Wednesday, August 12, 2009

What Is Swine Flu? How Is Swine Flu Treated?


Swine flu (swine influenza) is a disease of pigs. It is a highly contagious respiratory disease caused by one of many Influenza A viruses. Approximately 1% to 4% of pigs that get swine flu die from it. It is spread among pigs by direct and indirect contact, aerosols, and from pigs that are infected but do not have symptoms. In many parts of the world pigs are vaccinated against swine flu.

Most commonly, swine flu is of the H1N1 influenza subtype. However, they can sometimes come from the other types, such as H1N2, H3N1, and H3N2.

The current outbreak of swine flu that has infected humans is of the H1N1 type - this type is not as dangerous as some others.

Avian Influenza (Bird Flu) can also infect pigs

Avian flu and human seasonal flu viruses can infect pigs, as well as swine influenza. The H3N2 influenza virus subtype, a virulent one, is thought to have come from pigs - it went on to infect humans.

It is possible for pigs to be infected with more than one flu virus subtype simultaneously. When this happens the genes of the viruses have the opportunity to mingle. When different flu subtypes mix they can create a new virus which contains the genes from several sources - a reassortant virus.

Although swine influenza tends to just infect pigs, they can, and sometimes do, jump the species barrier and infect humans.

What is the risk for human health?

Outbreaks of human infection from a virus which came from pigs (swine influenza) do happen and are sometimes reported. Symptoms will generally be similar to seasonal human influenzas - this can range from mild or no symptoms at all, to severe and possibly fatal pneumonia.

As swine flu symptoms are similar to typical human seasonal flu symptoms, and other upper respiratory tract infections, detection of swine flu in humans often does not happen, and when it does it is usually purely by chance through seasonal influenza surveillance. If symptoms are mild it is extremely unlikely that any connection to swine influenza is found - even if it is there. In other words, unless the doctors and experts are specifically looking for swine flu, it is rarely detected. Because of this, we really do not know what the true human infection rate is.

Examples of known swine flu infecting humans

Since the World Health Organization's (WHO's) implementation of IHR (2005) in 2007, they have been notified of swine influenza cases from the USA and Spain.

In March/April 2009 human cases of influenza A swine fever (H1N1) were first reported in California and Texas. Later other states also reported cases. A significant number of human cases during the same period have also been reported in Mexico - starting just in Mexico City, but now throughout various parts of the country. More cases are being reported in Canada, Europe, and New Zealand - mainly from people who have been in Mexico.

How does a human catch swine influenza?
  • From contact with infected pigs (most common way)
  • From contact with infected humans (much less common way)
In cases when humans have infected other humans close contact was necessary with the infected person, and they nearly always occurred in closed groups of people.

Can I eat pork meat and pork products?

If the pork meat and pork food products have been handled properly transmission of swine influenza to humans is not possible. Cooking pork meats to a temperature of 70C (160F) kills the virus. So the answer is YES, pork meat and pork food products are safe to eat.

Where have pigs been infected?

As swine influenza infection among pigs is not an internationally notifiable disease we cannot be completely sure. Swine influenza infection among pigs is known to be endemic in the USA. Outbreaks have also occurred in other parts of North America, South American, Europe, Africa, China, Japan, and other parts of Asia.

Is there a pandemic risk?

People who are not in close contact with pigs generally have no immunity to the swine influenza viruses - they are less likely to be able to prevent a virus infection. If the virus infects enough people in a given area, the risk of an influenza pandemic is significantly greater. Experts say it is very hard to predict what impact a flu pandemic caused by a swine influenza virus would have on the global human population. This would depend on how virulent the virus is, what existing immunity among humans there already is, plus several other factors.

Do we have a specific swine flu vaccine?

No - not for humans.

Will current human flu vaccines help protect people from swine influenza infection?

We really don't know. Influenza viruses are adapting and changing all the time. If a vaccine was made, it would have to be specifically for a current strain that is circulating for it to be effective. The WHO says it needs access to as many viruses as possible so that it can isolate the most appropriate candidate vaccine.

What are the signs and symptoms of swine influenza in humans?

They are similar to those of regular flu, and include:
  • Body aches
  • Chills
  • Cough
  • Diarrhea (less common)
  • Headache
  • Sore throat
  • Temperature (fever)
  • Tiredness (fatigue)
  • Vomiting (less common)
What medications are there?

There are some drugs around that can effectively treat swine flu infection in humans - and many types of flu infections in humans. There are two main types:
  • adamantanes (amantadine and remantadine)
  • inhibitors of influenza neuraminidase (oseltamivir and zanamivir)
Most previous swine influenza human cases recovered completely without the need for medical attention.

What can I do to protect myself?
  • Wash your hands regularly with soap
  • Try to stay healthy
  • Get plenty of sleep
  • Do plenty of exercise
  • Try to manage your stress
  • Drink plenty of liquids
  • Eat a well balanced diet
  • Refrain from touching surfaces which may have the virus
  • Do not get close to people who are sick
  • Stay away from crowded areas if there is a swine flu outbreak in your area
If I am infected, how can I stop others from becoming infected?
  • Limit your contact with other people
  • Do not go to work or school
  • When you cough or sneeze cover your mouth with a tissue. If you do not have a tissue, cover your mouth and nose.
  • Put your used tissues in a waste basket
  • Wash your hands and face regularly
  • Keep all surfaces you have touched clean
  • Follow your doctor's instructions
Mexico City - Some good news

In Mexico City, where a sizeable number of people have become infected with H1N1 swine flu, authorities are urging people with flu symptoms to go straight to their doctors or a local hospital. They insist that the flu is completely treatable if the patient comes in straight away.

What is Swine Flu - Video

The Centers for Disease Control and Prevention (CDC) Influenza Division has produced a video all about swine flu.

This video includes information on the signs and symptoms of swine flu, how swine flu is transmitted, what medicines are available to treat it and steps that people can take to help protect themselves from it. There are also some tips on what to do if you become ill with swine flu.


Video by Centers for Disease Control and Prevention (CDC)

Resources:
http://www.medicalnewstoday.com/articles/147720.php

Human Swine Flu Conference To Be Held In Washington DC Next Week


Tribal, local, state, federal and other leaders in the field will share best practices and current research with more than 700 delegates already registered, including participants from 32 countries at the International Swine Flu Conference. Priority will be placed on identifying the responsibilities of various stakeholders in order to improve global communication coordination and collaboration. ISFC will be held at the Hyatt Regency Washington DC on Capitol Hill, August 19-20 and will be followed by all day hands-on workshops on the 21st.

"It is with great pleasure that we look forward to welcoming our international colleagues," said Ahmed Farajallah, senior vice president, events and conferences, New Fields. "Improving global communication and collaboration is our major objective."

The ongoing Swine Flu pandemic proved that now more than ever health, education, government, non-profit organizations, and business executives need to focus, discuss and share best practices and lessons which will be learned during this first pandemic in the age of globalization.

Each day of the conference will offer papers on a wide range of topics including:
  • Preparing Community Strategies
  • Local Partnership and Participation
  • Delivery of Vaccine and Antiviral Medication
  • Emergency Response and Hospital/Healthcare Coordination
  • Prevention Education Efforts and Risk Communication
  • Command, Control and Management
  • Business Community's Role
Panel Discussions include:
  • Clinical Picture: Country Report & Situation Update
  • Clinical Picture: Impact of US Export Regulations on International Cooperation in the H1N1 Pandemic Flu Response
  • Risk Communication, Prevention Education Efforts and Risk Communication
  • Understanding the Connection Between Human and Animal Disease, Exploring One World, One Health
  • Vaccines delivery
Over 20 breakout sessions will be offered addressing a wide range of issues, including:
  • Breakout-Agricultural Perspective: Socio-Economic Impact on Swine Industry
  • Breakout: Schools/University Planning: How and When to Close Schools
  • Breakout: Mass Fatality Management Planning
  • Breakout: Business Continuity Planning, "Pandemic Showstoppers: What leads to Success or Failure at the local Community level"
  • Breakout: School Emergency Preparedness
  • Breakout: Hospital and Emergency Medical Services
  • Breakout- COOP and Continuity of Government Planning: "Gearing up for the Fall: Rapid Training & Exercises for Health Department Staff & Partners"
  • Breakout-Business Continuity: Preparing the Community for a Severe H1N1
  • Breakout-Business Continuity: Global Pandemic Planning at Visa
  • Breakout: Schools/University Planning: The Uniqueness of Planning for Swine Flu in Higher Education: We are Much Different than the k-12 System
  • Prevention of Schools for Students, School Personnel, Parents and Communities
  • Breakout: Emergency Management: States Perspective and Strategy for Pandemic Influenza- Command, Control and Management
  • Breakout-Hospital& Emergency Medical Services: Impact of Swine Flu on Emergency Medical Services
  • Breakout-Community-Based Planning, Community Preparedness
  • Breakout: COOP & Continuity Government Planning and many more…
Workshops include:
  • Learn How to Plan- Contingency Scenario Exercise for Pandemic Influenza
  • Protect Your Community
  • Enhancing Pandemic Preparedness Through Volunteer Resources
  • Know How to Respond
  • Plan to Continue
Registration:

The 2-day event is open to all interested governmental agencies, organizations, and businesses from all countries. To register, download a registration form: http://www.new-fields.com/isfc/registration.pdf.

Resources: http://www.medicalnewstoday.com/articles/160408.php

Monday, August 10, 2009

Rapid Tests for Detecting H1N1 Flu Not Reliable


Posted by Madeline Ellis on 7 Aug 2009

Officials estimate that since its emergence in early April, the H1N1 flu has infected as many as a million Americans. Its symptoms, which are similar to those of seasonal flu, may include fever, headache, coughing, sneezing, sore throat, and muscle or joint pains, which can last up to a week. A significant number of people who have been infected with the virus have also reported diarrhea and vomiting. Antiviral drugs such as Tamiflu and Relenza have been found effective at treating and reducing the duration of the illness, usually by a day or two. But in order to be most useful, they must be administered within 12 to 48 hours of symptoms onset. That could be a problem considering that identifying the virus by traditional cell culture can take days, and the rapid detection tests that can provide results in 30 minutes or less fail to identify H1N1 more than half the time, according to a new government report.

The Centers for Disease Control (CDC) studied tests using clinical specimens that had been shown to contain an influenza virus through laboratory testing from three companies: Binax Inc., Becton, Dickinson & Co., and Quidel Corp. Of the three, the Quidel test fared the best, detecting 69 percent of the infections. The Becton, Dickinson test detected 49 percent and the Binax test detected 40 percent. All tests detected seasonal flu better than the H1N1 virus. “These findings indicate that, although a positive (rapid detection test) result can be used in making treatment decisions, a negative result does not rule out infection with novel influenza A (H1N1) virus,” the authors wrote.

These findings are not entirely unexpected. A recent study in the Journal of Clinical Virology found that one test detected only 10 percent of H1N1 infections, and a second detected only 40 percent. The rapid tests “are missing a ton of flu” that could be picked up by a more sophisticated laboratory culture, said Christine C. Ginocchio, director of the division of microbiology, virology and molecular diagnostics at the North Shore-Long Island Jewish Health System in Lake Success, N.Y. And in a letter to the New England Journal of Medicine in June, Navy researchers described the poor sensitivity of the Quidel tests, pointing out that they detected only half of the infections picked up by a more sensitive technique.

However, the manufacturers of the tests argue that their products are helpful if used appropriately. Senior vice president for clinical and regulatory affairs at Quidel Corporation, John D. Tamerius, says that Quidel’s QuickVue flu test for the detection of Influenza Virus type A and type B antigens could detect 80 percent of infections if done directly from a self administered nasal specimen swab taken correctly and if the test was given early in the course of the disease, when more virus was present. “When these tests are used properly, the performance is very, very good,” Tamerius said.

Last week the CDC updated guidance urging caution in relying on the tests, fearing that the negative readings might prevent health care providers from treating patients with antiviral drugs, particularly those at high risk, such as pregnant women and those with asthma or other underlying medical conditions like heart disease and diabetes.

Resources: http://www.healthnews.com/alerts-outbreaks/rapid-tests-detecting-h1n1-flu-not-reliable-3543.html

Tuesday, August 4, 2009

Scientists Find New Human HIV From Gorillas


Posted by Catharine Paddock on 2 August 2009

Scientists who found a new human immunodeficiency virus (HIV) in a Cameroonian woman living in Paris, have discovered it is an unusual variant of HIV-1 that could have come from gorillas.

The research that led to the findings was headed by Dr Jean-Christophe Plantier of the University of Rouen in France and is published in the 2 August online issue of Nature Medicine. Drs David Robertson and Jonathan Dickerson from the Faculty of Life Sciences at The University of Manchester, UK, were also involved in the study.

There are three established lineages of HIV-1, known as M, N, and O, which came from chimpanzees, but this new variant appears to be the prototype of a new lineage derived from gorillas and shows no evidence of recombination with the other known lineages, wrote the researchers.

They propose that the new lineage be called HIV-1 group P.

There are 33 million people worldwide living with AIDS which is caused by the HIV-1 virus group M (groups N and O are mainly confined to Cameroon).

HIV is a product of cross-species transmission of Simian Immunodeficiency Virus (SIV) found in chimpanzees, thought to have crossed to humans from eating infected bush meat.

While first recognized in 1980, HIV is thought to have started some 80 years earlier in and around the African country that is now called the Democratic Republic of Congo.

The 62-year old Cameroonian woman at the centre of the study moved to Paris in 2004 and began to have symptoms shortly afterwards. Her blood sample showed discrepancies in her viral load, and further tests revealed she was infected with a new strain of HIV that more closely resembled SIV from gorillas than HIV from humans.

However, before moving to Paris the woman had lived in a semi-urban part of the central west African Republic of Cameroon; she had not come into contact with bush meat or gorillas.

Because of this information and the fact further tests showed that the virus was able to replicate in human cells, the scientists suggest the strain may well appear elsewhere.

Robertson told the media that:

"The discovery of this novel HIV-1 lineage highlights the continuing need to monitor closely for the emergence of new HIV variants."

"This demonstrates that HIV evolution is an ongoing process. The virus can jump from species to species, from primate to primate, and that includes us; pathogens have been with us for millions of years and routinely switch host species," he added.

In the same way as the current swine flu pandemic is showing us, this is another example of how viruses can now move very quickly around the world because nowadays large numbers of humans travel long distances in a short space of time.

Plantier's team in France are part of a network of laboratories that has been monitoring HIV genetic diversity, while the The Manchester Life Sciences team helped with the computer-based evolutionary analysis.

"A new human immunodeficiency virus derived from gorillas."
Jean-Christophe Plantier, Marie Leoz, Jonathan E Dickerson, Fabienne De Oliveira, François Cordonnier, Véronique Lemée, Florence Damond, David L Robertson & François Simon.

Resources: http://www.medicalnewstoday.com/articles/159623.php

Could Migraine Pain be Permanently Erased by Plastic Surgery?


Posted by Allie Montgomery on 3 August 2009

Have you ever had a headache so bad that you want to crawl back in the bed and hide under the covers? Well, you are not alone. Migraines are a debilitating pain that affect approximately 10 percent of the population, which is 30 million people in the United States alone. Nearly one in four households have someone that is afflicted by migraines.

For many patients, the normal over the counter medications just don’t work. Dr. Lawrence Newman, who is the director of the Headache Institute at St. Luke’s-Roosevelt Hospital In New York, said, “There is a subset of patients who have what we call chronic migraines. Many of those people are quite treatment resistant. Why? We’re not really sure. I tell our patients it is a life-altering condition. Having a migraine interferes with the person’s life, their family members, their friends, their co-workers.”

But now there may be hope for patients with migraines from a common plastic surgery procedure that was a discovery stumbled upon by accident by Dr. Bahman Guyuron, who is the chairman of the Department of Plastic Surgery at University Hospitals Case Medical Center in Cleveland. Guyuron stated, “I operated on a patient who came for a follow-up after a forehead life. Not only did she like the way she looked, she didn’t have migraines headaches for six months since the surgery.” Other patients that suffered from migraines before the surgery told him the same thing, that the forehead life had made their migraine pain disappear.

While the origins of these type of headaches are often a mystery, the research shows that the irritation of certain nerves in the face by nearby muscles might be to blame for some of the cases. Guyeron said that it would explain the improvement that his patients reported following their procedure because what he does is remove the muscles in the forehead that pinch the nerve.

Doctors have also noted that the patients that were treated with Botox often reported they had migraine relief. The researchers believe the Botox relieves the source of the migraines by paralyzing the muscles that surround the facial nerves. The next question is, could the forehead lift surgery offer a more permanent solution?

In Guyron’s small, double-blind study, he treated the patients with migraines either with an operation that targeted three common areas the trigger migraines, or a fake “sham” surgery, which acted as a control for the study. A year after the surgery took place, approximately 57 percent of the patients in the actual surgery group reported the complete elimination of their headaches, while only 4 percent of the sham surgery group did.

Some of the pain specialists that were not affiliated with the research said that the results were encouraging. Dr. Richard Lipton, who is the director of the Montefiore Headache Center in New York, noted that this study provides, “fascinating and promising results” that could benefit the patients that have high levels of pain and disability for whom other migraine treatments have failed.

However, some of the doctors said that the research findings may not be as conclusive as they appear at first look. While approximately 83 percent of the actual surgery group had a significant reduction in their migraine symptoms, so did approximately 57 percent of those that received the sham surgery.

Dr. Joel Saper, who is the director and founder of the Michigan Headache and Neurological Institute in Ann Arbor, Michigan, found that this high placebo response rate to the surgery is very troubling. “Overall, the study raises more doubts than provides answers. Surgery should be a last resort,” he stated.

Dr. Robert Shapiro, who is a professor of neurology at the University of Vermont College of Medicine in Burlington, agreed that the high rate of the patients who appeared to have improved through receiving the “sham” treatment suggested that the technique needs to be studied further. “It would be unfortunate if large numbers of migraines sufferers underwent expensive and potentially hazardous surgery which was actually no more effective than sham surgery. This study does not allow a conclusion to be drawn about the effectiveness of the surgeries performed.”

Resources: http://www.healthnews.com/family-health/could-migraine-pain-be-permanently-erased-plastic-surgery-3525.html

Saturday, August 1, 2009

New Study Finds Organic Doesn’t Mean More Nutritious


Posted by Madeline Ellis on 31 July 2009

Organic food, which was once only available in small stores or farmers’ markets, is now the fastest growing sector of the American food marketplace, despite its higher costs. In 2008, the value of retail sales of organic food was estimated to be more than $28 billion, up from $1 billion in 1990. And, according to the Food Marketing Institute, more than half of Americans now buy organic food at least one a month. So why this surge in popularity? Why pay more for food because it’s organically grown? Do organic foods offer more nutritional value than their traditionally grown counterparts?

Whether or not organically grown foods are more nutritious has become a hotbed of debate, and the answer would likely depend on who one asked. For instance, The Organic Center (TOC), a pro-organic nonprofit research organization in Foster, Rhode Island recently concluded that organic foods, on average, offer a 25 percent higher nutrient level over conventional ones. And researchers at University of California at Davis claim to have found higher levels of nutrients in organic tomatoes, kiwifruit, corn, and strawberries grown side-by-side with conventional versions.

On the opposite side of the fence are major health organizations like the American Dietetic Association and the Mayo Clinic that hold an organic label is no assurance that a food is nutritionally superior, which is the same conclusion recently reached by a group of British researchers after reviewing 50 years of published data on the topic. The review, commissioned by Britain’s Food Standards Agency (FSA) and conducted by the London School of Hygiene and Tropical Medicine, found that organic food contained no more nutritional value than food grown traditionally.

Overall, the researchers found no differences of most nutrients, including vitamin C, calcium and iron, in organically or traditionally grown crops. The same was true for meat, dairy and eggs. There were differences in nitrogen and phosphorus levels, but the researchers said this was likely due to the differences in fertilizers and the ripeness at harvest, and likely provided no health benefits. “Our review indicates that there is currently no evidence to support the selection of organically over conventionally produced foods on the basis of nutritional superiority,” said Dr. Alan Dangour, study author and registered public health nutritionist.

“It is good to see that a systematic review of the literature supports what has long been believed—that the nutritional content of traditionally grown foods and organic foods are comparable,” said Connie Diekman, director of university nutrition at Washington University in St. Louis and past president of the American Dietetic Association. “This report provides confirmation for consumers that if they choose conventionally grown foods or organic foods they will be meeting their nutritional needs.”

However, others were disappointed with the findings, criticizing the study for failing to examine the impact of pesticides and herbicides, the use of antibiotics or the environmental issues. They are calling for better research. “You have to also look at what you’re not getting” with organic foods, said Sheah Rarback, director of nutrition at the Mailman Center for Child Development at the University of Miami Miller School of Medicine. “We know that young children are getting the nutrition, whatever choice they make, but we also have to look at the pesticide issue.”

Dr. Dangour admitted that “there is a possibility that organic food has less pesticide residues, but this was not part of the review.” He said that, as a nutritionist, he was not qualified to look at pesticides, but “this may be an area for further research.”

Gill Fine, the FSA’s director of consumer choice and dietary health, said the study was about ensuring people have accurate information in order to make informed choices about the food they eat. “This study does not mean that people should not eat organic food,” she said. “What it shows is that there is little, if any, nutritional difference between organic and conventionally produced food and that there is no evidence of additional health benefits from eating organic food.”

Resources: http://www.healthnews.com/nutrition-diet/new-study-finds-organic-doesn-t-mean-more-nutritious-3513.html