By BRYAN WALSH Friday, Aug. 21, 2009
Influenza vaccinations are usually an afterthought for most people. Despite the easy availability of the shots, fewer than 40% of Americans get them in any one year — never mind that flu kills some 36,000 of us annually. But this flu season is likely to be different. Thanks to the new H1N1/09 virus, to which almost none of us are immune, flu anxiety is high — and demand for the new vaccine should be too. Washington is now gearing up to respond, hoping to inoculate millions of Americans and blunt the severity of the first pandemic in four decades.
The problem is, there won't be enough vaccine to inoculate all 300 million of us right away, and that means health officials have to prioritize. Last month, the Centers for Disease Control and Prevention (CDC) identified the groups that should get the very first doses, and the list did not contain many surprises: pregnant women, children between 6 months and 4 years of age, anyone in a household who has contact with kids younger than 6 months old, health-care workers who have direct patient contact and all kids ages 5 to 18 who have underlying medical problems. "[Prioritization] is a very important step for planning vaccinations in the fall," says Anne Schuchat, director for the National Center for Immunization and Respiratory Diseases. The elderly, who usually get first dibs on seasonal flu shots, are conspicuously missing from this list because they have so far been much more resistant to the H1N1/09 strain than young children.
(See pictures of thermal scanners searching for swine flu.)
On its face, this plan makes sense, especially since it conforms to the usual epidemiological practice of protecting the most vulnerable first. But a new study in the Aug. 20 issue of Science suggests that in this case, the usual practice might not be the best. Rather than inoculating the people likeliest to die from H1N1/09, we may want instead to inoculate the people likeliest to spread it. After all, even the most at-risk among us can't get sick with a virus we never come in contact with. "If you can stop transmission, you can protect the people who are vulnerable," says Jan Medlock, a mathematician at Clemson University and one of the authors of the Science paper.
Medlock and co-author Alison Galvani of Yale University School of Medicine studied mortality data and data of infectious contacts from the influenza pandemics of 1918 and 1957. They then built a mathematical model to determine the best distribution by age for vaccinations, in order to contain the spread of a theoretical pandemic. In their calculations, the most effective policy was to aim first for inoculating children ages 5 to 19 and adults ages 30 to 39. That's because school-age children are such a powerful nexus of flu infection: they get sick, infect one another in the close and less-than-hygienic hothouse of school and then bring the virus back home to their parents. The parents, in turn, can then infect others in the community. Knock these links out of the transmission chain, and the spread of the virus slows down considerably — an assertion backed up by studies from Japan, where vaccinations of young children against regular seasonal flu reduced infections and deaths among the most vulnerable elderly. "There's really a disproportionate amount of transmission going in schools," says Medlock.
(See pictures of soccer in the time of swine flu.)
The new strategy is a variation on what's called herd immunity — the idea that even if you can't vaccinate an entire population, you can achieve nearly complete disease control by vaccinating at least the overwhelming portion of it. That's because every inoculated person serves as a sort of firebreak against the virus; surround the disease with enough people who are immune to its spread, and it simply winks out, never reaching the few people who still aren't immune. The Science study offers a chance to get a kind of herd immunity on the cheap by inoculating the super-spreaders first. "As long as there are more than 40 million doses of vaccine, this looks like the best way to go," says Medlock.
The CDC's vaccine recommendations track with the Science study more than they seem to, since the government does recognize that the elderly are less vulnerable to H1N1/09 than they are to regular flu and that super spreader school children are more vulnerable. Vaccinating the kids, as well as people in their parents' age group, could go a long way toward protecting all of us.
Source:Times Magazine
Showing posts with label H1N1. Show all posts
Showing posts with label H1N1. Show all posts
Friday, August 21, 2009
Thursday, August 20, 2009
How Deadly Is Swine Flu?
Newsweek
By Katharine Herrup
OMG! SWINE FLU!
It seems like everyone is freaking out about the upcoming flu season and the havoc H1N1 might wreak in America. Secretary of Health and Human Services Kathleen Sibelius says she’s “preparing for the worst.” Experts are worried vaccines won’t be ready in time. Schools are contemplating quarantine situations. And the media is very concerned, judging by all the “Swine Flu – How Will It Affect Your Weekend?” stories each week.
But how worried should we really be? The facts can sound a little staggering: swine flu first hit the scene in late April, and by June 11, the World Health Organization declared swine flu a pandemic. The last flu pandemic declared was in 1967, 42 years ago—the Hong Kong flu, which killed about 700,000 people worldwide. So far, this swine flu is responsible for 1,462 deaths globally. Already, hundreds of thousands of people have contracted swine flu—so many that the WHO has stopped counting. In America, 447 people have died. A little perspective shows that H1N1 isn’t as scary as it sounds. Pandemic, with all its seemingly lethal connotations, simply means geographically widespread. The common cold, for instance, can always be classified as a pandemic. So far, the deadliness of swine flu pales in comparison to heart disease, cancer, and other flu pandemics like the Spanish flu of 1918, which wiped out 50 million people worldwide and the Asian flu of 1957-58, which killed about 2 million people. Furthermore, the swine flu appears to be behaving like a regular seasonal flu, with mild symptoms and many full recoveries. That’s not to say that the seasonal flu is harmless. It’s the eighth-leading killer in America, with approximately 1 out of 5,000 dying from it. But deaths from the flu mostly occur because of complications like pneumonia or underlying chronic diseases like diabetes. Of the 56,326 people that died from the flu in America in 2006, only 849 of those deaths were caused directly by the flu, according to the Centers for Disease Control and Prevention, so if you're young and healthy—or even older and healthy—you're in good shape. Heart disease, on the other hand, kills about 1 out of 50 people per year in America, which accounts for 26 percent of deaths in America annually. Cancer constitutes about 23 percent of America’s yearly death toll, killing 559,888 people in 2006. The flu accounts for a measly 2.3 percent of deaths. Its death toll is just slightly higher than the number of people killed in auto accidents per year (43,664). Diabetes, stroke, Alzheimer’s, accidents, emphysema and chronic bronchitis, hospital infections, even lung cancer are all more deadly than the swine flu (so far) and the seasonal flu. (Of course, you are more likely to die of H1N1 than being one of the roughly 37,286 per year that die of poisoning and other noxious substances or being one of the 38 randomly hit by lightning.) With what little data we have—remember, swine flu only hit the U.S. about five months ago—it’s a safe bet that you probably won’t die from swine flu. But the odds are much better that you’ll be sick with it: H1N1 is spreading more quickly than the seasonal flu, in part because most people haven't built up an immunity to this new strain of virus. The flu’s also targeting a much younger, healthier age group. Typically, the large majority of people killed by the flu are those 65 years and older. However, the swine flu has been more prevalent among pregnant women and young adults. Currently, 6 percent of swine-flu deaths worldwide have occurred in healthy, pregnant women, compared with experts predict as many as 122,883,484 if 40 percent of the population does become infected with H1N1, more than 122 million people might contract swine flu. “What makes flu so bad is that it infects so many people,” says Dr. Martin Blaser, chairman of the Department of Medicine at NYU Langone Medical Center, be it swine, bird, or regular sick-kid-on-the-schoolbus flu. less than 1 percent very rare occurrences with regular flu deaths. Even though mortality will stay low, “the social impacts of the deaths will be greater because it produces death among younger people,” says Dr. Jarbas Barbosa, the Pan American Health Organization’s regional adviser in immunization and vaccines.
In Argentina, 20 to 25 percent of the population has been attacked by the flu over a three-week period. That could easily occur in the United States, where pandemics typically attack between 25 percent and 40 percent of the population. “If we get slammed with this massive burden of flu in a short period of time, even if the mortality rate is .01 percent, you’ll feel more mortality,” says Laurie Garrett, senior fellow for global health at the Council on Foreign Relations. “You’ll have such overwhelmed medical systems that you will have people who will die because the systems are overwhelmed.” (Luckily, the fact that swine flu hit in the off-season gave America time to prepare.)
We can’t know, with 100 percent certainty, how the flu will act once flu season kicks off this fall. “Swine flu is not deadly right now, but we don’t know what it will become,” says Stephen Morse, epidemiology professor at Columbia University’s School of Public Health. “Most believe that this is likely to come back during flu season and be more severe.” But for now, the statistics offer some safety.
And while it’s always good sense to wash your hands and not cough on strangers, there’s no need to break out the protective masks and quarantine kit quite yet. Instead, hit the gym, eat some fiber, and wear your seat belt.
Wednesday, August 19, 2009
The Invisible Enemy Within Our Midst
Hantu Laut
When I wrote 'H1N1: Something Gone Terribly Wrong' on 13 Aug there were 44 deaths.Today, the deaths stand at 67. In just a week 23 more people have died from the disease.Those are just the reported cases, there could be some unreported or wrongly diagnosed cases.
The government apathy towards the greater danger that this disease could manifest into new strain endangering the lives of greater number of Malaysians is unbelievable.The Health Minister's statement that the government would only consider calling an emergency if there are new waves of infection and when the mortality rate rises above 0.4 percent is certainly not taking a holistic approach to the problem.
The government may be looking at the wrong numbers.Where they got the 0.4 percent as the threshold before drastic action could be taken to curtail public activities and closing down of public places is a puzzle.The reality is Malaysians are dropping dead faster than most countries that got the pandemic.This is due to government inaction and the people apathetic view of the insidious danger of this invisible and voracious serial killer.
The government need not shut down every public places, only those considered non-essential should be asked to shut down or reduce their operating hours as suggested in my earlier article here.
Malaysians may have to sacrifice their personal liberty and lifestyle for a short while if they do not want to become the next victim of this invisible enemy.
When I wrote 'H1N1: Something Gone Terribly Wrong' on 13 Aug there were 44 deaths.Today, the deaths stand at 67. In just a week 23 more people have died from the disease.Those are just the reported cases, there could be some unreported or wrongly diagnosed cases.
The government apathy towards the greater danger that this disease could manifest into new strain endangering the lives of greater number of Malaysians is unbelievable.The Health Minister's statement that the government would only consider calling an emergency if there are new waves of infection and when the mortality rate rises above 0.4 percent is certainly not taking a holistic approach to the problem.
The government may be looking at the wrong numbers.Where they got the 0.4 percent as the threshold before drastic action could be taken to curtail public activities and closing down of public places is a puzzle.The reality is Malaysians are dropping dead faster than most countries that got the pandemic.This is due to government inaction and the people apathetic view of the insidious danger of this invisible and voracious serial killer.
The government need not shut down every public places, only those considered non-essential should be asked to shut down or reduce their operating hours as suggested in my earlier article here.
Malaysians may have to sacrifice their personal liberty and lifestyle for a short while if they do not want to become the next victim of this invisible enemy.
Thursday, August 13, 2009
H1N1; Something Gone Terribly Wrong
Hantu Laut
Something has gone terribly wrong with the spreading of the H1N1 influenza in Malaysia and the Malaysians 'mindset' of not taking adequate precautionary measures to protect themselves.
This is an imported disease and much could have been done to contain it if close monitoring and screenings were given earlier at all points of entry into the country.Stories from visitors and friends I collected revealed a very lax, typical Malaysian 'tidak apa' attitude at our entry points.Although, we can't police everyone coming in, strict procedures and serious-minded personnel who took pride in their jobs would have helped in better detection.
That may be water under the bridge now. The local transmission is moving at a dizzying speed with fatalities embarrassingly high for a modern nation like Malaysia which has better health care system than many other countries in the region.Is our government just talking but not doing the right things?Do Malaysians have such low immunity that makes the mortality rate so high.
Britain which got the pandemic earlier and with population of almost three times more than that of Malaysia has only 29 deaths and its neighbour France only has 24 deaths.At the rate Malaysians are dropping dead in no time we will surpass the US and Mexico death rates which stood at 211 and 119 respectively as of July.
India, with a patchy and fragile health care system, has recorded 17 deaths so far, but is expected to have particularly big toll, which is not surprising, due to its huge population.Surprisingly, the Indians seem to take the disease more seriously than the general Malaysian public.The picture tells a story.
Something has gone terribly wrong with the spreading of the H1N1 influenza in Malaysia and the Malaysians 'mindset' of not taking adequate precautionary measures to protect themselves.
This is an imported disease and much could have been done to contain it if close monitoring and screenings were given earlier at all points of entry into the country.Stories from visitors and friends I collected revealed a very lax, typical Malaysian 'tidak apa' attitude at our entry points.Although, we can't police everyone coming in, strict procedures and serious-minded personnel who took pride in their jobs would have helped in better detection.
That may be water under the bridge now. The local transmission is moving at a dizzying speed with fatalities embarrassingly high for a modern nation like Malaysia which has better health care system than many other countries in the region.Is our government just talking but not doing the right things?Do Malaysians have such low immunity that makes the mortality rate so high.
Britain which got the pandemic earlier and with population of almost three times more than that of Malaysia has only 29 deaths and its neighbour France only has 24 deaths.At the rate Malaysians are dropping dead in no time we will surpass the US and Mexico death rates which stood at 211 and 119 respectively as of July.
India, with a patchy and fragile health care system, has recorded 17 deaths so far, but is expected to have particularly big toll, which is not surprising, due to its huge population.Surprisingly, the Indians seem to take the disease more seriously than the general Malaysian public.The picture tells a story.
Passengers wore protective masks as on a train to Pune at the Chhatrapati Shivaji Terminus in Mumbai on Wednesday.
Our government seems to be talking a lot more than doing what they should be doing.Even the lowest form of human live is valuable and should not succumb to this heinous scourge due to incompetence of our Health Ministry.
By now Malaysia should be put on red alert and unnecessary public and social activities should be minimised or curtailed.
The first thing the government should do is to close all schools by bringing forward the year end school holidays, which means closing the schools for at least one and half months.They could be re-opened earlier if the pandemic has slowed down or fizzled out. Discourage people from going to cinemas, entertainment places or any crowded public places and disseminate information about the symptoms of the disease and how to avoid contracting the disease using the mass media. All TV and radio channels should be asked to beam at least every hour on the hour the public broadcast.If the pandemic gets worse than all public places like churches,mosques,temples,discos, and bars should be advised to limit their activities and those who ignored such warning should be compelled to close temporarily.
To date Malaysia have recorded 44 deaths from the H1N1 flu and for a population of just 26 million that's was wee bit too high.Most died of other complications.Infant, young children and the elderly are more susceptible if they have other ailments.
The Prime Minister should kick the Minister of Health's ass and ask him to shape up or sack him. The late response to the insidious danger of the disease has been the cause of the high rate of mortality.I bet most of the hospitals do not have Tamiflu to treat serious cases for those in the high risk group.
Below are statistic of fatalities of H1N1 for the countries mentioned above.
US 211 deaths Pop: 307 million
Mexico 119 deaths Pop: 109
UK 29 deaths Pop: 60
France 24 deaths Pop: 64
India 17 deaths Pop: 1.1 billion
India may be too early to judge and the people probably may have better immune system.Surprisingly, Indonesia which was the epicenter of the H5N1 epidemic in humans and home to the deadliest version of the virus has only confirmed 1 death from the H1N1 virus. Some countries do under report such pandemic so as not to cause panic but that would be unfair to the citizens.
At 44 deaths the Malaysian government should announced red alert before it's too late.We should take cue from Mexico City where the city virtually shut down, closing restaurants, cinemas, sport venues and other public places in a bid to contain the disease.
Our government seems to be talking a lot more than doing what they should be doing.Even the lowest form of human live is valuable and should not succumb to this heinous scourge due to incompetence of our Health Ministry.
By now Malaysia should be put on red alert and unnecessary public and social activities should be minimised or curtailed.
The first thing the government should do is to close all schools by bringing forward the year end school holidays, which means closing the schools for at least one and half months.They could be re-opened earlier if the pandemic has slowed down or fizzled out. Discourage people from going to cinemas, entertainment places or any crowded public places and disseminate information about the symptoms of the disease and how to avoid contracting the disease using the mass media. All TV and radio channels should be asked to beam at least every hour on the hour the public broadcast.If the pandemic gets worse than all public places like churches,mosques,temples,discos, and bars should be advised to limit their activities and those who ignored such warning should be compelled to close temporarily.
To date Malaysia have recorded 44 deaths from the H1N1 flu and for a population of just 26 million that's was wee bit too high.Most died of other complications.Infant, young children and the elderly are more susceptible if they have other ailments.
The Prime Minister should kick the Minister of Health's ass and ask him to shape up or sack him. The late response to the insidious danger of the disease has been the cause of the high rate of mortality.I bet most of the hospitals do not have Tamiflu to treat serious cases for those in the high risk group.
Below are statistic of fatalities of H1N1 for the countries mentioned above.
US 211 deaths Pop: 307 million
Mexico 119 deaths Pop: 109
UK 29 deaths Pop: 60
France 24 deaths Pop: 64
India 17 deaths Pop: 1.1 billion
India may be too early to judge and the people probably may have better immune system.Surprisingly, Indonesia which was the epicenter of the H5N1 epidemic in humans and home to the deadliest version of the virus has only confirmed 1 death from the H1N1 virus. Some countries do under report such pandemic so as not to cause panic but that would be unfair to the citizens.
At 44 deaths the Malaysian government should announced red alert before it's too late.We should take cue from Mexico City where the city virtually shut down, closing restaurants, cinemas, sport venues and other public places in a bid to contain the disease.
Subscribe to:
Posts (Atom)