what makes us human?

Scientific American | Language Clues - Whole-genome comparisons in other species have also provided another crucial insight into why humans and chimps can be so different despite being much alike in their genomes. In recent years the genomes of thousands of species (mostly microbes) have been sequenced. It turns out that where DNA substitutions occur in the genome—rather than how many changes arise overall—can matter a great deal. In other words, you do not need to change very much of the genome to make a new species. The way to evolve a human from a chimp-human ancestor is not to speed the ticking of the molecular clock as a whole. Rather the secret is to have rapid change occur in sites where those changes make an important difference in an organism’s functioning.

HAR1 is certainly such a place. So, too, is the FOXP2 gene, which contains another of the fast-changing sequences I identified and is known to be involved in speech. Its role in speech was discovered by researchers at the University of Oxford in England, who reported in 2001 that people with mutations in the gene are unable to make certain subtle, high-speed facial movements needed for normal human speech, even though they possess the cognitive ability to process language. The typical human sequence displays several differences from the chimp’s: two base substitutions that altered its protein product and many other substitutions that may have led to shifts affecting how, when and where the protein is used in the human body.

A recent finding has shed some light on when the speech-enabling version of FOXP2 appeared in hominids: in 2007 scientists at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany, sequenced FOXP2 extracted from a Neandertal fossil and found that these extinct humans had the modern human version of the gene, perhaps permitting them to enunciate as we do. Current estimates for when the Neandertal and modern human lineages split suggest that the new form of FOXP2 must have emerged at least half a million years ago. Most of what distinguishes human language from vocal communication in other species, however, comes not from physical means but cognitive ability, which is often correlated with brain size. Primates generally have a larger brain than would be expected from their body size. But human brain volume has more than tripled since the chimp-human ancestor—a growth spurt that genetics researchers have only begun to unravel.

One of the best-studied examples of a gene linked to brain size in humans and other animals is ASPM. Genetic studies of people with a condition known as microcephaly, in which the brain is reduced by up to 70 percent, uncovered the role of ASPM and three other genes—MCPH1, CDK5RAP2 and CENPJ—in controlling brain size. More recently, researchers at the University of Chicago and the University of Michigan at Ann Arbor have shown that ASPM experienced several bursts of change over the course of primate evolution, a pattern indicative of positive selection. At least one of these bursts occurred in the human lineage since it diverged from that of chimps and thus was potentially instrumental in the evolution of our large brains.

Other parts of the genome may have influenced the metamorphosis of the human brain less directly. The computer scan that identified HAR1 also found 201 other human accelerated regions, most of which do not encode proteins or even RNA. (A related study conducted at the Wellcome Trust Sanger Institute in Cambridge, England, detected many of the same HARs.) Instead they appear to be regulatory sequences that tell nearby genes when to turn on and off. Amazingly, more than half of the genes located near HARs are involved in brain development and function. And, as is true of FOXP2, the products of many of these genes go on to regulate other genes. Thus, even though HARs make up a minute portion of the genome, changes in these regions could have profoundly altered the human brain by influencing the activity of whole networks of genes.

humans are responsible for swine flu

Physorg.com | Our demand for meat means pigs, turkeys, chickens, cows and other animals must be mass produced in crowded, feces-ridden factory farms like the one in Mexico that is suspected of starting the current swine flu outbreak. These farms are incubators for disease.

While it's easy to point fingers at Granjas Carroll and Mexico, disease-ridden animal factories can be found all over the world. According to the Centers for Disease Control and Prevention, studies have shown that 30 to 50 percent of pigs raised for food in the U.S. have been infected with some strain of swine flu. Hans-Gerhard Wagner, a senior officer with the U.N.'s Food and Agriculture Organization, has called the "intensive industrial farming of livestock" an "opportunity for emerging disease."

Other harmful organisms, including salmonella, campylobacter, listeria and E. coli, also spread from animals to people. E. coli is found in the feces of farmed animals and often sprays in every direction when animals are eviscerated at slaughterhouses. A study published in the journal Nature revealed that not only are U.S. meat and dairy products more commonly contaminated with E. coli than other foods are, they also contain a substance that can raise the risk of E. coli infection.

Although health officials have been quick to point out people can't get swine flu from eating pork, they have failed to hammer home one significant detail: Raising pigs for pork is what puts us at risk for swine flu in the first place.

The fewer pigs, chickens and other animals we raise for food, the fewer animal-borne diseases there will be. It's that simple. And since meat is high in saturated fat and cholesterol and can cause heart disease, diabetes, certain cancers and a host of other health problems. We would all be better off if we stopped eating it today.

h1n1 systematization

Northwestern ROCS | In our simulations for the spread in the United States we take Mexico City to be the starting point of the infection. The initial conditions of the model are chosen to match the available information on confirmed cases in the United States and Mexico, and we permit for a bracket of unconfirmed cases. We take into account the travel of individuals between counties in the United States and the incoming flux of airline passengers from Mexico City. We consider a worst-case scenario based on assumptions made from the information we have gathered thus far. The key factors in our modeling approach are very accurate human mobility datasets on scales from a few to a few thousand kilometers. We obtained the underlying multi-scale human mobility network indirectly by our recent investigation on the geographic circulation of dollar bills in the United States, which is an excellent proxy for human mobility and includes small scale daily commuting traffic, intermediate traffic, and long distance travel by air. Our simulations consist of multiple layers, each layer possessing and increasing degree of accuracy and complexity. Our final projections are done with a fully stochastic model that incorporates the inherent randomness in disease dynamics that is particularly important at the onset of an epidemic when the number of infected individuals is small compared to the whole population.

CDC H1N1

CDC | CDC continues to take aggressive action to respond to an expanding outbreak caused by H1N1 (swine flu).

CDC’s response goals are to:

1. Reduce transmission and illness severity, and
2. Provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. This includes guidance on when to close schools and how to care for someone who is sick at home. Supplies from CDC’s Division of the Strategic National Stockpile (SNS) are being sent to all 50 states and U.S. territories to help them respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.

history and possible future of american coal

Uppsala University | Future coal production will not be entirely determined by what is geologically available, but rather by the fraction of that amount that is practically recoverable. Society demands energy, not energy from coal. This means if this energy can be obtained less costly and more practically from other energy sources, potentially nuclear power or wind, those will be favored.

Increased coal prices do not necessarily lead to increased production, increased reserves, and the transformation of resources into reserves. The price development and feasibility of other energy sources must also be considered, since it is the energy that is demanded. Increased coal prices might therefore also be a burden for the industry as investors may move towards cheaper energy sources. Increased concern around CO2 emissions from coal is likely to decrease coal’s price competitiveness, because of the potential from CO2-taxes and increased costs of carbon-capture and storage (CCS). A closer discussion of this is beyond the scope of this study, but has been performed by others (Kavouridis and Koukouzas, 2008).

There is a common belief in some form of self-regulating coal supply cycle (Thielemann et al., 2007), where increased prices and human ingenuity will automatically lead to reserve growth and higher production. Our results suggest that this theory should be reevaluated. The historical evolution of U.S. coal reserves shows a trend towards reduced recoverable reserves. There are a number of different factors causing this, ranging from land-use restrictions to changes in definitions. The historical trend towards reduced recoverable amounts is clear and likely to continue in to the future, with even stricter regulations imposed by increased environmental concern.

A steady decline in the heating value of U.S. coal has also been observed and this can be seen as a sign of the increased depletion and the movement to less optimal seams. This trend is likely to continue in to the future, justified by increased depletion of high energy coals in Appalachia and an overall increased dependence on subbituminous western coals. By 2030 the average calorific value could be slightly above 20 MJ/kg. This also implies that the coal production forecast in the International Energy Outlook (2007) would require the production volumes in 2030 be 70% higher than today. Whether this can be achieved is very questionable as shown by the historical production trends and the depleting reserves in many key producing states.

Using the recoverable reserves as an estimate of what is realistically available for production will yield a coal output of around 1400 Mt by 2030 through the rest of the century. This would require a massive development of the coal reserves in Montana, as they are the largest undeveloped reserves remaining for future exploitation. Unless this happens, US coal production could reach a peak around 2030. The demonstrated reserve base allows a significantly higher production volume to be reached but this should be regarded as unrealistic, as it completely ignores regulations and restrictions. The restrictions have proved to be a key factor for the amount of coal available for production and ignoring restrictions when creating possible future scenarios is a fundamentally flawed approach.

To summarize the geologic amounts of coal are of much less importance to future production than the practically recoverable volumes. The geological coal supply might be vast, but the important question is how large the share that can be extracted under present restrictions are and how those restrictions will develop in the future. Production limitations might therefore appear much sooner than previously expected.

from bust to boom?

WSJ | A massive natural-gas discovery here in northern Louisiana heralds a big shift in the nation's energy landscape. After an era of declining production, the U.S. is now swimming in natural gas.

Even conservative estimates suggest the Louisiana discovery -- known as the Haynesville Shale, for the dense rock formation that contains the gas -- could hold some 200 trillion cubic feet of natural gas. That's the equivalent of 33 billion barrels of oil, or 18 years' worth of current U.S. oil production. Some industry executives think the field could be several times that size.

"There's no dry hole here," says Joan Dunlap, vice president of Petrohawk Energy Corp., standing beside a drilling rig near a former Shreveport amusement park.

Huge new fields also have been found in Texas, Arkansas and Pennsylvania. One industry-backed study estimates the U.S. has more than 2,200 trillion cubic feet of gas waiting to be pumped, enough to satisfy nearly 100 years of current U.S. natural-gas demand.

The discoveries have spurred energy experts and policy makers to start looking to natural gas in their pursuit of a wide range of goals: easing the impact of energy-price spikes, reducing dependence on foreign oil, lowering "greenhouse gas" emissions and speeding the transition to renewable fuels.

A climate-change bill being pushed by President Barack Obama could boost reliance on natural gas. The bill, which could emerge from the House Energy and Commerce Committee in May, is expected to set aggressive targets for reducing emissions of carbon dioxide, the most prevalent man-made greenhouse gas.

the nafta flu

truthout.org | La Jornada columnist Julio Hernández López connects the corporate dots to explain how the Virginia-based Smithfield Farms came to Mexico:

In 1985, Smithfield Farms received what was, at the time, the most expensive fine in history - $12.6 million - for violating the US Clean Water Act at its pig facilities near the Pagan River in Smithfield, Virginia, a tributary that flows into the Chesapeake Bay. The company, according to the US Environmental Protection Agency (EPA) dumped hog waste into the river.

It was a case in which US environmental law succeeded in forcing a polluter, Smithfield Farms, to construct a sewage treatment plant at that facility after decades of using the river as a mega-toilet. But “free trade” opened a path for Smithfield Farms to simply move its harmful practices next door into Mexico so that it could evade the tougher US regulators.

The North American Free Trade Agreement (NAFTA) came into effect on January 1, 1994. That very same year Smithfield Farms opened the “Carroll Ranches” in the Mexican state of Veracruz through a new subsidiary corporation, “Agroindustrias de México.”
Unlike what law enforcers forced upon Smithfield Farms in the US, the new Mexican facility - processing 800,000 pigs into bacon and other products per year - does not have a sewage treatment plant.

America’s top pork producer churns out a sea of waste that has destroyed rivers, killed millions of fish and generated one of the largest fines in EPA history. Welcome to the dark side of the other white meat.

Smithfield Foods, the largest and most profitable pork processor in the world, killed 27 million hogs last year. That’s a number worth considering. A slaughter-weight hog is fifty percent heavier than a person. The logistical challenge of processing that many pigs each year is roughly equivalent to butchering and boxing the entire human populations of New York, Los Angeles, Chicago, Houston, Philadelphia, Phoenix, San Antonio, San Diego, Dallas, San Jose, Detroit, Indianapolis, Jacksonville, San Francisco, Columbus, Austin, Memphis, Baltimore, Fort Worth, Charlotte, El Paso, Milwaukee, Seattle, Boston, Denver, Louisville, Washington, D.C., Nashville, Las Vegas, Portland, Oklahoma City and Tucson.

Smithfield Foods actually faces a more difficult task than transmogrifying the populations of America’s thirty-two largest cities into edible packages of meat. Hogs produce three times more excrement than human beings do. The 500,000 pigs at a single Smithfield subsidiary in Utah generate more fecal matter each year than the 1.5 million inhabitants of Manhattan. The best estimates put Smithfield’s total waste discharge at 26 million tons a year. That would fill four Yankee Stadiums.

google flu trends

google.org | We've found that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate flu activity in your state up to two weeks faster than traditional systems.

here go the stupid....,

NYTimes | Egypt has begun forcibly slaughtering the country’s pig herds as a precaution against swine flu, a move that the United Nations described as “a real mistake” and one that is prompting anger among the country’s pig farmers.

The decision, announced Wednesday, is already adding new strains to the tense relations between Egypt’s majority Muslims and its Coptic Christians. Most of Egypt’s pig farmers are Christians, and some accuse the government of using swine flu fears to punish them economically.

According to World Health Organization officials, the decision to kill pigs has no scientific basis. “We don’t see any evidence that anyone is getting infected from pigs,” said Dr. Keiji Fukuda, the World Health Organization’s assistant director general. “This appears to be a virus which is moving from person to person.”

The outbreak has been dubbed swine flu — now officially called influenza A(H1N1) — because scientists believe it started in pigs, but they do not know if that was recently or years ago. The name change was designed to allay fears about pigs and eating pork.

Egypt has not reported any cases of the new virus that has hit 11 other nations, but the country has been hard hit by avian flu.

The great majority of Egyptians are Muslim and do not eat pork because of religious restrictions, but about 10 percent of the population is Coptic Christian. As a result, Egyptian pig farmers are overwhelmingly Christian. And although some of the country’s Christians are middle class or wealthy, the Christian farmers are generally poor.

On Thursday, several urban pig farmers in Cairo said they see the government’s decision as just another expression of Egyptian Muslims’ resentment against Christians. Last year, there were several violent incidents that some believed were aimed at Christians, including the kidnapping and beating of monks. The Egyptian government denied the incidents had sectarian overtones, saying they were each part of other disputes, including a fight over land.

flu prompts shutdowns in mexico, texas

NYTime | The swine flu continues to spread slowly but surely, with 114 confirmed cases in 12 states on Thursday, up from 91 in 10 states on Wednesday. Many more states have suspected cases, and 11 countries have been affected so far.

But little else seems sure about the disease, including how bad it will turn out to be and even its name, now officially influenza A(H1N1), according to the World Health Organization.

“This is a rapidly evolving situation,” said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention. “It is a situation filled with uncertainty.”

Dr. Besser praised a decision by the W.H.O. on Wednesday to raise the global alert level to Phase 5, one step below a pandemic. He said the move would not affect the United States, which is already taking measures against the outbreak, but would alert other countries to get pandemic plans in order. On Thursday, officials of the health organization said Phase 5, which means a pandemic is highly likely, was still the appropriate level.

In this country, hundreds of schools have closed, including Fort Worth’s entire school district of about 80,000 students. Texas has 26 confirmed cases.

On Thursday, the White House disclosed that a member of the Obama administration delegation that traveled to Mexico in mid-April probably contracted the disease. The man had flu symptoms when he returned to Washington, and spread the illness to his wife and son, but he and his family have recovered and he is back at work. Robert Gibbs, the White House press secretary, said the man did not work closely with the president and never posed any risk to him.

In Canada, the confirmation of 15 additional cases on Thursday brought the total number of cases there to 34.

Mexico now has 312 confirmed cases and 12 confirmed fatalities. More than 2,500 cases are suspected, and at least 150 people are believed to have died of the disease.

emergency medicine backchannel scoop...,

After I returned from a public health meeting yesterday with community leaders and school officials in Comal County and Hays County, Heather suggested I send an update to my patients in the area, because what we are hearing privately from the CDC and Health Department is different from what you are hearing in the media. Some of you know some of this, but I will just list what facts I know.

- The virus is infectious for about 2 days prior to symptom onset

- Virus spreads more than 7 days after symptom onset (possibly as long as 9 days) (this is more unusual than ordinary flu)

- Since it is such a novel (new) virus, th ere is no "herd immunity," so the "attack rate" is very high. This is the percentage of people who come down with a virus if exposed. Almost everyone who is exposed to this virus will become infected, though not all will be symptomatic. That is much higher than seasonal flu, which averages 10-15%. The "clinical attack rate" estimation from CDC and WHO may be around 40-50%. This is the number of people who show symptoms. This is a huge number. It is hard to convey the seriousness of this to those outside of the medical fields.

- The virulence (deadliness) of this virus is as bad here as in Mexico, and there are folks on ventilators here in the US, right now. This has not been in the media, but a 23 month old in Houston is fighting for his life, and a pregnant woman just south of San Antonio is fighting for her life. In Mexico, these folks might have died already, but here in the US, folks are getting Tamiflu or Relenza quickly, and we have ready access to ventilators. What this means is that within a couple of weeks, regional hospitals will likely become overwhelmed.

- Some of the kids with positive cases in Comal County have had more than 70 contacts before diagnosis as a minimum figure.

- There are 10-25 times more actual cases (not "possible" cases -- actual), than what is being reported in the media. The way they fudge on reporting this is that it takes 3 days to get the confirmatory nod from the CDC on a given viral culture, but based on epidemiological grounds, we know that there are more than 10 cases for each "confirmed" case right now.

- During the night, we crossed the threshold for the definition of a WHO, Phase 6 global pandemic. This has not happened in any of our lifetimes so far. We are in uncharted territory.

- They are advising President Obama to declare an emergency sometime in the next 72-96 hours. This may not happen, but if it doesn't, I will be surprised. When this happens, all public gathering will be cancelled for 10 days minimum.

- I suggest all of us avoid public gatherings. Outdoor activities are not as likely to lead to infection. It is contained areas and close contact that are the biggest risk.

- Tamiflu is running out. There is a national stockpile, but it will have to be carefully managed for law enforcement and first responders as it is not enough to treat the likely number of infections when this is full-blown. I don't think there is a big supply of Relenza, but I do not know those numbers. If I had to choose, I would take Relenza, as I think it gets more drug to the affected tissue than Tamiflu.

- You should avoid going to the ER if you think you have been exposed or are symptomatic. ER's south of here are becoming overwhelmed today-- and I mean that -- already. It is coming in waves, but the waves are getting bigger.

- It appears that this flu produces a distinctive "hoarseness" in many victims. The symptoms, in general, match other flu's; namely, sore throat, body aches, headache, cough, and fever. What is not too common in regular flu cycles is vomiting and diarrhea which seems to be associated with this, further dehydrating victims. Some have all these symptoms, while others may have only one or two.

- N-Acetyl-Cysteine -- a nutritional supplement available at the health food store or Wimberley Pharmacy, has been shown to prevent or lessen the severity of influenza. I suggest 1200mg, twice a day for adults, and 600mg twice a day in kids over 12. It would be hard to get kids under 12 to take it, but you could try opening the capsules and putting it on yogurt. For 40 pounds and up, 300-600 mg twice a day, for less than 40 pounds, half that.

- Oscillococinum, a homeopathic remedy, has been vindicated as quite effective in a large clinical trial in Europe, with an H1N1 variant. You can buy this at Hill Country Natural Foods, or the Wimberley Pharmacy.

I will try to keep everyone posted if I have any new information. Meanwhile, don't be afraid, stay informed and try to avoid infection. The fewer people infected the easier it will be for our public officials to manage it.

If any of my patients become ill, or suspect infection, call the office, do not come without calling and DO NOT go to the ER. If one member in a family is identified all would be given the Tamiflu or Relenza (that is normal course of action) if there is enough distributed to fill prescriptions. Public health stated that one family member identified or suspected to have contracted the flu it will require the whole family to be ‘quarantined’ in their own home until enough time has passed for the remaining household to have contracted it or be considered infection free ( 7 to 10 days per person). As another suggestion, if any member of the family is on routine medication- fill those prescriptions now. Have plenty fluids, Motrin, soups, etc available and make contingency plans in case your family is affected.

containment not economically feasible...,

NYTimes | “Containment is no longer a feasible option,” Dr. Keiji Fukuda, deputy director general of the World Health Organization, announced Monday night in Geneva after a meeting of the agency’s emergency committee on the spreading swine flu virus. “The world should focus on mitigation. We recommend not closing borders or restricting travel.”

Many countries are still ignoring that advice. The globe is a confusing welter of bans, advisories and alerts on some pork and some people.

On Wednesday, Homeland Security Secretary Janet Napolitano was heavily pressed in Congressional hearings to ignore the advice and close the border with Mexico. She defended her decision not to do so, saying it “would be a very, very heavy cost for what epidemiologists tell us would be marginal benefit.”

President Obama defended it too, telling a reporter that it would be “akin to closing the barn door after the horse is out.”

Experts on the global movement of flu say Dr. Fukuda, Ms. Napolitano and Mr. Obama are right. The world, they say, must bow to the inevitable: closing borders would not only fail to stop the virus, but would also cause economic collapse and possibly add to the death rate.

“But it’s wrong to think we’re throwing up our hands and saying ‘Let ’er rip and let’s hope for the best,’ ” said Dr. Martin S. Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention in Atlanta. “This has all been in the national pandemic flu plan since 2007.”

Closing borders is dangerous because many goods needed in a pandemic are made abroad, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, including most masks, gowns and gloves, electrical circuits for ventilators and communications gear, and pharmaceutical drugs and the raw materials to make them. (For example, most suppliers of shikimic acid, the base ingredient in the antiviral drug Tamiflu, are in China.)

“You cut those off and you cripple the health care system,” he said. “Our global just-in-time economy means we are dependent on others.” Much of our food is from overseas. “A Kellogg’s Nutri-Grain bar has ingredients from nine countries in it,” he noted.

The fallback position, experts said, is mitigation, the use of “nonpharmaceutical measures.” They include personal ones like washing hands and wearing a mask, occupational ones like working from home or arranging care for children who are sick or whose schools close, neighborhood-level ones like closing theaters, museums or restaurants, and metropolitan-wide ones like shutting a school system or canceling a major league ballgame.

mapmaker discusses the spread thus far...,

from phase 4 to phase 5

WaPo | The World Health Organization took the unprecedented step yesterday of warning that the world is probably on the verge of a pandemic, as new cases of swine flu mounted, the first death was reported in the United States and the dangerous virus appeared to arrive just outside the nation's capital.

The WHO's action came after the agency convened an unusual "global virtual science meeting" involving several hundred experts and officials to help assess the situation. The agency raised the alert from "phase 4" to "phase 5" two days after elevating it for the first time because the never-before-seen virus was spreading in Mexico.

Saying influenza viruses are "notorious for their rapid mutation and their unpredictable behavior," WHO Director General Margaret Chan told reporters: "This is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic."

The new alert level could prompt a variety of measures, including more intensive efforts to identify cases and stricter measures to prevent the illness's spread, such as discouraging or banning public gatherings.

With the virus now clearly being transmitted person-to-person in the United States, WHO officials said the outbreak appeared to be on a trajectory toward the highest alert level -- "phase 6" -- which is marked by sustained transmission in at least two regions of the world. That would mark the beginning of a pandemic -- a global spread of the virus.

"It's clear the virus is spreading, and we don't see any evidence of this slowing down at this point," said Keiji Fukuda, the WHO's interim assistant director general for health security and environment.

While there is a chance that the epidemic could stop on its own, officials said that such an outcome is impossible to predict and that governments around the world should plan for the worst.

"There may be a possibility that the virus will die out and stop, and that would be the best for us. But it can turn the other way. So the important point for us is to continue to maintain our vigilance and track its movement," Chan said. "Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world."

call 1 800 CDC - INFO

This podcast, intended for the general public, demonstrates how to put on and take off disposable respirators that are to be used in areas affected by the influenza outbreak.

centers for disease control on youtube

In this video, Dr. Joe Bresee with the CDC Influenza Division describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

flu may have spread within new york city

NYTimes | The swine flu outbreak in New York may have spread beyond one school in Queens — where victims now are estimated to number in the hundreds — to pockets across the city, including at least two other schools, officials said on Tuesday.

At Public School 177, a school for autistic children in Fresh Meadows, Queens, 12 students had fever or other symptoms that could indicate swine flu. The school, at 56-37 188th Street, which was closed as a precaution, is about half a mile from St. Francis Preparatory School, at 61-00 Francis Lewis Boulevard, where the first cases were detected several days ago. Tests of students there have not been completed.

About half a dozen children at Ascension School, a Roman Catholic school on 108th Street near Broadway in Manhattan, have come down with fever. That school was not closed, but health officials will test students for swine flu on Wednesday.

Mayor Michael R. Bloomberg said at a news conference that two people had been hospitalized with suspected swine flu — a young boy just admitted to a hospital in the Bronx, and a woman treated on Sunday at a hospital in Brooklyn. Both had family members who had traveled to Mexico, he said.

There were also unconfirmed reports of cases at Ernst and Young, an accounting firm in Times Square, and at Teachers College at Columbia University.

Though the symptoms of the virus in the New York cases have been mild so far, Mr. Bloomberg and Dr. Thomas R. Frieden, the city health commissioner, raised the possibility for the first time on Tuesday that people in the United States could die from the spreading outbreak, even as they urged New Yorkers to keep calm.

“It is here, and it is spreading,” Dr. Frieden said.

The big puzzle, Dr. Frieden said, is why the symptoms of those who have fallen ill so far in New York are mild, and whether the virus will just fizzle or get worse over time, becoming more like the outbreak in Mexico.

like you'd take it anyway....,

NYTimes | Federal officials said it would take until January, or late November at the earliest, to make enough vaccine to protect all Americans from a possible epidemic of swine flu.

And beyond the United States and a few other countries that also make vaccines, some experts said it could take years to produce enough swine flu vaccine to satisfy global demand.

Although production is much faster than would have been possible even a few years ago, it still may not be in time to avert death and illness if the virus starts spreading widely and becomes more virulent, some experts said.

In this country, the biggest problem is that despite years of effort, the country is still relying on half-century-old technology to make the flu vaccines.

Federal authorities have spent years and more than a billion dollars trying to shift vaccine production to a faster, more reliable method — one that involves growing the vaccine viruses in vats of cells rather than in hen’s eggs, the old technology. And there are numerous small companies developing totally new approaches that might allow for the production of huge volumes of vaccines in a matter of weeks.

But the cell-based production is not quite ready, and some of the newer techniques are not proven enough to satisfy many experts.

“Those are all great technologies, but it isn’t going to happen in time,” said Dr. Greg Poland, head of the vaccine research program at the Mayo Clinic.

when can the government quarantine its citizens?

Slate | When someone has been exposed to diphtheria, infectious tuberculosis, yellow fever, viral hemorrhagic fevers, SARS, and a new strain of influenza with pandemic potential. That's the federal government's list, which changes only by executive order; states may have their own. Patients who have actually been infected, like the Atlanta man [Andrew Speaker], are technically under "isolation," not quarantine.

The federal government took responsibility for isolating Speaker because his plane travel made his case an interstate and international health threat. Normally, the states have primary responsibility for quarantine and isolation. Some state laws specify which illnesses require quarantine, while others focus on public-health threats in general. In Louisiana, health officials need permission from a judge before confining a patient. Any people in Minnesota who lose their jobs because of a quarantine or isolation can sue their employers.

States have been broadening their public-health powers in recent years because of bioterrorism and pandemic fears. Sometimes a state will amend its laws to deal with a specific crisis. For instance, Alaska had to pass an amendment during the SARS scare to be able to quarantine and investigate a docked ship.

In certain states, disobeying a quarantine or isolation order can put you behind bars. A 27-year-old man in Arizona diagnosed with the same deadly strain of [tuberculosis] has been quarantined in a prison hospital ward for the past 10 months; state officials said they put Robert Daniels there because he failed to take his medicine and endangered others by going out and entertaining friends without wearing a mask.

But in general, the government rarely has to exercise these powers, because most of the time, citizens cooperate. In fact, until this recent situation, the CDC hadn't issued such an order since 1963, when it quarantined a woman for smallpox exposure.* Even during the SARS epidemic in 2003, officials relied mostly on voluntary isolation and quarantine. And the last large-scale quarantine in the United States took place during the Spanish flu epidemic of 1918-19.

Bonus Explainer: What happens in isolation? A patient often lives in a room with negative air pressure to prevent disease from spreading; an ultraviolet light may kill potential pathogens as they're sucked through a HEPA filter. Visitors must wear masks or, in some cases, sterile full-body suits.

authorities study differences in flu's severity

WaPo | Health authorities raced yesterday to unravel the many mysteries about the ominous new swine flu spreading around the world, including how widely the virus might cause the severe form of illness that so far has been restricted to the epicenter of the outbreak in Mexico.

As the number of confirmed infections in the United States jumped again and cases were confirmed for the first time in Britain, New Zealand and Israel, researchers searched for clues as to how readily the virus causes the pneumonia that has hospitalized and killed patients in Mexico. Only a handful of patients in the United States and elsewhere outside Mexico have been hospitalized, severe complications have been relatively rare, and no one has died.

"We still do not have a good explanation for why the pattern of cases in other countries appear relatively mild while the pattern of cases in Mexico appear to be much more severe," said Keiji Fukuda of the World Health Organization. "This will be the object of a great deal of research and attention, but at this time, we can't say why there appears to be a difference."

Experts said there are several possibilities: Victims in Mexico may be more vulnerable because of nutritional deficiencies, other infections or some other factor; medical care may be better in the United States and elsewhere; the virus could be weakening as it spreads; or too few cases may have occurred outside Mexico for severe illnesses to emerge.

"This is the mystery," said Arnold Monto, an influenza expert at the University of Michigan. "You could speculate about so many things. It's an incredibly important question."

little boy at the center of a viral storm

WaPo | One person who may have helped launch a rapidly spreading flu outbreak likes to draw hearts and flowers in the dirt outside his home. He likes to climb trees and give hugs and play with his soccer ball. And despite a persistent cough, he does not, he insists, feel sick.

"Not anymore," said Édgar Enrique Hernández, a smiling 5-year-old Mexican boy who tested positive for the deadly new strain of swine flu in this windswept valley surrounded by pig-breeding farms. "I feel good."

Although authorities have not determined that swine flu started in La Gloria, a village of about 2,500 people in the state of Veracruz, Édgar, who got sick in late March, is the earliest confirmed case of the virus in Mexico. He was just one of several hundred people from La Gloria and surrounding areas that fell ill around that time in an unexplained outbreak that left two children dead and prompted authorities to fumigate the entire village.

"I don't have words, I don't have answers," said Édgar's mother, María del Carmen Hernández, as she cried under a portrait of Jesus in her living room. "I feel terrible about all of this, because the people are thinking that this was all my son's fault. I don't think this is anyone's fault."

This dust-strewn hamlet of dirt streets surrounded by desert cactus and scrub brush has become a focus of attention for the spread of the virus because of the prevalence of pig farms in the area, and because of Édgar. But the link is far from certain, and infectious-disease specialists stressed that no one has located a pig infected with this particular virus, so proximity between people and pigs may not be all that's required to contract the disease. The strain appears, in fact, to be Eurasian in origin, further adding to the mystery of where it began.

folk medicines and herbs to use and avoid with flu

Health Gazette | Below is a list of foods that are said to contain substances that are natural antivirals, immune boosters or they decrease cytokines TNF-a and IL-6.

Alternative medications that are most likely to help us during a severe pandemic:

Garlic (allicin) - Very effective antiviral. Best if fresh (raw) and crushed. Must be consumed within 1 hour of crushing. Dosage is initially 2 to 3 cloves per day but later reduce until no body odour occurs. No toxic effects noted. (Pubmed PMID 9049657)

Vitamin C - Boosts the immune system and is an antiviral by blocking the enzyme neuraminadase. Viruses need neuraminadase to reproduce. There are anecdotal stories of people taking large amounts of Vitamin C (children ½) surviving the Spanish Flu. Research shows that it may reduce the production of cytokines TNF-a and IL-6. A study on 470 people involved giving the test group 1000 mg hourly for 6 hours and then 1000 mg 3 times daily after reporting flu symptoms. Symptoms decreased by 85%. (Pubmed PMID 10543583, 634178, 16169205, 12876306)

Green Tea (possible Tamiflu/Relenza alternative)- Very effective antiviral. Also decreases the production of the cytokine (catechins) TNF-a. Inhibits neuraminidase. May have antiviral activity that is equal to other antivirals such as Tamiflu. (Pubmed PMID 16137775)

St Johns Wort (Hypericum) - Very effective antiviral. Also decreases the production of the cytokine IL-6. Hypericum is an extract from St John’s Wort. There have been some very successful field trials in commercial flocks infected with H5N1 in Vietnam. (Pubmed PMID 7857513, 11518071, 11362353, 7857513, 11518071)

Vitamin E - Immune booster. Also decreases the production of the cytokine TNF-a. (Pubmed PMID 155882360, 10929076) Experiments involved using mice. Very suitable for immune compromised people, especially the elderly. Effects enhanced when taken with Vitamin C.

Apple Juice - Antiviral. Fresh apple juice including the pulp and skin has greater antiviral activity than heated commercial apple juice. More research is needed. Effectiveness on H5N1 is unknown. (Pubmed PMID 32832, 12452634)

Resveratrol - Antiviral. In addition to inhibiting neuraminidase, Resveratrol also sends a message to cells to stop manufacturing viruses. This is a proven antiviral found naturally in red wine, peanuts, mulberries, Japanese Knotwood root (richest source), raisins and red grapes. Resveratrol supplements are relatively inexpensive, are more stable than wine and is available in liquid form for absorption in the mouth. No toxic effects noted. (Pubmed PMID 1583880, 12817628, 15985724)

Scuttellaria (Skullcap) - Antiviral. A herb used as a tea. It has no side effects and is also a mild tranquilliser. Research suggests neuraminidase, which is a substance needed by the H5N1 virus to reproduce, may be inhibited.

Cranberry Juice - Early research shows that it may be an antiviral, making viruses less able to invade or multiply. Effectiveness on H5N1 is unknown. (Pubmed PMID15781126)

Cat’s Claw (Uncaria tomentosa) - Decreases the production of the cytokine TNF-a. Also boosts immune system. The number of white blood cells was significantly increased during treatment. No toxicity was noted. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed) Active constituents can be found in the leaves, bark, vine, and roots. Water extraction from bark used. Children and pregnant women are to avoid. Has a potentially damaging effect on the DNA of proliferating cells. (cancers, foetuses, growing children)

Curcumin (Tumeric Spice) - Decreases the production of the cytokine TNF-a. This is the yellow compound in turmeric spice. Research shows that this may be very good for preventing a cytokine storm although this is not proven. Must be taken with food or gastritis or peptic ulcers may occur. Pregnant women and feeding mothers should avoid this. The medicinal properties of curcurnin cannot be utilised when used alone due to rapid metabolism in the liver and intestinal wall. When combined with Piperine found in black pepper the absorption is increased with no adverse effects. Obtainable from health stores in tablets, liquid, capsules already combined with piperine. Dosage is 500mg to 4000mg daily.

Astragalus root (Astragali Radix) - Boosts immune system. (Pubmed PMID15588652)

Tea tree Steam Inhalation - Reduces the cytokine TNF-a. Add 2 drops of tea tree oil in a bowl of steaming water. Cover head with a towel and inhale for 5 to 10 minutes. Relieves congestion and fights infection. Its effectiveness is unknown. (Pubmed PMID 11131302)

The following substances may be best to avoid during a H5N1 pandemic

Elderberry juice (Sambucal) - AVOID - Increases production of cytokines TNF-a and IL-6. This substance is very effective against the common flu but may not be desirable for the H5N1 virus. Increases in these cytokines may trigger a lethal cytokine storm. (Isr Med Journal2002 Nov;4:944-6)

Micro Algae (Chlorella and Spirulina) - AVOID - Increases production of cytokine TNF-a. (Pubmed PMID 11731916)

Honey - AVOID - Increases production of cytokines TNF-a and IL-6. (Pubmed PMID12824009)

Chocolate - AVOID - Increases production of cytokines TNF-a and IL-6. (Pubmed PMID 12885154, PMID 10917928)

Echinacea - AVOID - Increases production of cytokines TNF-a and IL-6. Although it is often used for normal flu, research shows that it may increase the chance of cytokine storms for H5N1. (Pubmed PMID 15556647, 9568541)

Kimchi - AVOID - Increases production of cytokines TNF-a and IL-6. (Pubmed PMID15630182)

Dairy products & Bananas - AVOID - These foods increase mucous production.

source of the infection?

LATimes | Swine flu is suspected in at least 149 deaths and 1,995 cases, with nearly all states reporting infections. Officials look at what is thought to be the first case, near a pig farm in Veracruz.

Reporting from Mexico City — With the death toll climbing, Mexican authorities at the center of an international swine flu epidemic struggled Monday to piece together its lethal march, with attention focusing on a 4-year-old boy and a pig farm.

The boy, who survived the illness, has emerged as Mexico's earliest known case of the never-before-seen virus, Health Secretary Jose Angel Cordova said Monday. It provides an important clue to the unique strain's path.

The boy lived near a pig farm run by a U.S.-Mexican company, Granjas Carroll, in the municipality of Perote, in Veracruz state on the Gulf of Mexico. He contracted the disease on April 2, Cordova said, one of a group of residents who came down with what was at the time labeled a particularly bad case of the flu.

Only one sample from the group, that belonging to the boy, was preserved. It was retested after other cases of the new strain were confirmed elsewhere in the country, Cordova said. The boy had the same disease. It is unknown how many more of the hundreds of people who fell sick in Perote also were infected by the strain.

In an ominous disclosure, officials said the first confirmed fatality of the disease, a 39-year-old woman from an impoverished state neighboring Veracruz, worked as a door-to-door census-taker and may have had contact with scores of people.

In Perote, residents of the hamlet known as La Gloria have complained since mid-March that contamination from the pig farm was tainting their water and causing respiratory infections. In one demonstration in early April, they carried signs with pictures of pigs crossed out with an X and the word "peligro" -- danger. Residents told reporters at the time that more than half the town's 3,000 inhabitants were sick and that three children under the age of 2 had died.

Local health officials mobilized when the outbreak was first reported, but they gave a different account: The infection may have started with a migrant farmer who returned from work in the U.S. and gave the disease to his wife, who in turn passed it on to other women in the community.

(Smithfield) Granjas Carroll, which claims to be Mexico's leading pig farm at a million head a year, issued a statement Monday saying none of its employees had shown any signs of illness and noting that the sick are people who had no contact with its pigs. It is but one of numerous farms in the region.

The United Nations' Food and Agriculture Organization announced Monday that it was sending a team of experts to inspect pig farms in Mexico. The agency's chief veterinary officer, Joseph Domenech, said the teams would attempt to determine whether the new strain was circulating among pigs and then trace linkage to human populations.

The first officially confirmed fatality from the disease occurred April 13. Maria Adela Gutierrez died in the southern city of Oaxaca, capital of the state of the same name.

Gutierrez was a door-to-door census-taker for the tax board, meaning she could have had contact with scores of people at her most contagious point, before being hospitalized. But Martin Vazquez Villanueva, the regional health secretary in Oaxaca, denied local news reports that said she had infected 20 people, as well as her husband and children.

andromeda strain...,

The Scientist | As reported cases of swine flu continue to accumulate (as of today, 40 had been reported in the US) and mainstream media outlets dust off their foreboding music tracks and positively scary taglines, a biotechnology company in Maryland says that its approach may speed development of a successful vaccine.

Researchers at Novavax have been developing vaccines for the H5N1 strain of avian flu, along with other strains of influenza, over the past few years using an approach built around virus-like particles (VLP)--viral membrane proteins in a matrix of lipids. Researchers from the company, with scientists from the Centers for Disease Control and Prevention (CDC), published a study last month in which they successfully protected mice against a reconstructed virus from the 1918 Spanish flu outbreak through intranasal immunization with H1N1 VLPs.

A new strain of H1N1 is likely causing the current outbreak of swine flu in North America, which this weekend led both the World Health Organization and the CDC to declare a public health emergency.

Gregory Poland, an immunologist and head of the Vaccine Research Group at the Mayo Clinic in Minnesota, said VLPs and other novel approaches to vaccine development, for combating influenza are exciting but untested. "The issue, from the perspective of influenza, is that none of these is approved," he said. In fact, the only FDA-approved VLP-based vaccines on the market are those developed to protect women from human papillomavirus.

hurricanes, tornados and plague, OH MY!!!

The Scientist | A much-contested plan to build a $450 million government biodefense research lab has hit another snag: A group of Texas research organizations that lobbied for San Antonio to house the lab says it will sue the Department of Homeland Security (DHS) over its choice of site -- Manhattan, Kansas.

The Texas Biological and Agro-Defense Consortium earlier this week (April 22) filed a notice of its intent to sue DHS, a required step for suits against the government. They argue that the choice of Kansas for the site of the National Bio and Agro Defense Facility (NBAF), which would handle the world's most dangerous pathogens, was based on political machinations and overlooks the danger frequent tornadoes would pose to the facility.

John Kerr, chairman of the group, said that locating NBAF in Manhattan, Kan., would be "grossly irresponsible, the equivalent of playing Russian roulette with Mother Nature," according to the Associated Press.

Kerr argued that although DHS had initially ranked the Texas site slightly higher than Kansas, the agency's secretary in charge of choosing the site, Navy Admiral Jay Cohen, gave Kansas preference -- due to ties with Kansas officials involved in the process -- by making numerous visits there, the AP reports. Kansas officials deny the claim of political preference.

Kansas Bioscience Authority president Tom Thornton said in a statement: "...the Department of Homeland Security deserves commendation, not litigation, for the extremely comprehensive and fair process it undertook to ensure the success of the National Bio and Agro-Defense Facility. Only Kansas offers a credible pathway to jumpstart the NBAF's critical mission."

We earlier visited the intrinsic foolishness of situating a BSL-4 pathogen research and containment facility in the middle of hurricane alley, that goes double for tornado alley...,

"ism" and the unconscious immune system

Discover | Over the past few years, Mark Schaller, a psychologist at the University of British Columbia, has been developing an intriguing theory that behavior can be just as effective as microbiology at warding off disease. According to this theory, we have what Schaller calls a “behavioral immune system.” It’s a way of responding to the outside world, and to the people around us, that is so deeply embedded in our minds that we are hardly aware of it.

Schaller and his colleagues have been busily running psychological experiments to test his hypothesis. The results so far are preliminary but provocative. If Schaller is right, this behavioral immune system may prove to have a big influence on our day-to-day lives. It might even influence human nature on a global scale, shaping cultures around the world.

If the familiar, biological immune system were foolproof, it would be pointless to evolve a behavioral immune system too. In reality, however, our defenses are far from perfect. Some pathogens can disguise themselves well enough to go unnoticed, and others breed so fast that our immune systems cannot keep up. Then again, sometimes our immune system succeeds too well, using such overwhelming force against pathogens that it damages our own tissues in the process.

Not getting infected in the first place is a far safer alternative. Scientists have discovered a wide variety of animal species that use behavioral strategies to avoid becoming sick. Some caterpillars blast their droppings like cannons so that parasitic wasps that lay eggs in the droppings won’t be able to follow their scent. Sheep instinctively avoid grazing on grass near their own manure, advantageous because many sheep parasites release their eggs in the animals’ droppings. A female mouse can smell the difference between a healthy male and one infected with intestinal worms. She will avoid the latter and mate with the former.

Our closest living cousins, the chimpanzees, also display behavioral responses to signs of disease. When the primatologist Jane Goodall observed chimps in the 1960s, one of her subjects was a male she called McGregor, who suffered from polio. He dragged himself around by his arms after his legs became paralyzed, and his loose bladder attracted clouds of flies. Before McGregor got sick, he enjoyed hours of grooming from other chimpanzees, who picked out fleas, mites, and other parasites from his fur. But Goodall watched in amazement as the other chimpanzees stayed away from him once he became ill.

murder by injection?

Excerpted from the text:

Medical historians have finally come to the reluctant conclusion that the great flu “epidemic” of 1918 was solely attributable to the widespread use of vaccines. It was the first war in which vaccination was compulsory for all servicemen. The Boston Herald reported that forty-seven soldiers had been killed by vaccination in one month. As a result, the military hospitals were filled, not with wounded combat casual­ties, but with casualties of the vaccine. The epidemic was called “the Spanish Influenza,” a deliberately mis­leading appellation, which was intended to conceal its origin. This flu epidemic claimed twenty million victims; those who survived it were the ones who had refused the vaccine.

Ten years earlier, Eleanora I. McBean, Ph.D., N.D. had written a similar account in her book, Swine Flu Expose:

I heard that seven men dropped dead in a doctor’s office after being vaccinated. This was in an army camp, so I wrote to the Government for verification. They sent me the report of U.S. Secretary of War, Henry L. Stimson. The report not only verified the report of the seven who dropped dead from the vaccines, but it stated that there had been 63 deaths and 28,585 cases of hepatitis as a direct result of the yellow fever vaccine during only 6 months of the war. That was only one of the 14 to 25 shots given the soldiers.

When doctors had tried to suppress the symptoms of the typhoid with a stronger vaccine, it caused a worse form of typhoid which they named paratyphoid. But when they concocted a stronger and more dangerous vaccine to suppress that one, they created an even worse disease which they didn’t have a name for. What should they call it? They didn’t want to tell the people what it really was - their own Frankenstein monster which they had created with their vaccines and suppressive medicines. They wanted to direct the blame away from themselves, so they called it Spanish Influenza. It was certainly not of Spanish origin, and the Spanish people resented the implication that the world-wide scourge of that day should be blamed on them. But the name stuck and American medical doctors and vaccine makers were not suspected of the crime of this widespread devastation - the 1918 Flu Epidemic. It is only in recent years that researchers have been digging up the facts and laying the blame where it belongs.

Vaccines have dubious efficacy because the immune system is not designed to respond to injected microbes. The first line of defence is the mucosal membranes in the mouth and gut. If a microbe enters the body through injection, it triggers an antibody response but crucially, it bypasses the cellular immune system altogether and actually suppresses its function. The same microbe will become far more virulent if it is injected, hence the numerous accounts of epidemics amongst vaccinated populations in the medical literature.

This is not an endorsement of Mullins or of any of the many conspiracy-centric things he's written. In this case it just happens to be one of those topically pertinent things with a high potential to make you go hmmm....,

flu suspected in new zealand

Voxy NZ | An Auckland school group is being tested for swine flu after returning from Mexico with flu-like symptoms.

More than 80 people in Mexico are believed to have died and over 1300 are sick as a result of catching swine flu. Cases have also been reported in New York, California and Kansas and a British Airways pilot has been hospitalised in London with flu symptoms after returning from Mexico.

Three teachers and 22 senior students at Rangitoto College, New Zealand's largest secondary school, on Auckland's North Shore, yesterday returned to Auckland on a flight from Los Angeles, after a three week trip to Mexico .

Auckland Regional Public Health Service (ARPHS) said today some had symptoms of an influenza-like illness and were remaining in home isolation as a precaution while tests to exclude or confirm swine influenza were carried out.

One student was believed to be in hospital.

Ministry of Health spokesman Michael Flyger told NZPA the results of tests were expected this evening.

He said at this stage other passengers on the flight were not being sought and the next step would depend on what the tests showed.

"We don't believe at this point that there is a need for that.

"We might get no positives, we might get one, we might get all of them. It's a pretty big step to be taking (and) it's something that would be considered."

In the meantime the students and teachers had been told to stay at home in isolation and ARPHS was briefing their families and the school on infection control precautions.

While the virus' spread was considered serious enough for WHO declare a health emergency, Mr Flyger said hit had proven responsive to drugs.

"It is concerning for sure. You've just got to look at the WHO's advice on this, but it has shown it reacts to treatment so it's not as bad as it could be.

"We're not looking at (the horror film) 28 Days Later."

flu on the ground in mexico...,

BBC News | I'm a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. There is a severe emergency over the swine flu here. More and more patients are being admitted to the intensive care unit. Despite the heroic efforts of all staff (doctors, nurses, specialists, etc) patients continue to inevitably die. The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses. It is a great fear among the staff. The infection risk is very high among the doctors and health staff.

There is a sense of chaos in the other hospitals and we do not know what to do. Staff are starting to leave and many are opting to retire or apply for holidays. The truth is that mortality is even higher than what is being reported by the authorities, at least in the hospital where I work it. It is killing three to four patients daily, and it has been going on for more than three weeks. It is a shame and there is great fear here. Increasingly younger patients aged 20 to 30 years are dying before our helpless eyes and there is great sadness among health professionals here. Antonio Chavez, Mexico City

1918 flu pandemic

Wikipedia | The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiologic data are inadequate to identify the geographic origin of the virus. Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The pandemic lasted from March 1918 to June 1920, spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 20 to 100 million people were killed worldwide, or the approximate equivalent of one third of the population of Europe, more than double the number killed in World War I. This extraordinary toll resulted from the extremely high illness rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. The pandemic is estimated to have infected up to one billion people: half the world's population at the time.

The flu probably originated in the Far East. The disease was first observed at Fort Riley, Kansas, United States, on March 4, 1918, and Queens, New York, on March 11, 1918. In August 1918, a more virulent strain appeared simultaneously in Brest, France, in Freetown, Sierra Leone, and in the U.S. at Boston, Massachusetts. The Allies of World War I came to call it the Spanish flu, primarily because the pandemic received greater press attention after it moved from France to Spain in November 1918. Spain was not involved in the war and had not imposed wartime censorship.

Scientists have used tissue samples from frozen victims to reproduce the virus for study. Given the strain's extreme virulence there has been controversy regarding the wisdom of such research. Among the conclusions of this research is that the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths.

pandemic in the u.s.

NYTimes | Tests show that eight students at a Queens high school are likely to have contracted the human swine flu virus that has struck Mexico and a small number of other people in the United States, health officials in New York City said yesterday.

The students were among about 100 at St. Francis Preparatory School in Fresh Meadows who became sick in the last few days, said Dr. Thomas R. Frieden, New York City’s health commissioner.

“All the cases were mild, no child was hospitalized, no child was seriously ill,” Dr. Frieden said.

Health officials reached their preliminary conclusion after conducting viral tests on nose or throat swabs from the eight students, which allowed them to eliminate other strains of flu. Officials were also suspicious since some St. Francis students recently had been to Mexico, where the outbreak is believed to have started.

UPDATE: New York Mayor Michael Bloomberg says that the Centers for Disease Control and Prevention has confirmed that students at a city high school were infected with swine flu.

New York officials previously had said they were eight "probable" cases, but tests later confirmed that it was indeed swine flu. Bloomberg stressed that the cases were mild and many are recovering.

The city is awaiting the tests of additional samples to see if more St. Francis Preparatory School students were infected.

About 100 students complained of flu-like symptoms at the school. Some students went to Cancun on a spring break trip two weeks ago.

The president in Mexico assumed emergency powers to deal with the crisis, which has killed at least 81 people and infected about 1,300 others. All public gatherings have been banned, including more than 500 concerts and sporting events and the popular bicycle rides on closed boulevards.

Dr. Margaret Chan, the director-general of the World Health Organization, said the events in Mexico “constitute a public health emergency of international concern.”

The W.H.O. convened an emergency meeting of experts on Saturday, but the panel adjourned without raising the global pandemic alert level, saying it wanted more information. Some experts expressed surprise that no action was taken since the Mexico outbreak seems to meet the definition of a Level 4 alert — sustained human-to-human transmission of a new virus. The alert has been at Level 3 for years because of small clusters of human cases of avian flu.

In the United States, so far, at least 11 swine flu cases have been confirmed. Seven were confirmed in San Diego and Imperial Counties in California and two in Kansas. In Texas, two 16-year-old students at Byron Steele High School in Cibolo, near San Antonio, were confirmed to have swine flu, and one of their classmates was suspected to have the virus. There have been no deaths, and officials said most of the 11 seemed to be recovering.