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Swine Flu Megathread


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@Slim: Are you suggesting that those not worrying about threats until real evidence of threat emerges are somehow naive?

 

@ Chinahand: If you read the various and diverse commentaries in the BMJ, you realise that things are as confused as in the mainstream press! The comment in such journals cannot be portrayed as that of a unified medical profession, but of a diverse spectrum of scientific viewpoint in the face of uncertainty.

Why is this? Well, medics who feel 'involved' are going to be doubly prone to the 'what if' effect, and are under intense pressure from media and political concerns. Nobody wants to be brave and offer the correct type of cautious reassurance.

 

The article BMJ 2009;339:b2881 'Data on flu deaths are potentially misleading, say researchers' is a good case in point. It starts with the assertion that epidemiologists agree that the disease is not becoming more virulent, then quotes a case fatality ratio based on early data (never a good idea) of 0.5%, which doesnt even tally with the observable data based on WHO stats of known infections in the UK against reported deaths. (31 deaths would suggest that 6200 people had the disease in the UK by that ratio).

Rather than seeking to generate reassurance, the article goes on to quote prominent epidemiologists casting doubts on the rate of deaths 'caused' by H1N1, effectively suggesting that all deaths of those infected with this Influenza A ought be considered due to the virus! This would be wrong, and you get the impression of hand-wringing medics not wanting to get the blame for being the first to suggest that the WHO action plan being activated was probably some kind of mistake!

 

Good doctors should be guarded in prognosis, yet offer cautious optimism to their patients where it seems morally and psychologically beneficial to do so. The whole individual needs to be treated, and I get the impression it is the media that is getting treated.

 

FACT: Of all the deaths attributed in the media to H1N1 (and lets be honest, vets are not reporting the flu in swine!), the primary cause of death in most seems to have been another illness for which appropriate specific treatment is available. Tonsillitis and Pneumococcal Pneumonia are killers, but respond to prompt cases of antibiotics - especially when patients can have easy access to surgeries/casualty departments and have not been scared off by warnings to 'stay at home' and have a telephone conversation with a GP or untrained advisor!

 

FACT: There is no evidence that the anti-flu drugs would have prevented these deaths. It is even possible that the 'dont go to your doctor's surgery but phone the Flu-Helpline for Tamiflu' approach will lead to more deaths of people for whom antibiotics, NOT ANTIVIRALS, could have been provided earlier. This issue needs to be dealt with! Anyone with a bad chest, or a very sore throat needs to be treated with the correct caution they would normally be.

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this is widely regarded as the 'best' website link around. non-sensationalist, just providing the fact

 

http://www.admin.cam.ac.uk/univ/health/flu/

 

the big problem, as has already been written, is the thing is extremely fast working, so yes, by the time one person knows they have it, the clustering effect means that it is very likely a whole office environment could well have it at the same time.

 

a big concern is that as tissue paper etc is introduced into the drainage/sewage system it could easily mutate and if too many people have been treated for the original form, then there will be little control, if any, of the mutated form.... which is why the 'gold group' are taking this very seriously <_<

 

'Widely regarded' by who, might I ask? It links to the bog-standard HPA and WHO websites, which are at the political (but arguably not the philosophical or scientific) bleeding edge.

 

You obviously know nothing about virus transcription and mutation - that it happens WITHIN CELLS (in the current case in humans rather than in swine) and not within drains!

 

I take it you never attended Cambridge, then. ;-) If you did, then their standards are obviously slipping....

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The article BMJ 2009;339:b2881 'Data on flu deaths are potentially misleading, say researchers' is a good case in point. It starts with the assertion that epidemiologists agree that the disease is not becoming more virulent,

 

No it doesn't. It said that "the virus is not becoming more virulent, said epidemiologists this week", the epidemiologists in question being the ones who wrote the paper and not epidemiologists in general, as you seem to imply.

 

Rather than seeking to generate reassurance, the article goes on to quote prominent epidemiologists...

 

Again, the epidemiologists who wrote the paper that the article is commenting on.

 

...casting doubts on the rate of deaths 'caused' by H1N1, effectively suggesting that all deaths of those infected with this Influenza A ought be considered due to the virus!

 

Zuh? The article does raise questions about the current measure of severity, but I'm having difficulty seeing how this suggests what you say it does.

 

The actual paper the article is referring to (which I'm guessing you haven't read), states

 

"The two main sources of bias in estimates of the case fatality ratio we consider stem from shifts in case ascertainment (over time, efforts may become more focused on the most severe cases, leading to an overestimation of the case fatality ratio) and from the inevitable delay between symptom onset and death, which in the early phase of the epidemic can lead to underestimation of the case fatality ratio if it is not adjusted for."

 

You're making the report out to be something it's not, which at its core is the observation that current measurements of fatality rate may not be sufficient to predict the severity of the virus, and may overstated or understate the fatality rate.

Edited by VinnieK
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this is widely regarded as the 'best' website link around. non-sensationalist, just providing the fact

 

http://www.admin.cam.ac.uk/univ/health/flu/

 

the big problem, as has already been written, is the thing is extremely fast working, so yes, by the time one person knows they have it, the clustering effect means that it is very likely a whole office environment could well have it at the same time.

 

a big concern is that as tissue paper etc is introduced into the drainage/sewage system it could easily mutate and if too many people have been treated for the original form, then there will be little control, if any, of the mutated form.... which is why the 'gold group' are taking this very seriously <_<

 

'Widely regarded' by who, might I ask? It links to the bog-standard HPA and WHO websites, which are at the political (but arguably not the philosophical or scientific) bleeding edge.

 

You obviously know nothing about virus transcription and mutation - that it happens WITHIN CELLS (in the current case in humans rather than in swine) and not within drains!

 

I take it you never attended Cambridge, then. ;-) If you did, then their standards are obviously slipping....

 

 

 

...by whom? you may indeed ask; erm... lots of public sector departments for a start. Agreed, but probably better than coverage from say the 'Sun'

 

You are correct in your assumption, I don't, but am on a necessarily steep learning curve. Mutation under those conditions is, apparently, a very real threat. However, I will happily bow to your greater medical knowledge if you can advise me otherwise :)

 

Nope, I never attended Cambridge, wrong type of degree. And I agree, their standards are slipping. But then, so is everyone's ;)

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a big concern is that as tissue paper etc is introduced into the drainage/sewage system it could easily mutate

 

 

This seems a bit unlikely, do you know the source of this information?

 

 

 

 

I doubt this fully answers your question, but makes for good historical context, and alludes to the dangers of strains mixing (which is where, I believe, the drainage bit comes in) A few more minutes on google would no doubt reap dividends

 

 

http://www.newsweek.com/id/195692/page/1

Edited by english zloty
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a big concern is that as tissue paper etc is introduced into the drainage/sewage system it could easily mutate

 

 

That is a real worry. If toilet roll begins to mutate we could be faced with this...

giant-toilet-roll-bathroom-jokes-ph.jpg

 

That's Bellyache's bathroom isn't it?.

 

Toilet roll conveniently sized to cope with all the bullshit that comes out of him.

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a big concern is that as tissue paper etc is introduced into the drainage/sewage system it could easily mutate and if too many people have been treated for the original form, then there will be little control, if any, of the mutated form.... which is why the 'gold group' are taking this very seriously <_<

 

 

You obviously know nothing about virus transcription and mutation - that it happens WITHIN CELLS (in the current case in humans rather than in swine) and not within drains!

 

I take it you never attended Cambridge, then. ;-) If you did, then their standards are obviously slipping....

 

Transcription isn't the issue, that type of mutation is happening all the the time, it's genetic recombination that has the potential to cause real problems. The sewer theory is pretty far out though.

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@Slim: Are you suggesting that those not worrying about threats until real evidence of threat emerges are somehow naive?

 

I don't agree that there isn't a real evidence of a threat. The numbers reported now have exceeded a bad year for seasonal flu, so we're already over what our resources are set up to deal with. There is a justifiable risk and preparations should be made, you shouldn't wait until a catastrophe to start making your contingency plans. That would be stupid.

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I've just written my will !!! Off to Cuba and Jamaica soon , got my hankies ready :o

 

Wait till you leave Cuba before you get ill - best healthcare system in the world my foot! Also say hello to my friend Jose if you see him, he will be selling stolen cigars on the streets of Habana, remember don't pay more than USD 30 a box or you've been ripped off, he even includes the fake customs seal if you ask, but be sure you're not getting an empty box, he's a bit of a wag.

 

If interested I have a decent supply of Cohiba Esplendidos for sale to get you in the Hemmingway mindset - £10 each.

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Ah pish posh media rubbish.

 

Let me tell you my story. and then you might have a better understanding on how things like these nice viruses spread among us so easily.

 

Many people around me seemed unable to come to terms with the possibility that we had swine flu. I was finding myself bewildered as to why people were playing it down to the point of thinking I'm a hypochondriac.

 

Starts off with my little lad (4yrs) getting croup and struggling to breath. Well my little boy started sleeping all day on sunday and we thought he was just tired. By early evening he was struggling to breath (heavy chest) but not quite enough to worry us. 24 hours later (Monday) we had paramedics at our home as our son had a temperature of 39'C, by the time the ambulance arrived (minutes later) they registered his temperature at 40'C. Luckily a hefty dose of paracetamol brought his temp down to a cool 38'C. The doctor at A&E didn't think it serious as he had responded to the paracetamol and appeared to have an ear and throat infection, or as she put it " a mild infection and no antibiotics needed" So off we went home.

 

Me and the missus took shifts that night at home to stay up and watch him. We had to keep him cool and changing his position (kids are wriggle bums aren't they) that allowed him to breath easier, and a times we could see his lips turning blue. After about 12 hrs, his temperature came down to a sensible level and the panic was over.

 

Tuesday, took him doctors and doctor was flabbergasted that the hospital hadn't even given our son antibacterial treatment for his throat infection. The Dr asked us if we had been to an infected country recently and could this be swine flu?

 

So my son gets better over the next few days but was showing a lot of discomfort in his breathing and general chest area. We are convinced he had weird bout of croup but can't work out why nothing had preceded it. He's had chest problems before and if he gets flu or other virus like infections, he seems to get croup, not croup followed by an ear infection.

 

Anyway, come Thursday we're all feeling relieved that our little boy is over this mysterious illness (he's still ill, just not as bad). Then on Thursday evening, I start to get feverish and feeling weak; you know what I'm talking about, that unmistakable flu feeling. I put it down to the stress of the previous week and convince myself that tomorrow I'll be feeling better after a good nights sleep.

 

Friday, feeling groggy. Phone doctors surgery to find out what we should do if we have flu. Receptionist gives us a number to call, it's a recorded message about flu and how basically they ain't doing sweetFA about it.

 

I spend the weekend realising I caught it from my son who in turn caught it from a kid at nursery.

 

I'm feeling ok but for a sore throat. which is getting worse, then my ears start to play up, I think it was about Sunday my partner starts feeling ill with it.

This was a rather strange flu, spent a week going from feeling fine to feeling like crap, but all in all I've had worse flu than this before today, I'm quite convinced this isn't swine flu, it can't be, this couldn't kill a flea. But I'm a typical bloke when it comes to illness and the last time a flu got me bad was way back in '96; now that was real flu. My partner is more sensitive and appears rather down with her dose of it.

 

I keep referring to feeling ok to feeling bad with it and wondering what all the fuss is about this flu; and of course if it is swine flu, then I'm not impressed... Then..

 

It all comes clear to me why my son was so seriously ill the previous week. I woke up in the morning with the mother of all sore throats (not tonsillitis) and my chest is agony, I mean try and imagine what it would be like to swallow a fishing hook and try to pull it out..... It was then that the penny dropped with what my son had.

 

The poor sod has had the flu and at the end it's hit his chest. We've thought of it as croup when in fact it was the death throws of the the flu. I didn't get it as bad as my child and my wife didn't get it in the chest like my son and I.

 

I'm racing through this as it is late (01:30am) so excuse my vagueness.

 

Symptoms.

 

Feeling feverish, hot flushes, cold flushes, about 24hrs but didn't have a temperature like my son.

The snottiest nose and I swear it tried to come out of my ears as at times I felt like I was deaf. Constant ear popping and tinnitus.

skin, bone and muscle was feeling like it hurts, didn't last long though.

Sore throat all the way through that got progressively worse as it moved down my larynx.

Start feeling better and then my lungs feel like they want to burst. this is the scary bit and lasts about three days followed by a good week of coughing lungs up. mostly at night.

Oh, and yeh it's nice to know, but we all had mild diarhia was also present but not the sqwits.

 

So there you go. I'm +80% sure we had swine flu but we'll never know as nobody gave a shoit.

 

I can see how it could kill, if you have weak lungs etc this is going to hit hard. The youngest are at greatest risk as we didn't even see it coming.

 

Anyone with kids in nursery will need to be vigilant, the symptoms are mild until the end when it crashes into the lungs like one of ANS's posts. totally unpredicted and seriously not welcome.

 

My daughter didn't get it though, so it shows that even in close contact your not garrenteed to get it.

 

Oh, and as for all these posts and comments on whole work forces going down, well it just shows what a bunch of dirty gits you all are. lol.

 

Lastly, did you know that a study on how flu spreads proved that it was the touching infected surfaces that did the damage, and not the sneezing as many think. Hence the emphasis on 'catch it - bin it - kill it' campaign. The fact it is spreading so well is testimony to how dirty we are.

 

The media are full of shiiiiiiiiit, and a healthy person won't even take time off work with this flu.

 

There... don't panic. don't buy tabloid and sensationalist papers, there for idiots, especially 'The Guardian' who in my opinion are proper feeding this. Go read some real educational stuff about the flu written by people who know what they are talking about.

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The media are full of shiiiiiiiiit, and a healthy person won't even take time off work with this flu.

 

There... don't panic. don't buy tabloid and sensationalist papers, there for idiots, especially 'The Guardian' who in my opinion are proper feeding this. Go read some real educational stuff about the flu written by people who know what they are talking about.

 

Are you taking the piss? Your son was ill enough for you to call an ambulance and tie up paramedics, and you're saying it's nothing?

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