WUHAN flu

this year is bad for influenza: there are two influenza bugs out there, and alas the vaccine this year only works for less than half the strains.

I seem to remember a similar problem back in the late 1990s, when we almost lost two children who had flu and then developed resistant staph pneumonia and had to ship them to Minneapolis for treatment (they both lived, thank God).

And then we started to get influenza in our nursing home. That year, the influenza shot (for epidemic type b) worked, so we figured this was the usual type A influenza that lurks around all the time. After almost losing two patients, we stopped all visitors and I put everyone on Symetrel, which treats and prevents type A flu (this was before Tamiflu). No more cases, whoopie! The bad news? I messed up our pharmacy budget.

So, as I noted, it's a bad year for flu.

But I also remember SARS: the Chinese kept it secret how bad it was, and it spread to Hong Kong and then to Toronto. Luckily it stopped, mainly due to old fashioned quarantine (and screening airline passengers for fever) but that was scary, because it seemed to have a high mortality.

Mortality is hard evidence of a disease, but doesn't always give a clue to how many cases are actually around, since many mild cases never see a physician. (e.g. Dengue is probably under diagnosed since ordinary folks don't see doctors unless they are very sick because they can't afford it. )

So now, on top of ordinary flu, we have Wuhan flu. As suspected, the Chinese underestimated the cases and now there are cases all over Asia and perhaps in the USA: we have a few cases here in the Philippines.

Apparently it has a long "incubation period" which means you aren't sick right away so don't get sick until days later. (CDC says to check for it if your patient has been in Wuhan or in contact with another peson with the disease in the last 14 days, meaning the infected people could travel quite a distance before they got sick).

China finally has decided to stop flights from Wuhan to stop people from leaving the area, to stop more cases from leaving, but it is a bit late.

And the bad news: Some of the nurses etc. have caught it, meaning it spread person to person in close contact.
the treatment (like SARS) is "supportive", meaning oxygen, nutrition, isolation, antibiotics if a secondary infection occurs, and maybe put on a respirator if it gets bad.

the patient needs to be put in a private room, preferably one with respiratory protection (we use this in TB patients so the air with the germ doesn't get blown out to infect other patients: In SARS it spread via air ducts, but it's not known if this will also). Docs and nurses should wear special masks and even eye shields.

Luckily, the death rate isn't high, (China only reported 9 deaths so far, but of course, the bad news is that they lie and there could be more cases they are covering up).

But it does kill people, and with Chinese New Year coming up this weekend, it means everyone will be visiting family, (meaning traveling in crowded trains, buses and airplanes where viruses can spread easily) and so there is a big worry it will spread all over the world quickly.

Sigh.

The news changes from day to day, and there is a big meeting coming up to discuss the problem. However, China, as usual, has it's priorities intact: they pressured the World Health Organization to keep out scientists from Taiwan, because China hates Taiwan and thinks it should be part of China, whereas the Taiwanese don't, and politics is more important than people dying.

Here is John Bachelor's show discussion of the disease.



of course, the news is changing fast so it might already be out of date.

the latest CDC report is here. 

This article worries that the Wuhan flu could be more bad news for China's economy, which is already hit by Trumpieboy's trade negotiations. 

We have cases in the Philippines, but none in our district yet. Chinese new year is big in Manila, but not so much here in the rural provinces, and our fiesta season is pretty well over. But we are close enough to Manila that it could spread here quickly.

In Asia, they wear masks in flu season: The bad news? The heavy masks are already out of stock since people used them to breath after the volcano Taal put ash in the air (the gov't said a wet cloth would work better than the wimpy masks). I have a wimpy surgical mask here, just in case, but my personally fitted HEPA mask (which was used when we went into rooms with folks with TB etc) was left at home.

Sigh.

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update: Did you know Wuhan has a lab that studies "dangerous pathogens" (aka germs)?

From Nature (Feb 2017):

Inside the Chinese lab poised to study world's most dangerous pathogens
 Maximum-security biolab is part of plan to build network of BSL-4 facilities across China...

 Some scientists outside China worry about pathogens escaping, and the addition of a biological dimension to geopolitical tensions between China and other nations.

italics mine

But Chinese microbiologists are celebrating their entrance to the elite cadre empowered to wrestle with the world’s greatest biological threats....

and later in the article is this:

But worries surround the Chinese lab, too. The SARS virus has escaped from high-level containment facilities in Beijing multiple times, notes Richard Ebright, a molecular biologist at Rutgers University in Piscataway, New Jersey. Tim Trevan, founder of CHROME Biosafety and Biosecurity Consulting in Damascus, Maryland, says that an open culture is important to keeping BSL-4 labs safe, and he questions how easy this will be in China, where society emphasizes hierarchy. “Diversity of viewpoint, flat structures where everyone feels free to speak up and openness of information are important,” he says..

again italics mine.

headsup Bigleaguepolitics via FR

Yes these two sites are fake news/conspiracy type sites, but hey, when Nature Magazine (which is one of the top scientific journals) has an article about the Wuhan facility, why hasn't this been in the news?

Yes, I know: given the lack of hygiene in low end markets, it's probably started from animal contact, but still, when possible sources of a disease like this aren't mentioned in the MSM, it leads to people believing in conspiracy theories....

luckily, after the SARS and MERS outbreaks, the Infectious disease folks at Johns Hopkins did hold a "war game" (i.e. simulation) of such an outbreak a few years ago. LINK.  the simulation was called Event 201 and they do have a website.

This is not pushing a conspiracy theory: these are practice simulations to plan how to repond and they make recommendations.

Right before 911, a really scary simulation was about a bioweapon attack with smallpox release called Dark Winter. And the site has held other simulations: CladeX  about a pandemic of an influenza type disease (I suspect they were inspired by birdflu cases that jumped the species barrier about that time), and Atlantic storm that posited a bioweapons attack causing an outbreak.






Hospitals and emergency services organizations hold similar simulations all the time to prepare for mass casualty situations. so forget the conspiracy theory.

Indeed, the lessons from Dark Winter were used to plan for a possible bioweapons attack with smallpox after 911 (I had to review our clinic's protocol, which thank the Lord was never used).