News that an Iowa cat has been diagnosed with swine flu has sparked a new round of concerns, as pet-owners worry both that their furry companions could get sick, and that their pets could pass the virus on to other humans. The 13-year-old, mixed-breed cat showed the symptoms of lethargy, sneezing and coughing typical to sick cats [ABC News]. The veterinarians who treated him say that several people in the cat’s home had been experiencing flu-like symptoms, and lab work confirmed that the feline had the H1N1 virus.
Happily, the cat is expected to make a full recovery. But both vets and public health officials are rushing to reassure the public that one sick cat probably does not indicate a coming crisis. While it’s possible that more cats will be diagnosed with the swine flu, vets point out that the virus was circulating for more than six months before the first cat case was discovered, indicating that the virus probably doesn’t jump from species to species very easily. Doctors also note that there’s very little chance that a cat will spread the virus to humans: Even when inter-species transmissions do occur, the H1N1 virus seems more likely to move from humans to animals, rather than the other way around [HealthDay News].
There have been no reported cases of dogs catching the virus, but there is one type of pet that is known to be vulnerable. Ferrets are generally susceptible to the seasonal flu, and the AP reported Wednesday that H1N1 infection has been confirmed in two ferrets, one in Nebraska and the other in Oregon. “Not only can they be infected with the flu but they are clearly able to transmit the flu back to people,” Treanor said [HealthDay News]. But the bottom line appears to be: Unless you’re a ferret-owner, you probably have nothing to worry about.
Related Content:
80beats: This Week in Swine Flu: How It Kills, Lawsuits, and a Pregnant Woman’s Story
80beats: This Week in Swine Flu: Vaccines Arrive, and Doctors Combat Myths
80beats: This Week in Swine Flu: Pregnant Women’s Concerns & Hospital Woes
Image: flickr / theogeo
As swine flu is now prevalent in 41 states, doctors are getting plenty of chances to study the workings of the disease. They now know that in severely ill patients, intense inflammation in the lungs prevents oxygen from being tranfered to the blood stream. Says physician Robert Fowler: “Most patients are still able to take breaths, but these breaths are ineffective” [Science News]. That oxygen deprivation can cause widespread organ damage.
The speed with which swine flu patients can go downhill marks the H1N1 virus as strikingly different from the seasonal flu virus, doctors say. “In severe cases, patients generally begin to deteriorate around three to five days after symptom onset. Deterioration is rapid, with many patients progressing to respiratory failure within 24 hours, requiring immediate admission to an intensive care unit” [Reuters], says World Health Organization doctor Nikki Shindo.
Doctors say that severely ill patients should promptly be put on breathing machines and given antiviral drugs like Tamiflu. In cases where patients’ respiratory systems have already crashed, some doctors are trying a treatment called extracorporeal membrane oxygenation, in which blood is extracted from each patient and passed through a machine that adds oxygen [Science News].
(more…)
Swine flu vaccines have arrived! Or more accurately, limited amounts of the first available vaccine, a nasal spray, have been delivered to distribution points around the country, and several states began vaccinating health care workers and young children on Monday. It’s not a moment too soon: The Centers for Disease Control and Prevention have announced that flu is now widespread in most of the United States. The infections are “overwhelmingly” pandemic H1N1 influenza, commonly known as swine flu. The flu season generally lasts well into May, so many months of uncertainties lie ahead [Los Angeles Times].
CDC director Thomas Frieden says that so far, vaccine “demand is outstripping supply, but we expect that fairly soon supply will be outstripping demand.” … Over the next two to three weeks, tens of millions of additional doses will become available [Los Angeles Times]. The injectable form of the vaccine will be ready for distribution next week.
Now that the vaccines have been successfully hustled off the assembly lines, the next daunting challenge for public health officials is convincing people to go get vaccinated. Myths and worries about the vaccine have spread on talk radio and anti-vaccine Web sites [The New York Times], with even celebrities like Bill Maher unhelpfully chiming in via Twitter. At a Tuesday press conference, Frieden strongly refuted one of the most commonly voiced concerns: that in rushing the vaccine through production, it wasn’t properly tested for safety.
(more…)
A team of researchers recently discovered that Tamiflu, the leading flu-fighting drug, is accumulating in rivers downstream from sewage-treatment plants in Kyoto. How is this possible? Tamiflu’s active ingredient, oseltamivir phosphate, is excreted in the urine of people taking the medication. Concerns are now building that birds, which are natural influenza carriers, are being exposed to waterborne residues of Tamiflu’s active form and might develop and spread drug-resistant strains of seasonal and avian flu [Science News]. The resistant virus strains would be of the conventional seasonal or avian flu variety, not the H1N1 swine flu strain that is currently pandemic in humans. Seasonal flu, however, kills thousands of people each year.
Study coauthor Gopal Ghosh explains that the team took measurements during normal flu season, and found concentrations that seem “high enough to lead to antiviral resistance in waterfowl” [Science News]. Computer models show that oseltamivir phosphate will survive sewage treatment, but it should break down when exposed to sunlight and its concentrations should decrease by half every three weeks. The high concentrations were found during a period where 1,738 flu cases were reported in Kyoto, according to the study, published in the journal Environmental Health Perspectives. In the United States, Tamiflu is only recommended for the very sick or those with compromised immune system, while Japan has a more liberal policy.
Related Content:
80beats: Fish Are on Antidepressants, Allergy Meds, and a Host of Other Pharmaceuticals
Discoblog: Prozac Ocean: Fish Absorb Our Drugs, and Suffer for It
Discoblog: What You Need to Know About Drug Water
DISCOVER: Drugs, From Development to Testing to Marketing to Drinking Water
DISCOVER: Italians Find Drugs in River Sewage
Image: flickr / law_keven
As the nation prepares for a massive vaccination campaign to protect the most vulnerable people from the swine flu virus, scientists are preparing to combat public fears over the vaccine. Scientists worry that the public (or at least the activists who are convinced, against all scientific evidence, that vaccines cause autism and other diseases) will misinterpret coincidental deaths as side effects of the vaccine.
As soon as swine flu vaccinations start next month, some people getting them will drop dead of heart attacks or strokes, some children will have seizures and some pregnant women will miscarry…. “There are about 2,400 miscarriages a day in the U.S…. You’ll see things that would have happened anyway. But the vaccine doesn’t cause miscarriages. It also doesn’t cause auto accidents, but they happen” [The New York Times], says Jay Butler of the Centers for Disease Control and Prevention.
The CDC is particularly focused on convincing pregnant women of the vaccine’s safety. A recent study in The Lancet reported strikingly high rates of death and of complications like pneumonia in pregnant women with H1N1 influenza. Pregnancy meant a fourfold risk of hospitalization, sometimes with a tragic outcome [The New York Times]. Experts note that pregnant women often avoid medications out of fear of harming the fetus, but say that these women should be among the first to get vaccinated for swine flu, and should swiftly start antiviral medications if they come down with the virus. To date, the virus has killed 28 pregnant women in the United States.
(more…)
Now that the first vaccines against swine flu are about to become available, scientists are busy working out the details of how the vaccines can best be administered. Researchers already knew that a single dose was sufficient to protect adults, and they’ve now found that one shot works for teenagers and children over the age of 10. But young children who have never had the flu or a flu shot, however, need two doses, they said…. Children 6 months to 9 years old received some protection from one shot, but not enough, so health officials will recommend that they get two shots 21 days apart [The New York Times].
At least 6 million doses of vaccine will be available the first week of October, federal health officials announced today, and this first batch is in the form of a nasal spray called FluMist. The intranasal vaccine has not been approved for children younger than 2, adults older than 49 or pregnant women, so it may go primarily to healthcare providers [Los Angeles Times]. Injectable vaccines should make it to doctors’ offices a week or two later.
New York State has taken the drastic step of requiring that all hospital, home health and hospice workers get the swine flu vaccine. Experts say the mandatory vaccination will protect not just the workers, but also their patients. But some workers are upset by the edict. Health workers’ union official Joel Shufro says the unions do not oppose vaccination “but we oppose a mandatory program,” he said. “This is: ‘You don’t get the shot, you’re fired’” [The New York Times].
(more…)
The big news in swine flu this week: Vaccines from four drugmakers have been approved for use in the United States, and with the companies’ production lines cranking there will be plenty to go around. Clinical trials have also shown that a single shot is enough to create a strong immune response, which means stockpiles will go twice as far as they would have if two shots were necessary. Said U.S. Health Secretary Kathleen Sebelius: “There will be vaccines for everyone.” … The first doses should be available within the next four weeks, according to the FDA [Reuters].
But as flu season is already ramping up, some people are wondering what they can do to protect themselves until the vaccine is available. One enterprising reporter decided to find out what her daily routine would be like if she wore a paper jumpsuit, mask, goggles, and gloves provided by a company called Flu Armor. But experts are reminding the public that face masks, which became a symbol of the initial outbreak in Mexico last spring, are really designed to stop the spread of droplets from the person wearing the mask, not to protect the wearer from viruses [Los Angeles Times].
The most effective preventive measure is also a simple one: wash your hands with soap often, or use an alcohol-based hand sanitizer. Experts note that hand-to-face contact has a surprising impact on health. Germs can enter the body through breaks in the skin or through the membranes of the eyes, mouth and nose [The New York Times].
(more…)
Let’s start with the good news: Clinical trials of the swine flu vaccines currently under production are showing that a single shot may be enough to protect a person against the H1N1 virus, rather than the series of two shots that was thought to be necessary. That means the vaccine supplies rolling off the pharmaceutical companies’ assembly lines will cover twice as many people. Experts say it should be possible to vaccinate — well before the flu’s expected midwinter peak — all the 159 million people that the Centers for Disease Control and Prevention estimate are in the high-risk groups: pregnant women, people under 24 years old or caring for infants, people with high-risk medical conditions and health-care workers [The New York Times].
In China, vaccinations are already underway, still Chinese health official Liang Wannian says the virus may well sicken tens of millions in the coming months. “The situation we face is not optimistic,” Liang said, noting that the virus had been found in all of China’s 31 provinces and regions [AFP]. While most cases won’t be severe, Liang says the sick could overwhelm the country’s hospitals and clinics.
While Chinese officials have said that vaccinations would start with high-risk groups, they also disclosed that people participating in the festivities of National Day on October 1st, which marks the 60th anniversary of the founding of communist China, will be at the front of the line. There are at least 200,000 official participants, plus thousands of security police. According to the BBC’s China analyst, Shirong Chen, they have been pushed to the front of the queue not just because it is a huge public event that carries national pride, but because all the top leaders and dignitaries will be in Beijing. The authorities cannot afford the political risk of any infection there [BBC News]. However, this prioritizing may leave less vaccine available for children, pregnant women, and health care workers.
(more…)
The week began with the news that Colombian president Alvaro Uribe had come down with swine flu while meeting with other South American leaders in Argentina. But Uribe is making a full recovery, and experts note that cases of the H1N1 flu are starting to taper off along with the influenza season in the Southern Hemisphere…. “All countries report that after mid-July, disease activity in most parts of the country decreased,” [Reuters], according to a U.S. government report.
Meanwhile, schoolchildren and college students across the Northern Hemisphere are heading back to school, and health officials are bracing for swine flu, round two. It’s already cropping up where conditions are right. Just as the football season is getting under way, Duke, Texas Christian and Alabama have reported cases of swine flu or of players experiencing flulike symptoms…. The strain tends to spread most quickly among young adults, who have not built an immunity to flu strains. Because the athletes share dorm rooms, cafeterias and sometimes unsanitary locker rooms, “it’s kind of an ideal situation for the flu,” said Artealia Gilliard, a spokeswoman for the Centers for Disease Control and Prevention [The New York Times]. Outbreaks were also reported at some colleges where women are attending sorority rush events before the start of classes.
Colleges have put a number of contingency plans in place to deal with outbreaks, including swine flu buses to spirit away the sick to infirmaries and drive-up vaccination clinics that will open as soon as vaccines are available, probably in early October. City education departments are also kicking their preventive machinery into high gear. On Tuesday, New York Mayor Michael Bloomberg announced that all primary school-age children in New York City will be offered free vaccines for seasonal and H1N1 flu this year [Reuters]. School officials in New York and elsewhere have said that they’re reluctant to close schools, as they did in the spring during the pandemic’s onset, because it disrupts parents’ work schedules and does little to halt the spread of the virus.
(more…)
Another day, another swine flu story: Amidst all the chatter, it can be hard to find the most reliable sources and relevant info. To keep you informed of the latest intelligence, 80beats will round up the news each week.
On Monday, the President’s Council of Advisors on Science and Technology issued an alarming report spelling out a “plausible scenario” for how the swine flu pandemic will play out during the coming flu season. The report estimated that the H1N1 virus could hospitalize 1.8 million Americans, potentially clogging emergency rooms and intensive care wards, and could kill up to 90,000 people in the United States. In a typical year, the seasonal flu virus kills about 35,000 Americans.
But on Tuesday, some public health officials walked back the report’s conclusions. One expert who helped prepare the report said that the numbers were probably on the high side, given that some weeks had passed since the calculations were finished in early August. “As more data has come out of the Southern Hemisphere, where it seems to be fading, it looks as if it’s going to be somewhat milder,” said the expert, Marc Lipsitch…. “If we were betting on the most likely number, I’d say it’s not 90,000 deaths; it’s lower” [The New York Times].
(more…)
Up to half of the U.S. population could contract swine flu this upcoming flu season, killing up to 90,000 people and hospitalizing 1.8 million, according to a report released by the President’s Council of Advisors on Science and Technology.
Americans lack immunity to the swine flu, which gives the virus the potential to infect more people than the seasonal flu generally does. And although many people who contract the disease might not show symptoms, and most would not be hospitalized, the pandemic would put a strain on the U.S. health-care system … because those patients could occupy between 50% and 100% of available intensive-care beds at the peak of the epidemic in affected regions, while ICU units normally operate close to capacity. Seasonal flu normally causes about 200,000 hospitalizations a year [The Wall Street Journal].
(more…)
Genetic “pieces” of the 1918 flu virus, which killed between 50 and 100 million people worldwide, were likely circulating between pigs and people two to 15 years before the pandemic struck, according to a new study published in Proceedings of the National Academy of Sciences.
Catch two different flu viruses at once and a new one can emerge, something scientists call reassortment. Birds are the ultimate origin of influenza viruses, but because pigs can catch both bird and human flu strains, they’ve long been recognized as a species mixing vessel [AP]. The research shows that lethal flu strains may be the result of such reassortment of pre-existing strains, not a sudden genetic “jump.” It’s a cautionary tale for those studying the current swine flu outbreak, say researchers, as the findings suggest that the swine flu virus could evolve slowly over many years into a more dangerous form.
(more…)
It’s unknown whether the swine flu virus will mutate to a more deadly strain in the coming year, but the federal government is preparing for the worst in case the pandemic continues to spread. At yesterday’s flu summit at the National Institutes of Health, Health and Human Services Secretary Kathleen Sebelius revealed the government’s provisions for a possible swine flu emergency.
The campaign to combat the swine flu is different from the strategy usually employed against the seasonal flu. One reason is that the swine flu appears to be most deadly to children and young adults, while the seasonal flu traditionally is most fatal to the elderly. Therefore, if mass vaccination becomes necessary, school-aged children will be among the first to be immunized; this likely will occur at school, in a manner reminiscent of the 1950s polio vaccination campaign. “We are likely to have a different target population,” Sebelius said. “We will be seeking partnerships with schools potentially and other vaccination sites.” Time will have to be spent writing consent forms so parents are not blindsided when schools ask to vaccinate their children, Sebelius said [Reuters]. States should also prepare a plan for closing schools if needed.
(more…)
Researchers have revealed that seasonal flu and swine flu cause different symptoms because they have different destinations in the body: the seasonal flu lodges itself mainly in the nasal passages, while the swine flu virus travels into the trachea and lung, and even makes its way to the intestines. It also replicates more quickly and causes more damage than the seasonal flu, according to a pair of studies published in Science.
Flu viruses wreak their havoc by binding to molecules on the surface of cells in mammals’ respiratory tracts, including humans. But the researchers found that the swine flu binds to surfaces that are unusually deep in the respiratory tract, such as the branches within the lungs known as bronchioles. The scientists used ferrets for the experiments because the animals respond to the flu much the way humans do. Research teams in the United States and the Netherlands found that the new H1N1 flu virus replicated more extensively in the respiratory tract, going to the lungs, whereas the seasonal flu virus stayed in the animals’ nasal cavity. The U.S. team also found that the new virus, unlike the seasonal one, went into the ferrets’ intestinal tract [Forbes], which explains the unusual symptoms of nausea and vomiting that some swine flu patients experienced.
Such information could prove crucial to the public health response to the swine flu, which so far has sickened more than 77,000 people worldwide, killing at least 332, according to the World Health Organization.
(more…)
In the first confirmed case of drug-resistant swine flu worldwide, a Danish patient developed resistance to Tamiflu, the antiviral treatment used for flu prevention and treatment. The patient recovered and did not appear to have passed the resistant strain to others. While a drug-resistant virus could make it harder to treat and prevent the spread of the flu, experts maintain that the isolated case is not a cause for alarm, and say Tamiflu is still effective against the swine flu.
A spokesman for Tamiflu manufacturer Roche says the Danish patient developed drug-resistant swine flu while taking the drug as a preventative to avoid the contraction of swine flu…. He was probably already infected with the virus, and resistance to the drug emerged because he was given the lower preventative dose [The Wall Street Journal]. This type of resistance is known as drug-induced resistance, as opposed to naturally occurring resistance, in which a strain itself mutates to become unresponsive to a medication.
The U.S. Centers for Disease Control and Prevention continues to recommend Tamiflu to treat the flu, along with another flu drug, Relenza. The World Health Organization also is expected to keep supporting the use of Tamiflu. Tamiflu-resistant strains of the seasonal flu have been found in Japan, which has used more than half the world’s supply of the drug each year. But those strains were weak and did not spread. A Tamiflu-resistant strain of the H5N1 bird flu was also isolated from a Vietnamese patient being treated with low-dose Tamiflu in 2005, but it also died out [The New York Times].
(more…)
