday, April 28, 2009

Contra Costa county school closed as flu precaution

"Highlands Elementary in Pittsburg will be shut down for the next few
days because of swine flu. More here:"
- KCBS 740AM/106.9FM (@KCBSNews)

Sent from my iPhone

Swine flu in Marin: The facts and the questions

Although the Marin County Health Department reported two swine flu cases Tuesday, there are no reports of anyone contracting swine flu in Marin. In other words, the only people who have gotten sick are people who recently traveled to Mexico. So far, of the 64 cases confirmed by the U.S. Centers for Disease Control and Prevention as of midday Tuesday, only one -- in Kansas -- appeared to be person-to-person transmission at home.

The Marin woman, 60, and a 20-month old grandaughter, both of whom recently returned from Mexico, had confirmed cases of swine flu. The child is no longer sick, and the woman has only mild symptoms. Nobody else in the family appears to have gotten the illness, according to health authorities.

The rapid spread of the disease in Mexico, and its growing death toll, poses a number of questions for epidemiologists. So does the relative mildness of the illnesses within the United States. One possible explanation is that the swine flu virus may be losing potency as it is transmitted from one person to the next. Over the next few days and weeks, we will learn much more as physicians report more cases and their sources can be traced.

Because the virus is so easily transmitted, the CDC has recommended steps such as school closures at the first indication that a student has become infected. Keeping an infected individual away from other people is the single most important thing that can be done to reduce risk of spreading disease. Until we know how infectious the strain of swine flu in Marin actually is, people should do what ought to be done all the time: wash hands frequently, cover your mouth with a tissue when you cough, and stay home if you have any signs of illness.

Richard Besser, MD, acting director of the CDC, was quite definitive Tuesday when asked what people should do:

Hand washing. We say it every day. People will get tired of hearing it because we are always going to say that. Hand washing, use of alcohol hand gels can reduce the spread of viruses. And if people take that step, that can reduce the risk that they're going to get an infection. Covering your cough. Not with your hand, but with your arm or your shoulder. That can reduce the likelihood that you are going to transmit a virus.
My earlier post has good sources of updated information. Please email or add comments with questions that you want me to pursue. Let's all stay healthy.

Handy one-page flyer about swine flu in Marin

Here is a useful flyer with Marin-specific swine flu information.

What you need to know about swine flu

The news that a Marin woman and her grandaughter contracted swine flu on a recent trip to Mexico clearly indicates that we need to be careful, but my experience as a health care journalist and working in health care settings for more than 20 years tells me that there is a big difference between caution and alarm. In this case, prudence and caution make sense. First, some facts:
  • Swine flu, like other flu bugs, is a virus that is transmitted by tiny droplets usually found in mucus. Most flu is transmitted from one human to another, although infections like this are thought to originate in animals with human contact.
  • There is no evidence of risk of catching swine flu from eating pork or other animal products.
  • Most of the cases of swine flu that have been reported so far in the United States have been relatively mild and with typical flu symptoms (fever, muscle aches, nausea.)

    We do not yet know enough about why so many fatalities in Mexico have occurred, but the flu is one of the biggest killers worldwide every year, so some deaths are to be expected.

  • Everyday precautions -- like thoroughly washing hands -- will do more to protect each of us from any kind of flu than most of the other steps being touted by supposed media experts or concerned neighbors.
Perhaps the best news is that the sequence of events underway, so far, maps almost exactly to what was predicted in advance. In other words, most of the planning by government and health agencies worldwide looks to be on-target.

The World Health Organization currently calls the swine flu a "pandemic risk," not a "pandemic." This is an important distinction. Right now, there is no evidence that the flu is spreading rapidly beyond the initial outbreak communities. If that were to change, the level of precautions would, too.

For example, if there is evidence that these two people in Marin have in turn infected others, and then we have evidence that those individuals passed the infection along again, health officials would likely order a cancellation of large group events and potentially ask employers to allow workers to stay home. This "isolation in place" technique is critical for anyone who has flu symptoms, but if the outbreak spreads, it also keeps healthy people from contracting the disease.

Meantime, this is a good opportunity to make sure you or your families have appropriate emergency supplies on hand. This means nonperishable foods, a good supply of water, extra supplies of any necessary prescription medicines, and things to help pass the time like a deck of cards. And since we are in earthquake country, don't forget things like a flashlight and a wrench to turn gas valves off.

What you do not need: I've heard people rushing to buy surgical masks or "N95" protective masks. If you get the flu and must go out in public, wearing a surgical mask will help protect others around you, but you are better off staying home. The N95 masks are really only suitable for health care workers who are taking care of sick people. These masks are not very comfortable, are often worn incorrectly, and are not very useful for widespread use except in the most extreme circumstances. (For more information on protective measures, visit the CDC web site.)

And while disinfectants may be a good idea, plain old soap and hot water works just fine. Antibacterial gels may be convenient to keep in the pocket when a sink and soap aren't handy, but it's the alcohol in them that protects you -- not the antibacterial characteristics. (There's actually some evidence that widespread use of antibacterial gels and soaps promotes resistant bacteria, too.)

For Marin County's recommendations, visit the county Health Department web site and download its flyer on family precautions. The county has also created an RSS feed for swine flu news.

The San Francisco Department of Public Health also has compiled many excellent resources and links on its swine flu web site.

Why widespread fear of swine flu is unwarranted

Widespread concern may be appropriate, but widespread fear is unwarranted -- so far. Reporter Helen Branswell of the Canadian Press has done an article that cogently explains why the World Health Organization has designated the current swine flu outbreak as Phase 4, not the pandemic level, Phase 5. Experience suggests that many flu strains fail to infect more than two or three generations of individuals. In other words, a virus can move from an animal to a first human, from the first human to a second human, and maybe from the second human to a third human. Beyond that is much less likely. If it did occur, then a pandemic -- an infection established in a community and spreading -- would be the likely consequence. | WHO looking for signs of ongoing swine flu spread

Precautions for individuals/families in case of pandemic flu emergency

MarinPanFluFlyer10-06 .pdf (application/pdf Object) Marin County has published a helpful flyer on precautions that individuals and families can take in case of pandemic flu threat. This includes "worst case" preparations, which means being ready for "shelter-in-place" instructions to keep from being exposed to others in the community. We are nowhere close to that level, but living in Earthquake Country, most of these precautions are wise steps anyway.

Monday, April 27, 2009

GOP Stripped Flu Pandemic Preparedness From Stimulus [UPDATED]

GOP Stripped Flu Pandemic Preparedness From Stimulus [UPDATED]

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Swine flu should prompt caution, not fear

I suppose I shouldn't be surprised that people throughout the United States and beyond are searching for anti-viral medications, surgical masks and other supplies because of the swine flu outbreak. But I am concerned that people are over-reacting -- and wasting precious time and resources on things that should be a lower priority. If everyone in the United States was more diligent about hand washing, we would have much less to be worried about. Here are a couple of things to keep in mind:
  • All strains of influenza, including "swine flu," are transmitted by tiny particles most commonly found in mucus. If you don't come in contact with the secretions of a sick person's coughs or sneezes, you're unlikely to get sick.
  • The best way to prevent the spread of swine flu is a) for people who are sick to stay home and b) to wash hands frequently and thoroughly and avoid touching hands to your mouth, nose or eyes.
  • The best use of masks is for people who are sick to wear them when encountering other people. A simple surgical mask works fine for this purpose. This is an easy way to significantly reduce the risk to others.
  • Surgical masks are not effective as protection for people who must be around a person with swine or other flu. The CDC recommends that health care workers have properly fitted N-95 masks when caring for people with suspected swine flu or related illness.
  • The flu is a virus, not a bacteria, so stocking up on antibiotics won't help. Two of the four commonly used antiviral drugs for flu work against the swine flu, which is why you need to call a doctor as soon as symptoms appear.
Health officials appear to be taking prudent steps such as temporarily closing schools where an outbreak is suspected. As odd as it may be to see soccer games with nobody in the stands, that act by the Mexico government was exactly as planned in advance by world health authorities months ago when pandemic flu precautions were updated. The CDC has prepared an excellent reference for how to care for someone with the flu. If things get to the pandemic level, most gatherings will be curtailed, many workers will be expected to work from home, and hospitals will have challenges keeping patients properly isolated from each other if the numbers of infected individuals grows. We are a long, long way from that.

Here are a few credible places to go for information:

In my opinion, there are a few things that we should do:

  • Wash your hands frequently and thoroughly.
  • Clean doorknobs and similar surfaces frequently and thoroughly using a disinfectant.
  • Make sure you get a flu shot every year. You can't get sick from the vaccination, although you might have a muscle ache for a day or two.
  • Urge colleagues, friends, family to be responsible and stay home if they are sick.
  • Check with the CDC or state health department to verify information that you get from other sources before acting on it.

Regulators, manufacturers, blew it on peanut safety

The widespread contamination of peanuts all linked to a singled processor, Peanut Corp. of America, is perhaps the most dramatic proof yet that our current methods for ensuring food safety are perilously flawed. My former colleague Julie Schmit has done an outstanding article documenting the many missed opportunities to catch hazards at PCA. There is plenty of blame to go around: it was not only federal and state regulators who blew it, but also the manufacturers, like Kellogg's, who purchased products from PCA. Interesting to note that Nestle did its own inspections and stopped using PCA years ago, according to Schmit's reporting.

The outbreak sickened more than 700 people, may have contributed to nine deaths, and cost the food industry millions from the recall of more than 3,600 products. With evidence of health hazards at a PCA plant in 2001, one has to wonder why nobody did anything until after all these people were hurt.

David Kessler: Fat, Salt and Sugar Alter Brain Chemistry, Make Us Eat Junk Food -

My former boss, David Kessler, who led the Food and Drug Administration during most of the 1990s when I was a reporter covering the agency, has a new book out with some interesting research on why we keep eating things that we know are bad for us.

The Washington Post is one of several publications that have done major articles about the book. It's worth a read: David Kessler: Fat, Salt and Sugar Alter Brain Chemistry, Make Us Eat Junk Food -