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Professor Sir Roy Anderson, rector of Imperial College, London, declared yesterday that a pandemic had already begun and the focus had to be on drug distribution.
Sir Roy said the disease was being transmitted in a sustained way in the US, and this would happen in other countries.
He said: 'The definition of phases five and six [of the WHO's pandemic alert scale] is somewhat irrelevant. A pandemic has started.'
New data from Mexico and case numbers so far suggest that if the spread of H1N1 "swine flu" continues elsewhere as it has in the Americas, the virus could infect more than a billion people by July.
Professor Neil Ferguson, the corresponding author of the new research from the MRC Centre for Outbreak Analysis and Modelling at Imperial College London, said: "Our study shows that this virus is spreading just as we would expect for the early stages of a flu pandemic
Originally posted by Chevalerous
Let us just hope, that it doesn't turn itself into something nastier when it travels into the Southern Hemisphere and around our populated globe!
Professor Neil Ferguson, the corresponding author of the new research from the MRC Centre for Outbreak Analysis and Modelling at Imperial College London, said: "Our study shows that this virus is spreading just as we would expect for the early stages of a flu pandemic
www.sciencedaily.com...
"A third of the world's population could be infected with swine flu, expert projections suggest. Researchers say swine flu has "full pandemic potential", spreading readily between people and is likely to go global in the next six to nine months.
Although one in three who come in contact will likely become infected, the Imperial College London team declined to estimate the death toll. The study based on Mexico's experience is published in the journal Science.
This virus really does have full pandemic potential Professor Ferguson The number of laboratory-confirmed swine flu cases has reached 5,251 in some 30 countries around the world, with 61 having died from the disease, the World Health Organization has confirmed.
Working in collaboration with the WHO and public health agencies in Mexico, the researchers assessed the Mexico epidemic using data to the end of April and taking into account factors like international spread and viral genetic diversity.
Lead researcher Professor Neil Ferguson said it was too early to say whether the virus will cause deaths on a massive scale, or prove little more lethal than normal seasonal flu. His "fast and dirty" analysis of Mexico's swine flu outbreak suggests that the H1N1 virus is about as dangerous as the virus behind a 1957 pandemic that killed 2 million people worldwide.
But it's not nearly as lethal as the bug that caused the 1918 Spanish flu pandemic, which caused an estimated 50 million deaths in 1918.
Its full impact on the UK is not likely to be known until the annual flu season in the autumn and winter, when a "really major epidemic" can be expected in the northern hemisphere, says Professor Ferguson.
Prof Ferguson, who sits on the World Health Organisation's emergency committee for the outbreak, told the BBC Radio 4 Today programme: "This virus really does have full pandemic potential. It is likely to spread around the world in the next six to nine months and when it does so it will affect about one-third of the world's population.
"To put that into context, normal seasonal flu every year probably affects around 10% of the world's population every year, so we are heading for a flu season which is perhaps three times worse than usual - not allowing for whether this virus is more severe than normal seasonal flu viruses."
His study suggests swine flu could kill four in every 1,000 infected people. Professor Ferguson said his findings confirmed that decisions must be taken swiftly on vaccine production.
"We really need to be prepared, particularly for the autumn. At the moment, the virus is not spreading fast in the northern hemisphere, because we are outside the normal flu season, but come the autumn it is likely to cause a really major epidemic.
"One of the key decisions which has to be made this week by the world community is how much do we switch over current vaccine production for seasonal flu to make a vaccine against this particular virus? I think those decisions need to be made quickly."
Researchers from the MRC Centre for Outbreak Analysis and Modelling at Imperial College London, working in collaboration with the World Health Organisation and public health agencies in Mexico, have assessed the epidemic using data to the end of April. Their key findings are as follows:
Swine Flu May Be Human Error, Scientist Says; WHO Probes Claim
By Jason Gale and Simeon Bennett
May 12 (Bloomberg) -- The World Health Organization is investigating an Australian researcher’s claim that the swine flu virus circling the globe may have been created as a result of human error.
Adrian Gibbs, 75, who collaborated on research that led to the development of Roche Holding AG’s Tamiflu drug, said in an interview today that he intends to publish a report suggesting the new strain may have accidentally evolved in eggs scientists use to grow viruses and drugmakers use to make vaccines. Gibbs said that he came to his conclusion as part of an effort to trace the virus’s origins by analyzing its genetic blueprint
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"In addition, his research found the rate of genetic mutation in the new virus outpaced that of the most closely related viruses found in pigs, suggesting it evolved outside of swine, Gibbs said.
Some scientists have speculated that the 1977 Russian flu, the most recent global outbreak, began when a virus escaped from a laboratory."
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"The WHO wants to know whether any evidence that the virus may have been developed in a laboratory can be corroborated and whether there are other explanations for its particular genetic patterns, according to Fukuda."
‘Wild Idea’
“These things have to be dealt with straight on,” he said. “If someone makes a hypothesis, then you test it and you let scientific process take its course.”
Gibbs said he has no evidence that the swine-derived virus was a deliberate, man-made product.
“I don’t think it could be a malignant thing,” he said. “It’s much more likely that some random thing has put these two viruses together
"It only takes three days to grow the virus in eggs, but weeks for testing and formulating," Hessel adds. That means no vaccine until September, and no real quantities until October. Then countries have to administer millions of doses, which take weeks to take effect. In 1918, the worst wave of the pandemic hit in September.
The first to get pandemic vaccine will be the 15 countries who have pre-ordered a total of about 250 million doses. "We can't say how long making them will take," Palache warns. It partly depends on how much virus is needed per dose. In theory, countries that place new orders now might get vaccine in November. In 1918, the autumn wave was nearly over by then.
The 15 countries with advance purchase agreements include Canada and Australia, which have vaccine plants, New Zealand, and 12 European countries including the UK. Europe has 70 per cent of the world's manufacturing capacity. Other countries, including Japan and China, plan to produce their own.
The US has one vaccine plant, owned by French drug giant Sanofi-Aventis, which could in theory produce enough for the US population. However, the US has no advance purchase order in place.
H1N1 flu is still spreading. In North America, the number of cases may have passed the 100,000 mark; and cases in Japan may tip us into a pandemic. Yet Europe claims it doesn't have evidence of "sustained transmission" of the virus.
That's hardly surprising, as Europe isn't doing the relevant tests (see "Europe is failing to test for circulating swine flu"). Do governments fear that if they discover the virus is spreading, people with sniffles will swallow antivirals unnecessarily and spawn a drug-resistant strain? Whatever the reason, mad cows taught the UK that refusing to see - and tell - the truth about disease is unwise. If H1N1 is spreading elsewhere, it is unlikely to peter out in Europe. The authorities have had years to draw up pandemic plans. Yet they appear as ill-prepared to track the spread of this virus as they are to make a vaccine for it.
20 May 2009 by Debora MacKenzie
EUROPE might have more H1N1 swine flu than it knows. The virus could be circulating widely but not being spotted simply because people are not being tested.
As New Scientist went to press, the World Health Organization was still undecided about declaring a full-blown pandemic, despite a surge in swine flu cases in Japan. To do this it needs evidence of "sustained transmission" outside the Americas, where the virus originated. This means finding cases in the general population that have not had known contact with places or people confirmed to have the virus. Japan found H1N1 this week in over 100 people, many without known contact.
But European countries are using a case definition from the European Centre for Disease Prevention and Control (ECDC) in Stockholm, Sweden, that virtually precludes discovering such cases. It recommends testing people with symptoms only if they have been to affected countries or had contact with a known or suspected case in the past seven days.
We can't test every mild case of flu symptoms," says Johan Giesecke, chief scientist at ECDC. "But it's true, we might not be seeing community spread because we aren't looking." On 18 May, the UK had 101 confirmed cases of H1N1, of which only three fell outside the case definition.
The UK Health Protection Agency's criteria are similar (see diagram). Doctors "are encouraged to use this algorithm", an HPA spokesperson told New Scientist, but they can "use their clinical discretion" to test anyone.
An anonymous UK New Scientist reader, and two family members, had flu symptoms after one returned ill from New York on 10 April. They were not tested for H1N1. "My general practitioner is horrified that I am not even eligible for a test because I have not returned from Mexico in the last seven days, nor been in contact with someone who has been diagnosed."
Tests may simply be unavailable. "I was given only two swabs [for H1N1] initially," says Laurence Buckman, head of the GP committee of the British Medical Association. More are available now, "but if you can't do many tests you save them for people who meet the case definition".
Any others, says Buckman, will be picked up by "sentinel" clinics that compile weekly statistics. The ECDC claims this system "would detect circulation of the new H1N1 virus before any major outbreaks occur".
However, such sentinel systems are designed to track ordinary flu, not to detect a new infection that is initially highly localised. "It may take weeks before the numbers indicate an epidemic," warns Dick Wenzel of Virginia Commonwealth University in Richmond, past president of the International Society for Infectious Diseases. He advises testing clusters of flu and all severe cases.
Hong Kong is testing all hospitalised cases of flu and pneumonia. Belgium, departing from ECDC advice, is testing flu-like clusters and deaths. But without more tests, Europe may be missing an epidemic.
HIV's European tour may have begun in the Mediterranean. A new genetic map plotted from viruses in hundreds of people suggests that many European strains of HIV trace their ancestry to Greece, Portugal, Serbia and Spain.
Sun-seeking tourists from northern and central Europe might account for the pattern, the study's authors say.
The vast majority of the study's participants said they acquired their infections in their home country, so the patterns could be a vestige of HIV's emergence and early spread through Europe in the early 1980s, probably after arriving from the US.
The UK, Netherlands, Italy, Sweden, Norway, Switzerland, Denmark, Germany and Israel, meanwhile, may have served as hubs of HIV transmission, importing and exporting the virus throughout the continent.
Thursday, May 21, 2009 MEXICO CITY — No one has identified ground zero in the swine flu epidemic. Just where or when the new strain of influenza first jumped from a pig and began infecting people is a scientific mystery — one that a group of flu detectives is determined to solve.
Scientists are returning next week to La Gloria, a pig-farming village in the Veracruz mountains where Mexico’s earliest confirmed case of swine flu was identified. They hope to learn where the epidemic began by taking fresh blood samples from villagers and pigs, and looking for antibodies that could suggest exposure to previous swine flu infections.
Some experts say it’s pointless to worry about what happened in La Gloria now that the swine flu virus has spread around the world. But others argue that a thorough investigation could be key to preventing future epidemics.
And Mexico has another reason to care: If it can somehow rule out the possibility that La Gloria’s pigs infected humans, then it can tell the world it wasn’t to blame for the epidemic — that the never-before-seen H1N1 swine flu virus came from somewhere else.
More than half of La Gloria’s 3,000 residents fell ill with flu symptoms weeks before the new virus was identified. Many found it hard to breathe, burned with fever and ached all over. About 450 of the sickest residents were diagnosed with acute respiratory infections and sent home with antibiotics and masks.
Mexican health officials initially downplayed the outbreak, saying the villagers suffered from regular flu. A 5-year-old boy was the only confirmed swine flu case among 43 villagers whose mucous samples were taken in early April. By then, most other villagers had recovered, and the virus was gone from their systems.
But some disease experts suspect swine flu was circulating more widely in La Gloria.
I cannot understand it. I could almost bet that there were more infections related to this virus” in La Gloria, Dr. Carlos Arias told The Associated Press. Arias is leading a group of flu detectives from the Biotechnology Institute and the veterinary school of the National Autonomous University of Mexico back to the village at the invitation of the Veracruz state government.
As the influenza A (H1N1) swine flu virus fans out across the globe, there can be little doubt that we are already in the early stages of a flu pandemic. Nonetheless, there is considerable resistance to calling it a pandemic.
On 29 April, the World Health Organization (WHO) moved its assessment of the pandemic threat to phase 5 on its six-point scale, indicating that the new virus had caused "sustained community level outbreaks in two or more countries in one WHO region".
And that is where the threat level has sat ever since — one point short of official global pandemic status. The current definition of phase 6 requires that there are "sustained community level outbreaks in at least one other country in a different WHO region". That criterion will almost certainly be met sooner or later.
Yet this week Margaret Chan, director-general of the WHO, came under pressure from member states — including the United Kingdom and Japan — to move the goalposts to delay or prevent a move to phase 6, by redefining it to include an assessment of the severity of the disease, and not only its geographical spread.
Adding that requirement of severity may sound like common sense. But it is not, because the severity of a pandemic is unpredictable. The flu might fizzle out; or it could go away for months only to come back with a vengeance, creating as much devastation as the 1918 flu outbreak, which caused an estimated 50 to 100 million deaths worldwide.
Moreover, the WHO has pointed out that adding that criterion at a global level would be largely meaningless — what might be deemed a mild disease in a rich country with many doctors, drugs and intensive-care units might be more severe and cause considerable mortality in a poor country with little health infrastructure, and where underlying diseases may worsen outcomes of a flu infection.
So what's the big hang-up with calling a pandemic a pandemic? Those fretting over the term include news pundits in denial about the scale of the threat, along with politicians and scientists who fear that using the word may induce public panic.
Action, not phases
The importance of the phase 6 designation is overrated. It is not some alert threshold that, when passed, triggers an automatic and unstoppable series of draconian measures. As Chan says, "Level 6 does not mean that we are facing the end of the world."
This morning, Chan told the World Health Assembly that despite pressure to hold off from phase 6, she would not hesitate to raise the level if needs be. Chan is right - it is time to call a pandemic a pandemic.
Antibodies against some seasonal flu strains from prior years may be active against the new H1N1 swine flu currently circulating the globe, a recent study reports. The findings suggest an explanation for why swine flu appears to infect the young more often than the elderly, who are normally more susceptible to seasonal flu viruses.
The study, published today in the Morbidity and Mortality Weekly Report, analyzed blood samples taken from 359 participants in flu vaccine studies conducted from 2005 to 2009. 33% of the samples from people over 60 years old had antibodies that reacted with the swine flu virus, as compared to 6%-9% of the samples from people aged 18–64 years, and none of the samples taken from children 1.
The results match the apparent current epidemiology of swine flu infection, says Anne Schuchat, interim deputy director for the Science and Public Health Program at the Centers for Disease Control and Prevention (CDC) in Atlanta. Most cases of swine flu have occurred in people who are under 60 years old, and only 1% of confirmed swine flu infections in the United States were in patients over the age of 65.
Nevertheless, the results should be interpreted with caution, Schuchat urged in a press briefing today. Researchers have shown that the antibodies react with the virus in test-tube assays, but they have not yet shown that the antibodies can fend off the virus in animals or people. "Whether this particular assay will pan out over time as predictive of clinical protection, we can't say," Schuchat said.
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Genetic analysis of the new swine flu virus has shown that it differs dramatically from previous seasonal viruses. But Tripp notes that H1N1 viruses were circulating in swine during the 1940s and 1950s and could have mixed with seasonal flu viruses during that time. Exposure to these viruses could have launched an antibody response that continues to protect individuals against today's swine flu.
Meanwhile, Schuchat notes that it is possible for immune responses to the current swine flu and past seasonal viruses to overlap, despite the genetic dissimilarity. "We don't have a particular virus that we're thinking about," she says, "but we're wondering if there might have been some viruses around in the '30s, '40s and '50s that might be immunologically similar to the one we're seeing now."