|Swine Flu Information and Updates|
|Written by Naoum Issa, MD, PhD|
We have compiled a set of resources for medical professionals to help follow and deal with the Swine Flu emergency.
This includes WHO and CDC guidance for professionals, scientific information about the virus as it becomes available, and tracking of confirmed swine flu cases across the US and the world.
Swine Flu Resources
July 2009: WHO is set to make a statement discouraging nations with H1N1 outbreaks from testing; rather they should assume flu symptoms are indicative of H1N1 infection. Source: Chicago Tribune.
June 29, 2009: The first case of tamiflu-resistant H1N1 (Swine Flu) has been reported in a patient in Denmark. Oseltamivir and zanamivir are alternative antivirals that are effective against H1N1. Source: BBC News.
June 28, 2009: US health officials at the CDC estimate that over 1 million Americans have contracted Swine Flu. Mortality rates are lower than initially expected with 127 deaths. Source: CDC and BBC News.
Swine Flu Spread Data
US Cases of Swine Flu in Humans as reported by the CDC.
5/26/2009: Old influenza vaccines may have imparted immunity to H1N1, explaining why a larger fraction of the young population than older population are susceptible to the virus. Source: Nature News.
5/24/2009: "It's most likely that if you're sick with the flu, that you have the H1N1 virus" says Jessica Scaperotti, spokeswoman for New York City's Department of Health and Mental Hygiene spokeswoman. Patients with flu symptoms and underlying health issues should be prescribed Tamiflu. Source: ABC News.
5/11/2009: Google Flu Trends shows negligible increase in tracked keywords despite "Swine Flu" scare. Lack of bump may accurately reflect minimal actual impact of Swine Flu.
5/9/2009: CDC release "FluView" report for 2008-2009, ending May 2, 2009
CDC guidance has changed regarding school closure due to Swine Flu: closures are no longer recommended as a prevention method, and efforts should focus on early identification of ill students and staff, and on hygiene. Source: CDC school guidance.
A second patient in the US has died with Swine Flu (2009 H1N1), although it is clear that the virus was the cause of death since she had a long-term chronic illness. Source: CNN
5/5/2009: Update on US cases of Swine Flu (CDC update)Some states and municipalities will no longer require reporting of probable cases of Swine Flu unless the patient is hospitalized. This will likely reduce the number of cases reported moving forward.
Federal agencies now note that the severity of 2009H1N1 is no worse than typical seasonal flu. (CDC press briefing)
The CDC has completed the distribution of 25% of the strategic reserve of antiviral medication, as well as delivery of doses to Mexico. (CDC press briefing)
WHO update: A swine herd in Alberta Canada is infected with the Influenza A 2009 H1N1 virus.
An excellent piece by the BBC health reporter, Emma Wilkinson, describes the leading hypothesis for why the Swine Flu virus seems to be causing mostly mild disease rather than severe disease: What scientists know about swine flu.
The take home message is that the swine flu (H1N1) binds to receptors in the nasopharynx causing a URI and does not induce a cytokine storm. More deadly virus strains, like avian flu (H5N1), bind to receptors in the lung, so when viral load causes cell lysis there is damage to the cells of the lung and inflammation in the lung causing pneumonia.
4/29/2009 PM: WHO pandemic threat level raised from phase 4 to phase 5 (the second highest level) for Swine Flu on 4/29/2009.
WHO Director-General credits preparations for the threat of H5N1 virus (Avian Flu) for rapid response to the Swine Flu.
Source: WHO announcement
4/29/2009 AM: CNN reports the first death in the US from Swine Flu, a 23-month old from Mexico being treated in Houston, Texas.
Edgar Hernandez, a child in a mountainous region of Mexico (La Gloria in the state of Veracruz), is identified as "Patient Zero" of the Swine Flu outbreak that now appears to have started around April 2, 2009. Source: CNN.
In addition, there are confirmed reports in new states, including Arizona, Indiana, Massachusetts, Michigan, Nevada. Several possible infections are being tracked in many states, with the University of Chicago Hospitals reporting several cases are suspected and being tested.
4/28/2009: 64 cases now reported in the US, most in New York City (0 deaths in the US at this point). The following table is from the CDC.
4/28/2009: Swine flu genetics unusual: "Its genetic make-up is unlike any that researchers have seen: a swine H1N1 strain that combines an existing triple assortment first identified in 1998 — including human, swine and avian influenza — with two new pig H3N2 virus genes from Eurasia, themselves of recent human origin." Source: Nature News.
4/27/2009: WHO raises its pandemic threat level to phase 4. From WHO update:
"The Emergency Committee, established in compliance with the International Health Regulations (2005), held its second meeting on 27 April 2009. The Committee considered available data on confirmed outbreaks of A/H1N1 swine influenza in the United States of America, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries. On the advice of the Committee, the WHO Director-General has raised the level of influenza pandemic alert from the current phase 3 to phase 4."
4/27/2009: Update on cases and locations. Source: WHO
40 cases of Swine Flu confirmed in the US. Source: CDC
4/26/2009: The 20th case of Swine Flu in the US has been reported in Ohio. US administration declares "emergency", to release 1/4 of strategic stockpile of antivirals, ramps up detection efforts. Source: LA Times4/25/2009: WHO:"The first meeting of the [WHO] Emergency Committee was held on Saturday 25 April 2009...
The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.
Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations."
4/23/2009: CDC announces existence of the Swine Flu virus (H1N1).
Swine Flu - Updates and information on H1N1 2009 (AKA Swine Influenza) pandemic.
Ankylosing spondylitis - Current protocols for diagnosis and treatment options.
Wegener granulomatosis - Autoimmune etiology and clinical course.
Diabetes - disease and management information, including diagnosis, typical treatment plans and diabetes supplies.
The US medical jobs market has stayed hot for health care providers. Whether you believe that a provider shortage is in the offing or that the ratio of physicians-to-patients is too high, physician jobs and nursing jobs abound.
A wide variety of medical jobs can be found in the netdoc health care job listings. Particular strengths include permanent and locum tenens physician jobs, nursing jobs across the US, and radiology positions.