Phase Five

Mexico's Health Minister José Angel Córdova announced today that Government of Mexico has ordered all nonessential activity of the federal government and private business to cease for a five day period in an effort to contain the swine flu epidemic. The decision came as global health authorities warned that the swine flu was threatening to bloom into a pandemic. Friday is May Day which is a holiday in Mexico so the closure is in effect just a two day 'forced holiday'. All nonessential private businesses must also close for that period but essential services like transport, supermarkets, trash collection, hospital will remain open.

As of Monday the daily economic impact of the epidemic was costing Mexico City alone $57 million USD. Mexico's central bank warned the outbreak will likely deepen the nation's recession, hurting an economy that was already hit hard by the global financial crisis. Mexico's economy shrank 8 percent in the first quarter year-over-year. Clearly the impact to the Mexican economy and its ripple effect across the globe will continue to mount. Egypt, for example, took the highly unusual step of ordering its entire 400,000 swine herd culled sparking riots among Egypt's Coptic Christian minority. The order hits the the slum-dwelling Zebaleen rubbish collectors who rely on the hogs for their livelihood. The Zebaleen feed their animals with a country's food scraps. The war on the poor often finds the flimsy of excuses and Egypt's response, widely condemned, is little more than an assault on a beleaguered minority.

As the New York Times reports efforts to contain the epidemic at borders are not likely to be effective. The most effective solution, according to health experts, is to mitigate.

"Containment is no longer a feasible option," Dr. Keiji Fukuda, deputy director general of the World Health Organization, announced Monday night in Geneva after a meeting of the agency's emergency committee on the spreading swine flu virus. "The world should focus on mitigation. We recommend not closing borders or restricting travel."

Many countries are still ignoring that advice. The globe is a confusing welter of bans, advisories and alerts on some pork and some people.

Closing borders is dangerous because many goods needed in a pandemic are made abroad, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, including most masks, gowns and gloves, electrical circuits for ventilators and communications gear, and pharmaceutical drugs and the raw materials to make them. (For example, most suppliers of shikimic acid, the base ingredient in the antiviral drug Tamiflu, are in China.)

"You cut those off and you cripple the health care system," he said. "Our global just-in-time economy means we are dependent on others." Much of our food is from overseas. "A Kellogg's Nutri-Grain bar has ingredients from nine countries in it," he noted.

The fallback position, experts said, is mitigation, the use of "nonpharmaceutical measures." They include personal ones like washing hands and wearing a mask, occupational ones like working from home or arranging care for children who are sick or whose schools close, neighborhood-level ones like closing theaters, museums or restaurants, and metropolitan-wide ones like shutting a school system or canceling a major league ballgame.

No doubt, developments are moving fast. While Mexico reported another 17 deaths potentially linked to the swine flu epidemic, bringing the total to as many as 176. At least ten countries have now reported cases of the H1N1 strain, ranging from New Zealand to Spain. But the most noteworthy development was in Texas where officials said a 22-month-old boy had died while on a family visit from Mexico, the first confirmed swine flu death outside Mexico. Another critical development was in Spain which reported the first case in Europe of swine flu in a person who had not been to Mexico. The developments moved the World Health Organization's (WHO) to raise the level of alert.

"Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world," WHO Director General Margaret Chan told a news conference in Geneva on Wednesday as she raised the official alert level to phase 5, the last step before a pandemic.

"The biggest question is this: how severe will the pandemic be, especially now at the start," Chan said. But she added that the world "is better prepared for an influenza pandemic than at any time in history."

Meanwhile in Paris, the World Organization for Animal Health (OIE) said the pathogen was "not a classic human virus... but a virus which includes [in] its characteristics swine, avian and human virus components."

"The virus has not been isolated in animals to date. Therefore, it is not justified to name this disease swine influenza," the Paris-based OIE said in a statement.

It said that science would show whether the virus was circulating among farm animals and the outcome should determine whether countries were justified in banning pig imports.

"Currently, only findings related to the circulation of this virus in pigs in zones of countries having human cases would justify trade measures on the importation of pigs from these countries," it said.

In an interview with AFP, OIE Director General Bernard Vallat described the virus as a "cocktail" of four different strains.

"The background of these strains has been reconstituted," he said.

"The avian strain is of American origin, and of the two swine strains, one is American origin and the other appears to be Asian. The human strain is American."

He added: "There is no proof that this virus, currently circulating among humans, really is of animal origin. There is no element to support this."

Vallat argued that "it would be really unfair to penalise pig farmers, who depend on their output for their livelihood, by talking about a risk which is not at all proven."

The OIE noted that past epidemics of human influenza epidemics with animal origin had been named after their geographical origin, such as Spanish flu or Asian flu.

"It would be logical to call this disease 'North American influenza'," it suggested.

Actually the Spanish flu didn't originate in Spain (it is believed to have originated in China) but its effect where first fully felt in Spain hence the name and just to clear by American Dr. Vallat means the Western Hemisphere, not the United States. Whatever the authorities so choose to name the strain remains to be seen but I am more interested in following the ties of the virus to Granjas Carroll, the joint venture of Smithfield Foods. Smithfield continues to deny any responsibility.

"We are very comfortable that our pork is safe," Smithfield president and chief executive Larry Pope said in an interview. "This is not a swine issue. This is a human-to-human issue."

Mr. Pope said Mexican authorities have been on at least some Smithfield farms in Mexico for "several days" testing hog herds to confirm that there is "no incidence of this virus on our farms."

In recent days scores of Internet postings have attempted to link a large Smithfield hog operation in the Mexican state of Veracruz and the outbreak of swine flu that has cost more than 100 Mexican lives. Mr. Pope characterized the postings as "rumors," adding, "We don't have any reason to believe that this has anything to do with Smithfield at all."

Mr. Pope is rather coy. It is, of course, a human to human issue at this point but the virus jumped from swine to human at some point and while none of his workers at his Granjas Carroll JV, the largest confined animal feeding operation in Mexico, 30% of the nearby community of La Gloria fell ill and the first known case, Edgar Hernandez, has been traced to the locality. It is the case that strains of flu affect different species differently. Just because it is not lethal for hogs doesn't mean that it isn't lethal for humans. The point is more that Smithfield among others bear responsibility for this by failing to properly tackle the environmental contamination in the area, especially that of the clouds of flies that are drawn the so-called "manure lagoons" created by the CAFOs.

But this story grows ever more interesting by the day and points again to how the poor often pay the steepest price in the cause of enriching the rich. It turns out that farmers from La Gloria are members of a rather famous group, el Movimiento de Los 400 Pueblos, a group of thousands of farmers who claim that their land was stolen from them by the Mexican Government in 1992. Los 400 Pueblos - The 400 Towns - are famous for their naked marches through the streets of Mexico City in an effort to reclaim their lands. Globalization is seen as such a force for good in the world among the rich and powerful but globalization has a dark and very sinister side as the events in La Gloria and this phase five epidemic are now demonstrating.

Tags: Global Health Issues, globalization, Mexico, Swine Flu Epidemic (all tags)



I wonder

Good post. Few things came to mind.

First, I don't know if this has been pointed out yet, but no virus - in the history of human civilization has ever been cured. Only the symptoms managed, possibly vaccinated against.

I wonder if any virus has ever been contained?
There was apparently an outbreak of a similiar strain of flu - the govt. immediately jumped in, trying to prevent a spanish flu outbreak, spent alot of money and ended up giving people a disease syndrome as a result of the innoculation.

But help me understand - has any virus, ever actually been contained?

Finally, in the final summation - isn't this flu, a relatively mild flu. Why worry about it?

Sorry if those are blithe observations - I am concerned about these kind of things - but I am also quite free of the 24 hour news cycle and so this flu thing isn't quite on my radar yet.

by Trey Rentz 2009-04-30 04:01AM | 0 recs
Re: I wonder

Smallpox is a variola virus and it has been eradicated.

The influenza virus is a tricky. The reason that vaccines don't work is that it mutates quickly. Its antigens trick our immune system.

The best read on our dance with livestock and their germs is Jared Diamond's Guns, Germs and Steel.

by Charles Lemos 2009-04-30 06:11PM | 0 recs
Re: I wonder

Sorry Charles, but it is NOT eradicated.  There is no way to ERADICATE a virus...the smallpox virus still exists in nature.  We are just immune to it and our immunizing method seems to be effective in teh long, the smallpox virus may go extinct.  Or not.  It can resurface in a mutated form sometime in the future.  

Serious pathologists stay away from definative words like eradication.

by Hammer1001 2009-05-01 06:07AM | 0 recs
Re: Phase Five

Finally, in the final summation - isn't this flu, a relatively mild flu. Why worry about it?

With the number of deaths attributed to it in Mexico (159 as 4/29) there is reason for concern. However there has been only one confirmed death here in the states, an infant in TX and another possible in GA. It does seemed to have become less virulent here and elsewhere. However, it is early still and being proactive is better than being reactive.

by jsfox 2009-04-30 06:23AM | 0 recs
Re: Phase Five

thank you.  ok so thats alot of dead people in mejico.  it will come up across the border if it has legs.

are the cases exponentiating? thats a sign of  viral growth. the numbers should be like.

1 2 4 16 64 200 400 1100 6000 10,000 ... like that.  I am not sure what the series over time
is doing now but if you have something that
is on a vector and its reached exponential growth
then there won't just be another 10 cases per day for six days they'll be like. 10 cases one day.
20 cases the next. 100 cases after.

So. Is it exponentiating?

by Trey Rentz 2009-04-30 06:37AM | 0 recs
Re: Phase Five

just to add to this it says we jumped from about 100 to 250 cases so thats an exponential curve.

the big question is whether or not it will jump from 250 to 1000

newspaper is also saying that the cases they see around the globe are mild, that the flu is not virulent.

which leads me to wonder.. what if the numbers and case reports coming out of mexico.. are wrong?

anyway. the fact that another country somewhere is going over the top in their response doesn't surprise me.

Maybe I have at last become.. jaded.
Yay. I've been trying for years.
I'll turn on the evening news tonight on PBS
and see if I can feel that old knot of
fear and worry that our country will implode
- just like the days of the bush administration..
you remember that don't you?

by Trey Rentz 2009-04-30 07:43AM | 0 recs
Re: Phase Five

Definitely a good post.

Why in the name of God are the 'powers that be' in some places killing or quarantining pigs when it's quite well understood that swine flu doesn't get communicated by eating pork or being around pigs (a pig virus mutated and is now a human-affecting virus)? Just to say they did something? The stupid really ticks me off sometimes.

I'm no expert, but to answer the above comment, my understanding is that anti-viral drugs are available (though only fairly recently) that do in fact affect the ability of the virus to run its course to fruition in humans, though to say it's a 'cure' would be an overstatement. At least that's my understanding. Also, I'm fairly sure the range of viruses against which a given antiviral drug is effective is fairly limited, and that because viruses mutate so easily, drug-resistant strains develop rather quickly if said drugs are prescribed indiscriminately.

For mild viruses, I also believe taking certain formulations of zinc supplements early in the disease process and often can help the body's immune system better fight the virus in many cases and thus shorten the course and to a lesser extent the severity of the infection.

Please, someone who actually knows what they're talking about, correct me if I'm wrong.

In sum, despite a few really dumb reactions, I'm glad the world is working to get a handle on this as quickly as possible, because the nature of influenza is that it can spread rapidly and, while generally not fatal, some strains are more severe than others. Swine flu, based on what I've read, seems a fairly nasty flu but not generally or too-randomly fatal, though more often fatal than more generic varieties.

The Spanish flu (I thought it originated in the U.S. but first started spreading in Spain as infected soldiers were deployed in WW1, but my info is old I guess) outbreak in 1918 was the worst. It was not only fatal at an alarming rate, but fatal very randomly, often fatal for young and healthy individuals while sparing others for no apparent reason. By the time that pandemic finally petered out, a report on NPR last night indicated that a half-million Americans and about 50 million people globally died (God only knows how many were infected).

I'm glad we're taking so many steps as early as possible but we should probably look at other outbreaks and keep it all in perspective a little better.

by RecoveringRepublican 2009-04-30 06:47AM | 0 recs
The Food Industrial Complex

I am very supportive of the "Grow Local-Eat Local" movement, and consider it part of the general Green-undo the corporate monopoly movement.

I shop for a much of my food as possible at my local food Co-op (just a block away, so I am lucky) which actively tries to live by that mantra.

Like any large multi-national corporate sector, it will almost impossible to stop the incredibly economic power these corps can exert on our political system.

That is why, one of the best ways to beat them is to get off their grid.

by WashStateBlue 2009-04-30 07:17AM | 0 recs
Re: Phase Five

We really have to get the facts straight so that people do not panic.  The Mass media is part of the problem in that they approached this with their usual sensation, saw their massive fuck-up, and are now trying to get proper information out as quickly and accurately as possible.  Somedays Corporate Media really piss me off...

First, I am a pathologist.  I have been a micro-biologist, but am now a plant pathologist.  I understand this stuff very well, but I AM NOT a human pathologist or a virologist.  That said...

First, it is too early to tell how virulent it is.  Just because it seems "mild" right now does not mean it is, it just means that it has a low death rate within a VERY small sample.  We have to wait about 2 weeks to see if it indeed mutated into something less potent or if we are just begining to see the effects.

Second, the most accurate numbers I could find quickly were from 4/24/09 from the W.H.O. which reported 854 sick and 59 deaths...a roughly 7% mortality rate at this point.  Another report from the WHO on 4/29/09 puts the CONFIRMED cases at 148 sick and 8 deaths, a 5.5% Mortality rate.  But the numbers do not mesh because there are REPORTED illness' numbers and CONFIRMED illness' numbers.  We will not know the true numbers for a while.  The best information can be found at en/index.html

Third, the illness was first reported on 4/18/09, less than 2 weeks ago.  This still is playing out as the rule of thumb is 14 days incubation from first reported case.  May 2nd is the day to see how it is going.

Fourth, you CANNOT get the virus from eating pork.  Period.  

This is a quick run down, but it gives you a idea that while this IS serious, you do not have to wrap your house in plastic and stay home for 2 weeks.  Wash yours hands regularly, stay home if you are sick, get good sleep, eat healthy, and you should be in the best shape to resist the disease.  Infants and elderly are most vulnerable to this due to their weaker immune systems.

As for the comment on eradication...mostly correct.  Virus' cannot be wiped out because they are basically just DNA wrapped in a protein shell.  What we do is stimulate our immune system to recognize and eradicate the virus "type", in this case H1N1, so that we do not get the full disease.  We do not eradicate the disease, we neutralize it, for a while (timelines differ).  Viruses, like all other living things, evolve, so diseases we are immune to can become a threat again with time.  It is NOT just about immunizations, it is about lifestyle, sanitation, nutrition, exercise, PERSONAL GENETIC MAKEUP, and the nature of the virus.  NOT simple.

But, in the immortal words of "The Hitchhicker's Guide to the Galaxy"...DON'T PANIC!

by Hammer1001 2009-04-30 08:15AM | 0 recs
Re: Phase Five


by Trey Rentz 2009-04-30 10:47AM | 0 recs


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