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In a review of the world’s media in the last fortnight, the range of side effects to the flu vaccine is increasing.  We have headlines blaring “the cure may be worse than the disease” and notifications of at least a third of British doctors refusing to administer a vaccine.

However, not all of these “side effects” are clinical – some are educational whilst others are based in incorrect perceptions and assumptions.  This article is something of a catch-all incorporating published stories related to side effects, mis-diagnoses and assumptions.

We are repeatedly reading tales of mis-diagnoses of swine flu in the first place.  Recently a 17-year-old English girl was diagnosed with swine flu, no fewer than 4 times, when in fact she had meningitis as the symptoms appeared similar to swine flu.  She is making slow recovery, but the delays in correct diagnosis caused loss of valuable time.

Indeed, we do need to closely look at what is in fact being diagnosed.  It’s not as simple as assuming a bug may be swine flu, what with new variants – including where swine flu strain is moving to birds - will be causing the medical community enormous challenges.

Looking to anti-virals – the most common ones being Tamiflu and Relenza (manufactured by Roche Holdings AG and Glaxo SmithKline PLC, respectively) – there has been significant and confusing commentary in recent weeks.  Whilst Tamiflu (in existence since 1999) reduces the “miserable symptoms” of swine flu and can shorten the period of illness, it shouldn’t be viewed as a panacea as perhaps had been suggested by the UK government’s mass distribution of Tamiflu mid-summer (with over 100,000 packages given to children, alone).  Further study is showing its effectiveness limited to about an 8% benefit in healthy adults.

According to the British Medical Journal, the “limited data” available shows that children under 12 are being reported as suffering vomiting and nightmares as a result of taking Tamiflu.  Dr Matthew Thompson,  a GP and researcher at Oxford University, cites drinks to cool temperatures and rest as the most effective treatment for flu in children.  Even some adults are found to have experienced “little impact” on the length of their illness, or “limited benefit”.

The situation is even less clear for vaccines.  With at least two manufacturers of a swine flu vaccine (Baxter in the USA and Sinovac Biotech in China being a couple that come to mind), governments around the world have had the confidence to books orders numbering in the tens of millions of doses.  However, its suitability for human purpose is still in doubt as there has been relatively low amounts of testing.

According to Forbes.com, Sinovac has been testing for less than a month, on just over 1,600 people showing that the vaccine has “good immunogenicity” and thus fit for use.  Additional research monies are being released worldwide, with one example being Canada whose government has just released $2.7 million (CDN) on top of the $10.8 million (CDN) already identified for fighting swine flu (CBC).  But no amount of money can help the critical factor of time to allow completeness of clinical studies – GSK, for example will not be finishing its testing of the swine flu shot until mid-2010 — long after both the predicted “second wave” and “third wave” of swine flu will have hit.

The biggest concern around the actual threat of the vaccine is because it (Panderix) contains thimerosal, a mercury-laden preservative which has actually been removed from most mainstream vaccines because of the clear links to neurological effects.  The mercury-free version is called Celvapan – do note however that there may be trace amounts of mercury as manufacturers are even in that case allowed to call the product “mercury free”.

Children are at greatest risk from these issues because they do not have a well developed immune system, their bodies are still growing, and pregnant mothers in many countries will be given the vaccine as a priority if they suspect swine flu.  In Texas, where 14 children have already died from swine flu, there is a plan to immunise children in the schools themselves.

But what are the actual risks?  Over and above the hit to the neuro system from the mercury, there are two significant risks being revealed:

  1. risk of “Guillain-Barr Syndrome (GBS) in which paralysis of the breathing muscles cause death by suffocation”.  We have proven examples of this following the 1976 mass vaccination programme in the US where over 500 cases (of whom 25 people died, compared to 1 death as a result of swine flu) of GBS were detected.  At its worst, GBS can prove fatal.
  2. German lung specialist, Dr Wolfgang Wodarg is deeply concerned about the possible risk of cancer in humans as the vaccine “consists of cancerous cells from animals”.

These don’t appear to be isolated concerns.  According to the Associated Press, about half of health workers in Hong Kong would reject having the swine flu vaccine and in the UK at least a third of GPs are refusing to administer it.

Whilst many counter with the argument that the number of people the vaccine saves is greater than the number it harms, perhaps the real comparison needs to be (like in the 1976 example) how many will the vaccine kill as compared to swine flu?  Clearly, this would be the most tragic of all flu vaccine side effects.

Further 360 reading:

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Since our last post 10 days ago, swine flu has all but gone quiet.  While Europe may still be in the midst of summer holidays (with the seasonal drought of interesting news to report), swine flu is rearing its ugly head in the Middle East, South-East Asia and North America.

As previously reported, India and neighbouring countries (known for their poor hygiene conditions) have been seeing swine flu cases and deaths rise over the last fortnight.  Indeed Goa – a popular holiday destination – has begun screening large numbers of the 2.4 million holiday makers who arrive in that city every year (Source: AFP).

In the Middle East – including Algeria, Barhrain, Egypt, Iraq, Jordan, the Palestinian territories, Qatar, Sudan, Syria, Tunisia, UAE and Yemen – Ramadan has been severely affected.  AFP reports that in “Mecca, the Saudi birthplace of Islam … numbers were well below usual.” Egypt, Iran and Iraq have placed restrictions on the numbers of people who can attend pilgrimages this year, owing to the number of people in confined areas and the increasing risk of the spread of the virus.

People over 65, children under 12 and pregnant women have been discouraged from attending and everyone is being discouraged from shaking hands and kissing during this period.   This news will come as anticlimactic and disappointing, particularly during Eid – a time of feasting and celebration.  Participants will no doubt be reflecting on the first Middle Eastern swine flu death – an Egyptian woman who herself had just been to Mecca on an umrah trip.

This is alread on top of negative economic figures which have deflated many travel prices by as much as 40% (according to the Telegraph).  However, interestingly, whilst people are being encouraged to stay home and reflect on their lives, there is a segment of the economy (such as satellite TV stations) that are taking advantage of this different sort of captive audience.

Turning to North America, we see two major pieces of news.  The first is that up to 120 million Americans will be sickened with the virus and up to 90,000 (three times the amount of a normal flu season) could die from it.  Health planners believe that as many as 300,000 people could be admitted to Intensive Care and that the virus will “stress every aspect” of the health system.

Time is ticking on, however.  Even though $2 billion has been set aside to buy 160 million doses of swine flu vaccine, enough supplies will not be ready until mid-October.   Insurance companies are debating whether they will cover the cost of the vaccine (Illinois’ United Healthcare, have decided that they will [Chicago Tribune]) and governments examining their role in healthcare (Washington State’s health system may be affected by the $470 million worth of cuts through the state [Washington Examiner]).

Meanwhile, forecasts of the spread of swine flu are beginning to come true as North American schools, Colleges and Universities start a new academic year.  The Gainsville (Florida) Sun reports that the under-24 year old age group is at highest risk from contracting the flu.  The density of student populations, likelihood of touching and spreading the virus through human contact, and of course band and sports group travel and competitions against other schools are all raising concerns.  However, authorities across North America are attempting to limit any cause for “panic” in order to prevent a repeat of over 700 schools that closed earlier in 2009.  In British Columbia, presently “school closures are not part of its plan to deal with outbreaks of the swine flu” (CBC).

Students are being taught the “Dracula sneeze” (sneezing into the inside of your elbow) in Southern California.  Teachers in Silicon Valley are being issued with infrared thermometers which allow them to take temperatures of students from a distance.  Often in schools, where confirmed cases of swine flu have been identified, the affected student is sent home, letters go to the parents of the other children in his / her class and community areas (i.e. bathrooms and gyms) get wiped down and sterilised.  Indeed, Fairbanks, Alaska has already seen its first high school swine flu case.  In Texas, plans are in place to purchase 2.5 million courses of anti-viral drugs, with commonsense steps like handwashing in the interim. (Chron-AP Texas News)

Older students attending university are being affected with 32 confirmed cases amongst the University of Kansas’ 27,000 student population (KansasCity.com). Students across the country are being advised to pack a thermometer, over-the-counter medicines and a week’s worth of food just in case they feel the flu coming on (in Dayton, many of these items are being sold in the university’s bookstore).  Additionally, where practical, students with the flu are advised to go home and let family look after them.  Universities are planning “flu waiting rooms” to keep flu sufferers away from other types of injuries, or planning to convert gyms to recovery centres.  (New York Times)

Of course, in addition to the actual illness caused, the disruption could have severe affects across the education system.  If one underage student falls ill, then s/he will need to stay at home and lose valuable learning time.  Parents will need to take time off work or arrange for other childcare.  Any siblings may be infected too.  Then, it might hit the parents and so on, and so on.  The ripple effects through the system could be huge.

However US Secretary of Education Arne Duncan is looking for ways to mitigate at least the loss of learning time,  through provision of printed or downloadable teaching materials.   Also, whilst previous guidance recommended infected students stay home for a week, new recommendations are just for 24 hours once temperature has returned to normal – again, minimising the impact on learning and family life.

Any good news through all of this?  Supposedly with necessity being the mother of invention and all that, we’re seeing a rise in the hiring of private jets as a way to avoid travelling with public carriers (Media Line).  Watch this space.

Further 360° Reading:

  • Swine Flu School Closings: Fort Worth ISD, Lewisville, Ponder … – I’ve been paying close attention to the Swine Flu school closings in the Dallas-Fort Worth Metroplex, especially since I live in Plano TX myself. Swine Flu (H1N1) concerns has lead Fort Worth ISD to close all schools in the district, …
  • Get Some Flu-Fighting Foods in Your Diet – I have been sniffling and coughing off and on for a week now and it seems that no matter what medicine I take or how much time I spend “taking it easy” in bed or snuggled up on the couch with bad TV and great movies, the runny/stuffy …
  • Thermal Scanners Used to Screen for Swine Flu as Countries Race to … – hot-for-swine-flu. There is NO panic but countries are rushing to contain the Swine Flu outbreak. Governments including China, Russia and Taiwan began planning to put anyone with symptoms of the deadly virus under quarantine. …
  • Comment on No Swine Flu in the Philippines Yet by Electronic Cigarette – Big thank to god for saving us from Swine Flu.
  • Swine Flu & The Housing Crisis: A “Perfect Storm” – Reported/potential H1N1 Swine Flu cases as of … Image by pixelfrenzy via Flickr. It’s always something! Just when there are some small (real small) signs that the US economy may be on the mend, a new, never before seen type of swine …
  • SWINE FLU PANDEMIC AND WORK FROM HOME JOBS – With the swine flu scare going on right now, people who are lucky and have home jobs have to be feeling just a little bit safer than the rest of us. It is times like these that it is great to be able to be a little more self sufficient …
  • Swine Flu Maps – The origins of these animal-to-human diseases remain for me shrouded in “I don’t want to know.” But like others I’ve watched the Swine Flu story develop over the past few days. This evening Om Malik pointed out a Google Map showing …
  • Natural remedy for Swine Flu? – Is there a natural remedy for Swine Flu? Can the world heave a big sigh of relief? When Madras is running out of Swine Flu testing kit; When Bombay has shut down schools and shopping malls; When India is considering more drastic …

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What a week for swine flu in Asia.  There has been more press activity in that part of the world this week than – seemingly – since swine flu first hit the world’s headlines in April.

Interestingly, cases of swine flu are temporarily on their way down in Britain and in the United States, but we’re seeing a disturbing rise in cases in India and Asia.  Curiously, I would have thought that because of the significant population pressures in that part of the world, the disease would have spread a lot faster, and a lot sooner than it apparently has.

Or maybe, news is just slower to get out.

Yesterday, the Accociated Press commented that  “India confronted dueling outbreaks of swine flu and swine flu panic” as people flooded hospitals demanding to be tested for the virus, and stayed off the streets and out of schools and public areas.  The panic has forced up the cost of a single face mask thirty times from 5 rupees ($0.10) to 150 rupees ($3 USD).  In Mumbai, schools, offices and other public places are beginning to shut down as a “preventative measure”.  Meanwhile, Bloomberg is calling for some perspective citing that over 2,500 people in India die every day from tuberculosis and diarrhea.

Are we being overly concerned? Is Nepal over-reacting in its “fear [of a] swine flu invasion from India”?  Possibly, if we listen to Bollywood’s advice to simply provide education to people.  Possibly not, if we look at percentages and comparisons.

Last week, Maharashtra state has seen 11 of India’s 19 swine flu deaths – 3 of which were in Mumbai alone.  As absolute numbers, they can’t compare with TB deaths.  But in percentages (58% of all swine flu deaths), it’s a very concerning statistic.  More recently cases of swine flu – and deaths – have been identified in Pune,  Bangalore, Gujarat, Panchklula, Karnataka

Another “milestone” for swine flu, is that it has claimed its first aboriginal victim in Australia.  According to “H5N1 News and Resources about Pandemic Influenza”, blog’s author, swine flu is already disproportionately affecting other aboriginal communities around the world – but a survey run by one of the readers indicates that UK readers disproportionately will NOT accept vaccination when the shots are ready.  It would seem that the more advanced western cultures have the luxury of refusal of treatment, whereas cultures of poverty are more likely to be affected – and indeed more likely to benefit from the medicine we’re refusing in the West.

Again, we’re seeing interesting waves of media – perhaps increased public awareness hitting the west, while shock (and panic?) hits remoter regions.

Perhaps, most disturbing in these changing balances, is that Hong Kong is now finding that swine flu is resistant to Tamiflu – a drug that was supposed to help us get through the worst of the bug.  But then again, older people may be resistant to the disease in the first place owing to resistance built through mid-20th century exposure to other strains of H1N1.

Or, we might see swine flu waning whilst hype continues, according to Richard Schabas, a Canadian former chief medical officer?  Maybe not very likely if Canada has bought 50 million doses (for its 30 million population) for delivery in mid-Autumn.

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Every time a major crisis arises there’s a culture of blame that brews with it.  The disasterous economy.  Environmental damage. Poverty.  Hunger.  The world seems intent on filling the media and Internet with conversations about who is to blame, rather than actively trying to decide how to actually address and solve the problem.

Swine flu appears to be no different.  Over the last few weeks I’ve seen countless messages of blame coming up from all over the world.  The religious fundamentalists.  Xenophobic extremists.  The disenfranchised.  Radical right.  Conspiracy theorists. Companies not benefitting from swine flu.  And I am surprised by the volume of blame out there.  Or am I?

The collective voice seeking to pin the blame for swine flu’s very existence is rapidly drowing out the collective voice of medical experts, politicians and scientists actively trying to protect humanity from the bug.  The Blame Culture now appears to be its own Pandemic!

I start with one article published in Extremist Propoganda on April 28, 2009.  In “Where Swine Flu Lurks, Propagandists Rush In“, David Holthouse writes about the US Radical Right and its use of the swine flu pandemic to lobby for shutting down the US-Mexico border to support its hidden agenda of reducing Immigration into the US.  (Or rather “illegal immigration”, which they do not actually define so I take it to be shorthand for all immigrations to the US).

“William Gheen, head of Americans for Legal Immigration PAC, a nativist group commonly known as ALI-PAC, slammed President Obama, too. The Obama administration’s failure to secure our borders against a possible pandemic is putting American lives at risk at a time when days and hours matter, he said. (On the ALI-PAC website, Gheen is less subtle about linking Mexican immigrants with infectious disease. Call me old fashioned, but people should be able to shop at Wal-Mart without worrying about catching tuberculosis, he wrote.)”

I am perplexed to read the rationale – just how is border control going to spread of disease?  Surely this applies to not only “illegal” immigrants (however they may be defined) but also legitimate nationals travelling to other countries.  Sounds like Mr Gheen is just trying to blame Mexico for the rise and spread of swine flu.

The article then leads us to “garrulous anti-immigration extremist Frosty Wooldridge, [writing] for rightsidenews.com”.  Apparently tribal people from Laos and Cambodia, immigrated to Minnesota to build chicken wire, keep various farm animals in and out of their homesand – along with “Voodoo tribal people in Florida behead chickens and goats to spray the blood over themselves for cleansing” – form part of the 70 million third world people entering the US by 2035 to “bring their customs, their cultures, their diseases. We cannot educate them or change their habits fast enough to maintain our own health standards.”

Oh dear.  Given this comes from a citizen of a country which includes amongst its official guidance for swine flu that one should “sneeze into a sleeve”.  Gross!  Surely sneezing onto ourselves, is as useful as wearing chicken blood for cleansing.

More recently, on the other side of the Atlantic, it’s becoming apparent that employees can sue employers if they catch swine flu at the office.  Another one I am trying to figure out.  Shouldn’t we all be individually responsible for our own actions?  Isn’t it up to us to wash our hands, stay away from colleagues who we suspect to be ill and even carry wipes and soap?  Are we expecting employers to stock Vitamin C now?  Or indeed, can we expect public transit authorities to provide gel on buses and trains?

At the other end of the spectrum, isn’t it curious that we have no one to blame should we suffer from flu vaccine side effects?  Both the US and UK have given immunity to Baxter’s swine flu vaccine, ostensibly to enable a rapid roll out.  In contrast, however, the Czech government is holding firm on its requirement for any vaccine to be properly registered in the EU.

Baxter doesn’t (yet) have this registration.  Watch your back – they may be looking for someone to blame!

Further 360° Reading:

  • Natural remedy for Swine Flu? – Is there a natural remedy for Swine Flu? Can the world heave a big sigh of relief? When Madras is running out of Swine Flu testing kit; When Bombay has shut down schools and shopping malls; When India is considering more drastic …
  • cryptogon.com » Archives » Exposed: The Swine Flu Hoax – If the current H1N1 swine flu virus does become abnormally lethal, there would be three leading explanations: first, that the virus was accidentally released, or escaped, from a laboratory; second, that a disgruntled lab employee …
  • Wentzville, Fort Zumwalt report first suspected swine flu cases of … – Nearly all type A influenza viruses that are currently circulating are the H1N1 or swine flu subtype, but the state health departments are no longer doing detailed flu testing on every specimen because the treatment for any flu is the …
  • 21st Century Outbreak – “…references to swine flu in the blogosphere are far surpassing the actual spread of the virus itself. As the government tries to get in front of the rapid spread of information, it’s learning some important lessons about how social …
  • Plant substance triggers cancer cell death, keeps healthy ones intact – CM NEWS – A substance of popular Chinese herb huang qin (Scutellaria radix, 黃芩) triggers the death process in tumour cells, while it has virtually no effect on healthy cells, according to a new discovery of this selective function of …

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