Swine Flu, the Influenza A variant which first made headlines around the world during 2009, has reemerged as a potentially severe threat within the Chinese city of Hong Kong in recent weeks. Since January 24th 2011 there have been 9 confirmed deaths due to Swine Flu infection in the city, and current Hong Kong Hospital Authority figures indicate that there are 38 patients in local hospitals seeking treatment for the disease.
Hong Kong is currently entering peak flu season after the coldest and driest winter on record. According to a recent study by doctors at the University of Hong Kong, the unusual weather conditions over the last few months have contributed to the spread of the disease as Influenza Type A variants thrive in cool, dry climates.
Swine Flu, which was initially identified in Mexico during April of 2009, has been responsible for approximately 18,000 deaths globally since it first appeared, according to the World Health Organization.
During the 2009 outbreak of the disease Hong Kong health authorities were placed on high alert; however, the major cause of Flu outbreaks in that year were not attributed to the Swine Flu Strain. This year over 90% of Flu cases reported in the city have been attributed to Swine Flu, which has posed concern to medical professionals in the region.
According to University of Hong Kong doctors the main threat posed by the Swine Flu Virus is with regards to the fact that it is radically different from other Influenza Viruses, with infected patients showing decreased levels of a vital antibody known as IgC2. The lack of this antibody in patients is making Swine Flu deadlier than other Flu strains this year, as the deficiency radically increases the chance of secondary infection from bacterial based illnesses such as streptococcus pneumoniae, and staphylococcus aureus.
Recently conducted studies have found that the Flu strain present in the city this year is a radically different variant from those seen in 2007 and 2008, but is much more similar to the 1918 Spanish Flu strain.
The Spanish Flu, which caused a global pandemic from 1917 – 1920, was responsible for an estimated 50 Million deaths world wide.
The latest reported Flu fatality in Hong Kong was a young boy, aged 14 months, who died in the Caritas Medical Centre located in Sham Shui Po. Presently it is unknown whether the child had contracted human Swine Flu, however if positively identified as the cause of death it would bring the total number of confirmed Swine Flu fatalities in the city to 10 since the middle of January.
The outbreak poses a grave concern due to Hong Kong’s status as a regional travel and shipping hub. An estimated 92,000 tourists and visitors flock to the city each day, pointing to the risk of the virus spreading overseas in its more virulent form.
It is not the first time that Hong Kong has seen the outbreak of a major infectious disease, with the SARS epidemic in 2003 originating in southern China eventually causing 775 deaths worldwide, of which 299 were in Hong Kong.
The total number of Flu cases within Hong Kong has been lower than expected since the start of 2011. However, according to health authorities this is primarily due to the fact that many local schools were closed over the Chinese New Year holiday. Health Authorities have warned that the incidence of flu cases will most likely increase as schools return from the break. The Centre for Health Protection controller, Thomas Tsang Ho-fai said that, based on past experience, any school based outbreak of the virus would most likely involve up to a dozen students.
The Centre stated that due to the risk posed to students, any school where a student has died from the Swine Flu virus should suspend classes for at least a week; going on to say that this rule should also be applied in the event that 100 cases of flu like symptoms are displayed within a single student body – even if there are no deaths.
Health Authorities in Hong Kong are currently recommending that any individual experiencing flu-like symptoms wear a surgical mask while outside the home, and consult a doctor as soon as possible. Any children displaying flu symptoms should be kept home from school.
In order to combat seasonal flu and the Swine Flu viruses the Hong Kong government is offering a vaccination subsidy scheme for qualified persons. More information can be found on the Hospital Authority Website.
Now that the summer is winding to a close, we can all start getting ready for flu season. Only problem is, it’s come early this year.
Influenza-like illnesses are on the rise in both Britain and the United States. The American Centers for Disease Control and Prevention (CDC) are reporting that influenza-like illnesses have been on the rise in the U.S. for the last six weeks and while the numbers of influenza hospitalizations are similar or below regular flu season levels, it’s still higher than expected for this time of year. Currently, 26 U.S. states are reporting widespread influenza activity. Across the pond in England, numbers of estimated cases are at 14,000 people, which is 5,000 more cases than the previous week.
Swine flu continues to affect every age group, with 79 reported outbreaks in English schools since the start of the fall term with 39 of those occurring in two areas and 49 pediatric deaths in America (pediatric medicine covers infants to adolescents). Swine flu also remains is a major concern for people with severe underlying medical conditions, such as leukemia, and expectant mothers.
Swine flu vaccines are of course being prepared to be rolled out later this year, with the WHO estimating production capacity at 3 billion doses per year. Thankfully, clinical trails indicate that only one dose is necessary to give immunity to older children and adults, but 3 billion doses per year still doesn’t cover the 6.8 billion people walking the earth right now. Given that many countries are reliant upon vaccine donations, Australia, New Zealand, Brazil, France, Italy, the United Kingdom, Norway and the United States have pledged vaccine donations for developing countries. Understandably, the WHO is open to similar contributions and support from other countries.
On a sadder note, a telephone survey carried out by Consumer Reports found that only 34% of U.S. Adults would definitely get vaccinated. Furthermore, only 35% said they plan to have their child vaccinated, with 14% decidedly against the idea of vaccinating their child. Of all the people who are currently undecided or opposed to getting vaccinations 63% said they wanted to build ‘natural immunities’. This is, unfortunately, a tragic misunderstanding with potentially fatal consequences, according to Dr. John Santa, the director of health ratings for Consumer Reports, “[y]our body produces exactly the same antibodies, whether it’s from a ‘natural’ infection or from a vaccine[.]”
While the vaccine is still in the mail, let’s take a quick moment to reflect on what we can all do to help us, and those around us, not get infected. Wash your hands! With Soap! Let’s be clear now, running half a second’s worth of water over your hands and not even glancing at the soap dispenser accomplishes absolutely nothing. Given that influenza is communicable either by direct person-to-person transmission (the genius next to you on the bus is coughing and sneezing on you), or through surface contact (someone sneezes on an object, then you touch the object and then your face), it’s always a good time to wash your hands.
It is also important that if you’re going to cough or sneeze that you cover your mouth. While this may seem like a simple enough thing to do, most people just don’t do it. If you’re going to use a tissue to cover your face when coughing or sneezing, cover your face with it and then make sure to throw the tissue away. Carrying around a tissue filled with germs isn’t good for anyone and it sort of makes you a disease vector. Should you not have a tissue at hand, cough or sneeze into the inside of your elbow. Given that the influenza virus can survive on the surface of objects, if have the flu and you cough all over your hands and don’t wash them immediately, you’re basically spreading the virus to every object you touch after that. Trust me, that’s a bad thing.
Please take care as we come closer to the regular flu season, especially now that children have gone back to school. It is important that we all make an effort to stay clean and not get sick, please, for the sake of us all, make sure that you know how to wash your hands and cover your face properly. More importantly, put your knowledge into practice. Stay safe, I’m off to wash my hands.
On the 11th of June, the WHO Director-General Margaret Chan announced that after a careful review of the available data and much discussion among both experts in the area and public health officials they have decided to raise the influenza pandemic alert level from phase 5 to phase 6, although the severity of the pandemic has so far only been assessed as moderate.
For those of us not well versed in buzzword bingo, what exactly does that mean? Well, influenza pandemics are divided into 6 phases; the first three phases are generally associated with preparedness to deal with an outbreak as well as response planning. Phases 4 through 6 are aimed at signaling the need for appropriate responses to an outbreak and also mitigation efforts. Phases 1-3 are indicative of animal infections and few animal-to-human infections, phase 4 means that sustained human-to-human transmissions have been observed and phases 5 and 6 relate to widespread human infections. To be specific, phase 5 is typified by the observed spread of the virus by human-to-human infections into at least two countries within one WHO region, warning that a full pandemic may be looming on the horizon. Phase 6, which is currently in effect, means that there is a full pandemic going on and is characterized by community level outbreaks of the virus in a country in a different WHO region in addition to phase 5 criteria.
So at the moment, our world is in the midst of a global pandemic where swine flu, also known as Influenza A(H1N1), is being communicated from person to person in multiple countries in various regions of the world, so of what importance is it when they say the pandemic is only of moderate severity? As it turns out, quite a bit. The moderate assessment is based on three things: firstly, most people recover from the infection without the need for medication or hospitalization; second, while there have been high prevalence rates in some local areas and institutions, the national level of infections are no greater than local seasonal influenza infection rates; finally, while a few medical facilities around the world are being stressed, the vast majority of hospitals and healthcare systems are coping well with the number of patients coming in. As of June 17th, there were a documented 39,620 cases in over 75 countries worldwide with only 167 reported deaths, it is important to keep in mind that the WHO may revise their assessment of the pandemic based on a number of things, including changes in the virus and the limitations of healthcare systems around the world.
In other swine flu related news, Brazilian scientists have noticed a new strain of the virus. Agence France-Presse reported on June 16th that after examining samples from a patient in Sao Paulo and comparing it with a sample of the A(H1N1) virus from California, a team of virologists at the Adolfo Lutz Bacteriological Institute isolated the genetic sequence of a variant of the virus, naming it A/Sao Paulo/1454/H1N1. Apparently the mutation in the virus is made up of changes to the specific protein which allows the virus to infect new individuals, raising concerns that the new strain may possibly be more aggressive than the current strain although it is unknown at the moment.
Normally influenza infection rates die down in the summer as the virus doesn’t cope so well with the increased heat. However, United States health officials are warning that because this year’s spring was especially cool and long, the country could experience a year-long flu season where infection rates are low in the summer and then pick up as summer turns to fall. A possibly more worrying piece of news is that there seems to be a large number of infections in healthcare workers in the United States because they haven’t been taking proper precautions with patients. A doctor from the U.S. Centers for Disease Control and Prevention (CDC) has said that patients coming into American emergency rooms need to be checked for flu symptoms and healthcare workers need to wear gloves, masks and eye protection when working with possibly infected patients, as infected workers may transmit the virus to other vulnerable patients elsewhere in the hospital.
On the lighter side, due to heightened awareness of a possible flu pandemic after the bird flu outbreak in Hong Kong 12 years ago, more funding and attention has been funneled into vaccination efforts and numerous pharmaceutical companies have begun work on a swine flu vaccine for the A(H1N1) virus already. A number of companies including Baxter International, CSL Ltd., Chinese company Sinovac Biotech, Novartis AG and Sanofi-Aventis SA are all working on vaccines. Sinovac has said it can finish clinical trials by the end of July, while Baxter indicates it could be able to start filling orders for a vaccine next month. Most companies are expected to make a vaccine available around the autumn time. Sanofi-Aventis has said that it will donate 100 million doses of it’s vaccine to the WHO in order to ensure that poorer countries have access to the vaccine during the pandemic. On the other hand, Novartis, the Basel, Switzerland based country has previously decided that it will not donate vaccine doses to the WHO and is instead looking at a tiered system of pricing to make sure that both rich and poor countries will have access to the company’s vaccine.
During this time it is important to take care of yourself and those around you. Make sure that you wash your hands frequently and if you feel flu-like symptoms, be sure to wear a mask and make a visit to the doctor as soon as possible. If you develop symptoms, or otherwise think you may have contracted the virus, please do not go to work, school or crowded places, avoid contact with others and be sure to cover your mouth with a tissue when coughing. If a tissue is unavailable cover your mouth as much as possible with the crook of your elbow.
For an interesting graphic showing the day by day progression of the virus across the world, please click here.
In the modern day and age we as a human race have not experienced a major pandemic outbreak since the days of the Spanish flu, where it is estimated that 50 million people of the worlds population was wiped out. Prompting the question, are we prepared this time round? Do we have adequate methods in place now to deal with an outbreak of such scale? Can we prevent a pandemic with the possible power to kill a substantial percentage of the world’s population?
After less than a week of the worlds attention been drawn on the outbreak of the suspected next major pandemic, swine flu, the World Health Organization (WHO) has raised the global health alert from 3 to 4 to 5. Level 5 being a pandemic is imminent and level 6 being there is a pandemic and all humanity is at risk of catching the virus. This alertness shown today is in stark contrast to that shown during the Spanish Flu. Because of strange symptoms and lack of early dialogue between health officials of different countries, the Spanish flu initially was misdiagnosed as dengue, cholera or typhoid. This lack of early diagnosis and of Spanish flu was only exacerbated by the fact there was no global coordinated effort or central health body, thus allowing for no uniformed coordinated resistance against the pandemic, like those in place today in the form of the World Health Organization. Another significant factor contributing to the lack of early awareness during the Spanish Flu was the ignorance towards the matter shown by politicians during the pandemics infancy. This however is quite different from today where governments and politicians alike acknowledge the high risk of Swine Flu becoming a global pandemic and have begun planning for the worst case scenario. Such as in Hong Kong where a whole hotel guest list has been quarantined by the
Current antiviral stockpiles suggest that if there was a major outbreak of swine flu in the world, even the most powerful affluent nations such as U.S.A, the
With the widespread economic downturn facing the world it may seem that we are financially unstable and unprepared for a pandemic outbreak. However this may be the case but we are structurally and financially more prepared than in 1918 during the Spanish flu outbreak.1918, post war depression and war weariness rocked
We as a human race, although may not seem it, are more prepared than ever to tackle a global pandemic. As a human race, we have learnt from our past confrontations with serious pandemics and have put in place necessary procedures, infrastructure and methods to best tackle any future pandemic. If the Swine Flu was to reach the strength of the Spanish Flu We are more alert, aware and prepared both financially and medically to tackle a pandemic this time round.