Swine Flu Will Not Go Gentle Into That Good Night

H1N1 has not gone “gentle into that goodnight and seems to “rage against the dying of the light”, to quote Dylan Thomas.  When I last posted on the topic back on May 25th, there were 6,754 cases reported by the CDC in the U.S.  In just 19 days, that number has nearly tripled to 17,855.  Wisconsin now has the dubious distinction of having the most confirmed H1N1 cases in the nation with 3,008.

On June 11, the World Heath Organization issued its highest alert – Phase 6 – indicating that a worldwide pandemic is now in progress.  Close to 30,000 cases have been reported worldwide in 74 countries.  The U.S. leads all countries by a substantial margin – with nearly half of all cases reported and 30% of the 145 fatalities to date.

The virus has not invaded some of the most densely populated areas of the world – Japan, China and India where only about 2% of the total number of cases have been documented.  Perhaps this number is higher as it is difficult to believe any data coming out of China.  However, China has been agressive in its efforts to prevent the spread of the virus.   Visitors to China have been under the microscope.  Mayor Ray Nagin of New Orleans was quarantined for a week by Chinese authorities in Shanghai when a passenger on his flight was thought to be infected.

On the local front, dozens of schools in Massachusetts have been closed during the last two months as an unusually high number of students and staff have been out sick.   The medical establishment no longer tests for swine flu when a patient presents with flu like symptoms unless there is a serious underlying health issue that would make testing prudent.  Patients are urged (but not required) to stay home for 7 days.  I think both the closing of schools and testing only when necessary is a sensible approach to this public health crisis, that “will not go gentle into that good night”.

Why So Little H1N1 in AR, WV and VT?

The Natural State

While looking at some of the H1N1 flu data on the CDC website, I was struck by the fact that West Virginia had been completely spared, and that out of the 6,754 cases reported nationwide, Arkansas and Vermont had only 6 confirmed cases combined.

So what do the three states have in common that might account for this clean bill of health?  Not much on the surface.  I was thinking that both Vermont and Arkansas were given their names by Frenchmen.   But what about West Virginia?  No, no French connection there.   Vermont is named after a mountain.  Arkansas has the Ozark and the Ouachita mountain ranges; West Virgina the Appalachians.   Could it be the rarefied mountain air?  Or that the states are landlocked?

I have a theory, not entirely my own, that is a product of a little research and common sense.   First, what do the states with the most cases – Illinois, New York, Texas and California have in common?  They are densely populated. Mexico City fits this description too.  The virus can spread quickly when people are confined in close quarters on buses, subways, at school and work and in busy supermarkets and shopping centers.   Arkansas, West Virgina and Vermont are three of the least densely populated states in the country and there are simply fewer opportunities for exposure.  Makes sense?   Before you say duh, consider this:  these three states have something else in common – they have an aging population.  The median age of an Arkansas resident is 37, 40 for West Virgina and Vermont.   What does this have to do with anything?  The median age of the H1N1 victim is 15.   The theory here is that younger people do not yet have a fully functional immune system and will not have had the developmental benefit of exposure to many types of virus threats as have adults and the elderly.  California, Texas and Illinois, with the lion share of H1N1 victims, are three of the youngest states.  The median age of a Texas resident is 33.  Simply put, in these heavily and densely populated states, there are more high risk youth who will have much greater exposure rates to the virus than their counterparts in smaller, more sparsely populated states.

And there is another intangible that just came to mind.  The ArkBenJerry-UnitedSquare (Small)ansas mascot is the Razorback.   Arkansas hogs are treated with the utmost respect.  Go hogs! And in Vermont, they feed their pigs Ben and Jerry’s ice-cream.  It’s true.  Vermont pigs are a little bit spoiled and apparently don’t like mint chocolate.  They don’t!

Did Swine Flu Originate in Mexico?

Not according to a small sample of Mexicans. CNN reporter Ted Rowlands asked random Mexicans where they thought the Swine Flu originated. No one interviewed believed the strain developed originally in Mexico. Some had heard a Canadian tourist was the likely source. Others believed that the U.S. is unfairly blaming Mexico. Check out this CNN video:

Tourists to Blame

Which brings me to some interesting questions. Can we identify the original source of the human infection? Pigs and birds, yes, but from where? Canadian, Mexican or American pigs? Are these migratory birds without borders? And was the sickness spread by an infected Canadian through an American tourist in Mexico? Does it matter? Neither the World Health Organization (WHO) nor the Centers for Disease Control (CDC) have information on their websites with definitive answers as to the geographic origin of the virus, or models outlining the original transmission sequence.

UPDATE: As of 5/13, the CDC has confirmed 3352 casesof H1N1 and 3 deaths in 45 states, including DC.  Illinois leads all states with 592 cases.  Arkansas, Mississippi, West Virginia, Wyoming, Alaska and North Dakota have so far been spared.  Mexico has confirmed 2059 cases and 56 deaths.  The WHO reports that 5728 cases worldwide of Influenza A (H1N1) have been confirmed in 33 countries.

Here you can find a brochure entitled Swine Flu and You.

Swine Flu Vaccination, No Thanks!

The Swine Flu, known now simply as Influenza A (H1N1) to protect pigs from mass slaughter appears to be less virulent than previously suspected. The numbers of infected Mexicans thought to be in the thousands originally has been revised downward after initial testing confirmed only 397 cases and 16 deaths though that count has risen of late to 942 cases with 29 deaths as more people have been tested.  As of May 6th, according to the World Health Organization (WHO), the U.S. has reported 642 cases and 2 deaths. Worldwide, there have been 1893 confirmed cases in 23 countries – and no deaths outside Mexico and the United States. Most of the cases outside of Mexico have been mild and treated effectively with anti-viral medications. Though the WHO has issued a level 5 pandemic alert warning of an imminent pandemic, the number of cases has not increased exponentially. Notwithstanding the evidence and encouraging statistics, the public is still deeply concerned if not nearly panicked.

I ride the bus and subway into work in Boston and see a handful of people wearing masks, despite the fact that there have been no confirmed cases in Boston and only 8 in the state of Massachusetts according to the Centers for Disease Control (CDC). Update: there have been a few cases in Boston and now 45 confirmed statewide as of May 6. Notwithstanding, it seems to me that a mask would just make breathing a little more difficult. Yesterday, I saw and heard people sneezing on the MBTA and riders getting up and moving away from the “afflicted” but I know that this is the beginning of allergy season, not the flu season as tree pollen counts have been high lately.

And there has been talk of a vaccine, but this sounds like a bad idea. In an article posted on Prison Planet, Steve Watson of Infowars.net recounts that in 1976 President Gerald Ford along with then defense secretary Donald Rumsfeld, initiated a mass vaccination campaign in which 40 million people were innoculated. However, the campaign came to an abrupt halt after 500 people developed Guillain-Barre syndrome and 30 people died. Congressman Ron Paul who is also an MD, and one of only two congressmen to vote against the vaccination program had this to say about the most recent scare: “Here we are once again, swine flu coming up and everybody is panicking…it’s practically like we’ve been attacked by nuclear weapons.”

Hear Ron Paul speak on the recent swine flu pandemic: