May 3, 2009
What Foretells A Pandemic?
Sunday Morning: What Do Health Officials Look For When Responding To A Virus? And Is A High Alert Level For H1N1 Justified?
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Mexico City's Mayor Marcelo Ebrard arrives at the subway headquarters in Mexico City, May 2, 2009. Mexico reported no new deaths from swine flu overnight, but the virus keeps spreading around the world, with new cases confirmed in Europe and Asia. (AP Photo/Rodrigo Abd)
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Interactive Q&A: Swine Flu And Travel Precautions and advice for those worried about traveling
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Interactive Swine Flu's Impact The latest numbers, photos and information to keep you safe.
The virus that has now hit 18 countries isn’t really "swine" flu," said CBS News correspondent Martha Teichner; it’s a combination swine, bird and human virus. (And no, you can't catch it from being around pigs or eating pork.)
We're supposed to take precautions, like wearing masks, washing hands, and avoiding exposure to others with symptoms.
But not too many precautions. New York Mayor Michael Bloomberg took his typical subway ride.
Looking at a map, it's obvious the virus is spreading, not just in the U.S. but worldwide, as fast as you can say "boarding pass."
The World Health Organization has told us to brace for the worst, as it raised its alert level to 5 (out of a possible 6).
"It really is all of humanity that is under threat during a pandemic," said WHO head Dr. Margaret Chan.
Yikes! So how do we reconcile these mixed messages?
"The World Health Organization is entirely justified in raising the alert level," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.
"That message about the emergency is really directed towards public health departments and public health officials," Dr. Redlener said. "We want them to get ready to put plans in effect. It's not actually a message that's supposed to be for the general public."
But why, with relatively few people affected so far, alert level 5 out of a maximum 6? Because H1N1 meets these criteria:
What the alert level doesn't tell us is, what will end up happening? How serious will it turn out to be?
"If we had a dozen experts in public health and infectious disease, or 20 in this room, it would be hard to find two of them that actually agree on an answer to this very important question of how bad is it going to get?' Dr. Redlener said. "Will we see a 1918 redux?"
1918 is the benchmark for bad. The 1918 flu killed fifty million people or more.
In World War I, more soldiers died of the flu than on the battlefield. Living in close quarters, they got the sniffles one day and were often dead the next.
(AP (file))
In 1998 a molecular biologist, Dr. Jeffrey Taubenberger, announced he had decoded the 1918 virus and mapped its genome, which meant lessons could be learned about why it was so deadly, with applications for other flus.
At the time, Dr. Taubenberger worked at the Armed Forces Institute of Pathology in Washington.
There, he had access to an incredible warehouse filled with tissue samples - millions of them - from dead soldiers dating all the way back to the Civil War, including, he discovered, soldiers from WWI who died of the 1918 flu virus.
"What we're doing is analyzing a virus right out of the lungs of people who died in the prime of their lives, soldiers who were just in their 20s when they died," he said.
Taubenberger showed us what a typical sample from a 1918 flu victim looks like.
Since then, microbiologists have been able to compare the genetic signature of the 1918 flu with newer viruses.
Which is how the week ended with the Centers for Disease Control announcing the first good news about H1N1.
"We do not see the markers for virulence that were seen in the 1918 virus," Nancy Cox of the CDC said.
Is this a pandemic non-event? No one knows.
"Even if it turns out that H1N1 is relatively mild on the front end, it could come back in more virulent form during flu season," President Obama said.
That's exactly what happened in 1918. Viruses mutate, unpredictably.
"This is too much of a gamble over public health to say, let's see if it really becomes severe," said Dr. Marie-Paule Kieny, director of the WHO's Initiative for Vaccine Research.
So, are the warnings, the school closings, the masks, the stockpiles of Tamiflu just overkill? Media hype.or not, what if the H1N1 virus does have an even more vicious second act?
In Mexico City, CBS News correspondent John Blackstone reports that the metropolis has been turned upside-down by the flu bug.
Tucked inside their home near the city center, Tracey Bryan and her husband Valdir Ugalde are trying to keep their daughters entertained.
"Movie theatres are closed, all public events and activities have been closed for large groups of people, so those aren't really options," Tracey said. "We're just trying to be cautious, but not scared."
They worry, of course, about 2-month-old Alexandra and Sophia, nearly 3. But Tracey, originally from North Carolina, says it doesn't feel as dangerous here as the rest of the world might think.
"My mom of course would say, 'Come home tomorrow,'" Tracey said.
With everything from restaurants to sporting events shut down until at least Wednesday, one joke heard in Mexico City is that more people will die from boredom than the flu.
With nowhere else to go, John Marrone from the American School in Mexico City is teaching history in the park.
"We can't go to school, it's absolutely forbidden that we go to school," Marrone said. "I was told by my superiors not to take them to school, it's against the law."
About the only place people do gather these days is at hospitals. Few of those waiting at Mexico City's general hospital are here for the flu; most have come for other health reasons, creating a constant crowd at the main gate.
Come inside the walls of this big metropolitan hospital and it becomes like a refuge, almost like a garden.
But head toward the influenza ward and they want you to have on the mask and the rubber gloves.
Down a long outdoor walkway, Dr. Jorge Ramirez guided us toward the infectious diseases unit, which he says is not as busy as it was a week ago.
"You were never overwhelmed here?" Blackstone asked.
"No, no. Never," Dr. Ramirez said.
Only seven swine flu patients remain in the isolation ward here; six are due to be discharged shortly.
Hernando Flores is here to visit his 28-year-old daughter Paulina now recovering well. "Sunday, she feel very bad," he said.
"So how many days was she in the hospital before she said, 'I feel wonderful'?" Blackstone asked.
"Six."
With early diagnosis and treatment, Dr. Ramirez says they now know the virus can usually be beaten.
We don't know for sure what's going to happen," he said, "but we think - think - we're getting better."
The Mexico City district of Gustavo Madero, where poverty and a chronic water shortage makes hygiene difficult, has more victims of the virus than anywhere else. The basilica here attracts pilgrims from all over, perhaps a factor in spreading the virus.
Now in the middle of a five-day shutdown of all but essential business, Mexico is hoping to stop the virus' spread. But the shutdown is costing Mexico City alone some $57 million a day.
Valdir Ugalde said the stores' closing and the economic ramifications caused by the virus are a bigger concern than the flu itself.
In her 11 years in Mexico his wife Tracey Bryan says she has experienced plenty of hardships large and small.
"You learn to adapt, and the people of Mexico do that very well," she said.
Having adapted to a life behind masks, Mexicans are waiting to be assured they can once again breathe easily.
2009 H1N1 Flu Outbreak Map:
This is a map depicting confirmed and suspected cases of the 2009 H1N1 outbreak, with contributors from all over the world, from a variety of backgrounds including health, journalism, technology.
View 2009 H1N1 Flu Outbreak Map in a larger map
© MMIX, CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.
Add a Comment See all 28 Comments
- The question I believe is, "What foretells a pandemic?" That's easy. It's an administration trying desperately to put something else in the limelight besides its failings. Let's focus on the fact the 'Whole World" is getting the flu. Nope, I still just see the Country going broke. Now that does make me sick!
- Reply to this comment
- You know what is so ironic??
The Government is shutting down the "AFIP" and transfering it's repository to a wholfuly inadequate storage facility to manage these tissues that .Dr. Taubenberger worked with to make his discoveries. The public will never know what a treasure they are loosing until it's too late. - Reply to this comment
- I do not recommend keeping Tamiflu or anything like that on hand.
Posted by chachajoe at 4:47 PM : May 3, 2009
I don't recommend it either. I said that you could, but it isn't good for you and can cause problems. There were several people that died from the tamiflu.
Also I am pretty sure that within the first day or two, you will have no doubt about how sick you will be. Plenty enough time to get it if you think it's necessary.
This is a story on CBS right now.
"Can Taking Tamiflu Unnecessarily Hurt You?
CBS Evening News: Healthy Patients Taking Antiviral Drug Could Create Public Health Risk" - Reply to this comment
- Deja Vu becomes Deja Flu all over again. A couple of years ago we were all going to die from Bird (Avian) Flu. What happened?
What happened Andylance1? The WHO stopped it, as did the media. The WHO told us to and how to prevent it, and the media spread the word for us all to get into prevention mode. By the way, in one tiny city in Hong Kong alone, over 300 people died from the Avian flu (2003). That is what can happen.
From Erasmus: You can have the Tamiflu on hand, but I would not take it unless I was feeling really sick.
My suggestion: since it isn't the degree of illness but rather the timing, I would suggest you take the Tamiflu as soon as you get definite symptoms. Certainly no later than 2-3 days. If you do have any kind of flu, Tamiflu can decrease its severity and duration. If you wait to get "really sick", Tamiflu probably won't help you as it might be too late.
Note: I do not recommend keeping Tamiflu or anything like that on hand. There is a limited amount of it this time of year, as we are out of flu season. If people stockpile it, there may not be any for those who actually need it. And it's too expensive to allow it to just sit in a medicine cabinet and expire.
And all, how in the world could this be a Republican conspiracy when it goes worldwide? Thought of that? My pal is in the Far East right now, and some hotels have quarantined all tourists staying there. Not a Republican in sight. - Reply to this comment
- CDC Reported a september 2008 case of SWINE FLU in Wisconsin.
Take a look at this CDC official LINK: http://www.cdc.gov/EID/content/14/9/1470.htm
It looks the swine influenza has been around in the states for quite a while. - Reply to this comment
- Deja Vu becomes Deja Flu all over again. A couple of years ago we were all going to die from Bird (Avian) Flu. What happened?
An inconsequential minor virus becomes an international hit and resulted in a media feeding frenzy. Just like throwing a pork chop into a tank of pirranha, these so-called "health experts" should be quarantined to prevent international panic, especially at the World Health Organization. Cover their mouths with industrial strength duct tape. Don't bother me unless 5,000 people dropped dead last week.
What are the results of this panic? Mexico will loose a substantial chunk of its 13.1 Billion USD tourist trade. Cruise ships and airlines have already canceled scheduled trips and flights. There is no hope for the media swine. - Reply to this comment
- "Wanna pee in my mouth? "
Ummmm......nope, not particularly. - Reply to this comment
- People MUST be diagnosed early so they can be treated! If someone has flu symptoms, they must go to the Dr. right away. People are dying from this, Erasmus. Young people. You can stay away from the Dr. if you like...
Posted by chachajoe at 10:49 AM : May 3, 2009
The only people dying from this flu are the Mexican people. That of course can change, but it hasn't so far. And I wouldn't count that baby in Texas. There were other reasons that contributed to it's death. There was a baby here that had it and it is just fine.
This is a very mild flu and there shouldn't be any problems. IF things change and people start getting sicker and dying, well that's different. But I'm not going to go to the hospital or the doctor if I have a mild flu. And like I said, withing a very short time you should know whether you are going to be bad or not. You can have the tamiflu on hand, but I would not take it unless I was feeling really sick. If everybody is running to the hospital or the doctor for a mild flu then you are spreading it to everyone else.
The problem with the U.S. is that their media is out of control, and because of it the people either ignore them completely or go to the other extreme. - Reply to this comment
- Pandemic my arse, it has affected .00000001 of the world's population. I am so sick of newspapers and doctor's trying to scare everyone. Anything could happen, but stop crying wolf and making this sound bad.
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- "What if it weren't hygiene? What if being dirty was the key? Being dirty has got a bad rap by the status quo, if ya azzz me. "
The cleaner you are, the more often you get sick.
Posted by erasmus111 at 12:15 PM : May 3, 2009
What I meant was, if you sterilize your house everyday, it actually makes it worse for you when you come into contact with the germs in the outside world. - Reply to this comment
- "What if it weren't hygiene? What if being dirty was the key? Being dirty has got a bad rap by the status quo, if ya azzz me. "
The cleaner you are, the more often you get sick. - Reply to this comment
- Actually what they said was that they check for the type "B" and when it doesn't show up as that, they know it's the swine flu.
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- Oh my goodness Erasmus, what is your problem? Wanted to be a doctor? Just weren't smart enough?
The swine flu is not "Type B". Neither was the flu post WWI - that was the Spanish flu. We have Type A, Type B, and Type C flu all the time. There are at least 9 types of flu. This is called SWINE flu. It is new (reread the article). Every year the drug companies and CDC try to figure out whether we will be hit with Type A or B flu so the flu shots can be specific.
How in the world can you tell people not to see a Dr. unless they are "really sick"??? How irresponsible! If you knew anything about the flu meds on the market, you would know that the viruses only respond to the meds in the first 48-72 hours. People MUST be diagnosed early so they can be treated! If someone has flu symptoms, they must go to the Dr. right away. People are dying from this, Erasmus. Young people. You can stay away from the Dr. if you like, but then be sure to stay away from us too. Do it anyway.
Posted by chachajoe at 10:49 AM : May 3, 2009
Are you reading the stories on here? Obviously not.
And as far as the flu meds go, in Canada, they are telling people that there is no need to take tamiflu, unless you are feeling really ill. You should be able to tell almost immediately. Tamiflu itself can make you ill, so you shouldn't be taking it unless it's really necessary. Any cases of the flu, here, have been very mild. There is absolutely no reason to take that tamiflu. They are also stating that it is unnececcary to go to the doctor unless you are really sick. Do you go to the doctor everytime you get the flu, normally? I don't. But then I haven't gotten it in years. If you lived in Mexico where people are dying, then YES, I would go to the doctor. - Reply to this comment
- Yes he is but you are not with that silly childish question yesterday for no reasons at all getting me in trouble,are you happy now mommy .....Its a total shame in these senseless games to seek the shazmi fame without any gains just causing rear ends pain ...Be happy now..
Posted by shazmispanks at 10:26 AM : May 3, 2009
What are you talking about, getting you into trouble? How could I get you into trouble? I just asked why you get away with slamming ALL Americans and I get attacked for just criticizing the healthcare and guns. Like what's up with that? And then you didn't even give me an INTELLIGENT answer! : ) - Reply to this comment
- Oh my goodness Erasmus, what is your problem? Wanted to be a doctor? Just weren't smart enough?
The swine flu is not "Type B". Neither was the flu post WWI - that was the Spanish flu. We have Type A, Type B, and Type C flu all the time. There are at least 9 types of flu. This is called SWINE flu. It is new (reread the article). Every year the drug companies and CDC try to figure out whether we will be hit with Type A or B flu so the flu shots can be specific.
How in the world can you tell people not to see a Dr. unless they are "really sick"??? How irresponsible! If you knew anything about the flu meds on the market, you would know that the viruses only respond to the meds in the first 48-72 hours. People MUST be diagnosed early so they can be treated! If someone has flu symptoms, they must go to the Dr. right away. People are dying from this, Erasmus. Young people. You can stay away from the Dr. if you like, but then be sure to stay away from us too. Do it anyway. - Reply to this comment
- The public should never be thrown into a panic unless there is a clear and present danger. Media coverage of Jack The Ripper kept London in a panic for years. One madman on the loose kept millions indoors. The flu epidemic is a perfect example. Unless there are thousands dead we should pay it no mind. Fear and panic is the greatest killer. it destroys the health of a nation and takes years off their lives.
- Reply to this comment
- LAST YEAR THE REGULAR FLU KILLED A COUPLE HUNDRED THOUSAND PEOPLE WORLDWIDE
IT NOBODY CALLED IT A PANDEMIC
SO RELAX - Reply to this comment
- Perhaps this has not had such a bad outcome (so far) because we have been so careful with it. And it certainly never hurts to learn how to use basic hygiene precautions.
In WWI, the virus was hitting young men who were often battle-weary and rundown. And after you have had bullets zinging past your head, or hitting you, a case of the "sniffles" would not send a soldier to the Clinic. All over the world there were nutritional shortages and poor hygiene. Most of all, we are told that the H1N1 can be managed if it is diagnosed early and treated. They had nothing to treat flu in WWI, and nothing to treat the sequelae. For most of those who commented before me, "sequelae" refers to illnesses that arise from the flu, such as pneumonia and and other infections.
No, the virus cannot split genes. One would have to understand viruses to understand how there could be so many different types in one H1N1 virus. I can tell from past comments that that understanding would not come easily to you. Trust the Scientists.
Would it hurt us to allow the CDC to make these complex decisions? They know just a tad bit more than we do! If you were ill, you would be flying to the Doctor. Listen to them now, before you become ill! - Reply to this comment
- This is getting ridiculous 800 people have gotten the flu and they are comparing it to 1918
I think this Swine flu is a lot of overblown hype being propagated by xenophobic, right wing elements ,who are using it to manipulate public opinion against Mexico and encourage the government to send troops to the border. Influenza Kills 30 40 thousand Americans EVERY year, and probably close to a million worldwide. What has the Swine Flu done? Killed a few dozen?
Posted by norcalruss at 10:01 AM : May 3, 2009
The type of flu that you see every year is type "A", the swine flu and the 1918 flu is type "B". There's a difference, and if people were actually READING the articles, you would know that.
I agree that your media overblows things, but you still need to be prepared. That doesn't mean you have to panic, it just means dealing in reality. This flu is capable of becoming a pandemic. That doesn't mean it will, but just in case it does, you need to be prepared. If you get sick, wear a mask so your family doesn't get it. Do not go to the hospital or clinics unless you are REALLY sick. And if you should have to go to the hospital for any other reason, that's where you need to wear a mask to keep yourself from getting it.
So far, in Canada and the U.S., this flu is quite mild. You shouldn't even need to go to the doctor.
But keep in mind that this is the way that the 1918 flu started. It then went away and came back. That's when it started killing people. It can mutate into something much worse. - Reply to this comment
- compare:
http://www.interbent.com/images/flu-pandemics.png - Reply to this comment
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