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"Roche Holding AG’s antiviral drug Tamiflu may not prevent complications from influenza in healthy adults, according to a review by an independent research group that reversed its previous findings that the medicine warded off pneumonia and other deadly conditions linked to the disease." http://www.bloomberg.com/apps/news?pid=20601100&sid=a9acc7qIJFdU
Also: http://www.bmj.com/cgi/content/extract/339/dec08_3/b5387
And: http://www.bmj.com/cgi/content/full/339/dec08_3/b5351
How do you think we should add this information? Gandydancer (talk) 14:42, 9 December 2009 (UTC)
"If oseltamivir is no better than placebo in its ability to reduce the complications of influenza, and if it is also ineffective against influenza-like illness not caused by influenza, then the drug’s ability to treat the symptoms of influenza may be similar to that of an NSAID such as aspirin." I'd say that's pretty dramatic! Gandydancer (talk) 00:15, 10 December 2009 (UTC)
On December, 8 the Cochrane Collaboration, which reviews medical evidence, announced in a review published in the British Medical Journal that it had reversed its previous findings that the antiviral drug Tamiflu can ward off pneumonia and other serious conditions linked to influenza. They reported that an analysis of 20 studies showed Tamiflu offered mild benefits for healthy adults if taken within 24 hours of onset of symptoms, but found no clear evidence it prevented lower respiratory tract infections or other complications of influenza. Their published finding relates only to its use in healthy adults with influenza; they say nothing about its use in patients judged to be at high risk of complications—pregnant women, children under 5, and those with underlying medical conditions, and uncertainty over its role in reducing complications in healthy adults may still leave it as a useful drug for reducing the duration of symptoms. Gandydancer (talk) 23:53, 10 December 2009 (UTC)
http://www.bmj.com/cgi/content/full/339/dec07_2/b5106?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=neuraminidase&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT
[from Introduction] “ . . . This criticism centred on one paper in particular, a meta-analysis of the effects of oseltamivir on complications of influenza.[10] . . "
Impact of Oseltamivir Treatment on Influenza-Related Lower Respiratory Tract Complications and Hospitalizations, Archives of Internal Medicine, Laurent Kaiser, MD; Cynthia Wat, MBBS, MRCP; et al., July 28, 2003:
“ . . . lower respiratory tract complications (LRTCs) . . . ”
“ . . . In those subjects considered at increased risk of complications, 74 (18.5%) of 401 placebo recipients developed an LRTC leading to antibiotic use compared with 45 (12.2%) of 368 oseltamivir recipients (34.0% reduction; P = .02). [ . . . ] In contrast, among subjects with an influenzalike illness but without a confirmed influenza infection, the incidence of LRTCs (6.7% vs 5.3%), overall antibiotic use (19.7% vs 19.3%), or hospitalizations (1.7% vs 1.9%) was similar between placebo and oseltamivir recipients, respectively."
The first sentence of the second paragraph reads, "The outbreak began in Veracruz, Mexico, with evidence that there had been an ongoing epidemic for months before it was officially recognized as such.[5]"
The reference seems to suggest that the outbreak did not actually start in Mexico. Either the sentence needs to be changed, or a new reference found; however, if there is indeed debate as to the flu's origin, this should probably be noted in the article. —Preceding unsigned comment added by 128.138.64.56 (talk) 21:43, 14 December 2009 (UTC)
Some of the links here in this article go back to that time as well. I would like to see this information in this article, however I will admit to a strong bias against factory farms and NAFTA. It could be argued that factory farms treat the food we eat in a manner that could, at least in the US, land anyone in jail if they treated their pet cat or dog in such a manner. Due to crowding and horrific conditions, factory farms could be called influenza factories as well. Ok, a little rant here...which I know I'm not supposed to do. Gandydancer (talk) 17:46, 15 December 2009 (UTC)
Non-Safety-Related Voluntary Recall of Certain Lots of Sanofi Pasteur H1N1 Pediatric (0.25 mL, for 6-35 month olds) Vaccine in Pre-Filled Syringes Questions & Answers, CDC, Dec. 15, 2009:
" . . . ongoing stability testing of its influenza A (H1N1) vaccine after the vaccine has been shipped to providers. Stability testing means measuring the strength (also called potency) of a vaccine over time. It is performed because sometimes the strength of a vaccine can go down over time. On December 7, Sanofi Pasteur notified CDC and FDA that the potency in one batch (called a “lot”) of pediatric syringes that had been distributed was later found to have dropped below a pre-specified limit. As a result of this finding . . . "
Transmission of the new strain is human-to-human, >>> and eating cooked pork products will not transmit the virus.<<< In my opinion i think this statement should be revised and taken into consideration on wheather it should even be here. Technically this statement only makes sense to those who believe that this was once true. To anyone else this is not "encyclopedic information".
Oberon10001 (talk) 07:06, 23 December 2009 (UTC)
The last 2 sentences in this section do not seem related. Do you think they should be moved or deleted? Also, it seems to me the sudden development of ARDS (cytokine storm?) and viral pneumonia which presents as sudden respiratory distress (and other symptoms) is such a medical emergency that perhaps we should give it more weight, perhaps including this CDC info in the signs and symptoms space: http://www.cdc.gov/h1n1flu/homecare/warningsigns.htm I know it is more or less elsewhere, but I'd like to stress it a little more. Thoughts? Gandydancer (talk) 15:11, 16 December 2009 (UTC)
There has been a lot of discussion about the fact that in some people the H1N1 virus, unlike seasonal flu virus, seems able to attack cells deep in the lungs of some people, though it is not known why it affects only a small number of people in this manner. There is a lot of interesting information here: http://www.flutrackers.com/forum/showthread.php?t=136298&highlight=cytokine+storm Gandydancer (talk) 14:15, 18 December 2009 (UTC)
Can You Catch Obsessive-Compulsive Disorder?, New York Times, Lisa Belkin, May 22, 2005, a seven-page article:
“ . . . They call it Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection, or, because every disease needs an acronym, Pandas. . . ” [page 1]
“ . . . So the antibodies mistake the basal ganglia for strep and attack. This, of course, will not happen to every child who has strep throat, or even to most children, in the same way that every child who gets strep does not get rheumatic fever. "It's the wrong germ in the wrong child at the wrong time," says Swedo, who suspects that some children are genetically predisposed toward Pandas. . . ” [page 2]
“ . . . The bane of all science is coincidence. For example, a notable percentage of children develop their first signs of autism soon after a vaccination, and it is tempting to blame the shot for the symptoms. But autism as a rule tends to show itself during the years when children are also scheduled to receive fairly regular immunizations. So the odds are good that the two events will be temporally linked. . . ” [page 4]
“ . . . And they cite as an example children with Tourette's syndrome, who frequently have O.C.D. symptoms that ebb and flow with stress. Children with neurological disorders "are sensitive to any number of things," Kurlan says. "If their dog dies. If their parents are fighting. I've seen O.C.D. get worse with a cold, with hay fever, with pneumonia. If there is anything special about strep, I don't think anyone has been able to find it." . . . ” [page 5]
PANDAS, National Institute of Mental Health, Pediatrics and Developmental Neuroscience Branch, Susan E. Swedo, MD, Branch Chief, page last updated Feb. 24, 2009: “ . . . researchers at the NIMH are pursuing a theory that the mechanism is similar to that of Rheumatic Fever, an autoimmune disorder triggered by strep. throat infections. In every bacterial infection, the body produces antibodies against the invading bacteria, and the antibodies help eliminate the bacteria from the body. However in Rheumatic Fever, the antibodies mistakenly recognize and "attack" the heart valves, joints, and/or certain parts of the brain. This phenomenon is called "molecular mimicry", which means that proteins on the cell wall of the strep. bacteria are similar in some way to the proteins of the heart valve, joints, or brain. . . ”
1)I tried to add figures to the subjective phrase "a small percentage" of healthy people also died. The actual figures, quoted by the references alongside these phrases, but no figures quoted in wiki are: WHO for the world: 50% of those hospitalised that died were perfectly healthy. CDC for USA: 30% of hospitalised that died were perfectly healthy.
This page is semi-protected so I cannot add the figures in order to explain what "small percentage". Many readers are confused by this understatement of the dangers of Swine Flu.
2) In the symnptoms, someone had maintained the phrase "a small fraction" of the normal flu deaths of 32000 in USA. That may be appropriate in May, when only 3 died, but by December this number is 10,000 estimated deaths for Swine Flu for 7 months versus 32 estimated deaths for Common Flu in 12 months.
Fortunately the figures that I had added survived to this day. But earlier on, some figures that I quoted from the cited references were mysterious deleted. I am not sure how long this current figure will last.
Overall this article is trying to promote that Swine Flu is milder than Common flu quoting the deaths figures of the early months but without the exact figures. They use subjective words such as "a small percentage" and " a fraction", instead of quoting the figures and duration that these figures refer to, and let the readers decide if it were really is a "small percentage".
Swine Flu is not at all dangerous as long as we all take precuations. SARS was much more dangerous but the death toll from SARS(about 800) was much lower because everyone, especially frontline doctors, took excessively high precautions. The death toll from Swine Flu is limited because many parties, even WHO had taken precautions, such as declaring it a Pandemic, but a smaller number still believe that Swine Flu 2009 is milder than common flu and tried to impose their views by denying the facts and figures so far.
With 111 million doses of vaccine available in USA, I would say that the Swine Flu danger has abated in USA but the world at large is still exposed. Part of the reasons for the low fatality of Swine Flu in USA and developed nations, is due to the widely available Tamilflu that are still effective and Vaccine. This is not so for many developing nations. —Preceding unsigned comment added by Othmanskn (talk • contribs) 05:07, 26 December 2009 (UTC)
The end of the 1st paragraph states "it cannot be spread by eating pork products or being around pigs" and gives 2 citations, a page containing public information put out by the CDC and a piece by the LA Times. However, the CDC page cited [2] makes no mention of it being safe to be around pigs. In fact it specifically mentions that the virus contains genes from European pigs (not American mind you). That comes from the LA Times article that discusses the monetary loss incurred by American hog farmers. So this line is ambiguous at best.
Now, in the May 22 edition of Science Magazine ref#1[2], under the title "Past Pandemics Provide Mixed Clues to H1N1's Next Moves" by Jon Cohen, it is stated that "The new virus is a so-called triple reassortant—a mix of swine, human, and avian genes—that researchers first found in North American pigs in 1998.". Furthermore, in a European Commission Press Release ref#2[3], Dr Nancy Cox, one of the authors of another paper entitled "Antigenic and Genetic Characteristics of Swine-Origin 2009 A(H1N1) Influenza Viruses Circulating in Humans" ref#3[4] and Director of the Influenza Division at the Centers for Disease Control and Prevention (CDC) in the US states "This study reinforces the fact that swine are an important reservoir of influenza viruses with the potential to cause significant respiratory outbreaks or even a possible pandemic in humans, and the results of the study show the global need for more systemic surveillance of influenza viruses in pigs."
I am of the opinion that the LA Times opinion on the subject should defer to that of the CDC. As such, I propose that the last sentence of the first paragraph be change from this:
Although the virus, first detected in April 2009, contains a combination of genes from swine, avian (bird), and human influenza viruses, it cannot be spread by eating pork products or being around pigs.[3][4]
To this:
The virus, first detected in April 2009, contains a combination of genes from swine, avian (bird), and human influenza viruses [5]. Although it cannot be spread by eating well cooked pork products [6], recent findings have restated the well known fact that pigs are a reservoir of influenza viruses and highlighted the need for more systematic surveillance of influenza viruses in pigs [7][8].
I believe this is a fair request based on sound argument. Thank you.
Oberon10001 (talk) 05:02, 22 December 2009 (UTC)
Simply deleting "or being around pigs" does not impress upon the reader the risk that unmonitored factory farming of hogs presents. At the very least the fact that pigs are virus mixing factories should be clearly stated. This article discusses the facts of the 2009 H1N1 flu pandemic and should present the facts as is without trying to shield hog farmers. The fact that the pandemic is still ongoing and may make a turn for the worse should be reason enough not to accept the status quo wrt to hog farming practices. If Copenhagen teaches us anything it is that pandering to the political sensitivities of vested interests will continue to perpetuate the Tragedy of the Commons. No more please. We need to reform systems that puts us all at great risk.
Oberon10001 (talk) 07:25, 23 December 2009 (UTC)
I think that this section should be pared down considerably. It was quite an item at one time, but is no longer worth more than a mention, IMO. Thoughts? Gandydancer (talk) 13:42, 30 December 2009 (UTC)
In the introduction it is stated that there are 12,121 deaths, however the ref provided does not back that up and I have no idea where that number came from. Here is a late news report that says "nearly 12,000". http://www.reuters.com/article/idUSTRE5BS14B20091229 Another report says, "more than 11,5000. I went to the WHO site and this info is not available. I would change the number, but perhaps due to my inexperience I do not understand the way it has been added. Could someone change it or explain to me why it has been entered in the way it is? Thanks. Gandydancer (talk) 13:55, 30 December 2009 (UTC)
Always put the date. Flu and any infectious diseases spread exponentially. Meaning it becomes more rapid as time passes. A week's difference can mean thousands, in the coming months. Othmanskn (talk) 02:27, 31 December 2009 (UTC)
Pandemic (H1N1) 2009 - update 79, WHO, Weekly update, 18 December 2009: “ . . . In West Africa, a mixture of pandemic and seasonal influenza viruses have been detected. Seasonal viruses have included both seasonal H1N1 and H3N2, with the later predominating. . . ”
http://www.cdc.gov/flu/weekly/weeklyarchives2008-2009/weekly39.htm
The adamantanes (amantadine and rimantadine) are used to treat seasonal flu (seasonal H1N1).
2008-2009 Influenza Season Week 39 ending October 3, 2009
"Synopsis:
"During week 39 (September 27-October 3, 2009), influenza activity increased in the U.S
• "2,968 (27.4%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
• "99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses. . . "
And per the chart in the “Antiviral Resistance” section:
For Seasonal influenza A (H1N1), only 7 out of the 1,157 samples tested were resistant to Adamantanes.
For Influenza A (H3N2), Zero out of 264 samples were resistant to oseltamivir (Tamiflu).
For Influenza B, zero out of 654 samples were resistant to oseltamivir (Tamiflu).
And for 2009 Influenza A (H1N1), only 10 (12 counting additional labs) out of 2,040 samples tested were resistant to oseltamivir (Tamiflu).
I am pro-vaccine. I think vaccines are one of the foremost achievements of modern medicine. There's a vaccine against one of the main causitive agents of pneumonia, a lot of people don't know this, but it is recommended for persons over age 60. And when smallpox was wiped off the face of the earth, with WHO doing major, serious coordination, and they felt they had to wait a year and a half to really be sure, and then the formal announcement around 1979, that was perhaps the greatest single achievement in the history of medicine. And I cannot believe there has not been a movie made about it, ever bit as good as Schindler's List (and with a flawed hero, well of course!).
All that said, doctors do not seem to be very open to criticism of vaccines. Canada has a baseline rate of approximately 1 case of anaphylactic shock per 300,000 people receiving the vaccine, and one batch in which 6 people had anaphylactic shock out of approximately 150,000 people receiving it. If we could improve this on both counts, why wouldn't we? And yet doctors seem to take the approach, don't confuse the lay people. That is, they seem to think discussion is a bad thing (I'm speaking in generalities of course.)
So, a person gets a vaccine for their child. And it becomes increasing clear that the child is different, has issues. And then child is diagnosed with autism. Coincidence! Perhaps. Perhaps so. But let's not be so entirely quick. Just like Guillain-Barre is a real phenomenon, maybe there's something else that we just don't know about that's also a real phenonomenon. So, you or I, if we observed this close a relationship between cause and effect, or this close relationship in time, with one following the other, we would also wonder. We would also have our reasonable questions. And if we were then treated disparagingly . . . . Well, I can say with a fair degree of confidence that stonewalling is not a constructive way to work with either your patients or your fellow citizens
In addition, I think I could bring in William Osler, that the individual case study is of central importance. The patient history and the physical exam. It should not be too readily dismissed. Cool Nerd (talk) 01:15, 18 December 2009 (UTC)
Now, first off, I hope we're going to phrase things as confidently in other areas as we do here with thimerosal. For example, it's not that helpful to just laundry-list all the symptoms of influenza. If we can say which of the symptoms are really common, which are medium common, and which are just occasional, that will be a lot more helpful (provided as always that we can find the references).
Okay, I read the whole controversy (and not from direct experience, but rather my world view on how institutions usually work), that it's not for the sake of lawsuits, but rather that doctors have bailed on their patients. The doctor who's suppose to be there through thick and thin, once things start to get a little bit thick, including the parents being hard to work with, refusing to listen to "logic," etc. etc. Well, you don't just bail. You pull a lesson from business. And if necessary, you physically move your chair around so you are literally sitting on the same side of the desk with your patient. And if there's something useful you can show the parent, maybe something in a medical textbook that's the closest you know of, you do so. Or something else. In either case, you acknowledge real human solidarity. And you tell the parent, this is too important not to get a second opinion, but you're going to still be there with them. And maybe you did miss the diagnosis of autism that you could have made early. Or maybe not, since it's a developmental disorder, takes a little time to manifest. You let the parent be a little irrational. You give them space if necessary. And it's not outside the realm of possibility that you made a mistake. It's just like anything else, you try treating an infection with one broad-spectrum antibiotic. And if it doesn't work, you try another. It's all part of the ongoing conversation that so important to have with patients.
Just guessing, as a businessman, not a doctor, I'd say that a more likely cause is an autoimmune reaction to the vaccine. Just like Guillain-Barre syndrome is an automimmune reaction. Or like PANDAS, and that's the really interesting one. Okay, it's been known for 50 years or more that strep throat, in a small percentage of cases, can cause damage to the heart valves (rheumatic fever). This is in children. (In adults, it's more so damage to the joints.) And this is not strep directly attacking the heart valves. This is the antibodies your body produces in response to strep also attacking the heart valves (or the joints), as if they have a similar kind of protein or something. That is, it's an autoimmune response. Now, rheumatic fever has been known about for a long, long time, and just recently it's been discovered that in some cases, the antibodies attack and damage a part of the brain causing a rather sudden onset of OCD or Tourette's. Now, that's way out. Of course, to someone who knows a lot about the human immune system (which usually works beautifully, sometimes goes awry), it might not be all that way out. What I find fascinating is that while some aspects of this autoimmune response have been known for decades, this part has not.
Okay, I plan to make a second, separate section on PANDAS here on the discussion page, and eventually move it off and to the PANDAS article, and if there isn't one, maybe we should make one.
And Gandydancer, the things you list---solvents, PCBs, phthalates, etc, etc---maybe it's someone's body way overreacting, roughly along the lines of an allergic inflammation. Or, something else entirely.
And Tim, your last point is well-taken. Instead of thoroughly, thoroughly looking at thimerosal, and then completely nonlooking at a whole list of other possibilities, maybe we should first skim and see if something absolutely jumps out. And that should also be part of the real conversation with parents and patients. Cool Nerd (talk) 21:14, 23 December 2009 (UTC)
Thimerosal and Vaccines — A Cautionary Tale, New England Journal of Medicine, Paul A. Offit, M.D. (Dr. Offit reports serving on the scientific advisory board of Merck and being the coinventor of the bovine–human reassortant rotavirus vaccine RotaTeq, on which he holds a patent.), Sept. 27, 2007: “ . . . 75 µg from three doses of the Haemophilus influenzae type b vaccine, and 37.5 µg from three doses of the hepatitis B vaccine . . . ”
“ . . . ethylmercury (thimerosal). . . Ethylmercury is excreted from the body much more quickly . . . ”
“ . . . Although the precautionary principle assumes that there is no harm in exercising caution, the alarm caused by the removal of thimerosal from vaccines has been quite harmful. For instance, after the July 1999 announcement by the CDC and AAP, about 10 percent of hospitals suspended use of the hepatitis B vaccine for all newborns, regardless of their level of risk. One 3-month-old child born to a Michigan mother infected with hepatitis B virus died of overwhelming infection. . . ”
“ . . . charlatans offering false hope, partly in the form of mercury-chelating agents. In August 2005, a 5-year-old autistic boy in suburban Pittsburgh died from an arrhythmia caused by the injection of the chelating agent EDTA. Although the notion that thimerosal causes autism has now been disproved by several excellent epidemiologic studies, about 10,000 autistic children in the United States receive mercury-chelating agents every year. Furthermore, this notion has diverted attention and resources away from efforts to determine the real cause or causes of the disorder.
“Meanwhile, some preparations of influenza vaccine still contain thimerosal . . . By choosing not to vaccinate their children, these parents have elevated a theoretical (and now disproved) risk above the real risk of being hospitalized or killed by influenza. . . ”
Studies in Animals Suggest 2009 H1N1 Virus May Have Biological Advantage Over Seasonal Influenza Viruses, NIH News, National Institutes of Health, August 31, 2009:
“ . . . Tests in animals showed that levels of the 2009 H1N1 virus rose more quickly than levels of the seasonal virus strains, and the new virus caused more severe disease. . . ”
“ . . . When the investigators inoculated ferrets with 2009 H1N1 virus plus either seasonal H1N1 virus or seasonal H3N2 virus, the animals became co-infected with both viruses. However, only the 2009 H1N1 virus was then transmitted from co-infected ferrets to uninfected ferrets; . . . ”
.
.
“ . . . The investigators' findings are posted on PLoS Currents: Influenza, a Web site for rapid communication of new scientific data on influenza. Submissions to PLoS Currents: Influenza are screened by a panel of leading influenza experts prior to posting but do not undergo formal peer review. The new research may be submitted later for peer review and eventual publication in scientific journals. . . ”
.
.
“ . . . Reference: D Perez et al. Fitness of pandemic H1N1 and seasonal influenza A viruses during co-infection. PLoS Currents: Influenza. Posted Aug. 25, 2009. RRN1011. Available at: http://www.ncbi.nlm.nih.gov/rrn/RRN1011 . . . ”
http://knol.google.com/k/plos-currents-influenza#
why is this titled "2009 flu pandemic" and not "2009 influenza pandemic"?24.17.211.150 (talk) 08:52, 4 January 2010 (UTC)
"Roche Holding AG’s antiviral drug Tamiflu may not prevent complications from influenza in healthy adults, according to a review by an independent research group that reversed its previous findings that the medicine warded off pneumonia and other deadly conditions linked to the disease." http://www.bloomberg.com/apps/news?pid=20601100&sid=a9acc7qIJFdU
Also: http://www.bmj.com/cgi/content/extract/339/dec08_3/b5387
And: http://www.bmj.com/cgi/content/full/339/dec08_3/b5351
How do you think we should add this information? Gandydancer (talk) 14:42, 9 December 2009 (UTC)
"If oseltamivir is no better than placebo in its ability to reduce the complications of influenza, and if it is also ineffective against influenza-like illness not caused by influenza, then the drug’s ability to treat the symptoms of influenza may be similar to that of an NSAID such as aspirin." I'd say that's pretty dramatic! Gandydancer (talk) 00:15, 10 December 2009 (UTC)
On December, 8 the Cochrane Collaboration, which reviews medical evidence, announced in a review published in the British Medical Journal that it had reversed its previous findings that the antiviral drug Tamiflu can ward off pneumonia and other serious conditions linked to influenza. They reported that an analysis of 20 studies showed Tamiflu offered mild benefits for healthy adults if taken within 24 hours of onset of symptoms, but found no clear evidence it prevented lower respiratory tract infections or other complications of influenza. Their published finding relates only to its use in healthy adults with influenza; they say nothing about its use in patients judged to be at high risk of complications—pregnant women, children under 5, and those with underlying medical conditions, and uncertainty over its role in reducing complications in healthy adults may still leave it as a useful drug for reducing the duration of symptoms. Gandydancer (talk) 23:53, 10 December 2009 (UTC)
http://www.bmj.com/cgi/content/full/339/dec07_2/b5106?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=neuraminidase&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT
[from Introduction] “ . . . This criticism centred on one paper in particular, a meta-analysis of the effects of oseltamivir on complications of influenza.[10] . . "
Impact of Oseltamivir Treatment on Influenza-Related Lower Respiratory Tract Complications and Hospitalizations, Archives of Internal Medicine, Laurent Kaiser, MD; Cynthia Wat, MBBS, MRCP; et al., July 28, 2003:
“ . . . lower respiratory tract complications (LRTCs) . . . ”
“ . . . In those subjects considered at increased risk of complications, 74 (18.5%) of 401 placebo recipients developed an LRTC leading to antibiotic use compared with 45 (12.2%) of 368 oseltamivir recipients (34.0% reduction; P = .02). [ . . . ] In contrast, among subjects with an influenzalike illness but without a confirmed influenza infection, the incidence of LRTCs (6.7% vs 5.3%), overall antibiotic use (19.7% vs 19.3%), or hospitalizations (1.7% vs 1.9%) was similar between placebo and oseltamivir recipients, respectively."
We're throwing two dates at our readers. This makes it easily for us as editors, but harder for our readers.
People read things skimmingly fast. We should accept that. Cool Nerd (talk) 21:08, 4 January 2010 (UTC)
In a reference like "In New Theory, Swine Flu Started in Asia . . . ", June 23rd[9]
We are throwing two dates at our reader. Cool Nerd (talk) 21:41, 6 January 2010 (UTC)
From the Signs and symptoms section:
That is, we use this reference to laundry–list preexisting conditions.
When actually, it is a much more meaty and substantial article, and from what I see, having at least two main points.
“Dr. Frieden intended his warning, which he has applied to all four New York deaths so far linked to the H1N1 virus, to be at once helpful to those who might be more at risk for the disease and reassuring to those who are not.”
And the article rather argues that Dr. Frieden and other health authorities may have overplayed their hand. They may have talked too much about preexisting risk factors,
when in fact . . .
“She [Bonnie Wiener] disputed the city’s assertion that underlying conditions were a factor in his death. “He was overweight and he was taking medicine for high blood pressure,” she said. “How many people 50 and above don’t?” ” [Bonnie is the wife of Mitchell Wiener, who I think may have been the high school principal who died in New York City in that rather famous case.]
and . . .
“Judy Trunnell, 33, a teacher from South Texas, was the first American citizen to die of swine flu, in early May, after delivering a healthy baby girl by Caesarean section. A Texas Health Department spokeswoman said she had “chronic underlying health conditions,” which her husband, Steven, later denied on CNN.”
“ . . . and mild asthma, in addition to her pregnancy.”
Okay, so this one, not so much. These are conditions that lead to increased risk, even though pregnancy is entirely normal of course.
The criticism, the debate, is that health authorities are overstating risk factors, perhaps to reassure people without. But, but plenty of people with no risk factors at all have ended up in the hospital.
And the second main point which I take, again it’s meaty and substantial and different people may disagree.
“ . . . statistics suggest that the city’s long list of red flags may encompass as many as one in three people. . . ”
“About 400,000 New Yorkers have asthma, the city’s most common chronic childhood illness; about 700,000, or 12.5 percent of adults, have diabetes . . . ”
So, if you worry all the people with risk factors, you may jam emergency rooms, perhaps unnecessarily.
So, both points, is basically a debate that health officials are overstating risk factors. And we use the article for rather the opposite, to compile a list of factors that put a person at increased risk. (From what I see, we cite this New York Times article three times in our article.) Cool Nerd (talk) 02:41, 6 January 2010 (UTC)
Seeing as it's now 2010 and the pandemic is (apparently) still on, should we move the article to 2009-2010 flu pandemic? --Cybercobra (talk) 08:52, 6 January 2010 (UTC)
This is where wiki habits of distilling, formalizing, summarizing might work against us. CDC sees fit to separately list the warning signs, and I'm not sure where we should overrule them.
As I understand (again, not a doctor) little babies are really different creatures. A doctor who's an internist and treats adults would have a much better chance treating an eight-year-old child than an infant. That is, if we're going to group and categorize, we should group children and adults together, and then infants as a separate, stand alone category. So, even though CDC's listing is repetitive, it's probably not a percentage move to overrule them.
Remember, we don't give general information for general parent. Or rather, 'general parent' doesn't read wiki. It's specific parent with nice little specific baby Sally who rides wiki. The more specific information we can include, still within the flow of a good overview of the entire swine flu situation, the better.
If we do our very best work, we have the chance to maybe save several dozen lives. That possibility should be taken very seriously. And it trumps formality, easily. Cool Nerd (talk) 22:42, 5 January 2010 (UTC)
You need to revert the change you have made in the symptoms. Here is what the CDC says:
In children, emergency warning signs that need urgent medical attention include: Fast breathing or working hard to breathe Bluish skin color Not drinking enough fluids Not waking up or not interacting Being so irritable that the child does not want to be held Flu-like symptoms that improve but then return with fever and worse cough Fever with a rash Being unable to eat Having no tears when crying
In addition to the signs above, get medical help right away for any infant who has any of these signs: Being unable to eat Has trouble breathing Having no tears when crying
Note that the CDC only repeats 3 of the signs already listed in the infant section. The way you have changed it there are only 3 signs for infants rather than 6. As for doing my edits too quickly and dealing with information that I am not up to dealing with, please point out where I have done that. I am careful with my edits and I usually bring up any change I plan to make on the talk page before I go ahead. In fact, since I've been watching this article, I can't remember one instance of anyone doing differently. I would guess that most of the people that work on this article have some sort of medical training and are well able to edit this article. Gandydancer (talk) 08:17, 6 January 2010 (UTC)
Gandydancer, you are one of the bright lights of wikipedia. And I thank you for being a bright light.
My argument is with the policies and practices and habits of wikipedia. We seem to elevate formality above all else. It's as if we believe, perhaps like earlier generations believed about Latin, if only we can translate our thoughts into formal language and gain that clarity of thought, that will surmount any problem. And I just don't see it.
From Dr. Nikki Shindo's Nov. 12th virtual press conference:
Someone rewrites that in more formal language and that's going to improve it? And especially if a second or third person rewrites it again. No, it's not going to improve it.
And from the very first paragraph of our article: "The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus, often referred to colloquially as "swine flu". . . " I think it was wikiwatcher1 who described "colloquially" as a spelling bee word, and yeah, he pretty much hit the nail right on the head. Either he or someone else changed it to a more common word like "informally." And now, apparently someone has changed it back. And that's what we do. We spend an enormous amount of time debating questions of formality.
And from our second paragraph: "The outbreak began in Veracruz, Mexico, with evidence that there had been an ongoing epidemic for months before it was officially recognized as such.[1] The Mexican government closed most of Mexico City's public and private facilities in an attempt to contain the spread of the virus. However the virus continued to spread globally, clinics were overwhelmed by people infected, . . . " I don't think Mexico closed schools and offices in an attempt to completely stop the virus. I think they were just trying to slow it down. That is, we have overly cleaned up the narrative. And the very last part is arguably overstated and alarmist. Clinics is some areas have been overwhelmed, but not clinics globally.
And from our "Symptoms and severity" section before yesterday: "Dr. Thomas R. Frieden, Director of the CDC,[2] suggests that people with "underlying conditions" who come down with flu symptoms should consult their doctors first before visiting an "emergency room full of sick people," since it "may actually put them in more danger." "
But, from the New York Times article: "Such anxiety has been a headache for doctors. They say that people with underlying conditions who have flu symptoms should consult their doctors, but that visiting an emergency room full of sick people may actually put them in more danger." http://www.nytimes.com/2009/05/28/health/policy/28flu.html?_r=1
Quite a difference. Such that Dr. Thomas Frieden didn't say that at all! Plus, these are not direct quotes. They are just part of the narrative of the article.
But, that's what happens. If a second, third, fourth person rewrites a citation, it may drift considerable from the original source. (I made this correction yesterday. But in no way do I have the time, or energy, to check even a tenth of our citations.)
But still, our biggest problem is omissions. For example, our "Vaccines" section includes "On December 15, 2009, manufacturer Sanofi-Aventis recalled 800,000 doses of pediatric vaccine in the United States because of slight under-potency. . . " But we don't talk about a later recall:
(Apparently, vaccines on the shelf seem to decline in potency over time. Again, not a safey issue, but an issue of how much protection the vaccine is going to give.)
We need to find other news sources, not just what looks like a company site. And we need to try and find this on the CDC site if at all possible. It's all a fair amount of work.
Okay, back to the CDC warning signs for infants (say that the virus has gone deep enough into the lungs to have caused direct viral pneumonia or acute respiratory distress syndrome)
"In addition to the signs above, get medical help right away for any infant who has any of these signs:
"• Being unable to eat
"• Has trouble breathing
"• Having no tears when crying"
http://www.cdc.gov/h1n1flu/homecare/warningsigns.htm
I take it that there are saying---"In addition to the sign above"---be particularly alert if any of these happen to an infant. Cool Nerd (talk) 20:08, 6 January 2010 (UTC)
Second H1N1 vaccine recall announced, The Tampa Tribune, December 27, 2009:
“ . . . MedImmune notified the CDC and FDA that during routine, ongoing stability testing that 13 lots of its nasal spray vaccine's potency decreased below the pre-specified limit, according to a press release. This recall only involves a slight decrease in potency and is not safety-related. . . ”
“ . . . Highlands County received 1,100 doses from the MedImmune manufacturer and these lots were among the first to be delivered to the counties and therefore have been administered when they were at full potency. Therefore, the CDC and FDA do not recommend revaccination of persons who received the vaccines included in these lots. . . ”
More swine flu vaccine recalled: FDA, CHICAGO (Reuters), Julie Steenhuysen, Wed Dec 23, 2009: “The U.S. Food and Drug Administration said on Tuesday AstraZeneca's MedImmune unit is voluntarily recalling some of its H1N1 swine flu vaccine because it was not as potent as it should be. . . ”
" . . . but only about 3,000 of those doses are left in warehouses.
"The rest of the doses were given out in October and November, when the vaccine was still at full potency, Baylor told reporters on a conference call.
"The FDA said people who had already received the vaccine do not need another dose. . . "
“ . . . MedImmune is recommending that all lots marked with an expiration date of between January 19 and January 26, 2010 not be used. . . "
and see: http://www.cdc.gov/h1n1flu/vaccination/sprayrecall_qa.htm
"In the federal government's explanations of swine flu, through its Web site and public-service announcements, one message has come through loud and clear: seniors can rest easy. Children face a much greater risk from this disease, and they are dying from it in numbers never seen with regular, seasonal flu. Maybe seniors even have some special immunity to H1N1."
Article here: http://www.newsweek.com/id/229947 —Preceding unsigned comment added by Gandydancer (talk • contribs) 13:02, 9 January 2010 (UTC)
Several news articles have been published by reliable sources questioning the authenticity of this "pandemic" manufactured by drug companies, why is there no mention of it here? JBsupreme (talk) 20:08, 12 January 2010 (UTC)
Scandal prompts WHO to assert consistency in pandemic definition
The World Health Organization has said they have not changed the definition of pandemic during the course of the influenza A (H1N1) outbreak.
http://www.thanhniennews.com/healthy/?catid=8&newsid=54637
(copyvio from above address redacted, just the link please)
Some links: http://news.bbc.co.uk/2/hi/health/8455035.stm http://www.abs-cbnnews.com/world/01/12/10/under-fire-who-ready-review-handling-flu-pandemic http://www.reputationmanagementfor.com/blog/2010/01/12/pharmaceutical-companies-and-bird-flu/ Gandydancer (talk) 23:46, 12 January 2010 (UTC)
Himalayan Blunder, Comment, Times of India, 20 January 2010, 12:00am IST: “ . . . The ties between the members of the board and pharma majors have prompted speculation that the WHO colluded with drug manufacturers to panic governments into buying vaccines. While that may not necessarily be true, at the very least such ties do amount to a significant conflict of interest. . . ”
Pandemic Flu Scare Fades, Vaccine Glut Seen for Glaxo (Update1), Bloomberg, by Andrea Gerlin, Jan. 15, 2010:
‘ . . . The Strasbourg-based council [Council of Europe], set up in 1949 to promote democracy and human rights, will debate Wodarg’s proposed resolution on Jan. 28 that governments made unnecessary vaccine purchases after drugmakers, seeking to boost sales, influenced them. . . ’
.
.
‘ . . . “The orders were decided in May and June, a moment of real uncertainty,” Didier Houssin, director general of health in France, said at a Paris news conference last month. “We were working under the possibility it could require two shots a person.” . . . ’
Regarding the probable or possible history of novel H1N1, a July 9, 2009, New England Journal of Medicine article states: "H1N2 and other subtypes are descendants of the triple-reassortant swine H3N2 viruses isolated in North America.[1] They have spread in swine hosts around the globe and have been found to infect humans. The segments coding for the neuraminidase and the matrix proteins of the new human H1N1 virus are, however, distantly related to swine viruses isolated in Europe in the early 1990s."[2]
((cite journal))
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((cite journal))
: CS1 maint: multiple names: authors list (link) See especially Figure 1.
The basic reproduction number (the average number of other individuals that each infected individual will infect, in a population that has no immunity to the disease) for the 2009 novel H1N1 is estimated to be 1.75.[1]
((cite journal))
: Unknown parameter |arXiv=
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The pandemic is expected to peak by mid-winter in the Northern hemisphere.[1] The CDC recommended that initial vaccine doses should go to priority groups such as pregnant women, people who live with or care for babies under six months old, children six months to four years old and health-care workers.[2] In the UK, the NHS recommended vaccine priority go to people over six months old who were clinically at risk for seasonal flu, pregnant women, and households of people with compromised immunity.[3]
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To combat the virus, the WHO and the US government geared up for a massive vaccination campaign in late 2009, one not seen since Jonas Salk discovered the polio vaccine in 1955.[1]
The Mayo Clinic suggested personal measures to avoid seasonal flu infection were applicable to the 2009 pandemic: vaccination when available, thorough and frequent hand-washing, a balanced diet with fresh fruits and vegetables, whole grains, and lean protein, sufficient sleep, regular exercise, and avoiding crowds.[2] Smoking raises the risk of contracting influenza, as well as producing more severe disease symptoms.[3] In Melbourne, Astralia, Fifty percent of hospitalized 2009 influenza patients without identified risk factors were smokers.[4]
Leading health agencies have stressed that eating properly cooked pork or other food products derived from pigs would not cause flu.[5]
((cite journal))
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Diagnosis Confirmed diagnosis of pandemic H1N1/09 flu requires testing of a nasopharyngeal, nasal, or oropharyngeal tissue swab from the patient.[1] Real-time RT-PCR is the recommended test as others are unable to differentiate between pandemic H1N1/09 and regular seasonal flu.[1] However, most people with flu symptoms do not need a test for pandemic H1N1/09 flu specifically, because the test results usually do not affect the recommended course of treatment.[2] The CDC recommends testing only for people who are hospitalized with suspected flu, pregnant women, and people with weakened immune systems.[2] For the mere diagnosis of influenza and not pandemic H1N1/09 flu specifically, more widely available tests include rapid influenza diagnostic tests (RIDT), which yield results in about 30 minutes, and direct and indirect immunofluorescence assays (DFA and IFA), which take 2–4 hours.[3] Due to the high rate of RIDT false negatives, the CDC advises that patients with illnesses compatible with novel influenza A (H1N1) virus infection but with negative RIDT results should be treated empirically based on the level of clinical suspicion, underlying medical conditions, severity of illness, and risk for complications, and if a more definitive determination of infection with influenza virus is required, testing with rRT-PCR or virus isolation should be performed.[4] Dr. Rhonda Medows of the Georgia Department of Community Health states that the rapid tests are incorrect anywhere from 30-90% of the time. She warns doctors in her state not to use rapid flu tests because they're wrong so often.[5] The use of RIDTs has also been questioned by researcher Paul Schreckenberger of the Loyola University Health System, who suggests that rapid tests may actually pose a dangerous public health risk.[6] Dr. Nikki Shindo of the WHO has expressed regret at reports of treatment being delayed by waiting for H1N1 test results and suggests that "doctors should not wait for the laboratory confirmation but make diagnosis based on clinical and epidemiological backgrounds and start treatment early."[7]
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There's a lot of dated material, much of it written as news reports, that can be removed without any harm to the article. There are also numerous minor facts with multiple cites, so removing one of the cites should mostly be OK. Any support for a citosuction?
Also, have there been any discussions about the article title, now that it's 2010? --Wikiwatcher1 (talk) 04:01, 22 January 2010 (UTC)
I feel that the WHO criticism does not really fit in the vaccine section. Does anyone else have any thoughts on this? Gandydancer (talk) 12:47, 25 January 2010 (UTC)
The redirection to this article gives the impression that the term "swine flu" didn't exist prior to 2009. —Preceding unsigned comment added by 122.107.81.33 (talk) 00:17, 6 February 2010 (UTC)
Pandemic (H1N1) 2009 - update 86, Weekly update, 5 February 2010:
"As of 31 January 2010, worldwide more than 209 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 15174 deaths. . . "
" . . . In North Africa, pandemic influenza transmission remains active and geographically widespread but overall activity has been declining since peaking during late December 2009 and early January 2010. . . "
" . . . In northern and southern China, rates of ILI have returned to levels seen during recent seasons; however, approximately 30% of respiratory specimens tested were positive for influenza suggesting that active transmission of influenza viruses persists. Of note in China, in recent weeks the circulation of pandemic influenza H1N1 continued to decline with a concomitant increase in the circulation of seasonal influenza type B viruses (pandemic H1N1 and seasonal Type B viruses accounted for 34% and 66% of all influenza viruses detected, respectively). . . "
" . . . In addition to the increasing proportion of seasonal influenza type B viruses recently detected in China, low levels of seasonal H3N2 and type B viruses are circulating in parts of Africa, East and Southeast Asia and are being detected only sporadically on other continents. . . "
Many readers understandably want to know what’s going on right now, and on a deeper level, that’s half the story. And perhaps more than half the story since 2009 influenza A (H1N1) first became known in April ’09 (and maybe existing on a smaller scale for several months prior), but will go on, for who knows how long? Now, we could quote various scientists and public health officials regarding their predictions for the future. But many of the best ones are cautious, saying we don’t really know how things will develop. And so, a better way may be to simply include somewhat more material about the present, all the while acknowledging that we do not know which of these trends or aspects will prove to be most significant, but this is what’s going on right now. And for you, our reader, we are laying it on the table the best we can.
encyclopedia --> completeness
Yes, I would say the defining characteristic of an encyclopedia is completeness. (it sure isn’t formality which is window dressing at best.) Whether the topic is Etruscan Art, the life of Gautama Buddha, the Magna Carta, etc, does our article cover the main aspects with reasonable completeness? And I encourage us to think through what this might mean for ongoing situations. Cool Nerd (talk) 15:23, 10 February 2010 (UTC)
Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans, New England Journal of Medicine, Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team*, June 18, 2009 (published on May 7, 2009, and was last updated on June 3, 2009, at NEJM.org):
“ . . . The most common presenting symptoms were fever (94% of patients), cough (92%), and sore throat (66%); . . . ”
The accurate information is that there were hundreds of millions of cases and many tens of thousands of deaths. This is the lead, and it has been buried. —Preceding unsigned comment added by Ocdcntx (talk • contribs) 17:04, 21 February 2010 (UTC)
2009-2010 Influenza Season Week 6 ending February 13, 2010, CDC, Fluview: A Weekly Influenza Surveillance Report Prepared by the Influenza Division.
“Influenza-Associated Pediatric Mortality . . . Two hundred seventeen (83%) of the 262 deaths were due to 2009 influenza A (H1N1) virus infections, 44 were associated with an influenza A virus for which the subtype is undetermined, and one was associated with an influenza B virus infection. . . ”
The chart in this section shows that 217 pediatric deaths from lab-confirmed 2009 H1N1 have occurred since Aug. 30, 2009, and 277 have occurred since April 26, 2009.
There is no mention of them NineNineTwoThreeSix (talk) 04:12, 1 March 2010 (UTC)
I think there should be an article for that don't you think? —Preceding unsigned comment added by User2010II (talk • contribs) 01:22, 24 March 2010 (UTC)
maybe if this was a serious disease that took out half the population and notable people died or were maimed by it, then maybe.. it should be in the article. Otherwise we can't really start a list of people who caught the flu now, can we? I mean by the next year or two its likely just about everyone will have caught it at some point... and this flu (up to this point) actually has caused less death then the regular flu usually does every year.. so Id go with no. -Tracer9999 (talk) 04:21, 24 March 2010 (UTC)
This is actually kinda deceptive. We list estimated deaths for all the other flu's and labatory confirmed cases for pandemic h1n1. Im sure there was more then 14k deaths when reg flu does approx 250k yearly. It might be best to leave h1n1 out of the graph all together or find an estimate. otherwise.. the numbers are just misleading in the big scheme of things and is like comparing apples to oranges. -Tracer9999 (talk) 04:48, 24 March 2010 (UTC)
Resistance can develop fast with swine flu: report, Reuters, Mar 26, 2010:
“ . . . Dr. Jeffery Taubenberger and colleagues studied two flu patients who had immune limitations due to past blood stem cell transplants. They were treated with Tamiflu.
“Writing in the journal Clinical Infectious Diseases, Taubenberger and colleague Dr. Matthew Memoli said the virus infecting one patient developed a drug-resistant mutation after nine days and the other after 14 days of treatment.
“And one of the patients also developed resistance against a second antiviral, Biocryst's peramivir, which is an experimental drug approved for emergency intravenous use in patients who cannot take Tamiflu. . . ”
Pandemic (H1N1) 2009 - update 90, WEEKLY VIROLOGICAL SURVEILLANCE UPDATE, WHO, 5 March 2010:
“ . . . 264 cases of oseltamivir resistance have been reported by GISN and other partners. . . ”
Weekly update on oseltamivir resistance to pandemic influenza A (H1N1) 2009 viruses:
“5 March 2010 -- For this reporting week (25 February - 3 March 2010), 11 new sporadic cases of oseltamivir resistant pandemic influenza A (H1N1) 2009 viruses have been reported. It brings the cumulative total to 264 so far. . . ”
Weekly update on oseltamivir resistance to pandemic influenza A (H1N1) 2009 viruses
19 March 2010 -- For this reporting week (11 - 17 March 2010), 3 new sporadic cases of oseltamivir resistant pandemic influenza A (H1N1) 2009 viruses have been reported. It brings the cumulative total to 267 so far. All have the H275Y substitution and are assumed to remain sensitive to zanamivir. . . ”
see also . . . http://www.cdc.gov/eid/content/16/4/723.htm
from the beginning of the Resistance section:
“As of March 2010[update], the World Health Organization (WHO) reported 264 out of over 15,000 samples of the prevalent 2009 pandemic H1N1 (swine) flu tested worldwide have shown resistance to oseltamivir (Tamiflu).[1] . . . ”
whereas the WHO briefing note states:
“ . . . Since the beginning of the pandemic in 19 April 2009 to 27thFebruary, 2010, cumulatively 153 countries [emphasis added] shared a total of 24,304 specimens (18,748 clinical samples and 5,556 virus isolates) with WHO CCs for further characterization. The majority of pandemic A (H1N1) 2009 influenza viruses analysed to date are antigenically and genetically closely related to the vaccine virus A/California/7/2009.
“Antiviral susceptibility surveillance has been conducted by the WHO Global Influenza Surveillance Network (GISN) including WHO CCs. So far, pandemic A (H1N1) specimens and isolates from at least 91 countries [emphasis added] have been tested, showing that oseltamivir resistant pandemic A (H1N1) viruses are sporadic with rare onward transmission. So far, 264 cases of oseltamivir resistance have been reported by GISN and other partners. All of these viruses showed the H275Y substitution and all remain sensitive to zanamivir. . . ” Pandemic (H1N1) 2009 - update 90
Antiviral Resistance: “ . . . and 1,688 2009 influenza A (H1N1) virus isolates have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir), and 2,735 2009 influenza A (H1N1) original clinical samples were tested for a single known mutation in the virus that confers oseltamivir resistance. . . ”
And from the chart Antiviral Resistance Testing Results on Samples Collected Since September 1, 2009, for 2009 Influenza A (H1N1): 4,423 samples have been tested and 52 have been found to be resistant to oseltamivir. (For zanamivir, 1,617 have been tested and zero have been found to be resistant.) http://www.cdc.gov/flu/weekly/ week ending April 3, 2010
"1,688 . . . tested . . . (oseltamivir and zanamivir)" Yet, the chart shows 1,617 tested for resistance to zanamivir. Wow. Well, like with system accidents, it is extremely difficult to get both big picture and details. And between the two of them, I'll take big picture. (And I'm sure there are things I'm not seeing, but multiple quick passes, and multiple sets of eyes, that helps.)
" . . . The proportion of oseltamivir-resistant 2009 H1N1 viruses does not represent the prevalence of oseltamivir-resistant 2009 H1N1 in the United States. Most cases were tested because drug resistance was suspected. . . "
" . . . To prevent the spread of antiviral resistant virus strains, CDC reminds clinicians and the public of the need to continue hand and cough hygiene measures for the duration of any symptoms of influenza, even while taking antiviral medications . . . "
Geographic Dependence, Surveillance, and Origins of the 2009 Influenza A (H1N1) Virus, New England Journal of Medicine, Vladimir Trifonov, Ph.D., Hossein Khiabanian, Ph.D., and Raul Rabadan, Ph.D., July 9, 2009.
“Genomic analysis of the 2009 influenza A (H1N1) virus in humans indicates that it is closely related to common reassortant swine influenza A viruses isolated in North America, Europe, and Asia (Figure 1). . . ”
And to see Figure 1. http://content.nejm.org/cgi/content-nw/full/361/2/115/F1
Blood Oxygenation Key To Survival Of H1N1 Respiratory Failure Patients, New Zealand, Voxy, 13 October 2009:
" . . . During 01 June to 31 August this year [2009], 68 patients with severe influenza A H1N1 associated acute respiratory distress, received Extracorporeal Membrane Oxygenation (ECMO) in 15 intensive care units across New Zealand and Australia," says Dr Shay McGuinness, Specialist in Cardiothoracic Intensive Care, at Auckland City Hospital. . . ”
“ At the time of reporting, 54 of the 68 patients had survived and 14 (21 percent) had died. Six patients remained in ICU, including two who were still receiving ECMO. The 68 patients who received ECMO had a median (midpoint) age of 34.4 years and half were men.
“Acute Respiratory Distress Syndrome is a lung condition that leads to respiratory failure due to the rapid accumulation of fluid in the lungs. . . ”
That's odd...there seems to be a ECMO page... http://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation Gandydancer (talk) 22:05, 30 April 2010 (UTC)
Removed inaccurate info about mortality rate in Japan because the figure quoted did not appear to be from the article which was referenced: http://knol.google.com/k/epidemiological-characteristics-and-low-case-fatality-rate-of-pandemic-h1n1# Nameless123456 (talk) 16:25, 16 April 2010 (UTC)
Lung Recruitment in Patients with the Acute Respiratory Distress Syndrome, New England Journal of Medicine, Luciano Gattinoni, M.D., F.R.C.P., Pietro Caironi, M.D., Massimo Cressoni, M.D., et al., April 27, 2006.
“ . . . The lung-protection strategy combines the use of higher levels of positive end-expiratory pressure (PEEP) (greater than 12 to 15 cm of water) and low tidal volumes to prevent regional and global stress and strain on the lung parenchyma. Ventilation at low tidal volumes alone has been shown to increase survival among patients with acute lung injury or ARDS, and the addition of higher PEEP to low tidal volumes did not further increase survival. In patients with low levels of recruitable lung (i.e., lung tissue in which aeration can be restored) however, the application of higher levels of PEEP may be more harmful than beneficial, since it will serve only to increase inflation of lung regions that are already open, increasing the stress and strain on these regions. . . ”
Should we mention the preliminary estimates of a high level of years of potential life lost due the pandemic? [9]? Nil Einne (talk) 09:28, 5 May 2010 (UTC)
Researchers take step to 'universal' flu vaccine, Reuters, Washington, Maggie Fox, Health and Science Editor, (Editing by Eric Walsh), May 25, 2010:
‘ . . . The "neck" of hemagglutinin does not mutate the way more visible bits of the virus do, and if there was an easy way to help the immune system to see it, this provides a good antigen -- a target for a vaccine.
‘But the top, umbrella-shaped part of the hemagglutinin protein hides this vulnerable neck from the immune system. Palese's team found a way to get to the neck, cut it out and make a vaccine out of it
‘"A headless hemagglutinin molecule could form the basis for a broadly protective influenza virus vaccine," the researchers wrote.
‘"This paper is more proof of concept," Garcia-Sastre said in a telephone interview. "We don't think we have yet the most optimal way to display the antigen." . . . ’
The following comments are from an external reviewer BSW-RMH as part of the new joint Wikipedia talk:WikiProject Medicine/Google Project.
Hello 2009 Flu Pandemic article writers and editors, This article currently has GA status and is a priority article for the Wikipedia talk:WikiProject Medicine/Google Project. I hope that I can offer some useful suggestions to enhance it further. Specific suggestions are as follows:
This topic is of great interest to communities worldwide, and it is critical that the information be factually correct and well-referenced. I am going to make some direct edits to sources that are more relevant or reliable than the current sources used in this section. The references to the 'number of incidences being in steep decline' have been replaced with WHO references because the Google.org Flu Trends shows total seasonal flu incidences, rather than just H1N1 incidences, and the AP article is not a reliable or up-to-date source for scientifc or medical statistics. In addition, this statement has been altered to reflect that the incidences are only in decline in most of the world. Some parts of the world are in their winter flu seasons and are still experiencing increases in the incidences of H1N1. Please see the noted resources for more information. These sources were replaced with:
In general, I highly recommend replacing newspaper articles with primary scientific or medical resource articles for this article. For example, I replaced: McNeil Jr., Donald G. In New Theory, Swine Flu Started in Asia, Not Mexico The New York Times 2009-06-23[14]with:
In the paragraph mentioning susceptibility, I recommend noting that unlike most strains of influenza such those that cause seasonal flu, H1N1 does not disproportionately infect adults older than 60 years. This is an unusual and characteristic feature of the H1N1 pandemic. See: Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza. Clinical Aspects of Pandemic 2009 Influenza A (H1N1) Virus Infection. N Engl J Med (2010);362:1708-19.
Total worldwide death figure was updated from 14,286 to the current figure of 18,036, and clarified to show this figure is for deaths confirmed to be due to H1N1 with laboratory testing. I also removed this statement "The WHO states that total mortality (including deaths unconfirmed or unreported) from the new H1N1 strain is "unquestionably higher" but this conclusion has been criticized." The total number of deaths that are reported by the WHO are only for laboratory confirmed cases and it is unequivocal that the number of unconfirmed cases far excedes the number of laboratory-confirmed cases and thus laboratory-confirmed deaths due to H1N1. *WHO Pandemic (H1N1) 2009 - update 100, May 14, 2010[16]
In regards to the last paragraph: "The pandemic began to taper off in November and critics claimed the WHO had exaggerated the danger, spreading "fear and confusion" rather than "immediate information". The WHO began an investigation to determine whether it had "frightened people unnecessarily." This does not seem like a balance presentation of the WHO investigation and the recent reports. It relies heavily on articles on newspapers that chose to give voice to a "A small but vocal minority of scientists and government officials around the world"-a quote taken directly from the MSNBC source cited as support for this paragraph (WHO admits errors in handling flu pandemic: Agency accused of overplaying danger of the virus as it swept the globe, MSNBC.com news services, updated 11:15 a.m. CT, Mon., April 12, 2010). This type of questioning always occurs after a major worldwide health event, whether the agency errs on the side of caution or the side of risk. I strongly suggest rewriting this paragraph from a more balanced majority POV and taking into account the recent updates on the investigation.
BSW-RMH (talk) 20:49, 14 May 2010 (UTC)
The Pandemic mortality data figure needs updating. See the previousy cited WHO website.
I find the Template:Flu extremely confusing. Parts of it seem to refer to influenze in general, others to multiple strains, others specifically to the 2009 H1N1 strain. Could someone please define the purpose of this figure, make that clear (especially in the title), and also make sure it refers in entirely to 2009 pandemic H1N1?
The world map of deaths and confirmed cases is also confusing. What is this showing? Please add a title or caption as the legend is inadequate. Is it showing any country that has a confirmed death in black and any that has not had confirmed deaths but does have confirmed cases in red? I would expect this would be similar, if not identical, for influenza in general in any flu season. Wouldn't heat maps showing percents of influenza that are H1N1 at the peaks of nothern and southern flu seasons be more informative? This would give an idea of the extent of the pandemic of this particular strain in 2009, which is the focus of this article. The layout within the article is also awkward.
Why is this statement tagged onto the description of the image of Obama being vaccinated? "well after the number of reported cases of the flu had decreased." Is this to emphasize that he is being vaccinated in preparation for the usual second wave of flu season expected in Jan-March of 2010 (which was the case)? Please clarify that because it might seem odd most readers, who would not necessarily know there are usually two peaks of cases during every flu season, that he is being vaccinated "after the cases of the flu had decreased".
BSW-RMH (talk) 21:18, 14 May 2010 (UTC)
The classification section as written discusses common names of the viral strain and the disease it causes. This section should begin with a paragraph giving the official taxonomic classification of the pandemic H1N1 virus. Example: Order:Mononegavirales, Family:Orthomyxoviridae, Genus:Influenzavirus A, Species: Influenza A virus, Subtype:H1N1, Strain: Influenza A/California/07/2009 (H1N1), (commonly informally shortened to pandemic H1N1/09). See:
BSW-RMH (talk) 16:25, 17 May 2010 (UTC)
This section needs to be expanded to discuss pulmonary complications (like pneumonia and exacerbation of chronic lung diseases), which are the most common types of complications, and cardiac complication in more detail. In addition, kidney and neurological complications have been noted. See:
BSW-RMH (talk) 16:51, 17 May 2010 (UTC)
This section could benefit from more detailed information on the available tests, including the recent IQuum Liat assay, and their emergency use approval by the FDA. (http://www.fda.gov/MedicalDevices/Safety/EmergencySituations/ucm161496.htm) This information guides CDC and WHO testing policies. BSW-RMH (talk) 16:51, 17 May 2010 (UTC)
It might be good to rewrite the intro overview paragraph from the current perspective, rather when starting with the early Fall 2009 perdpective when the vaccine supply was limited and therefore recommended for priority groups only. For example, the CDC is now recommending that everyone over the age of 6 months ve vaccinated for seasonal flu, which will include protection against H1N1/09.
Also, many parts of this section are written as if certain situations are currently happening-which they probably were when this was written, but this should be updated. ex. "In California, school districts and universities are on alert and working with health officials to launch education campaigns." in the Schools section.
The section on Pigs and Food Safety contains an inaccurate statement, "However, despite its origin in pigs, this strain is transmitted between people and not from swine to people", which I have deleted. While the virus cannot be contracted from pork, it can spread from live pigs to humans.
I added some details about the firstlab-confirmed H1N1/09 related death-occurred in Houston but was of a child from Mexico city. I happen to work in the Texas Medical Center, one block from where this happened. Very sad.
BSW-RMH (talk) 17:19, 17 May 2010 (UTC)
One final note: Throughout the article, the H1N1/09 pandemic flu is sometimes referred to as swine flu. This an inaccurate term, and although it may be in common use, it probably should not be used in this article for the sake of accuracy.
Good luck with the updates!
BSW-RMH (talk) 17:23, 17 May 2010 (UTC)
With new information about scientists being paid by profiting drug companies, there needs to be a criticisms section with links to that information if this article is to be considered neutral. guardian.co.uk/..swine-flu-experts-big-pharmaceutical 88.0.226.31 (talk) 04:33, 4 June 2010 (UTC)
[18] 188.2.24.42 (talk) 10:04, 17 June 2010 (UTC)
((copyvio redacted, see the link- LeadSongDog come howl! 18:47, 19 June 2010 (UTC)) http://www.winnipegfreepress.com/special/flu/h1n1-swaps-genes-with-other-pig-viruses-proves-surveillance-need-scientists---96582079.html Gandydancer (talk) 14:56, 19 June 2010 (UTC)
It is hard to make heads or tails of this article, so for now I am just going to park it here. Sounds like the flu vaccine is on hold because it has caused high fevers with seizures in 1% (that's a lot!) of children under 5 in Australia. Sounds like a very dirty lab, but it's hard to tell for now... http://www.foxnews.com/story/0,2933,596767,00.html Gandydancer (talk) 23:38, 15 July 2010 (UTC)
The pandemic is not yet over. I shall change "was a global outbreak" to "is a global outbreak". Gandydancer (talk) 14:41, 19 June 2010 (UTC)
http://www.ncbi.nlm.nih.gov/pubmed/20644650 Gandydancer (talk) 23:12, 21 July 2010 (UTC)
The title of the chart "20th century flu pandemics" should be changed to reflect that it also lists a 21st century flu pandemic. I would do it, but I am not an "autoconfirmed" user. Hurtsmyears (talk) 00:14, 11 August 2010 (UTC)
"From August 30, 2009 to April 3, 2010, there were 2,125 laboratory-confirmed influenza-associated deaths were reported to CDC." AND "Since August 30, 2009, A total of 282 deaths in children associated with 2009 influenza A (H1N1) virus infection have been reported to CDC."
w w w .c d c.g o v / f l u /w e e k l y May 21, 2010 —Preceding unsigned comment added by 207.144.182.4 (talk) 20:20, 22 July 2010 (UTC)
Regarding this edit[19]:
Please don't repeat these edits without discussion and consensus. Jehochman Talk 20:55, 1 September 2010 (UTC)
This article fails to give the estimated numbers of those infected with swine flu and those who died from it. It only gives the number confirmed by labs, this would be a tiny proportion of the total number of people effected globally as in most cases only the richest people will get lab confirmation. Even in countries like the UK, most swine flu suffers before and after the pandemic was identified were not tested, in developing countries the number would be almost zero.
Worse still, the lab confirmed numbers are placed in tables against estimated number from other pandemics and comparison, this is terribly misleading. It needs sorting out.--Hontogaichiban (talk) 04:21, 6 February 2011 (UTC)
The CDC estimated that cases in the US alone might have been as high as 88 Million! With maybe 18,000+ deaths.
http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm
--Hontogaichiban (talk) 04:30, 6 February 2011 (UTC)
Im confused. it says in the lead of the article "According to the latest WHO statistics, the virus has killed more than 18,000 people since it appeared in April 2009,[22] approximately 4% of the 250,000 to 500,000 annual influenza deaths.[23] ".. Thats basically what your saying right. As for the total amount of people infected.. thats a bit more difficult has most wont even end up in the hospital.. its basically a guess. Its a bit easier to count bodies and hospitalizations but not so much total people that caught the flu. If you can source better number from a reliable source then feel free to include them in the article. -Tracer9999 (talk) 06:14, 6 February 2011 (UTC)
I don't think there is an estimate of the real number of infections and deaths yet, I think the WHO has still to calculate it. My main immediate issue is that there is a table in this article which is comparing apples and pears, i.e. estimates of total deaths with lab confirmed cases which will be a tiny proportion of the true total worldwide. I know it kind of points this out in the table, but for most people it will still be dangerously misleading.--Hontogaichiban (talk) 11:34, 22 February 2011 (UTC)
I totally agree. The sentence "the virus has killed more than 18,000 people since it appeared in April 2009,[22] approximately 4% of the 250,000 to 500,000 annual influenza deaths.[23" is seriously misleading, as it compares rare lab-confirmed cases with a rough estimate (probably an overestimate anyway) of total flu mortality. To put the relations in perspective: In Germany, for example, rough estimates of annual seasonal flu deaths are 5000 to 20 000. But there are fewer than 100 lab-confirmed cases in normal flu years because doctors simply don't test. The text above suggests that even in 2009, far more people died of seasonal flu than from the epidemic. This is utter nonsense. In 2009/2010, lab-confirmed deaths from seasonal flu were a tiny minority compared with lab-confirmed h1n1(2009)flu fatalities. Lab confirmed deaths were higher than in normal flu years in the US during the pandemic conpared to normal years, because of the pandemic. Even in the current 10/11 season, when both seaonal and pandemic strains are circulating in Germany, the number of lab-confirmed deaths from pandemic flu are higher than those from seasonal flu (124 of a total of 137 flu deaths had pandemic flu).(http://influenza.rki.de/Wochenberichte/2010_2011/2011-14.pdf, page 4) This really needs to be changed. Either no comparison at all (with the hint that real numbers are far higher, as most patients don't get tested), or the comparison needs to be with lab confirmed deaths from seasonal flu.)Hezarfen67 (talk) 09:25, 16 April 2011 (UTC)
For sure a pandemic this big would've gotten to famous actors, politicans, and athletes. Is there a list for notable cases for this pandemic? And is someone working on it? C'mon the whole thing happened last year. —Preceding unsigned comment added by 68.88.14.124 (talk) 13:48, 20 September 2010 (UTC)
Sorry but I don't think that a list of famous victims of Swine flu would be very important in the general scheme of things.--Hontogaichiban (talk) 11:37, 22 February 2011 (UTC)
After extended discussion of possible alternates, the Wikipedia community arrived at a good choice for article title. "2009 flu pandemic"
"Swine flu" was wisely avoided as a title. It is disapproved by pork producers and some Muslims.
"H1N1" or "AH1N1" was likely wisely avoided. It is triple-ambiguous -- could equally as easily refer to:
1. The original deadly Spanish Flu H1N1;
2. Seasonal, relatively mild, H1N1; OR
3. The 2009 pandemic H1N1.
Better a specific title, non-offensive to pork producers -- as we have. —Preceding unsigned comment added by 66.167.61.75 (talk) 00:15, 29 December 2010 (UTC)
Actually there were more than 2 H1N1 pandemics. Harrison's
[1] says that H1N1 had pandemics or epidemics in the following years:
1918-19 Severe pandemic
1933-35 Mild epidemic
1946-47 Mild epidemic
1977-78 Mild pandemic
--Nbauman (talk) 03:27, 21 September 2011 (UTC)
I understand what the editor is getting at, but I believe there are some problems with the edit. First, what does this mean: "and this is frequently misunderstood as an indication that the H1N1 strain was not as severe as seasonal influenza. The misunderstanding arises from the fact that this figure is an average of "influenza-related" deaths: deaths in which influenza is at least partially involved, but which may have another direct cause" I don't see anything about "at least partially involved, but which may have another direct cause" in the ref, did I miss it? Here's a good ref that explains why the CDC changed their estimate [22]. Also, we do know that this strain actually was less severe (less deaths) than the other strains that have been going around. Thoughts? Gandydancer (talk) 18:00, 14 September 2011 (UTC)
Deaths in the United Kingdom attributed to pandemic 2009 H1N1 flu were almost four times as high during the second wave as during the first, according to data from Department of Health researchers published today. They investigated deaths reported through the country's mandatory reporting system and found a rate of 5.4 per million during the second wave in the fall of 2009, compared with a rate of 1.6 per million in the first wave in the preceding summer (P < 0.001). They found per-million mortality rates during both waves particularly high in those with chronic neurologic disease (450), chronic heart disease (100), immune suppression (94), and chronic respiratory disease (39), compared with a rate of 2.4 in those with no risk factors. The difference between the two waves, they suggest, may have been based largely on people's behavior, such as actions reflecting a decreased perception of risk. They conclude that the data emphasize "the importance of maintaining preventative and treatment-seeking behaviours in the population beyond the period of initial high profile that the pandemic phenomenon attracts." Nov 1 Epidemiol Infect
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/nov0111newsscan.html — Preceding unsigned comment added by 99.190.133.143 (talk) 01:36, 2 November 2011 (UTC)
This is a notice that I have proposed merging the content of 2009 flu pandemic summary with this article. Andrew (talk) 03:51, 26 December 2012 (UTC)
more than a 100 people have been infected and one is already dead. — Preceding unsigned comment added by 84.208.59.120 (talk) 23:39, 29 December 2012 (UTC)
"H1N1 Virus Outbreak Kills 17 in Venezuela", May 27, 2013. --Wikiwatcher1 (talk) 05:57, 28 May 2013 (UTC)
The WHO estimates for total deaths is used once at the beggining of the article, then pretty much ignored after that. The figures of fourteen and eighteen thousand deaths are quoted multiple times as being fact. Which it is. Some tens of thousands of people definitely died of the H1N1 strain. But those are only the people in the developed world who died close enough to labs and doctors to be recorded, and we are essentially misrepresenting the deaths of around two hundred and fifty thousand people mostly in africa and southern asia. That's wrong. We can't just be citing the figures of deaths from the developed world and saying that those are the only ones that count.
The WHO is a reliable enough source to be trusted to tell us how many lab tested cases there were of the H1N1 strain, but not to estimate the total number of people who died? That's madness.
We need to be honest and open in this regard, and report what sources we trust are telling us. They are telling us that outside the developed world the 2009 flu killed fourteen times as many people as are being reported on this page. The people reading the page can understand that estimates aren't perfect, and as long as it it's clear that they are estimates but from reliable sources they can better understand exactly why the 2009 pandemic was an event worthy of note.
As it stands if you don't see the estimate quoted in the opening section then you are lead to believe that less than twenty thousand people died the world over and that as a result 2009 outbreak is scarecly worthy of note; barely contributing to the world wide flu season and that is absolutely not the case. While reports in the press at the time were overblown, there certainly were a lot of people getting sick and a significant number dying. How can we justify just ignoring them because they didn't have the good manners to live in countries with a good enough health care system to run the tests? — Preceding unsigned comment added by 86.162.189.172 (talk) 06:12, 23 June 2013 (UTC)
WHO is not a reliable source. WPcorrector (talk) 01:17, 5 July 2013 (UTC)
This article was already quite long and the vaccine section has recently been increased by a third. If there are no objections, I'm going to cut it back--a reader that has interest may read further information in the vaccine article. Gandydancer (talk) 23:05, 28 April 2014 (UTC)
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I removed this misleading map. The removal is based on academic source https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70121-4/fulltext
Maybe ask the Graphic Lab to update it. Yug (talk) 16:45, 8 March 2020 (UTC)
This statement from the text: "The 1918 flu epidemic began with a wave of mild cases in the spring, followed by more deadly waves in the autumn, eventually killing hundreds of thousands in the United States and 50–100 million worldwide". Why the reference to the US? 5.81.164.49 (talk) 20:00, 8 March 2020 (UTC)
First, coronavirus is not an influenza virus so it technically doesn’t belong in a chart labeled Influenza Pandemic, but I previously found having this in the chart was helpful and informative.
More importantly most of the key info in this row at 4:25am ET is wrong.
The subtype column says H1N1 and H3N2 but these are are types of influenza viruses and to repeat, a coronavirus is a different type of virus from influenza virus. H1N1 specifically is the swine flu virus and apparently H3N2 is the type of flu virus by that caused the 1968 Hong Kong flu. Coronavirus is not a flu or influenza virus.
Even more importantly the coronavirus Estimated Infected column indicates 11% and 800 million globally and 33-42 million in the US. That might be a very speculative projection of what could happen but the actual current numbers for the ongoing pandemic are much much less than that - less than 1/300th of 1% and about 246,000 globally and about 14,000 in the US.
For deaths the chart indicates (very speculative projections?) 0.45 to 1.2 million worldwide and 20-52,000 in the US. Those numbers are not even consistent with the above projections of Estimated Infected. The actual current numbers for deaths for the ongoing pandemic are much much less than what the chart indicates - about 10,000 globally and about 200 in the US.
This needs to be corrected!
A good source for the correct current coronavirus numbers would be https://www.worldometers.info/coronavirus or the Johns Hopkins dashboard at https://coronavirus.jhu.edu/map.html Rschwalb (talk) 08:45, 20 March 2020 (UTC)
This help request has been answered. If you need more help, you can , contact the responding user(s) directly on their user talk page, or consider visiting the Teahouse. |
Why does this article claim 800 million; USA, 34-49 million
infected with COVID-19, and 1.2 million
deaths? The source says nothing about that virus, and current confirmed case numbers are a lot lower than that. Besides, COVID-19 is not a kind of flu so it certainly doesn't belong in a table of influenza pandemics... The coronavirus pandemic is relevant to that section, but the addition to the table seems questionable. Renerpho (talk) 05:47, 20 March 2020 (UTC)
I posted a similar concern in discussion. I like having coronavirus in the comparison table even though it is not an influenza virus, but
1. The (influenza) subtype should be blank or N/A or “Not Influenza”
2. The Ongoing Est. Infected should be 244,523 globally and 14,250 in the US as of 3/19 and would need to be updated at least daily.
3. The Deaths should be 10,049 globally and 217 in the US as of 3/19 and would need to be updated at least daily. Rschwalb (talk) 09:00, 20 March 2020 (UTC)
What happened to the reference to Covid-19/Coronavirus in the comparison table? It looks like that reference was changed to 2019-2020 seasonal flu, which makes sense, but why isn’t that update reflected in the page history? Rschwalb (talk) 15:20, 20 March 2020 (UTC)
An editor has asked for a discussion to address the redirect America flu. Please participate in the redirect discussion if you wish to do so. Praxidicae (talk) 20:10, 20 March 2020 (UTC)
It was proposed in this section that multiple pages be renamed and moved.
result: Links: current log • target log
This is template ((subst:Requested move/end)) |
– I recently proposed Talk:Spanish_flu#Requested_move_15_March_2020 where I proposed the title to be 1918 influenza pandemic, but I'm not sure whether it should be that title or 1918 flu pandemic so I am currently seeking a consensus to whether pandemics like this should be called Flu pandemics or Influenza pandemics. Interstellarity (talk) 16:21, 16 March 2020 (UTC)
Hi, could someone explain me which is the correct number of victims of the 2009 flu pandemic? Because in these template we have "only" 19,654 victims, but in the infobox someone wrote 150,000–575,000. Thanks. -- Nick.mon (talk) 22:43, 20 March 2020 (UTC)
Hey, anybody could find exact information about deaths? I think 150-575 thousands is really exaggerated. This is information of late period of pandemic (1 months before post-pandemic period) and it states 18449 deaths. https://www.who.int/csr/don/2010_08_06/en/ Couldn't found death statistic after official end of pandemic. — Preceding unsigned comment added by Gota (talk • contribs) 16:37, 23 March 2020 (UTC)
I am very confused by the statements that the swine flu killed 18,000 people and other articles says perhaps over 500,000. Why this difference? What was the more reliable extimate? — Preceding unsigned comment added by 62.11.3.98 (talk) 15:06, 15 March 2020 (UTC)
Take note in the first table of the article, the number of cases and deaths has changed severely, it seems very inaccurate
In addition, I think the previous title ("2009 flu pandemic") was better — Preceding unsigned comment added by 179.113.172.58 (talk) 00:33, 1 April 2020 (UTC)
I have been looking at this since Jan. 2020 and the number of fatalities has dropped significantly. It was 1.5 million in January. Apreinesberger (talk) 13:46, 29 July 2020 (UTC)
Shouldn't the title be "2009 Swine Flu pandemic" since the Swine Flu is a proper noun? — Preceding unsigned comment added by 76.102.2.73 (talk) 21:18, 25 January 2021 (UTC)
A discussion is taking place to address the redirect Recent swine flu outbreak. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 June 21#Recent swine flu outbreak until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Hog Farm Talk 01:15, 21 June 2021 (UTC)
A discussion is taking place to address the redirect The recent swine flu outbreak. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 June 21#The recent swine flu outbreak until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Hog Farm Talk 01:16, 21 June 2021 (UTC)
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