Saturday, April 3, 2010

Egypt Confirmed Human H5N1 Cases For 2010

This listed will be located under Egypt Fact Box in the right sidebar.

Confirmed Human Cases For 2010

Age, Location, Onset Date and # confirmed by Min. of Health

20 yo, [Beni Suef] January 6,- Given Tamiflu for 10 days- #91- Died

1.5 yo [Dakahliya], January 7, #92

3 yo [Asyut] January 19, #93

45 yo [Ash Sharqiyah] January 12, #94

40 yo [Daqahliya] January 31, #95 (WHO Update #28)

29 yo [Menoufiya], January 27, #96 - WHO update #28 - Died

37 yo (Helwan] January 31, #97 - Died 2/9

32 yo [Menoufiya] February 6, #98

29 yo [Menoufiya], February 6, #99 - Died

10 yo [Daqahliyah] February 10; #100

30 yo [Ash Shaykh] February 10; #101

13 yo [Ash Shaykh] February 10; #102

1 yo [Qalyubia Gov.] February 22; #103

53 yo [Qalyubia Gov.] February 27; #104 - Died

20 yo [Qalyubia/Qaloubiyah Gov.] Adm: 3/5; #105 - Died

1.5 [Ash Shaykh Gov.] Adm: 3/2; #106

4 yo [Beni Suef Gov.] Adm: 3/18; #107 - Died

30 yo [Damietta Gov.] Onset: 3/24; #108

18 yo [Fayoum Gov.] Adm: 3/31; #109 - Died

20 yo [Qalyubia/Qaloubiyah Gov.] Adm: 7/21; #110 - Died

2 yo [Cairo Gov.] Adm: 8/4; #111

Egypt: H5N1 Human Case #109 - Fayoum Gov.

Ministry of Health: a new human case of bird flu, a woman from Fayoum

The Ministry of Health for a new human virus (H 5 to 1) causes AIDS "bird flu", bringing the total casualties since the disease appeared in Egypt in 2006 and so far 109 cases.

وأوضحت وزارة الصحة - فى بيان صحفى اليوم "السبت" -أن المصابة سيدة تبلغ من العمر 18 عاما من "إطسا" بمحافظة الفيوم -صعيد مصر- وحالتها حرجة،حيث دخلت مستشفى حميات الفيوم يوم 31 مارس الماضى،وهى تعانى من إرتفاع شديد فى درجة الحرارة وصعوبة فى التنفس وضيق فى الصدر.

The ministry of health - in a press release today, "Saturday" - that the infected woman at the age of 18 years of "Atsa" Fayoum Governorate - Upper Egypt - and in critical condition, where he entered the hospital admitted Fayoum on March 31, suffering from a very high degree of heat and difficulty in breathing and tightness in the chest.
وذكر البيان أنه تم اعطاء المصابة عقار "تاميفلو" على الفور، إلا ان حالتها حرجة وتم تحويلها إلى مستشفى صدر الجيزة.
The statement said it was given infected drug "Tamiflu" immediately, but the critical condition was transferred to a hospital in Giza.

Campaigns to larger markets and shops selling live birds and frozen meat refrigerators in Cairo

In the fight against avian influenza, said Dr. Ezzat Ramadan, Director of Directorate of Veterinary Medicine in the seizure of the car number 865 AD. E.'s Driving b / Sheriff Abdel-Mohsen loaded ..

The number of 1455 live chickens weigh about 2852 kilograms and does not have any licenses for the transfer of live birds, was immediately confiscated the car and go to the abattoir the United Company for Poultry Production walks and supply the amount of forfeiture to the state treasury, as the Directorate ambush zone of peace at the position X, which enables set of 4 cars loaded with live birds, the number of 2650 birds were confiscated four cars and edit the records of the facts.

This comes following the instructions of Dr. Abdel Azim Wazir, Cairo Governor need to tighten control on markets, shops and ambushes on the entrances and exits of Cairo to prevent the circulation of live birds, which is prohibited by law No. 70 of 2009 sold live for citizens around without causing any injuries from bird flu, as well as directives of the Governor of Cairo to set the meat, fish unfit for human consumption in order to preserve the health of citizens, the Directorate of Veterinary Medicine campaigns enlarged to increase its grip on the market and prevent any attempts to manipulate and endanger public health campaigns have resulted in seizures of live birds and frozen meat and fish corrupt.

In the context of control over markets and shops selling, offering meat and fish, and in preparation for the Spring Festival, has been seized 1853 kilograms fish herring and Fissek and salinity unfit for human consumption, and adjust the plant is not authorized City of Peace fills, and meat processing without a license and control of veterinary terms is set to 1300 kilogram of sausage and meatballs and frozen meat and non-anonymous blogger on the data to the production and shelf life, and is set to 140 kg of smoked fish in an invalid state of the central market and consumption market random Nile city of peace.

Also managed the Directorate to set the Shader unauthorized Square Isbeko city of peace in a bid for goat meat, of great age weighing 350 kg and the state unfit for human consumption, and the execution of the meat in a healthy way, as well as to adjust the 75 kg of meat outside the massacres place of Butcher Quarter Tenth City Nasr, corrupt, and with jaundice and yellow, and adjust the car number P-963. and. p ambush umbrellas carry 225 kg liver imported unfit for human consumption, and adjust the 350 kilogram liver Moqattam invalid.

Were raided Store Street Revolution were seized large quantities of meat, fish, shrimp and Alcalmari and artifacts fish weighing 4667 kg unfit for human consumption, were also seized 12 kilograms of cheese, different factory were burned quantities of rotten meat and fish Holocaust slaughter automation gardens.

During the traffic on the massacres to make sure there are no violations of it, transmitted d. Ezzat Ramadan, the doctor in charge of the abattoir Bibo 2 to investigate the lack of presence and to supervise the slaughter of animals Palmdzr and also decided to withdraw the licenses of movement of birds from slaughter for three days because he is developing products in the bags of white does not have any data for the slaughterhouse or product.

The execution of 350 birds alive in the campaign against avian influenza in Alexandria

Saturday, April 3, 2010

Investigation of Supply officers managed to Alexandria, to set the 48 issue of the sale of live birds and the execution of 350 birds alive, and in the framework of the efforts of security officers of the Directorate of Alexandria in the fight against bird flu.

During the campaign, which included east and west of the city, and was attended by officers of the Investigation of Supply and criminal investigators, and bodies and the environment and facilities in coordination with the Directorate of Veterinary Medicine and Department of Agriculture, remove 17 of the nest of breeding birds and re-closure of 10 stores selling live birds by their owners seals were broken and open, as awareness citizens the seriousness of the disease. And continue the Security Directorate of Alexandria efforts to combat the disease.

Egypt: 4 cases of swine flu in Alexandria

There is also a lot of H5N1 in poultry in Alexandria recently.
East & West of the City...arrest 47 in Alexandria, issue of sale of live birds have been culled 550 birds alive and in the framework of the efforts of security officers,...remove 20 of the breeding birds nest and re-closure of 23 shops for the sale of birds...And seized a truck carrying 270 live birds before they are sold in markets east of the city

Execution of 924 birds, East & West Alexandria.... to remove 122 of breeding birds nest and re-closure of 28 shops selling live birds.

Saturday, April 3rd, 2010 - 15:48

Dubai Chamber of follow-up to the swine flu, Alexandria governorate, the emergence of 4 new cases of the disease, which is of a girl (22 years) from the region of Sidi Bach district park and Confectioner (37 years) from the Kabary district of the West, and a woman (32 years) Amriya district and are months pregnant and the sixth child 9 months Asafra area district park. All cases have been transferred to the fever hospital in Alexandria.

US Capital, New York and Wisconsin Add 15 Recent Samples to the Cross-Linked Background

Silent HA and NA Polymorphisms Correlated with Fatal 225G Cases in the Ukraine and Russia

  • HA:syn413K encoded from A1281G, AAa->AAg
  • NA:syn407V encoded from T1221C, GTt->GTc
PF11 Sequences Demonstrating Cross Segment Linkage
  • Iraq8529E3 with HA 131L, 160L, 194I, 298V and syn419L (Kentucky19 and 225G Utah42)
  • Iraq8529M1 with HA 131L, 160L, 298V and syn419L (Kentucky19 and 225G Utah42)
  • Iraq8531 with HA 130E, 131L, 298V and syn419L (Kentucky19 and 225G Utah42)
  • Australia Victoria2129 with potential H5N2 inclusions and NA 454S
  • Australia Victoria2130 with NA 454S
  • Ukraine Kyiv377 with mixture of 225D, 225G, 225N, 225S, 225T and 225A
  • Ukraine Lviv673
  • Ukraine Lviv682
  • Ukraine Cherkasy332
  • Ukraine Cherkasy333
  • Ukraine Cherkasy346
  • Ukraine Chernihiv855L with mixture of wt 225D / 225G and additional 1918 Markers (syn238E & 324I), Fatal outcome
  • Ukraine Chernihiv856 with mixture of wt 225D / 225G , Fatal outcome
  • Ukraine Chernihiv857 with mixture of wt 225D / 225G and additional 1918 Markers (186P, syn238E, 324I & G796A), Fatal outcome
  • Ukraine Chernihiv858, Fatal outcome
  • Ukraine Dnipropetrovsk260
  • Ukraine Dnipropetrovsk267
  • Ukraine Dnipropetrovsk268
  • Ukraine Dnipropetrovsk272
  • Ukraine Dnipropetrovsk273 with mixture of wt 225D and 225G
  • Ukraine Dnipropetrovsk274
  • Ukraine Dnipropetrovsk1124
  • Ukraine Dnipropetrovsk1171
  • Ukraine LvivN2 with 225G
  • Ukraine LvivN6 with 225G
  • Ukraine TernopilN10 with 225G
  • Ukraine TernopilN11 with 225G
  • Ukraine Volin226 with 225G
  • MoldovaG120
  • MoldovaG140
  • MoldovaG181
  • MoldovaG182
  • MoldovaG191
  • HA and NA Norway2924 with mixture of wt 225D and 225G
  • HA and NA Norway3364-2
  • HA and NA Denmark AarhusINS82 with syn177L and 324I
  • HA and NA Denmark CopenhagenINS95 with 69K, syn157K and 176I
  • HA and NA Denmark CopenhagenINS98
  • HA and NA Poland WarsawINS100 with 324I and 377K
  • HA and NA Greece AthensINS85 with syn57C, syn233Y, 324I and 377K
  • HA and NA CatNS7362 TamiFlu Resistant
  • HA and NA CatS1096
  • HA and NA CatS1162
  • HA and NA CatS1179
  • HA and NA CatS1181
  • HA and NA CatS1267
  • HA and NA CatS1268
  • HA and NA CatS1402
  • HA and NA CatS1501
  • HA and NA CatS1687
  • HA and NA CatS1748
  • HA and NA CatS1751
  • HA and NA CatS1761
  • HA and NA CatS1827
  • HA and NA CatS1935
  • HA and NA CatS2120 with multiple swine markers
  • HA and NA CatS2151 with swine markers and 165N (TamiFlu Resistant CatNS7632 and Russian 225G Salekhard01)
  • HA and NA Guangdong02
  • HA and NA Guangdong05
  • HA and NA SingaporeON1156
  • HA and NA India BloreNIV236 with 226R, syn372Q, 454N and 550T
  • HA and NA Sweden Stockholm31
  • Sweden Malmoe1 from 2010 with 190Y, 324I and 377K
  • Sweden Gothenburg2 with 146G, 324I (1918) and markers found extensively in Moldova and Russia
  • HA and NA Russia4 with syn238E and 324I (1918)
  • HA and NA Russia12 with 324I (1918)
  • HA and NA Russia14
  • HA and NA Russia19 with 324I (1918)
  • HA and NA Russia74
  • HA and NA Russia149
  • HA and NA Russia165
  • HA and NA Russia171 with 165N
  • HA and NA Russia178
  • HA and NA Russia180 with 165N, syn239P and 264G
  • HA and NA Russia190
  • HA and NA Russia191
  • HA and NA Kurgan01 with HA 214E (MoldovaG168, G176, G188) and NA mixture at 407 (Fatal 225G Abakan02)
  • HA and NA Omsk02
  • HA and NA Tver2969 with 225G, Fatal outcome
  • HA and NA Salekhard01 with 165N and 225G, presumptive Fatal outcome
  • HA and NA Orenburg2974 with 225N, potential Fatal outcome
  • HA and NA Perm01 with 131P, 225G and 324I, presumptive Fatal outcome
  • HA and NA District of ColumbiaINS43 with 22I, syn157K and 176I *
  • HA and NA NY3702
  • HA and NA NY3715
  • HA and NA NY3828
  • HA and NA NY4398 *
  • HA and NA NY4977 with 189T *
  • HA and NA NY5086 with 22I, syn157K, 176I and 264T *
  • HA and NA NY5186 *
  • HA and NA NY5227 with 189T *
  • HA and NA NY5931 with 22I, syn157K, 176I and 262K *
  • United States NewYork96
  • HA and NA RhodeIsland08
  • HA and NA Texas42102708
  • HA and NA Texas45072128
  • HA and NA Texas45122886
  • HA and NA Wisconsin629_D00544 with 22I, syn157K and 176I *
  • HA and NA Wisconsin629_D00853 with 22I, syn157K, 176I, 188I, 231K and 277N *
  • HA and NA Wisconsin629_D01915 with 22I, syn157K, 176I, 188I, 231K and 277N *
  • HA and NA Wisconsin629_D01987 with 189T and 324I *
  • HA and NA Wisconsin629_D02060 with 22I, syn157K and 176I *
  • HA and NA Wisconsin629_D02337 with 22I, syn157K, 176I, 188I, 231K, 277N and 285S *
  • HA and NA Wisconsin629_S1252 with 189T and 324I *
  • United States Kentucky19 from an 18 year old subject with HA 298V
  • United States Indiana20 from a 10M subject with 5 Avian H5N1 markers
  • US Private Sequence TamiFlu Resistant
  • United States NorthCarolina37 from a 24F subject with HA 298V
  • United States NorthCarolina44 from a 50M subject with 6 Avian H5N1 markers
  • United States NorthCarolina46_C2 from a 39F subject with HA 298V
  • United States NorthCarolina46_C2C1 from a 39F subject with HA 298V
  • HA and NA swine/NC/34752 with 298V
  • HA and NA swine/OR4060 Emergent Non-PF11 Lineage of H1N1 2009-12-31 *
113 sequences have encircled the globe as of 2010-03-24 * with high fidelity carrying a cross-segment paired set of background markers matching and contributing to fatal cases in the Ukraine and Russia. 225G appears in 14 on this background; 225N once and 225E precisely zero. The first occasion of 226R entered the list this week retrospectively due to sequence release delay with a June 2009 case from India.

The 15 newest entries represent a diverse geography within the United States of ΣPF11 infections, including 1 entry for Washington D.C., the nation's capital, 6 from New York and 7 from Wisconsin. The final entry is an H1N1 swine from Oregon that documents an emergent non-PF11 lineage building onto this cross segment linkage.

The available data, though sparse, requires the simple evaluation that this pandemic reservoir is not approaching stasis. The background continues to widen within the existing clades adding polymorphisms from H5N1 and 1918 strains demonstrating that ΣPF11 is far from reaching Omega status. Movement onto this cross-linked background has accelerated recently, now encompassing 2% of all available pandemic sequences.

Areas covered include Texas (3), the Northeastern United States (11), Wisconsin (7), Oregon, Washington D.C., Kentucky, Indiana, North Carolina (5), China (2), Singapore, India, Australia (2), the Ukraine (23), Moldova (5), Russia (18), Iraq (3), Denmark(3), Norway (2), Sweden (3), Poland, Greece and extensive penetration in Spain (17 sequences).

Receptor Binding Site (RBS) changes at 225 are associated with fatality, 225G and 225N at a rate higher than 225E.

If LvivN6 is officially confirmed as a vaccine escape event, these cross-segment pairs may be surveilled as potential future effectors of vaccine efficacy failure.

Zoonotic H9N2 Avian Influenza Further Destabilises Pandemic Genetics

Is the Pandemic Influenza Reservoir Stable?

If you enjoy counting, even measuring by observation, please continue reading.

But you must realize that the iota, the jot and even the title, will be considered of value in this forthcoming exercise. Some in the science community appear to find the process of discovery by observation just too tedious. If you are of that mindset, please direct your attention to any of the many “Science for Hire” venues where illogical, but comforting, summations are drawn from cleverly manipulated data streams. Science sells today. But we sometimes speculate that science is becoming just another sell-out, an industry pursuing profit over knowledge?

On the other hand, if careful examination, even hard work, is part of your daily lab book, you'll find evidence in this discussion to introspect.

Leading public health officials continue even today to indicate that the pandemic virus is unchanged. Keep that statement in mind as you read this analysis of heavy change activity in the pandemic reservoir, watching closely for the recent branching into genetic areas matching H9N2.

Also keep in mind that even single changes have demonstrated substantial importance.

Ongoing worldwide studies duplicated by independent, geographically dispersed laboratories, including the labs of those noted public health officials, indicate that a single polymorphism may produce a significant outcome within a Pandemic Influenza reservoir. Numerous accounts of important revisions are on record across a vast geography. 225G has produced a Vaccine Escape event in LvivN6, an elevated Case Fatality Rate and a substantial number of severe outcomes. Individual changes between 157 and 159 have also demonstrated “low reactor” status and registered as Vaccine Escape events. 230I entered the H5N1 Gharbiyah cluster in Egypt and the resultant Case Fatality Rate was 80% for that strain, a substantial increase from the accepted H5N1 CFR.

Three separate single genetic changes are well characterised in leading to various forms of Anti-Viral resistance. TamiFlu Resistance has now dispersed widely in a pattern following the rapid spread of resistance in seasonal influenza via the same Single Nucleotide Polymorphism coding for 275Y on the Neuraminidase. Emergent and attractant H1N1 strains (Triple Reassortments again) co-circulating alongside the pandemic reservoir also carry 275Y. H5N1 inclusions increase in the pandemic reservoir with a continuous flow. The PB2 627K is confirmed as leading to increased replication speed in humans and has recently been documented in a second pandemic sequence. As we have maintained from the beginning of this pandemic, TamiFlu Resistance and 627K are foregone conclusions according to our calculations.

Our team noted an increase in Avian inclusions and recently predicted HA 230I for ΣPF11. The polymorphism was documented last week in Wisconsin (US) on a background that does not deter transmission. The geographic area has a notable increase in cross-linked activity. The individual sample, A/Wisconsin/629-D00337, is primed for spread with 2 additional HA markers, 275A (TX, NM, CA and Sweden) and 377K (aggressively emerging). The NA carries 220K, a marker found on one cross-linked sequence from the Ukraine and across a wide US geographic pattern from December 2009 to the most recent 2010 sequences (North Carolina, New Hampshire, Wisconsin and Nebraska). We consider the Wisconsin0337 sample to be an excellent candidate as a universal donor of sorts due to limited polymorphisms and the fact that each revision is currently an emergent change.

H9N2, a "bird flu" serotype, has been recently evaluated for human pandemic potential. By all appearances, the present H9N2 reservoir is not becoming a pandemic virus, but is very much influencing the genetic acquisition cycle of the currently circulating PF11 pandemic virus. Which is worse, another species-jumping serotype entering the fray or a combinational virus with genetics from multiple pandemic potential reservoirs appending onto the current partially-adapted virus? In either case, the Hydra Effect appears to be operating in full force.

Given this information, obvious questions begin to form. If one genetic change may potentiate variant clinical outcomes, drug resistance or Vaccine Escape, what is the potential for multiple changes producing a variant outcome? And if a single genetic change and/or multiple changes are capable of producing large changes in behaviour, should we, in turn, have a very high and accurate level of surveillance on this reservoir? And what should we do with that important information? Should our public health officials speak from a platform of candor and accuracy when carrying out the responsibilities of their trusted positions?

Let’s investigate now if the viral reservoir is, in fact, unchanged?

More than 80% of the Hemagglutinin positions between 188 and 244, including antigenic areas of the RBD, are on record as polymorphic. Many positions rate multiple changes. Tracking these revisions against various baselines has informed our studies over the past year. One particular range of those variations is documented in the trailing data. For the sake of brevity, only one section of the HA gene segment is discussed. The list is certainly not comprehensive.

The positional summary may perhaps be instructive for those who hold the belief that the pandemic reservoir is stable. The report may provide reversing guidance for those who make public statements to the effect that pandemic H1N1 is not changing. Repetition of their “All Clear” social messaging cannot reverse the weight of the actual data. Repetition of an untruth does not create a fact, but that ongoing strategy of repetition is apparently very effective in managing the perception and manipulating the belief of the unsuspecting public.

The viral reservoir backing this present pandemic is far from stable and is actively acquiring new genetics. Current data does not indicate an immediate direction toward stability.

As is the nature with an IDRREAV, the positions reported here will not necessarily be the most important amino acid positions in the future. The reservoir will evade immunity and escape vaccine by heavily self-revising in the near future at key locations between 131 and 182 (emphasis at 155 to 177). Variation will occur with lower penetration at the head of the HA and from 272 downstream approximately 55 positions. Potential is very high that 22I will achieve density in one or more sub-clades. Expect 100N to spread and penetrate initially on sub-clades without the 22I appearances. South American polymorphisms from their fatal mid-pandemic strains of 2009 will recycle into the United States and other Northern Hemisphere nations with substantial thrust in the coming 90 days. Acceleration of the Avian based cross-linking will continue in the Western world.

Bear in mind also that a solid portion of the changes documented in this current list will become fixed even as additional donations are accumulated. The zoonotic movement from birds into human PF11 sequences is earnestly progressing in the most recent 45 days of available data. Several polymorphisms, HA and NA, from the Georgia hospitalization resurgence may have originated in Avian Influenza samples. Expect continued acquisition from Avian H5N1 and H1N1, and also watch the acceleration from one particularly new Avian donor serotype. H9N2 demonstrated a human jump in late 2008 and has very recently become fully engaged in ΣPF11 genetics with a well-defined etching on the newest cross-linked sequences. The reservoir flux will also be influenced by Swine H1N2 and H1N1 (emphasis on 3 particular emergent strains).

Is the Pandemic Influenza Reservoir Stable?

You decide . . .

188N SC16, SC31, NY3502, MA15, CatS1187, Milan433, Japan, S5
188I Growing in US on cross-linked background (4), BZSP53823
189V Sydney2503
189T Growing on US cross-linkage (4), H5N1 2009, H9N2 2008
189A synonymous (GCc), Georgia01_2010, swOR4060
190D synonymous (GAt) Milan326, 1918
190Y SwedenMalmoe1_2010_01_01
191R Chengdu18 (129P)
192Q synonymous (CAg) RomaISS50, Nebraska01_2010
193S synonymous (AGc) SC18, US 2010 (3), Milan294, Japan, H9N2
193G AR08
193N Washington72, H9N2
194I NC38E3, VA27, SC18, Bangladesh3009, StPete59, StPete99
194L synonymous (CTa) Japan4081
196Q synonymous (CAa) Wisc (3), Malaysia (2), Milan326
197T Malaysia4039
198V Malaysia5283, Malaysia9117
199N Milan80, Milan83
199D synonymous (GAc) swine Illinois, H5, H9N2
200T FL31, Asia (13), MilanUSHR1, H5, H9N2
200S NC57, SC46
201H Wisc1140, Darwin2140
202A MXinDRE797 2010 TmX, IA14, KY25, HK34360
202V synonymous (GTc) YAMAGATA778, YAMAGATA803, swIllinois
204V synonymous (GTa) PA31, SHIZUOKA1573, 1918, S7
205G synonymous (GGa) Texas76C2, S5, H9N2 (GCa)
206A CatS1161
206T Extensive
207S synonymous (TCg) California01_2010
208K US, UK, HK, MX, Italy (2), Australia (12), Asia (3), swOR4060
208S Australia43, Australia45, ChukkarH6N1
208G NY6292
208T Norway3440
210S synonymous (AGt) Bogota0466N, Malaysia9131, H9N2 (Aat)
210N Texas76C2
211K synonymous MXinDRE50617 (225G)
211R swOR4060_2009_12_31, 1918
212R swOR4060_2009_12_31, 1918
212E Vlad01 (225G), Argentina8574_41, IN21, Malaysia4039
212N MA15
212T Anadyr177_F (225G), CA07X179, CA07X181
213L TX15
213F synonymous StPete99 (225E)
214E Kurgan01, Moldova (3), swOR4060_2009_12_31
214N ENG92960012, SHIZUOKA1514
214Q Wisc0936 (237L)
214K synonymous (AAa) CatS1937, NM13, ENG620, China22811
215P synonymous (CCa) SC33, Eng616, GuangdongyunchengSWL51
215P synonymous (CCt) NY_WC37RG, MO02
216E synonymous (GAg) Moldova (4), Belarus, Bosnia (3, 225G), Indiana, H9N2 (GTg), tn
218A synonymous (GCg) Belarus, H9N2 (GGg)
218E Texas77 (159S, syn173G, 275A, 377K, 454I)
218T Hiroshima201 (225G)
218V GuangdongyunchengSWL51, Malaysia (2 mix wt) (GtA)
218V swIll02930, 2931, 2932, 2937 (2009-12-29, 30) (GTc)
219I synonymous Ancona451_F, Lyon2490
219T Wisc0134 (225E), RomaISS223, swOR4060_2009_12_31
220R synonymous (AGg) Mexico476, Malaysia9451
223V synonymous (GTa) Utah59
223M CA33
224K SC18_VxX
224M NY5186
225N BZ_SP53838, Ukraine mix wt, Victoria2125, Malaysia8860 et al
225E Extensive on multiple backgrounds
225G LvivN6_VxX with syn413K, UkDnip273 (GgT mix wt), H9N2
225G RomaISS1897 & 1941, EgyptVacsera138 (300S) ex225E (Gga)
225E+226R Russia (3), GermanyBY74, swMX4
226R Trabzon01 (Turkey), et al
227A swOR4060_2009_12_31, 1918
227V RomaISS50
227G Utah20 with wt mix
229R synonymous (AGg) swMX04 (225G, 226R)
230I Wisc0337_2009_12_15, H5 Gharbiyah 80% CFR, H9N2
231D Ankara05, OSAKA2143, H9N2 2008
231N CalifVRDL36
231K Wisc0853, Wisc1915, Wisc2337
232Y synonymous (TAc) Florida30, PuertoRico51, H9N2, H5, S9, S7, M7, Sask
233Y synonymous (TAt) AthensINS85, Hiroshima645, H9N2 2008
233H NC Duke (5, wt, 225G, 225N), AZ17 & Australia6
235A CatNS7632, CalifVRDL55
236V Eng93120020, ENG645, H9N2
237I Cal_SDINS69, England (2), Russia (4), Asia (2)
237L Wisc0936 (214Q), 1918, H5, tn
237V synonymous (GTg) Pennsylvania31, H9N2 (TTg), M7 (CTg)
238D Kaliningrad01 (225E+226R), tn
238K Wisc2485 (225E), Spain (2), China, swOR4060, H5, H9N2 2008
238E synonymous. Extensive and recently growing
239P synonymous (CCt) ENG621, swOR4060_2009_12_31
239P synonymous (CCa) Ancona508PG, Russia180, Australia60
240G synonymous (GGg) DC_INS24, H9N2, S9, S7, M7, Sask
241D synonymous (GAt) CatS1943, tn
241G NH17, ENG93040048
241E China22811
242K synonymous (AAg) swOR4060_2009_12_31
244I ThaiCU_H9
244T synonymous (ACt) CatS1935, CatS2120

The truth is in the sequences.

via email from NS1 -

Our analyses are intended to provide the most straightforward explanation possible . . . but as you must realise, the backing science of Influenza is far from robust. Simplicity is simply not attainable. Though the community produces thousands of point studies with valuable content data, a lack of cohesive framework results in frequent knowledge gaps. We are working to bridge those gaps, but today’s tools and the scarcity of data unfortunately limit the scope.

H5N1 and H9N2 are the two Influenza A serotypes considered most capable of reaching human pandemic status. Each is on record as zoonotic. H5N1 has been an active, but limited, contributor to ΣPF11. Throughout the current human pandemic, H9N2 has provided consistent influence as well. In the most recent sequences, a new trend is emerging as H9N2 accelerates to become a dominant contributor, especially on the cross-linked backgrounds.

If you’re able to review the idea of Influenza Flux at, you’ll begin to understand why an emergent contributor (H9N2) to a presently adapting viral reservoir is important. Every new combination presents the human immune system with a potentially separate challenge. An advancing Avian Influenza donor reservoir introduces new genetic material that is quite valuable to the virus, but quite dangerous to humans. Until the pandemic viral reservoir reaches a level of stability, an Omega state, the clinical outcomes may be highly variant with symptoms and outcomes that are beyond the normal parameters of seasonal influenza.

In a word, the pandemic virus is “confused”.

That’s what a pandemic is: a virus that doesn’t belong in humans, but really wants to belong. And, as you’ve seen, a pandemic reservoir is willing to do some work to become capable. This reservoir will continue to produce “confused” symptoms and “confused” outcomes until some reasonable stasis is achieved with the human host.

Yes, advancing H9N2 influence will be more of a problem. An accelerating donor pool from an Avian Influenza serotype is more likely than not to prolong the adjustment period.

Malaysia: Cluster & Deaths = 80


54 yo (Mother)
Adm: 3/30
Notes: Diabetic
DOD: 3/31

29 yo (Daugher)
Adm: 3/30
Notes: Pregnant, baby saved, not infected
DOD: 4/2

March 02, 2010

Woman Latest H1N1 Death

KUALA LUMPUR, March 2 (Bernama) -- A 22-year-old woman died of H1N1-related illness at the Universiti Sains Malaysia Hospital (HUSM), Kubang Kerian, on Sunday.

Health Minister Datuk Seri Liow Tiong Lai said today the woman was admitted to the hospital on Feb 15 after having fever and cough for eight days.

She was treated at a private clinic and referred to the hospital the same day.

She was confirmed to be infected with Influenza A (H1N1) on Feb 16 and admitted to the intensive care unit (ICU) after suffering lung complications the following day, Lion said in a statement.

She died two weeks later and the cause of death was recorded as septicaemic shock with acute respiratory distress syndrome secondary to H1N1 infection.

Prior to this, the H1N1 death toll was 77.

Liow said although the H1N1 infection in this case was said to be secondary, it showed that although the spread of the disease was low, it could cause death if not treated early.

"Although not many H1N1 deaths occur now, the Health Ministry wants to stress that the disease is still active in Malaysia and hopes that the society will continue to adopt preventive measures to contain the disease," he said.


hat-tip RoRo

Malaysia: H1N1 Cluster (Mother & Daugher) Die

UALA KUBU BARU: A 54-year-old woman and her 29-year-old daughter died of Influenza A (H1N1) related illnesses at the Malacca Hospital on March 31 and Friday respectively.

Health Minister Datuk Seri Liow Tiong Lai who confirmed the cases here Saturday, said both deaths were due to complications and were not direct H1N1 deaths.

Currently, the total H1N1 death remained at 77 cases, excluding the latest two cases, he told reporters after being briefed by the Kuala Kubu Baru Hospital staff.

Liow explained that the woman who had diabetes tested positive with the H1N1 virus when she was admitted at the hospital on March 31.

It was her diabetes, he said that had led to the complication of severe metabolicacidosis, causing an infection to the kidney and its eventual failure.

“Therefore, her death was due to diabetes complication,” he added.

The victim’s 29-year-old daughter was 36 weeks pregnant and was admitted on the same day at the hospital where she was diagnosed with Foetal Distress Syndrome. Later she showed symptoms of influenza-like illness (ILI) and tested positive with H1N1.

Urging the public not to panic, Liow said it was not a second outbreak of the virus.

He, however, said the ministry would issue a media statement every Wednesday or update on the situation to the media regularly.

“I hope everyone would take care of themselves and not to be in a crowd if they have fever and cough,” said Liow, reminding hospital management and medical officers to be on alert for suspected A(H1N1) cases.

Meanwhile, BERNAMA reported Education director-general Tan Sri Alimuddin Mohd Dom urging schools to take preventive measures to check the spread of A(H1N1).

“I urge schools to refer to the Education Ministry circular as the directive remained the same as that issued last year,” he told reporters after the opening of the National Co-curriculum Gala 2010 by Deputy Prime Minister Tan Sri Muhyiddin Yassin at Kem Tangok in Bachok, Kelantan here Saturday.

Alimuddin said the Health Ministry reported a rising trend for H1N1 since three weeks ago with 50 positive cases weekly.

Liow had said that there were 10 influenza like illness (ILI) cluster cases reported in Kelantan, Perak, Kedah, Selangor and Malacca last week.

They were at SK Selat Bagan Nyior, Pulau Dayang Bunting, Langkawi (48), SM Teknik Langkawi (43), Purnama Beach Resort, Pulau Pangkor (31) and SMK Langkawi Pulau Tuba, Langkawi (30 cases).

Hat-tip tetano

Malaysia: Schools Urged To Take Preventive Measures Against H1N1

2 hours 39 minutes ago

BACHOK, April 3 (Bernama) -- Director-General of Education Tan Sri Alimuddin Mohd Dom has urged schools to take preventive measures to check the spread of Influenza A H1N1.

"I urge schools to refer to the Education Ministry circular as the directive remained the same as that issued last year," he told reporters after the opening of the National Co-curriculum Gala 2010 by Deputy Prime Minister Tan Sri Muhyiddin Yassin at Kem Tangok here today.

Alimuddin said the Health Ministry reported a rising trend for H1N1 since three weeks ago with 50 positive cases weekly.

Health Minister Datuk Seri Liow Tiong Lai said there were ten influenza like illness (ILI) cluster cases reported in Kelantan, Perak, Kedah, Selangor and Melaka last week.

They were at SK Selat Bagan Nyior, Pulau Dayang Bunting, Langkawi (48), SM Teknik Langkawi (43), Purnama Beach Resort, Pulau Pangkor (31) and SMK Langkawi Pulau Tuba, Langkawi (30 cases).

Georgia (USA): Health officials urging H1N1 vaccination

Apr 2, 2010

By Johnny Jackson

State health officials are encouraging all residents to consider getting vaccinated against the novel Type-A H1N1 influenza virus.

H1N1 infection activity has been on an upward swing throughout the state this spring, according to Hayla Hall, risk communicator for District 4 Health Services, which includes Henry County. Hall said the virus has been associated with three deaths in Henry County alone, so far in 2010. The most recent death, a 51-year-old, occurred last week.

The Southeast region, compared to other parts of the country, has a smaller percentage of residents who have been vaccinated, according to a report released Friday by the Centers for Disease Control and Prevention (CDC).

The CDC’s Morbidity and Mortality Weekly Report revealed that during the period between October 2009 and January 2010, Georgia had the least H1N1 vaccination coverage among children ages six months to 17 years.

The report noted that Georgia’s rate of coverage for children during that window of time was 21.3 percent, compared to a nationwide median of 36.8 percent, and that only 15.3 percent of Georgia adults were reportedly covered by the H1N1 vaccine, compared to a 20.1 percent median.

Additionally, Georgia continues to be listed on the CDC’s Weekly Influenza Surveillance Report as one of a handful of states with regional influenza activity. Last week’s list included Alabama and South Carolina, both states having low rates of vaccination coverage among adults but higher coverage rates among children.

“The disease rates among children are high, but our death rates among adults — especially adults with underlying health conditions — are worrisome,” said Hall. “It is very important for people who are at high risk to get vaccinated.”

Hall said spring break is an opportune time for parents to have their children vaccinated against H1N1, and get the vaccination for themselves.

Health officials saw near-large scale H1N1 infections last spring and fall, and “we’re starting to see it coming back,” Hall said.

She said officials have continued to monitor the apparent rise in infections lately. She noted that the Georgia Department of Community Health recently reported 16 hospitalizations and one death associated with H1N1, for the week March 21-27.

The CDC recommends people practice good personal hygiene to stave off contracting H1N1, by washing their hands with soap and water, covering their nose and mouth when sneezing or coughing, and avoiding touching the eyes, nose, and mouth.

Residents can also find what facilities have the H1N1 vaccine available by using the Georgia Division of Public Health’s online H1N1 Influenza Vaccine Provider Locator, at

Malaysia: Mother, daughter die from H1N1 (2) articles

Apr 3, 10 4:39pm

The Health Ministry confirmed today the death of two persons, a mother and daughter in Malacca, from the Influenzae A(H1N1 virus) this week.

In a statement today, Health Minister Liow Tiong Tai said a 54-year-old woman was warded on March 30 with an 'Influenza-like Illness' (ILI).

Mother and daughter die of A(H1N1) illnesses
Saturday April 3, 2010 MYT 6:34:00 PM
A woman and her daughter have died of A(H1N1)-related illnesses at the Malacca Hospital on March 31 and April 2 respectively, said Health Minister Datuk Seri Liow Tiong Lai.
More to come:


WHO Chart: Southern hemisphere circulation of influenza viruses

Graph produced: 30 March 2010

Malaysia: H1N1: Take precautions, people told


By Annie Freeda Cruez

KUALA LUMPUR: At least 145 schoolchildren from several schools were reported to be suffering from suspected influenza A (H1N1) in another 10 new cluster cases reported within four days of this week.

Health Minister Datuk Seri Liow Tiong Lai said the cases whose victims, included primary and secondary school children, were reported in Kelantan, Perak, Kedah, Selangor and Malacca.

Another 48 victims included trainees at a national youth institute, residents in Jalan Jasin-Merlimau, staff of Purnama Beach Resort in Pulau Pangkor and workers of Madrasah Bustanul Ulum Abu Bakar in Malacca (see table).

Throat swabs have been taken from all of them who came to government hospitals and health clinics with influenza-like illness (ILI) to ascertain if they were victims of H1N1.

In view of many cluster cases, especially among schoolchildren and those in institutions, Liow called on parents to adhere to the following measures, namely:

- Schoolchildren with fever, cough and sore throat must get immediate medical treatment and remain at home. They are not to go to schools or universities. These students can only go to schools or colleges once they have fully recovered;

- They must wash their hands regularly with soap and water;

- They must cover their mouth and nose when coughing or sneezing and use face masks to avert spread of fever, cough and sore throat to other family members;

- They must adhere to the cough and sneeze etiquette at all times by using tissue or handkerchief. Throw used tissues into the rubbish bin and do not share used items with others, and;

- Take plenty of fluid, eat a balanced diet and have enough sleep.

Liow urged those who came in contact with people with H1N1 or ILI to adhere to social distancing, besides washing their hands with soap and water or using hand sanitisers after coming into contact with patients and touching things in public places.

"I call on the people to lead a healthy lifestyle by doing regular exercise, eating healthy and nutritional food, drinking lots of water and ensuring they have sufficient sleep."

He said those in the high-risk category, especially pregnant women and children, should take extra precautions so as not to be infected.

He also cautioned kidney failure patients, those with chronic diseases and individuals with morbid obesity to get themselves vaccinated against H1N1.

"High risk group people can get themselves vaccinated at any of the 104 government facilities," he said, adding that front liners must ensure that they were protected against the disease.

Liow reminded Malaysians that due to limited doses of vaccination available, it was on a first-come-first-serve basis.

"I must stress that the virus is still spreading very actively in Malaysia although the situation is still under control.

"It's important that Malaysians take all precautions to prevent being infected with the disease."

He added the pandemic was seeing an increase during the past three weeks, with an average of at least 50 positive cases being reported every week compared with 20 cases a week in January and February. Between May last year and April 1, a total of 12,688 people were infected with the diesease.

As of Thursday, 380 people had been warded in hospitals nationwide, with 32 of them confirmed positive for H1N1.

The death toll stands at 77.

Malaysia: H1N1 - Third Kedah school told to close


LANGKAWI: Sekolah Menengah Teknik here has been ordered closed for three days from yesterday after 86 of its 616 students showed symptoms of influenza-like illness (ILI).

The school is the third in Kedah to do so to prevent a possible spread of the virus, a state health department said.

On Wednesday, SMK Langkawi Pulau Tuba and SK Bagan Selat Nyiur, both in Langkawi, were ordered closed for five days days after a number of their students showed symptoms of ILI.

Symptoms of influenza A (H1N1) and ILI are similar and they include fever, cough, sore throat, body ache, headache, chills and fatigue with some reporting diarrhoea and vomiting.

Malaysia: H1N1 - Health Ministry on high alert

Alert over new cluster cases
By Annie Freeda Cruez
KUALA LUMPUR: New influenza A (H1N1) cluster cases have been detected throughout the country, putting the Health Ministry on high alert. And for the first time, staff of a government hospital were also infected.

Between March 21 and 27 alone, 83 people in Selangor, Malacca and Terengganu were found to have the virus.

Health director-general Tan Sri Dr Ismail Merican said these cluster cases indicated that the H1N1 virus was still active. He, however, said the situation was under control.

Of the 83 people, 15 were staff of Hospital Serdang in Selangor, Sime Darby Merlimau Estate in Malacca (16), Madrasah Tahfiz Raudatul Muslihin Masjid Tanah in Malacca (31), IKM Jasin Malacca (7), Rumah Anak Yatim Vidyalaya Kuala Kubu Baru (9) and Sekolah Menengah Agama Rantau Abang in Dungun, Terengganu (5).

Dr Ismail said clinical analysis of throat swabs taken from confirmed victims of the disease showed no signs of a second wave.

However, the risk of a second wave among the people was still high due to them being susceptible to the infection.

On March 27, 371 people were admitted to 38 government and seven private hospitals nationwide with influenza-like illnesses. Of the total, 25 were found positive for H1N1 and eight are in the intensive care unit.

No new deaths have been reported.

Dr Ismail also called on the people to alert the nearest district health departments if they know of individuals or cluster of people with symptoms of the disease.

On the Kuala Kubu case where 59 pupils of Sekolah Jenis Kebangsaan (Tamil) Kuala Kubu Baru were placed in home quarantine after 47 were found with H1N1, he said only one was confirmed positive.

Two pupils are waiting the outcome of laboratory results while another 15, who were admitted with influenza-like illness, were discharged and were now in home quarantine.

Thirty-five other pupils have recovered from their illness but have been told to return to hospital if they had a recurrence of the symptoms.

"Parents of these pupils have been told to closely monitor them."

Malaysia: H1N1 Cases On The Rise

April 02, 2010 22:23 PM

KUALA LUMPUR, April 2 (Bernama) -- The Influenza A(H1N1) pandemic has shown signs of a resurgence, with an average of 50 cases a week in the past three weeks compared to 20 cases per week in January and February, Health Minister Datuk Seri Liow Tiong Lai said.

There were 12,688 cases reported so far this year, he said in a statement.

He said 380 patients with Influenza-like Illness (ILI) were still being treated in hospitals nationwide but the death toll remained at 77.

"Throughout the week, 10 ILI clusters have been reported in Kelantan, Perak, Kedah, Selangor and Melaka," he said.

As the clusters involved mostly schools, Liow advised students and their parents to practice preventive measures and seek early treatment should they experience ILI symptoms.

Friday, April 2, 2010

Silobreaker Widget

Move the mouse over the dots for more information.

Vietnam: 25 yo Hanoi: Battle for survival for pregnant women three times 'encounter' death

She and her husband on the Marine Institute, with grandmothers and boys more than 4 months


The patient rooms are always three doctors on duty day and night, regularly monitor indicators, adjust all sorts of machines plugged into the patient. Not to mention large numbers of foreign health workers in disease prevention and ran off to get supplies ... Hundreds of health workers to join treatment cases.
According to Associate Professor Nguyen Gia Binh, the patient was saved thanks very much on the method of continuous dialysis with special effect filters, a new method of Japan. Prior to the survival of patients, doctors decided to try this new approach to the internal adsorption toxin circulating in the blood, reducing the inflammatory reaction and damage organs.

He also said that this method is widely used in Japan, treatment of all infections, viral ... However, this is the first application on bird flu patients.

"A patient's survival will open a new direction in the treatment of patients with multiple organs failure due to infection of H5N1, H1N1 ... The death rate in patients with multiple organs failure is very large, up to 90 %, even 100%, "said Associate Professor Binh

However, the cost of this technique is also very large, each filter costs $ 3,500, but patients often use 3-5 per fruit. In the case of patients Cards, treatment costs up to $ 10,500, equivalent to 200 million.

However, patients will be completely free, as prescribed by the Ministry of Health. While the filter is located in specialized hospitals cooperation project with Japan, should also free.

Vietnam: Survival of patients severe influenza A/H5N1 by dialysis

[A bit more on the 25 yo from Hanoi, that successfully beat H5N1]

Dan - good luck this case the patient T. Nguyen Thi Thu (25 years) in Soc Son, Hanoi. This is influenza A/H5N1 patients had complications viscera failure was saved by using results filtering method was first applied in Vietnam.

Ms. T. infected after the family discovered dead chickens culled away. However, after five days to onset of symptoms of cough, high fever, severe shortness of breath, the pale, she moved to New Bach Mai Hospital (on 10-3).

The tests showed that the disease has turned the organ failure: respiratory failure, circulatory failure, kidney failure, blood clotting disorders, metabolic disorders, severe infections.

In the treatment of patients influenza A/H5N1, scientists have warned very clearly: Tamiflu works well when used within 48 hours after virus penetration body. Accordingly, Dr. Nguyen Gia Binh - Dean of intensive care, Bach Mai hospital - because she said T. too late to hospital, five days after the influenza A/H5N1 virus, so treatment with antiviral drug Tamiflu have very little effect. Not to mention, with a weak condition after birth (she is raising children Vol 3 months), patients face a high risk of death.

The doctors have decided to combine the treatment with Tamiflu use continuous dialysis method, using special filtering effect adsorption of toxins in the blood reduces the inflammatory response.

After 10 days of treatment, patients used three filtering effect and gradually recovered health. This morning, Ms. T. was discharged.

This is influenza A/H5N1 patients had complications viscera failure was saved by using results filtering method was first applied in Vietnam. It is known that adsorption filter result is the invention of Japanese scientists, effects and filters to keep the toxins circulating in the blood, reduces the organ injury. Price per fruit is 3.500USD filter.

U.S. influenza vaccination programs require further expansion

Coverage with the influenza A (H1N1) 2009 monovalent vaccine was less than 40% among health care workers in the United States, and varied considerably from state to state in the public, according to two CDC reports published today.

Data for the 2009-2010 influenza season indicated that among a nationally-representative cohort of 1,417 health care workers, seasonal influenza vaccination coverage was 61.9%, and influenza A (H1N1) vaccination coverage was 37.1%. The findings were published in the Morbidity and Mortality Weekly Report.

Occupational requirements for vaccination were linked to a three- to eight-fold increase in coverage, CDC officials wrote.

The seasonal vaccination coverage rate among health care workers was the highest ever, but it is still not sufficient, according to CDC officials. CDC recommends that influenza vaccination coverage should be prioritized by health care administrators.

A second analysis in the same issue examined influenza A vaccination uptake data from the Behavioral Risk Factor Surveillance System and the National 2009 H1N1 Flu Survey.

Data collected by CDC from November 2009 through February 2010 indicated that as of the end of January 2010, 23.9% (range, 12/9% to 38.8%) of U.S. adults and children older than 6 months had been vaccinated against influenza A (H1N1).

Among children aged 6 months to 17 years, coverage was 36.8%. For adults 18 years old or older, the rate was 20.1%.

State-by-state analysis indicated that coverage ranged from 19.4% in Mississippi to 57.5% in Rhode Island.

Harris KM et al. MMWR. 59:357-362

Lu PJ et al. MMWR. 59:363-368

Georgia: Coweta - Children hospitalized with breathing troubles

April 01, 2010

Coweta County authorities remain unsure what caused three children in the Shoal Creek neighborhood to have breathing difficulties and end up in an Atlanta hospital Wednesday, two of them flown by helicopter ambulance.

The Coweta County Fire Department's Hazardous Materials unit was dispatched to 153 Hazel Ridge Drive, in the neighborhood off Highway 34 East, after receiving reports that three children may have stopped breathing, according to Assistant Fire Chief Todd Moore.

"We don't receive these type of calls every day," said Moore. "From a fire department standpoint, we were initially looking at a possible environmental-type emergency."

Upon their arrival, they found the children conscious and ambulatory. They were immediately placed into awaiting ambulances for further evaluation.

The Haz-Mat crews used air monitors to check the residence for explosive gases and volatile organic compounds but found none, according to the assistant fire chief.

Two of the children were flown by air ambulance to Children's Healthcare of Atlanta hospital while the third child was transported by ground ambulance to the same location, according to Moore.

The incident also remains under investigation by the Coweta County Sheriff's Office.

Sheriff's Major James Yarbrough said Wednesday that sheriff's office officials remain unsure what caused the children's breathing difficulties. No criminal charges have been filed.

Georgia: H1N1 District 4

10 locals hospitalized for swine flu since May
March 31, 2010

Georgia is seeing a spike in swine flu hospitalizations, Associated Press reports. Georgia has recorded the most hospitalizations in the nation for three straight weeks.

"We are keeping up with the numbers," said Hayla Hall, spokesperson for District 4 Health Services.

"We have had 70 hospitalizations since May 2009" in District 4, she said. Ten of those were Coweta residents, she said.

"We have had 11 total deaths for the district since May 2009," said Hall. "Six of the 11 have occurred since January of this year. Two Coweta residents have died from influenza-associated illness."

One passed in October 2009, the other died earlier this month.
"Unfortunately the increase in hospitalizations is in older adults with underlying medical conditions."
There have been a total of 1,012 H1N1 hospitalizations and 72 influenza associated deaths in Georgia since April 2009.

District 4
District 4 Public Health promotes wellness and protects the health and wellbeing of all people who live, work, and play in Butts, Carroll, Coweta, Fayette, Heard, Henry, Lamar, Meriwether, Pike, Spalding, Troup and Upson Counties of Georgia.

U.S. Georgia: H1N1 On The Rise (3 articles)

H1N1 flu on the rise in the Georgia

Florida, Georgia, and Alabama are the three states on the CDC’s radar because of adult hospitalizations from the H1N1 flu

By Romney Smith
Tuesday, March 30, 2010 at 9:39 p.m.

The Center for Disease Control says adults in Georgia who are not diagnosed against the H1N1 virus are being hospitalized at the highest rate in the country.
The CDC is helping the Southwest Georgia Health Department investigate why so many adults are being hospitalized with the H1N1 flu. The CDC is looking at items like vaccination status, sex, race, underlying health conditions, and more to figure out if a pattern exists.

Dr. Brenda Greene with the Southwest Georgia Health Department has a theory on why we may be seeing an increase in hospitalizations. “We saw a lot of H1N1 in the fall and by the time the vaccine arrived people didn’t seem as alarmed by it because it had been circulating for quite some time at that point. That’s our theory at the moment, but we have no assurance of that” says Greene.

Rates of US Pandemic Influenza Vaccination Are Lowest in the South
April 1, 2010
At the end of January, 21.3% of the children of Georgia had been vaccinated against the pandemic A (H1N1) influenza virus, the lowest such immunization rate in the nation, the US Centers for Disease Control and Prevention (CDC) announced today.

In addition, when it comes to all individuals who were vaccinated, Georgia ranked fifth from the bottom, at 16.6%.

Lower vaccine uptake in Georgia and other southeastern states may help explain why the pandemic virus has produced an upswing in disease and hospitalization there over the past 2 months, Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases at the CDC, said at a press conference today. However, Dr. Schuchat noted that the rebound of the virus in that region also may represent the "third wave" of disease that public health officials have feared.

"It's possible (the rebound) is a herald for other states," she said.

Nationwide, the median vaccination rate for pandemic influenza was 23.9% for all individuals, 20.1% for those aged 18 years and older, and 36.8% for children aged 6 months to 17 years, according to the April 2 issue of the Morbidity and Mortality Weekly Report. The performance of individual states and regions varied widely. Rhode Island led the country, with an immunization rate for all individuals of 38.8% — 3 times that of Mississippi, which ranked last. The highest rates in all 3 categories occurred in New England, and the lowest in all categories were in the 5-state region consisting of Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.

The southeastern states, including Georgia, posted the second-worst immunization rate for all individuals, at 20.1%. Georgia's neighbor Alabama had a total immunization rate of 15.7%, tying the state with Missouri for third worst.

Georgia, Alabama, and South Carolina have experienced a recent uptick in influenza-related illness, reporting regional influenza activity for the week ending March 27 that was one step below widespread activity. Hardest hit is Georgia, which has had more pandemic-related hospitalizations than any other state lately, and the most it has experienced since last October, when the virus was producing its second wave of illness nationwide. Since December 1, the virus has caused 357 hospitalizations and 22 deaths in that state, Dr. Schuchat said Thursday.

One reason why vaccination rates might be lower in Georgia and other southeastern states is that the second pandemic wave hit that region earlier than it did the rest of the country, Dr. Schuchat explained. By the time the pandemic influenza vaccine became available in large quantities, the wave had already passed, and demand for the vaccine waned as a result.
Morb Mortal Wkly Rep. 2010;59:363-368.

West Georgia Flu Update: 39% of People Hospitalized Require Breathing Machines to Stay Alive
April 1, 2010

New data shows that nearly 40 percent of those hospitalized for flu illnesses in West Georgia require breathing support to stay alive, according to Pam Fair of the West Central Health District.

It is mostly those with chronic illnesses that end up hospitalized for flu in West Georgia.

This news comes as the rest of the state has seen record highs in hospitalizations since September, outpacing the rest of the nation. Most of those hospitalized are unvaccinated adults.

Free H1N1 vaccines are still available at the health department: 2100 Comer Ave., 2nd Floor, in Columbus.