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Ordinarily this headline would be met with smirks and admonitions of "Don't drink the water!"  But it is glaringly apparent that in Mexico, a virus of some sort has caused hospitalizations and deaths. 

From the Canadian Press:

Doctors warned to watch for mystery illness in tourists returning from Mexico

TORONTO — Public health units, quarantine officers and medical practitioners across the country have been warned to be on guard for cases of a mystery illness in Canadians returning from Mexico.

The warning follows reports from that country of cases of severe respiratory illness, which in some cases has led to death.

Mexican authorities have insisted the outbreak is not an epidemic and that preventive measures are being taken to reduce the risk of transmission of disease.

Mexican authorities informed Canadian counterparts about the situation on April 17, asking for help with their investigation. Scientists at the National Microbiology Laboratory in Winnipeg are assisting in efforts to determine the cause or causes of the illnesses.

"We are aware of the reports and are looking into them," said Andrew McDermott, a spokesperson for the Public Health Agency of Canada.

It's not clear if there is any link between these illnesses and the recent discovery of several human cases of swine flu infection in California. (bold mine)

Dr. Arlene King, who is the Public Health Agency of Canada's point person for pandemic influenza preparedness, said samples from Mexico will need to be studied to see if there is any link.

King, who was named Ontario's new chief public health officer on Thursday and takes on the job in mid-June, said it is important to be on the lookout for new infectious disease outbreaks.

"We absolutely have to remain vigilant in the country around the situation in Mexico and globally," said King, who is director general of the public health agency's centre for immunization and respiratory infectious diseases.

"We need to be prepared for any emerging infectious disease threat that may occur outside of our borders. It's absolutely fundamental."

A spokesperson for the Pan American Health Organization - the World Health Organization's Americas branch - said PAHO is also working with Mexican authorities to look into the reports.

"We're co-operating with (Mexican) authorities on it," Donna Eberwine-Villagran said from Washington.

"We have people in our field office in Mexico City and also in our border office working with Mexican authorities looking at the cases."

The illnesses are said to have been occurring in south and central Mexico and involve mainly young, previously healthy adults. Some reports have suggested health-care workers have become ill.

To date, two clusters of severe respiratory infections with death have been reported in April, one in Mexico City and one in San Luis Potosi. Mexico City has reported 120 cases including 13 deaths while San Luis Potosi, in central Mexico, has reported 14 cases including four deaths. (bold mine)

In addition there has been a death reported in Oaxaca, in southern Mexico and two deaths reported in Baja California Norte, which borders California.

Health authorities have been told some of the cases have tested positive for influenza, but some cases are influenza A and others are influenza B.

A leading infectious diseases expert said a number of pathogens could be the culprit or culprits.

"It could be anything," said Dr. Allison McGeer of Toronto's Mount Sinai Hospital. "Full range from new and unidentified virus to stuff that goes on every day and somebody just did a test."

She added, though that it was "improbable" that the illness was being caused by anything exotic and was most likely the work of influenza or an adenovirus. (bold mine)

An advisory from Toronto Public Health to health professionals said that given the severity of the illness, health care workers should be actively looking for cases of severe respiratory infection in people who have been in Mexico in the previous two weeks.

But the advisory stressed that there is no evidence the infections are caused by an unusual pathogen or a novel flu strain.

Mexican health officials held a news conference Wednesday to discuss the situation, putting the surge in illnesses down to end-of-season flu activity.

Mauricio Hernandez Avila, the undersecretary for health prevention and promotion, said the health department had initiated an active search for cases of serious pneumonia associated with the illness in the country, especially in the federal district that encompasses Mexico City.

Copyright © 2009 The Canadian Press. All rights reserved.

The pattern of cases to deaths looks similar to what the pacific Northwest saw with its most recent documented outbreak of Adenovirus 14, or Ad14 for short.  A ten to twenty-five percent CFR (Case fatality Rate) in hospitalized patients would mirror the findings in the Seattle study, which can be found in great detail on this Blogsite (keyword search: adenovirus).

Of course, a 10% CFR is also reminiscent of SARS, but it is highly doubtful that SARS would have skipped oceans and continents and found its way to Mexico.

Likewise, influenza is just not a killer in these numbers, even swine flu.  So my vote is good old Ad14, and the sooner the CDC starts testing for it, the sooner we all will find that is our latest "silent epidemic" and then someone can set about finding a vaccine for Ad14 and other flavors of adenovirus.

Just today, the news-gathering sites are absolutely aflame with the twin stories of the (for them, bless their hearts) "sudden" increase in Egyptian bird flu infections -- and the revelation that two Southern California youtes (that's "youths" for those of you not from New Jersey) were infected in march with swine flu.

The swine flu in question is good old swine H1N1, the decendant of the 1976 "swine flu scare" virus. According to the MSNBC story, the children were diagnosed last week. One was a 10-year-old boy in San Diego County, and the other a 9-year-old girl in neighboring Imperial County. Both recovered.

As you recall, in 1976 a soldier in Fort Dix, New Jersey, died of H1N1 swine flu, and some 500 other soldiers showed antibodies. That promoted the biggest mobilization of government and the scientific community to combat a viral plague in the shortest timeframe in recorded history.

Of course, the result was a vaccine that caused Guillain-barre syndrome in an uncomfortable number of elderly people,especially in and around Pittsburgh, PA. A few people died and the vaccine went on the shelf until after the swearing-in of president Jimmy Carter. Just after Carter took office, an outbreak of A/Victoria occurred, with its starting point a nursing home in Miami. The only vaccine against A/Victoria was in the swine flu cocktail. Then-HEW secretary Joe Califano ordered the release of the swine flu vaccine, and there was no statistically significant difference in the number of complications due to Guillain-Barre than if there was no vaccine at all! This has confounded researchers to this very day.

OK, so now you are all caught up on swine flu. Oops, not quite: Swine flu was diagnosed in Texas in 2008. A person was tending pigs, including a sick one. The Texan developed swine H1N1 and recovered.

But wait, there's more: In December 2005, a Wisconsin teenager developed respiratory distress after he helped his brother-in-law slaughter pigs.

From the (always excellent) CIDRAP report:

At an outpatient clinic a few days later, healthcare workers collected nasal wash specimens, which tested positive for influenza A and were forwarded to the Wisconsin State Laboratory of Hygiene. Though further testing isolated influenza A, the virus didn't match human H3 or H1 subtypes or the H5 avian subtype. CDC investigators sequenced the virus, identifying it as a swine influenza A (H1N1) triple reassortant virus, A/Wisconsin/87/2005 H1N1.

Back to today's story: According to the AP, this new H1N1 is a variant of a variant. They say:

Health officials have long feared the emergence of a deadly form of flu. They have not noted a spike in flu cases or a rash of severe illnesses. But they are continuing to investigate the genetics of the virus and track down and test people who may have been in contact with the children.

Both children became sick in late March and experienced fever and cough. The boy also vomited.

The two had not been in contact with each other, CDC officials said.

The boy's mother and brother also had a flu-like illness recently, as did a brother and a cousin of the girl. None of those relatives were tested for flu at the time of their illness.

The San Diego County boy and his 8-year-old brother flew from California to Dallas in early April and are currently with relatives in Texas. Health officials also are trying to contact the plane's flight crew and two children who sat near the boys, CDC officials said.

In the past, CDC received reports of approximately one human swine influenza virus infection every one or two years. But more than a dozen cases of human infection with swine influenza have been reported since late 2005.

Most cases occur in people who were exposed to pigs. Neither child had touched a pig, according to their families, although the girl had been at an agricultural fair four weeks before she got sick.

The jump in cases in the past few years could be because of technological improvements and expansion of public health laboratories, which have improved testing capacity. But genetic mutations could also play a role.

The new flu contains a unique combination of gene segments that have not been seen in swine or human flu viruses before, CDC officials said.

Here in Tallahassee, we are experiencing something which is much nastier than our traditional "Tallahassee crud," or "southernus capitolus cruditis." And look at the huge numbers of flu samples that go "untyped" each season, meaning they cannot be conclusively identified as A or B, H1N1 or H3N2.  In light of this new story, one cannot help but wonder if this new variant of swine flu has a wider dispersion than anyone realizes.

As we all know, and as the New York Times has dutifully picked up on in today's editions: There is something decidedly different going on in Egypt right now. The number of human cases seems to be accelerating, with almost a case a day on average in the past week alone.

Not just that: The news reports of a dead 6-year old boy, first admitted to hospital on march 28th of this year, breaks a pattern of (generally) mild H5N1 symptoms in younger children and returns the virus to lethal status. The dead boy lived in what MSNBC calls a "gritty" suburb of Cairo.

I have not taken the time to map the locations of the numerous human cases, but Dr. Henry Niman has, and it can be seen here. The data are pretty amazing to see mapped out.

And if you look at the chatter on Egyptian Websites, especially news-gathering sites, the number of suspected cases continues to climb and will continue to climb.

In the past several weeks, the human cases seemed to be confirmed to younger children, and the virus itself seemed to be mild. In fact, the virus' effects seemed to be so mild that speculation began to infect even the highest scientific and medical circles that a mild form of human H5N1 might be circulating all along the Nile Delta. This speculation was added to be others who then began to openly speculate about the possible presence of asymptomatic human carriers of H5N1. Asymptomatic human carriers of a pandemic-ready virus, whether or not it was capable of sustained human-to-human transmission, would mark the official Tipping Point of H5N1's transition from killer of birds to mass murderer of humans.

But last week, the first two adult cases of H5N1 in several weeks surfaced.  Curiously, the two adult cases were female -- a pattern we have seen before.

However, the cacophony regarding the possible presence of asymptomatic human carriers was not universal. Far from it: The Pope of Influenza himself, Dr. Robert G. Webster of St. Jude, proclaimed that all this worry was a lot of "hot air." From the New York Times:

“Right now, it’s all hot air,” said Dr. Robert G. Webster, a flu expert at St. Jude Children’s Research Hospital in Memphis. “I hope to hell it’s not happening, because it would mean the virus is adapting to humans. But there’s not a shred of data.”

I admire and respect Dr. Webster greatly, and I communicate with his protege on occasion.  Another scientist who is in my personal Hall of Fame is the late Dr. J. Allen Hynek, founder of the Center for UFO Studies, and was a consultant to the USAF's Project Blue Book.  But Hynek is probably and wincingly best known for his proclamation that certain Michigan 1960's UFO sightings were "swamp gas."  Of course, he was taken out of context -- but the comment remained.

So, hopefully, Doctor Webster's "hot air" comment will be borne out; because if not, as he says, it would mean the H5N1 virus would have evolved toward H2H transmission. But his tone also suggests he has had the opportunity to personally view samples of the Egyptian virus, as a WHO world-class reference lab.  The Egyptian government is refreshingly transparent when it comes to reporting and disclosing bird flu cases and samples. 

One thing is absolutely certain: The number of human H5N1 cases in Egypt is double that of the entire year of 2008. It is on track to be the worst year for human H5N1 in Egypt since its introduction in 2006.  More than 6,000 Egyptians have been suspected of having H5N1 and were given Tamiflu as a precaution.  Egypt is averaging a confirmed human case of H5N1 every six days.  At this rate, and even factoring in seasonal fluctuations in the virus' appearance, it will be a long 2009 for the Egyptian government and its people.

The concept of asymptomatic human carriers being the final prerequisite for pandemic is not new; as readers know, I frequently refer to the good works of the late Dr. R. Edgar Hope-Simpson, who felt that a pandemic would not start with any sort of localized outbreak; rather, it would start with simultaneous infections either across a continent or across many continents.  These asymptomatic carriers of infections would explain the ability of previous flu pandemics to "jump" across entire oceans and mountain ranges within days of the diagnosis of preliminary cases.  It would help explain the argument about whether the Spanish Flu first appeared in China or in Kansas; whether it first appeared in pigs or in people.  The answer would be "yes."

The world needs to stay focused on Egypt.  The news coming out of there is bad, bad, bad.

This is another long blog, so prepare your posterior. I ask you to follow the story and be patient.

CIDRAP News has delivered another bang-up story on Panasonic's shocking decision to remove its foreign dependents and bring them home prior to the end of September.

I don't need to revisit the details: Just follow my blogsite, Crof's, FLA_MEDIC's, Zoe's, FluTrackers and Flu Wiki and about a million others. Here is the CIDRAP article, and then a Time Magazine story that I will interlace with current events. So settle back and enjoy.

Panasonic addresses speculation over employee pandemic order

Lisa Schnirring, Staff Writer

Feb 12, 2009 (CIDRAP News) – A spokesman for Panasonic Corp. said today that the company had no proprietary information about any increased risk of an influenza pandemic in December 2008 when it instructed some of its overseas employees to send their families back to Japan by September.

Jim Reilly, a Panasonic spokesman based in New York City, also denied speculation that the company ordered the families to return to Japan as a cost-saving measure to mitigate the effects of the global economic downturn.

However, he told CIDRAP News that the company realizes its move may seem unusual, given that they are the first major company to enact such a pandemic planning measure. "They realize that there are different perceptions around the world," Reilly said of Panasonic officials.

No change in pandemic risk
Masato Tashiro, MD, PhD, a virologist at Japan's National Institute of Infectious Diseases and a consultant to the World Health Organization (WHO), told CIDRAP News that he hasn't seen any increase in the global pandemic risk. "As far as I understand, the recent situation of poultry outbreaks and human infections in China is within our prediction," he said.

Panasonic said its request to the employees was based on a review of where the H5N1 virus has been detected and an assessment of medical facilities in the areas, according to previous reports.

The regions that were named align with its operational divisions, Reilly said. He reiterated that Japanese employees have been asked to return send their families back from Asia (except Singapore), China, the Middle East, Africa, the Commonwealth of Independent States (the former Soviet republic states), and Latin America. Divisions that aren't subject to the repatriation request include North America, Western Europe, and Oceania (Australia and New Zealand).

He said it was difficult to determine how many people are affected, but he said, for example, that Panasonic has 60 factories and about 100,000 employees in China. The company has 307,000 employees worldwide, including 13,500 in North America.

Panasonic gave the affected employee families several months to make their moving arrangements, because Japanese families aren't typically as mobile as those in other countries, Reilly said. Making new living and school arrangements might be more complicated and take longer, because families don't frequently make such adjustments.

Importance of business preparedness
One element of Japanese culture is that the country is very prepared to address natural disasters, Reilly said. "People from outside of Japan are always impressed when they see lots of information on what to do about earthquakes," he said, alluding to a 1995 earthquake centered in Kobe that killed nearly 6,500 people and one in 1923 that killed 140,000.

"Companies know the importance of continuing business," he said.

Japan's pandemic plan, posted on the health ministry's Web site, contains 14 pages of guidance on business preparedness. It urges employers to consider options for evacuating employees and their families assigned overseas in regions that experience pandemic outbreaks, minimizing travel to outbreak areas, and ensuring that returning employees and families follow quarantine guidelines.

William Raisch, executive director of the New York University International Center for Enterprise Preparedness, told CIDRAP News that Panasonic's action shows that some of the largest corporations still see a pandemic as a continuing and real threat.

"Further, this announcement by Panasonic indicates that they are actively monitoring the prevalence of bird flu and have begun to assess the capability and access to healthcare in key elements of their supply and distribution networks," said Raisch, who is an editorial board member of the CIDRAP Business Source.

Earlier this month, Japan's defense ministry said it had developed a plan to fly Japanese citizens in foreign lands home in government-chartered jets in the event of an influenza pandemic, the Yomiuri Shimbun, an English-language newspaper in Japan, reported on Feb 4.

Strict quarantine, mass cremation
The country's health ministry today announced some new details of its pandemic plan, which includes strict quarantine measures such as shutting down all but four airports and three ports, the Associated Press (AP) reported today. Other plans include closing schools and conducting mass cremation of pandemic flu fatalities.

The ministry said, "It is important to delay as much as possible the virus' entry through measures such as strengthening quarantine to take advantage of the special qualities of our nation as an island nation," according to the AP report.

Some pandemic flu experts have said that closing borders won't stem the spread of a pandemic virus and could hamper the flow of crucial supplies.

Health minister Yosuke Yamaki told the AP that Japan is updating its pandemic plan, based on public feedback collected in recent weeks.

As I mentioned, I see absolutely no coincidence between the Panasonic announcement/admission and the sudden fervor that the Japanese government has shown in upgrading and preparing its population for the management of a flu pandemic.

Now let's shift to Time Magazine, and its story on the sudden resurgence of H5N1 in the country of China:

Is China Making Its Bird Flu Outbreak Worse?

One thing is certain about avian influenza: it's deadly. Of the three people who contracted the H5N1 strain of the virus in China last year, three died. In the first six weeks of 2009, eight people have come down with bird flu and five have died. Another thing is that — while the disease has yet to go pandemic as many doctors fear it could — it remains worryingly persistent. Every year since 2003, about 100 people in Asia, the Middle East and Africa contract the disease. Last year, in a rare exception, the number dropped below 50.

But bird flu, it seems, is back. This year, China has already recorded eight human cases of the disease. Last month five people died in locations as far removed from each other as Beijing in the north, Xinjiang in the west, Guangxi in the south, Hunan in the center and Shandong in the east — and one of the highest tallies of bird flu deaths China has ever recorded in a month. "From a disease-control perspective, the increase in cases in China is notable — as is the wide geographic spread," says Dr. Hans Troedsson, the World Health Organization's representative in China. There is still no evidence that the virus has mutated to spread easily between humans, he says. But while such a nightmare scenario, which could set off a global flu pandemic that could kill millions, has shown no signs of being an immediate threat, serious concerns remain. "The fact that this is the highest number for a single month in China reminds us that the virus is entrenched and circulating in the environment," Troedsson says. See pictures of the resurgence of bird flu.(bold mine)

On Feb. 10, authorities in the far western region of Xinjiang culled more than 13,000 chickens in the city of Hotan after 519 died in a bird flu outbreak. But until this week China had reported no widespread outbreaks of the virus among bird populations, prompting concerns among some public health experts that mainland health and veterinary authorities could be missing — or even concealing — the spread of the disease through mainland poultry and wild birds. Hong Kong, "Hong Kong, where the first human cases of H5N1 infection were found in 1997, reported finding a dozen birds with the deadly strain of the virus earlier this year — a good indication that the virus is very likely present in adjacent Guangdong province. But so far Guangdong has reported no bird cases. Equally unusual is that after such a busy month of infections in China, reports of human cases have gone silent. "It's a surprise for me since in January the human cases, you have so many, but in February it suddenly stops," says Dr. Guan Yi, a virologist from the University of Hong Kong. Read "Is Hong Kong's Bird Flu Vaccine Failing?"

The human deaths in China, plus new outbreaks among poultry in neighboring Vietnam and northeast India indicate the likelihood of a firm presence of the virus on the mainland. Some experts worry that China could be missing the disease's deadly progression. Last week Dr. Lo Wing-Lok, an advisor on communicable diseases to the Hong Kong government, said the mainland had not been forthright about the spread of bird flu in poultry. "There's no doubt of an outbreak of bird flu in China, though the government hasn't admitted it," he told Bloomberg. Yu Kangzhen, the Ministry of Agriculture's chief veterinarian, responded in an interview with the state-run Xinhua news service that human bird flu cases are not necessarily linked with animal cases. Read about living with bird flu in Indonesia.

If mainland investigators are missing the virus, it may be because efforts to block it are inadvertently hiding it. China developed an avian influenza vaccine for poultry in 2005 and inoculates millions of birds annually. But not everyone agrees it's a panacea. In 2005 Dr Robert Webster, a influenza expert at St Jude's Children's Hospital in Memphis, Tennessee, suggested that China may have been using substandard vaccines that stopped symptoms of bird flu in poultry but allowed the virus to continue to spread. Recently, Guangzhou-based expert Zhong Nanshan has also said there is a danger that China's widespread vaccinations could conceal the virus. "Special attention should be paid to such animals, including those that have been vaccinated," Xinhua news service quoted him as saying on Feb. 6. "The existing vaccines can only reduce the amount of virus, rather than totally inactivating it."

Mainland controls may also be lacking another layer of more basic prevention in the way that live chicken markets, prevalent throughout Asia, are inspected. Some worry that Chinese monitors may only be calling for culls once a large number of poultry has become sick, as in the Hotan case this week in which 519 birds died. In contrast, last year Hong Kong culled thousands of birds after a regular inspection found only infected chickens in a wet market. The infected birds, experts say, showed no external signs of disease, and could have been missed if inspectors were only screening birds that were dead or visibly ill.

Ramping up preventative measures may increasingly be a matter of life and death. Since bird flu re-emerged in 2003, 254 people in 15 countries have died from it. Researchers now fear that other crises like global warming and the global recession have crowded the virus out of the news. But the disease survives — in the limelight or out of it. "The point is this virus has not disappeared at all," says Malik Peiris, a virologist at the University of Hong Kong. "It kind of dropped off the radar screen of media attention, but the virus itself has increased its spread. It's not only entrenched in Asia, the Middle East, in Egypt, Africa, parts of India and Bangladesh. It's really a problem."

This is the best digest of news written for the casual reader I have seen since 2006. It also mirrors the concerns I have raised for months and months now. The widespread cases of deaths are somehow reassuring to some, because to them it implies no H2H outbreak center. But to me, it implies the potential confirmation of Hope-Simpson's belief that pandemic influenza appears simultaneously all over the place, not just emanating from an isolated location. Avid readers of this blog know of my affinity toward Hope-Simpson's theories and life's work. And Hope-Simpson's theories may solve the one nagging and inconvenient question regarding previous pandemics -- namely, how did panflu reach out across oceans and mountain ranges simultaneously when it took weeks or even months for people to cross? That little question unravels almost all conventional theories of pandemic flu spread. As Sherlock Holmes said, "Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth."

So as late as the mid-1800s, it was impossible to cross the Atlantic, Pacific or the Eurasian continent and deposit flu virus in as many widespread places as were simultaneously experienced during pandemics. Migrating birds explain part of the story, but not the whole story.  Hope-Simpson believed that a single, simultaneous change in the virus became the tipping point and enabled influenza to cross over genetically to become a human pandemic.  Keep this in mind as you read on. From the English-language Vietnamese newspaper, the Saigon GP-Daily:

Illegal poultry slaughter, sales: HCMC fears bird flu epidemic

Veterinary workers fear Ho Chi Minh City could be hit by a bird flu epidemic since illegal slaughter and sales of poultry are rife in some districts and water fowls bred on small farms have not been vaccinated.

One of the poultry hotspots is Cau market on Quang Trung Street in Districts Go Vap and 11. It is a notorious wet market where poultry has been slaughtered illegally for many years, and it continues to flourish despite the bird flu scare.

Neither district has cleared it. A Go Vap official said sellers in the market flee to the other district when they see inspectors. Besides, he said, since most are migrants from other provinces, it is difficult to catch them.

The situation is similar at Tan Son market which is situated in both Districts 8 and Binh Chanh. The city’s Steering Board for Bird Flu Prevention is unhappy that district authorities have not closed down these illegal markets. The head of the city Department of Animal Health, Phan Xuan Thao, said the city faces the threat of bird flu from the widespread smuggling in of water fowls from neighboring provinces.

Nguyen Trung Tin, vice chairman of the city People’s Committee, expressed worry about a possible human bird flu epidemic. He said inspectors must be posted round the clock at “hot” spots to deal with violations, assisted by police officers. He warned officials in charge of preventing the disease that they would be taken to task if live poultry is found to be sold in their area by inspectors or the media.

The photo here is of confiscated poultry, illegally smuggled into a Ho Chi Minh City market.

I am going to proclaim something here, and for some it may be profound, and for others it may provoke a "DUH!" response.  Here we go:

I believe something has changed.  Not necessarily in the virus itself; it still has not "gone H2H."  But I do believe that the chickens themselves are adapting to the virus.  And once that happens, the virus must also adapt to find new hosts or it will perish.

There is absolutely no reason to believe that H5N1 is going to do anything but adapt.  This virus is amazing, even by influenza standards.  Now factor in the extreme and absolutely sudden number and geographic spread of human cases in China that we know of, and re-read the Time story.  Now also factor in the situation in eastern India, Bangladesh and Nepal.  Look at the new Vietnamese human cases and the continuing situation in Indonesia.

Here's what I think has happened:  H5N1 has won its latest battle with the human race and has completely overrun its defenses.  It has not won the war, but it is clear that it has completely  outmaneuvered every attempt by humans to thwart its advance.  But this latest victory may, eventually, be considered as the turning point in the war. 

Consider the circumstances.  The global economy is in shambles. Surveillance is about to become very lax and unaffordable.  Farmers are risking imprisonment and even execution by bringing in illegal poultry.  Culls cannot keep the virus out of any region. And now the chickens are not doing their duty and dying to warn us -- at least not according to the latest news coming out of China.

Open speculation from leading Chinese scientists regarding this "living chickens" theory leads me to believe that the government itself is stymied and this is how they are asking -- no, begging for outside help to solve the riddle.  This collective shrugging of scientific shoulders from a country that is welling with pride and also within a couple of years of putting a Chinese man on the surface of the Moon is very telling.

So let's review these signs and portents. 

Panasonic is not recanting its earlier plans; in fact, it is restating them and telling anyone who listens not to question their motives nor their methodology.

China has lost the handle on containing H5N1, according to the Time article.  And the widespread geographic location of human cases is not assuring; it is downright troubling (thank you, Time).

Vietnam has also lost the ability to rein in illegal smuggling of poultry, usually from China.

Chickens are not dying in certain areas of China.  But people are.

Human cases are abundant, compared to last year.

Pandemic money is in the US stimulus bill.  Of course there are skateboard parks and a quadrillion condoms, but the presence of panflu monies in both versions was eyebrow-raising.

And the British government recently announced plans to double its antiviral stockpile with Relenza, and not Tamiflu, as the antiviral centerpiece (as I have advocated for two years).

These signs and portents may be the first real indications that the Pandemic Doomsday Clock is ticking. The countdown may have begun, and the cumulative weight of these separate events may have convinced both the Japanese government and Panasonic executives that the countdown has indeed begun; that the clock is no longer stuck at five minutes to midnight; and that the first outbreaks of bona-fide, H2H2H2H avian influenza are just weeks or months away.

It may have also served to convince the Chinese government to lay in additional supplies of their human bird flu vaccine, although to be honest I would rather take my chances with the virus. 

We keep hearing  that the WHO and others are emphatically saying there is no need to raise the pandemic threat level and that there are no outward signs that the virus has mutated.  We don't know if this is true or not; not that we think anyone is lying, but it may take longer than a few days to look at the virus and make that pronouncement. 

But the WHO protocol for changing the threat level ignores the holistic situation and should force us to question if a change in the virus itself is the best/only way to proceed with moving from Phase 3 to Phase 4. 

Everyone needs to be renewed and refreshed and vigilant as heck right now.  And we need to find more signs and portents.  I am uncomfortably sure they are out there and will manifest themselves in due time.

A special "vaccine court" has finally closed the door on claims that vaccines containing thimerosol are not responsible for autism.

The ruling was aimed at the measles-mumps-rubella vaccine, more commonly known as the MMR vaccine. But its effect could just as well be applied to all approved vaccines, and should be.

As we all know, there is a new culture of opposition to vaccines that is both absurd and bad for public health. These parents, led by several celebrities (and gee whiz, how many times do we have celebrities abusing their status for such flat-earth initiatives?), have suddenly made it chic and cool to not vaccine children because of some perceived risk.

Here are two story links on the topic. The first is from Stacy Garfinkle's column On Parenting, which appears in the Washington Post.

http://voices.washingtonpost.com/parenting/2009/02/the_original_vaccineautism_stu.html?hpid=topnews

The Original Vaccine/Autism Study Debunked

Eleven years ago, a study appeared in The Lancet that linked the Measles, Mumps and Rubella vaccine to autism. On Sunday, The Times of London ran an investigative story saying that altered data was behind the study all along.

The Times' story isn't the first to dispute those original vaccine claims that sparked the continuing vaccine debates that still exist today. Study after study of MMR have shown no link of the vaccine to autism. But it is a reminder of just how easily we can all be played when it comes to our kids.

Just take a bunch of health news in recent weeks and years. Salmonella found in Peanut Corp. of America's processing plant and foods made from products from that plant are affecting sales of jarred peanut butter. Not that anything has been found to be wrong with jarred peanut butter; in fact, it's a pretty healthy food in small portions.

International studies on BPA and phthalates have made us question our use of plastics, from water bottles to cans of food lined with the chemicals. Mercury in fish makes us rethink what seafood to feed our pregnant selves and our families. Lead in toys has us scrambling to remove dangerous toxins from our toy bins. Our cleanliness and obsessions with Purell are causing some of our health issues. Recent news stories on potential dangers of high fructose corn syrup are being e-mailed friend to friend, sister to sister. And these are just the bigger topics.

While it's good to be informed and make the best choices we can for our kids, The Times' story is a reminder that life just is sometimes. We can't always explain why our kids may have allergies or asthma or autism or cancer or colic just as we can't explain why some kids are mellow and some are hyper, why some are clumsy and others are athletic. And we can't -- and shouldn't -- feel guilty for not preventing all the bad stuff.

So, while I won't be giving up our metal water bottles anytime soon, I don't have a problem if my kids eat a little dirt. And while I may not be a fan of corn syrup, I'm not going to snatch something out of their hands that has the stuff in it. And just as I continued to take my kids to the park in the midst of the sniper shootings in Maryland several years ago, I'm not going to yank peanut butter from the pantry.

Are there news stories that make you feel responsible for something in your child? How do you handle it? And what do you think of latest information about that original MMR vaccine study?

By Stacey Garfinkle| February 11, 2009; 9:00 AM ET |

Here is a post regarding the Washington Post story that pretty much sums the situation up:

Andrew Wakefield's falsified study has led to a resurgence in measles in Britain, as frightened parents have foregone the vaccine. Two children have died, with more undoubtedly to follow. That charlatan's lies have cost lives.

So the Lancet study was doctored! Sorry for the pun. And people took that doctored study and ran with it, and as a result children are dying. Now if there is any justice, those people will catch the disease and suffer mightily. And parents, perhaps otherwise normally well-educated, are just too damn smart for their own good and wind up doing something just plain stupid -- not inoculating their children.

Of course there are risks. There are risks when you leave your house, take a bath, and order food at a restaurant. There are risks on the playground and in the classroom. You can never eliminate all risks -- but you can surely make some terrible decisions which serve to magnify known risks. This is the road the anti-vaccine flat-earthers have taken.

Here is the MSNBC story:

Court says vaccine not to blame for autism

Blow for parents who claimed measles shots caused their children's disorder The Associated Press updated 4:01 p.m. ET, Thurs., Feb. 12, 2009

WASHINGTON - Vaccines aren’t to blame for autism, a special federal court declared Thursday in a blow to thousands of families hoping to win compensation and to many more who are convinced of a connection.

The special masters who decided the case expressed sympathy for the families, some of whom have made emotional pleas describing their children’s conditions, but the rulings were blunt: There’s little if any evidence to support claims of a vaccine-autism link.

The evidence “is weak, contradictory and unpersuasive,” concluded Special Master Denise Vowell. “Sadly, the petitioners in this litigation have been the victims of bad science conducted to support litigation rather than to advance medical and scientific understanding” of autism.

Science years ago reached the conclusion that there’s no connection, but Thursday’s rulings in a trio of cases still have far-reaching implications — offering reassurance to parents scared about vaccinating their babies because of a small but vocal anti-vaccine movement. Some vaccine-preventable diseases, including measles, are on the rise, and last fall a Minnesota baby who hadn’t been vaccinated against meningitis died of that disease.

The special court represented a chance for vindication for families who blame vaccines for their children’s autism. Known as “the people’s court,” the U.S. Court of Claims is different from many other courts: The families involved didn’t have to prove the inoculations definitely caused the complex neurological disorder, just that they probably did.

More than 5,500 claims have been filed by families seeking compensation through the government’s Vaccine Injury Compensation Program, and Thursday’s rulings dealt with the first three test cases to settle which if any claims had merit. The first cases argued that a combination of the measles-mumps-rubella vaccine plus other shots triggered autism.

“I must decide this case not on sentiment but by analyzing the evidence,” said Special Master George Hastings Jr., writing specifically about Michelle Cedillo of Yuma, Ariz., who is disabled with autism, inflammatory bowel disease and other disorders that her parents blame on a measles vaccine given at 15 months.

Disappointed families
“Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment,” Hastings concluded.

Attorneys for the families said they were disappointed and may appeal.

“There was certainly no scientific proof that vaccines caused autism, but that’s not the standard; the standard is likelihood,” said Kevin Conway of Boston who represented the Cedillos. “We thought our evidence was solid.”

“Certainly those three families are discouraged with the ruling,” added Tom Powers, a Portland, Ore., attorney overseeing all the claims. “It’s a big step, it’s a significant step but it’s not the last step.”

Indeed, the court’s ruling will do little to change the minds of parents who believe vaccines have harmed their children, said the head of a consumer group that questions vaccine safety, the National Vaccine Information Center.

“I think it is a mistake to conclude that because these few test cases were denied compensation, that it’s been decided vaccines don’t play any role in regressive autism,” said Barbara Loe Fisher, the center’s president.

The court still must rule on additional cases that argue a different link — that vaccines that once carried the mercury-containing preservative thimerosal are to blame, if the mercury reached and damaged brain cells — and Powers said families making those claims remain hopeful. The court has given no timetable for a ruling.

‘Great day for science’
But Thursday’s rulings clearly gave great credence to numerous large studies that have looked for but not found any link between the measles vaccine, other vaccines and autism.

“Hopefully, the determination by the special masters will help reassure parents that vaccines do not cause autism,” the Department of Health and Human Services said in a statement that pledged to continue research into possible causes and better treatments.

“It’s a great day for science, it’s a great day for America’s children when the court rules in favor of science,” said Dr. Paul Offit, an infectious disease expert at the Children’s Hospital of Philadelphia and developer of a vaccine for rotavirus.

“A choice not to get a vaccine is not a risk-free choice,” Offit added, pointing to recent outbreaks of vaccine-preventable diseases that authorities suspect are partly due to delayed or rejected vaccinations.

Autism is best known for impairing a child’s ability to communicate and interact. Recent data suggest a 10-fold increase in autism rates over the past decade, although it’s unclear how much of the surge reflects better diagnosis.

Worry about a vaccine link first arose in 1998 when a British physician, Dr. Andrew Wakefield, published a medical journal article linking a particular type of autism and bowel disease to the measles vaccine. The study was soon discredited, and British medical authorities now are investigating professional misconduct charges against Wakefield.

Then came questions about thimerosal, a preservative that manufacturers began removing from all vaccines given to infants in 2001. Today it is present only in certain formulations of the flu shot.

http://www.msnbc.msn.com/id/29160138/

Here's my proposal:  In addition to making MMR and other vaccines mandatory for entry into public school, make flu shots mandatory for all school-age children.  Give them at school or get them done at a doctor's office.  If someone objects on "religious grounds," say "fine,"and excuse them for all of flu season and send them home.  They can learn online, or they can be perpetually held back until they are old enough to make their own vaccine decisions.  Or, until they can ask for condoms, in which case a flu shot is a prerequisite for obtaining condoms from school.