Influenza Update #14 - H1N1-(swine)

MedPrep Consulting Group LLC Dr. Stuart B. Weiss  IMPORTANT INFLUENZA UPDATE #14 WHO PANDEMIC ALERT LEVEL 5 MAY 5, 2009   Daily Brief Call Today at 1:00PM  call-in: 866-369-8761    SUBSCRIBE: Click button at bottom or send email to alert@MedPrepGroup.com   Fears calm in the U.S. but continue in the Far East As fears in the U.S. of a severe pandemic continue to diminish reports continue from mainland China and Hong Kong of quarantines and growing concern. And although the new case reports in Mexico are reportedly diminishing, there are still new cases cropping up in the U.S.   CURRENT SITUATION: The WHO is reporting that since yesterday, the number of confirmed cases increased from 985 people in 20 countries to 1124 people in 21 countries around the world. In the U.S. there are 286 confirmed cases and about 700 probable cases.  Mexico continues to report a marked drop in the number of people presenting to hospitals with flu-like illness. Canada reported a jump in cases from 101 to 140. The vast majority of cases outside of Mexico continue to be mild influenza illness which people recover from uneventfully The news media is reporting that China has quarantined 4 U.S. citizens. In Hong Kong, 300 people are still quarantined after a Mexican traveler came down with illness. China has tracked down and quarantined 128 of his fellow travelers as well. A group of 25 Canadian students and a professor were quarantined as well. This is all in an attempt to prevent a repeat of the 2003 SARS outbreak. HOUSEKEEPING ITEM: If you receive this alert indirectly through a mailing list or from a friend or colleague please take a moment and sign up to receive it directly from us by clicking on the button at the bottom of this alert or by sending an email to alert@MedPrepGroup.com with the word signup in the subject.     ANALYSIS: This situation is highly fluid as details continue to emerge.     Yesterday, I wrote about several reasons that we need to remain vigilant about this new viral outbreak. Today, I want to spend a few moments discussing why the H1N1 (swine) virus, in its current form, may not turn out so bad.   I spent some time yesterday talking about genetic changes in the H1N1 virus and I want to go there again today. As scientists have studied the 1918, 1957 and 1968 pandemic viruses as well as the circulating lethal H5N1 (avian) flu they have found an important characteristic called PB1-F2 protein. In studies in mice, this protein seems to be linked to making a virus more lethal. It is thought to induce more inflammation, to increase cell death and to increase the frequency and severity of secondary pneumonia. These are all bad things that lead to worse mortality. The current H1N1 (swine) does not produce this protein. Now, there are many characteristics that lead to viral severity and this is only one but if this protein is important in lethality, then this virus can't become a bad player.   Another reason why this may not become a bad virus is the fact that it is an H1N1 type of virus. Humans have been exposed to a variety of H1N1 viruses over many decades and have built up some immunity to it. While this does not seem sufficient to keep people from getting sick, it could be helping to keep the severity of illness down.   Lastly, we can feel some comfort because so far, this virus seems no more lethal than seasonal influenza (outside of Mexico). Even in Mexico, since we are not sure how many mild cases were missed before this outbreak was identified it is not possible to tell if the mortality rate is higher than seasonal flu.   These reasons, while comforting, are still uncertain at best. Experts are still concerned about this virus and we will have to watch this closely over the spring and summer months. We must remember that the 1918 pandemic followed the same pattern of a mild outbreak in the spring and a more severe return in the fall.     ADVICE: As you continue to mature your pandemic plans keep your executives up to date on changes. Your executive team will be reading the same reassuring press that we all are reading. While I agree that we have an opportunity to catch our breath, it is important for you to keep your executives informed about the continuing threat from this new virus. Now is not the time to let up on your planning efforts. Follow changes in CDC guidance. The CDC has done a fantastic job of issuing interim guidance throughout this developing crisis. As we continue to gain more understanding about the spread and severity of this virus, expect guidance to change. One of the items that may change soon is the guidance concerning school closures.      MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. Let us know if you need help reviewing your plans, designing educational posters, writing FAQ's (frequently asked questions) or policies, etc.. We have resources and expertise that you can count on.     Not preparing now would be a serious mistake should things worsen quickly.      If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com   SUBSCRIBE TO ALERTS by clicking the button below.    Dr. Stuart Weiss is a nationally recognized pandemic planning expert and CEO of MedPrep Consulting Group. MedPrep can assist you with your pandemic, disaster and business continuity planning, training and exercising needs. Drop me a note if you want more information about us.            Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC