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“It suddenly struck me that that tiny pea, pretty and blue, was the Earth. I put up my thumb and shut one eye, and my thumb blotted out the planet Earth. I didn't feel like a giant. I felt very, very small.” – Neil Armstrong (1930-2012)

Fresh Reads from the Science 'o sphere!

Monday, April 27, 2009

Health Alert: Swine Flu

An outbreak of Swine Flu, caused by a new subtype of the Swine Influenza A/H1N1 virus, has occurred in the USA and Mexico.

The World Health Organization (WHO) states that this is a situation of high concern:

"The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico.

Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern."

1. Here are the affected countries so far (27 Apr 2009):

Google Maps - H1N1 Swine Flu (by niman)

Pink markers are suspected cases
Blue markers are confirmed cases
Deaths have no dot in the marker


Total - about 900 suspected cases

18 laboratory confirmed cases
20 confirmed deaths due to swine flu

United States of America

Total - 20 cases(laboratory confirmed cases)

California - 7 cases
Kansas - 2 cases
New York City - 8 cases
Ohio - 1 case
Texas - 2 cases


Total - 6 confirmed cases

British Columbia - 2 cases
Nova Scotia - 4 cases

New Zealand

Total - 10 likely (Influenza A positive) cases


Total - 1 suspected case


Total - 3 suspected cases


Total - 2 suspected cases

2. Health advisory from the US Centers for Disease Control and Prevention (CDC).

For public:

Residents of States with Swine Influenza Cases

CDC has identified human cases of swine influenza A (H1N1) virus infection in people in the U.S. CDC is working with local and state health agencies to investigate these cases. We have determined that this virus is contagious and is spreading from human to human. However, at this time, we have not determined how easily the virus spreads between people. As with any infectious disease, we are recommending precautionary measures for people residing in these areas.

- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.

- Try to avoid close contact with sick people.

- If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

- Avoid touching your eyes, nose or mouth. Germs spread that way.

There is no vaccine available at this time, so it is important for people living in these areas to take steps to prevent spreading the virus to others. If people are ill, they should attempt to stay at home and limit contact with others. Healthy residents living in these areas should take everyday preventive actions.

People who live in these areas who develop an illness with fever and respiratory symptoms, such as cough and runny nose, and possibly other symptoms, such as body aches, nausea, or vomiting or diarrhea, should contact their health care provider. Their health care provider will determine whether influenza testing is needed.

For Clinicians:

Clinicians should consider the possibility of swine influenza virus infections in patients presenting with febrile respiratory illness who

- Live in an area where human cases of swine influenza A (H1N1) has been identified or

- Have traveled to an area where human cases of swine influenza A (H1N1) has been identified or

- Have been in contact with ill persons from these areas in the 7 days prior to their illness onset.

If swine flu is suspected, clinicians should obtain a respiratory swab for swine influenza testing and place it in a refrigerator (not a freezer). Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory.

Update 28 Apr 2009

WHO raises pandemic alert to phase 4

Latest tally:

Mexico = ~ 2000 suspected cases (149 suspected deaths)
USA = 40 confirmed cases
Canada = 6 confirmed cases
Spain = 1 confirmed case
UK = 2 confirmed cases

Update 29 Apr 2009

Till date, no deaths outside of Mexico.

Latest tally:

Mexico = ~ 2000 suspected/ 26 confirmed cases(152 suspected/ 7 confirmed deaths)
USA = 64 confirmed cases
Canada = 13 confirmed cases
New Zealand = 11 confirmed cases
Spain = 2 confirmed cases
UK = 2 confirmed cases
Israel = 2 confirmed cases

*Update 30 Apr 2009

WHO raises pandemic alert to phase 5

First death from swine flu outside Mexico - a 23-month-old Mexican child died in Texas.

Latest tally:

Mexico = ~ 2000 suspected/ 26 confirmed cases(159 suspected/ 7 confirmed deaths)
USA = 91 confirmed cases (1 confirmed death)
Canada = 13 confirmed cases
New Zealand = 11 confirmed cases
UK = 5 confirmed cases
Spain = 4 confirmed cases
Germany = 3 confirmed cases
Israel = 2 confirmed cases
Austria = 1 confirmed case

Would you like to know more?

- Swine Influenza and You (US CDC)
- Singapore will be pro-active in handling possible swine flu outbreak (Channel NewsAsia)


carstereis said...

CDC Chief: "We're Going To See More Severe Disease In This Country."

This strain of virus is more potent and more deadly than the virus that hammered the world in 1918 and 1919. Viruses come in waves. There are striking similarities to this virus and the virus that killed up to 100 million people in 1918. The first wave is historically more mild than the later waves.

In addition to this virus becoming more severe, it is mutating faster than previous virus that we have seen. In addition, this virus is nothing like we have ever seen before because it combines features from viruses natural in different parts of the globe. We are in uncharted territory.

If it follows the same path as the 1918 flu, we will see very damaging results. However, we must remember we are a global society now and the virus can spread quicker than we have ever witnessed in history. This is very concerning especially since the drugs we have now seem resistant.

While there have been no deaths in America, it is shadowed by the fact the common variable among the deaths seem to be age. While most American cases have involved the very young and very old (under 10 and over 50) the Mexican cases that ended fatally involved the robust and healthy (over 20 and under 45).

This virus kills the host by over-stimulating the immune system. The term that is used when the immune system over reacts is called a Cytokine Storm. It is usually fatal. During this “Storm” over 150 inflammatory mediators are released. This would account for the high mortality rate in 1918-19.

See history and projections here:
Swine Flu -

Lim Leng Hiong said...

Hi Carstereis, thanks for your comment.

I am also very concerned about this outbreak, in particular I hope they will soon provide us with more details about the infectivity and latent period/incubation period of this new virus.

I think that at this point in time there isn't enough data to know if this virus will be more deadly than the 1918-1919 virus, or if it kills primarily via the cytokine storm mechanism.

Epidemiologist Dr. Tara C. Smith has written articles about this issue and other aspects of swine flu.

Suffice to say that Fresh Brainz is watching the situation closely and will be providing updates if there are any significant developments.