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Online Discussion: Tracking new emerging diseases and the next pandemic.

Swine Flu is Back - 2016

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    Posted: December 18 2015 at 1:43pm
http://medicalxpress.com/news/2015-12-swine-flu-outbreak-nears-tehran.html

An outbreak of swine flu in Iran has claimed 42 lives since mid-November, including in a province neighbouring Tehran, Health Minister Hassan Hashemi said Thursday.

Hashemi, quoted by ISNA news agency, said 33 deaths from the H1N1 virus were recorded in Kerman and five in Sistan-Baluchistan, both provinces in southeastern Iran.

comment: the infecting strain is coming from outside of Iran. 

"This flu comes from beyond our borders, especially from Sistan-Baluchistan" near Pakistan, the minister said Monday. "But every year it becomes wilder and more resistant" to treatment."

https://en.wikipedia.org/wiki/2009_flu_pandemic

comment: We need to watch this for it could become another Pandemic "not if, but when." 

We just had to deal with this in India early this year.

http://zeenews.india.com/news/health/tips/swine-flu-in-india-five-facts-you-should-know-about-the-deadly-virus_1551024.html

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 20 2015 at 8:14am
http://www.ncr-iran.org/en/ncri-statements/human-rights/19621

The swine flu presently sweeping across Iran is a full fledged outbreak. It has already spread to many provinces in the country, including highly populated areas such as the capital city, Tehran. Yet despite its increasing severity, the Iranian regime has yet to take any credible step to fight the outbreak.

Fearing social unrest, the regime is publishing contradictory figures and false reports on the number of those afflicted, including a mounting death toll.

While, the regime’s leaders claim that just a few have been affected and that the disease is under control, the regime’s Ministry of Health is sending a contradictory message. The Ministry of Health alleges that following the outbreak in Kerman and Sistan-Baluchistan provinces, the deadly disease will spread to Kurdistan, Lorestan, Khuzestan, Chaharmahal Bakhtiari, Esfahan, Tehran, Semnan and Northern Khorassan provinces in the coming weeks.


comment: The outbreak is not limited to Iran. It is coming from Pakistan and could spread to other countries.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: December 20 2015 at 9:06am
"Hashemi, Rouhani’s Minister of Health, reacted to the crisis with callous and unnerving indifference.. He even stated, “Always the virus that causes flu is dangerous to some… there is no need for vaccination in this season” (Iranian regime state TV – December 8).

Sounds more like a vaccination issue than a potential pandemic strain to me, Med.
And this guy's the Minister of Health?



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"Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote arirish Quote  Post ReplyReply Direct Link To This Post Posted: December 21 2015 at 9:18am
There's also a large out break in the Caribbean!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote arirish Quote  Post ReplyReply Direct Link To This Post Posted: December 21 2015 at 9:44am
Considering the proximity to India this could also be a new mutated strain!

This is an article I read back in March.

Deadly outbreak of swine flu in India may be due to a mutated strain

http://america.aljazeera.com/articles/2015/3/23/deadly-outbreak-of-swine-flu-in-india-may-be-due-to-a-mutated-strain.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 21 2015 at 11:20am
Originally posted by arirish arirish wrote:

Considering the proximity to India this could also be a new mutated strain!

This is an article I read back in March.

Deadly outbreak of swine flu in India may be due to a mutated strain

http://america.aljazeera.com/articles/2015/3/23/deadly-outbreak-of-swine-flu-in-india-may-be-due-to-a-mutated-strain.html


Arirish - I did some more digging to get you a cleaner link to the original publication from MIT and also the debate about it.

http://news.mit.edu/2015/swine-flu-outbreak-india-mutations-0311

http://timesofindia.indiatimes.com/india/India-and-US-researchers-clash-over-swine-flu-strain-mutation/articleshow/46552397.cms



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 21 2015 at 11:30am
http://news.mit.edu/2015/swine-flu-outbreak-india-mutations-0311

Since December, an outbreak of swine flu in India has killed more than 1,200 people, and a new MIT study suggests that the strain has acquired mutations that make it more dangerous than previously circulating strains of H1N1 influenza.

The findings, which appear in the March 11 issue of Cell Host & Microbe, contradict previous reports from Indian health officials that the strain has not changed from the version of H1N1 that emerged in 2009 and has been circulating around the world ever since.

With very little scientific data available about the new strain, the MIT researchers stress the need for better surveillance to track the outbreak and to help scientists to determine how to respond to this influenza variant.

“We’re really caught between a rock and a hard place, with little information and a lot of misinformation,” says Ram Sasisekharan, the Alfred H. Caspary Professor of Biological Engineering at MIT and the paper’s senior author. “When you do real-time surveillance, get organized, and deposit these sequences, then you can come up with a better strategy to respond to the virus.”

In the past two years, genetic sequence information of the flu-virus protein hemagglutinin from only two influenza strains from India has been deposited into publicly available influenza databases, making it difficult to determine exactly which strain is causing the new outbreak, and how it differs from previous strains. However, those two strains yielded enough information to warrant concern, says Sasisekharan, who is also a member of MIT’s Koch Institute for Integrative Cancer Research.

He and Kannan Tharakaraman, a research scientist in MIT’s Department of Biological Engineering, compared the genetic sequences of those two strains to the strain of H1N1 that emerged in 2009 and killed more than 18,000 people worldwide between 2009 and 2012.

The researchers found that the recent Indian strains carry new mutations in the hemagglutinin protein that are known to make the virus more virulent. Hemagglutinin binds to glycan receptors found on the surface of respiratory cells, and the strength of that binding determines how effectively the virus can infect those cells.

comment: It is very difficult in the research community for some to publish results which have such sweeping conclusions. No doubt, Swine Flu has mutated - that is what viruses do quite frequently. This could make the current vaccines less effective and cause more problems if a new strain evolves and makes its way to other countries.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote arirish Quote  Post ReplyReply Direct Link To This Post Posted: December 21 2015 at 1:12pm
Med-Thanks for the links!

JD said- "Sounds more like a vaccination issue than a potential pandemic strain to me, Med. And this guy's the Minister of Health?"

I agree but one does not rule out the other! I've been following the situation in India and this strain died back but did not die out all summer! Something's different!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: December 21 2015 at 7:30pm
Yep, India got hit hard a short while ago - and during a heatwave, no less Confused
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 22 2015 at 5:45pm
It's not over. Although it is a jumble on there with all kinds of old news posts and new dates - this looks pretty solid.

http://medicalxpress.com/news/2015-12-swine-flu-toll-iran.html

December 15, 2015

An outbreak of swine flu has claimed 57 lives since mid-November in Iran, where hundreds of people have been diagnosed with the virus, the health ministry said Tuesday.

"Around 900 patients have been diagnosed with the H1N1 flue virus across the country," the head of the ministry's communicable diseases department, Mohammad Mehdi, told AFP.

He said 57 patients have died, 15 higher than the last death toll announced on December 10.

The deaths from the H1N1 virus have been mostly in southeastern Iran: 33 were recorded in Kerman and five in Sistan-Baluchistan provinces.

"In the past two weeks 2,700 suspected cases have been tested," Gouya told Mehr news agency.

comment: It's back and hard to know how many have it or have died outside the clinics.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 26 2015 at 9:19am
Background and briefing - Swine Flu spreading in Iran and now in Israel as well.



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: December 26 2015 at 10:06am
There are also reports from Algeria and Egypt-calling it bird-flu while detecting H1N1, indicates this virus has adepted to warmer weather (comes from India via Pakistan, Iran westward). Over the spread of H1N1 the mild cases seem to be spreading most (more than a "super-spreader"?)

http://www.ncbi.nlm.nih.gov/pubmed/26692335#

Transmission of the First Influenza A(H1N1)pdm09 Pandemic Wave in Australia Was Driven by Undetected Infections: Pandemic Response Implications.

Abstract

BACKGROUND:

During the first wave of influenza A(H1N1)pdm09 in Victoria, Australia the rapid increase in notified cases and the high proportion with relatively mild symptoms suggested that community transmission was established before cases were identified. This lead to the hypothesis that those with low-level infections were the main drivers of the pandemic.

METHODS:

A deterministic susceptible-infected-recovered model was constructed to describe the first pandemic wave in a population structured by disease severity levels of asymptomatic, low-level symptoms, moderate symptoms and severe symptoms requiring hospitalisation. The model incorporated mixing, infectivity and duration of infectiousness parameters to calculate subgroup-specific reproduction numbers for each severity level.

RESULTS:

With stratum-specific effective reproduction numbers of 1.82 and 1.32 respectively, those with low-level symptoms, and those with asymptomatic infections were responsible for most of the transmission. The effective reproduction numbers for infections resulting in moderate symptoms and hospitalisation were less than one. Sensitivity analyses confirmed the importance of parameters relating to asymptomatic individuals and those with low-level symptoms.

CONCLUSIONS:

Transmission of influenza A(H1N1)pdm09 was largely driven by those invisible to the health system. This has implications for control measures-such as distribution of antivirals to cases and contacts and quarantine/isolation-that rely on detection of infected cases. Pandemic plans need to incorporate milder scenarios, with a graded approach to implementation of control measures.

Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: December 27 2015 at 2:13am
https://flunewseurope.org/

Week 51/2015 (14−20 December)

  • Influenza activity remained low in most countries in the WHO European Region.
  • While the number of consultations for influenza-like illness and/or acute respiratory infections was stable, the proportion of sentinel specimens testing positive for influenza virus increased from 6% for week 50/2015 to 11% for week 51/2015.
  • Sporadic detections of A(H1N1)pdm09, A(H3N2) and type B influenza viruses were reported.

 

Season

  • The proportion of influenza virus postive sentinel specimens increased to over 10% for the first time since week 40/2015, indicating the start of the season. 
  • The increase in virus detections seen since week 49 in sentinel and non-sentinel cases is due almost exclusively to influenza A(H1N1)pdm09. This subtype was detected more frequently than A(H3N2), and B/Victoria lineage was detected more frequently than B/Yamagata in both sentinel and non-sentinel specimens. Viruses characterized so far this season are genetically similar to the strains recommended for inclusion in this winter’s trivalent or quadrivalent vaccine for the northern hemisphere.
Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 27 2015 at 7:50am
Originally posted by Dutch Josh Dutch Josh wrote:

https://flunewseurope.org/


The proportion of influenza virus postive sentinel specimens increased to over 10% for the first time since week 40/2015, indicating the start of the season. 



What is the epidemic level for flu in Europe?

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: December 30 2015 at 9:54am
It is happening.

http://www.medindia.net/news/112-swine-flu-deaths-reported-in-iran-since-mid-november-156582-1.htm

December 30, 2015 1:56 a.m.

Media said that a swine flu outbreak in Iran has killed 112 people since mid-November and the country's first medical worker has died of the virus.

"About 1,190 people have been diagnosed with the (H1N1) virus and hospitalized" and "the death toll has reached 112", state news agency IRNA quoted a health ministry official as saying.



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 02 2016 at 8:12am
Continuing to wait for more reports from Iran which seem to have vanished during the New Year's Holiday.

http://news.yahoo.com/iran-reports-112-swine-flu-deaths-since-mid-132048462.html


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: January 04 2016 at 8:03am
http://www.todayszaman.com/anasayfa_4-suspected-swine-flu-deaths-reported-in-turkey_408593.html

Four people suspected to be suffering from swine flu have died in the Central Anatolian province of Niğde and the southern province of Adana in the past two days.

Three people in Adana died after they were hospitalized with symptoms of swine flu, Governor Mustafa Büyük announced on Saturday. One of the victims was a four-month-pregnant woman while the other two were Syrians, he said.
Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: January 04 2016 at 8:08am
Epidemic flu level Europe is 10%: 

Week 52/2015 (21-27 December)

  • Influenza activity remained low in most countries in the WHO European Region.
  • The proportion of influenza virus-positive sentinel surveillance specimens increased to 17% from 11% the previous week.
  • Detections of A(H1N1)pdm09, A(H3N2) and type B influenza viruses among sentinel surveillance specimens were reported by 14 countries.

Season

  • For the first time since week 40/2015, the proportion of influenza virus-positive sentinel surveillance specimens was over 10% for two consecutive weeks, confirming the start of the influenza season in week 51/2015.
  • The increase since week 49/2015 in virus detections among sentinel and non-sentinel patients with respiratory disease is due largely to A(H1N1)pdm09 viruses, the subtype representing 84% of subtyped type A viruses. Influenza type B viruses of the Victoria lineage were detected more frequently (75%) than those of the Yamagata lineage (25%). Viruses characterized so far this season are genetically similar to the strains recommended for inclusion in this winter’s trivalent or quadrivalent vaccines for the northern hemisphere.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote arirish Quote  Post ReplyReply Direct Link To This Post Posted: January 07 2016 at 9:14am
Eight people died from swine flu in Turkey since early 2016

Eight people have died as a result of swine flu in Turkey since early 2016, Turkish Health Minister Mehmet Muazzinoglu said, the Turkish TRT Haber TV channel reported Jan. 6.

http://en.trend.az/world/turkey/2477097.html
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 19 2016 at 8:14am
Once more we are seeing outbreaks of Swine Flu in many countries. It is very hard to tell in the U.S. as the current tracking system for even Flu is very limited to a very small handful of samples for the entire country. 

The Flu is out there, especially Swine Flu, and the last reports from Iran were of a jump in cases and now there is silence.

http://outbreaknewstoday.com/iran-swine-flu-update-deaths-double-in-two-weeks-98079/

It really is unlikely that after such a rise in case there would be no more. We look at a 15 day silence with no reports at all.

Last year in the United States the Swine Flu was widespread in the United States on this date. Is it possible the vaccine has been that effective for the first time in years in stopping it.

Disease and the resistance to antibiotic and antivirals has been on the rise for a decade. Suddenly are not serious outbreaks?  As I sit looking out the window the raining is falling hard in California. It is winter, one would expect there to be finally storms. The same is true of the flu. There should be more of it.

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