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Two California human swine flu infections raise eyebrows -- and pandemic concerns

Posted on Tuesday, April 21, 2009 at 04:08PM by Registered CommenterScott McPherson in | Comments2 Comments

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.

Reader Comments (2)

Although the rapid response of US CDC followed to this incident is greatly commendable, I am asking myself whether a couple of not epidemiologically linked cases of H5N1 was appeared in US instead in Egypt, the response would have been the same we are seeing in other parts of the world, where dozen of suspected and confirmed H5N1 cases occur everyday without prompt WHO to suggest any changes in Pandemic Alert Level.
Because I suspect that if this swine influenza incident would reach epidemic proportion (more than 10 cases) the alarm among public opinion would be extremely high to prompt a quick reactions by pharmaceutical industries and government agencies. The same reactions we aren't seeing for Egyptian and Indonesian people.
I am sure that US CDC will perform very well its job and will guard world population against the pandemic spectre.

April 22, 2009 | Unregistered CommenterGiuseppe Michieli

I think because the rest of the world's press is more experienced with covering H5N1 cases up close, be they in people or in poultry, the US press has a tendency to overreact. I agree: let's see how many more human cases come along in Claifornia and elsewhere.

April 22, 2009 | Registered CommenterScott McPherson

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