Swine Flu in Idaho (Boise, Idaho Falls: house, pharmacies, legally)

[Clark Fork Fantast]

[Mtn. States Resident;9221766] For those who haven't really thought of where we get our goods from (or send them to), all the doornobs, papers we give each other etc. and don't know for sure who has touched them (and whether they could be carriers or not), it really makes one think abou the global spread of germs/bugs.

MSR,
Your reliable, factual, informative posts are highly appreciated. I'm quoting the paragraph above, because some early cases in SoCal did not involve any visits to Mexico or close contact with visiting Mexicans, and I've wondered the whole time if the contagion was not because of imported goods.
But the official attitude down here, where the flu started spreading, is that the emergency is over (for now). Here's a quote from yesterday's San Diego Union-Tribune:

County supervisors yesterday formally terminated the public-health emergency they declared as a result of the recent swine flu outbreak. The decision came with none of the fanfare that accompanied the declaration in late April by Chief Administrative Officer Walter Ekard and ratified by the boiard early this month. At the height of the scare, county officials hosted daily press briefings and closed three public schools to prevent the spread of the previously unknown virus. Through June 1, 212 people in the county were confirmed to have been infected with the disease. The county Health and Human Services Agency will continue to monitor cases.

Meanwhile I think we should all monitor the Bonners Ferry cases mentioned by Pimit2 above. The story was also featured in the Bonner County Daily Bee.

Be safe--it appears that you're on the frontline in your own profession.

[Mtn. States Resident]

Originally Posted by Clark Fork Fantast

MSR,
[font=Verdana]Your reliable, factual, informative posts are highly appreciated.



Meanwhile I think we should all monitor the Bonners Ferry cases mentioned by Pimit2 above. The story was also featured in the Bonner County Daily Bee.

Be safe--it appears that you're on the frontline in your own profession.

Clark Fork Fantast,

Thank you for your kind remarks. I do agree it would serve residents of NID to monitor the Bonners Ferry cases. Pimit2 found that info in the Seattle-PI, what the detective he has become. When the local paper prints information about local residents being infected, I do agree it is information worth following.

Those who may have high risk family members might want to contact their healthcare providers now to see if it would be appropriate to start an anti-viral prophylactially. Only the practitioner caring for the patient, along with the patient/or family of the patient, will be able to advise the best course of action. Sometimes, prevention with medication is useful to certain people.

I do wish those in NID (and elsewhere) a safe and speedy recovery. Potentially, exposure prior to 1957 may help some have more mild symptoms.

CA news, what can I say? Probably nothing. It is better that way.

Looks like my 48 hrs. up with no sleep caught up with me and my typos. Glad you could see past them and get the intent of the message.

Take care of yourself and hope all the cases in ID are mild.

MSR

[Mtn. States Resident]

I'm not a fan of a lot of politicians. Some have made absolute fools of themselves concerning A/H1N1, IMHO. Mayor Bloomberg in NYC would rank in my top five of "ignorant remarks," saying in early May the Swine Flu was more of a hassle than anything. He certainly has changed his tune the last month encouraging all to seek care, regardless of citizenship or not.

Mayor Bloomberg now has had over a half million citizens infected with A/H1N1. That includes 12 deaths, 3 of them just announced yesterday.

http://www.nytimes.com/2009/06/11/ny...l?ref=nyregion

If there is any comic relief in all of this for me, and yes I have "gallows humor" by now, is the fact Mayor Ray Nagin of New Orleans was quarantined in Shanghai for over 3 days due to a passenger on his flight being sick. Now that he is out of quarantine, Mayor Nagin is heading to Australia to give speeches. Woops, Mayor Nagin, has anyone told you the latest information?

The WHO had another emergency medicine this a.m. and due to the great increase of cases of A/H1N1 in Australia, a lot of the press is reporting the WHO will raise the world to a Level 6 alert. That is the highest rating on the WHO scale.

It seems some people don't have a lot of positive luck:

http://www.google.com/hostednews/afp...KsYtFA7h6bJJqg

The article says, "And in Australia, four swine flu victims were admitted to intensive care wards Thursday.

Australia's A(H1N1) tally ticked up by 39 to 1,263 cases, with rugby league player Karmichael Hunt the latest high-profile athlete to contract the virus that threatens to throw the country's sporting schedule into chaos.


Good luck Mayor Nagin. I hope to never travel with you, but do hope you, your wife and guard return to NOLA healthy.

MSR

[Mtn. States Resident]

Right now I wish I were writing about the WHO -famous for "Pinball Wizard," "Who Are You?" etc. Unfortunately, this WHO refers to the World Health Organization.

For the first time in 40 years, the WHO has raised the world to an Alert 6- which is a Pandemic. In other words, the spread is in more than 70 countires and on so many different continents, no one can stop the spread of this virus now.

From the CDC's Website:

"A Pandemic Is Declared"
On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. A Phase 6 designation indicates that a global pandemic is underway.

As I'm sure most of you know by now, WHO went ahead and raised the
A/H1N1 (Swine flu) alert to Level 6, the highest Alert the WHO can issue.

CDC H1N1 Flu - - check out the sub-sections: "A Pandemic is Declared, "WHO Declares H1N1 Flu Pandemic, "What You Can Do to Stay Healthy," "General Info on H1N1 Flu," and other links. Essentially, the entire first page of the CDC currently is devoted to A/H1N1.

In honor of Clark Fork Fantast, who was ahead of the CA press in knowing the total numbers were not being released because states couldn't keep up with them (and in CA, perhaps for other reasons), I'm linking this L.A. Times Article. Also, their chart showing cases of worldwide A/H1N1, is fairly good. The CDC one has always been good for the U.S. and has a direct link to the WHO.

Swine flu pandemic declared by World Health Organization - Los Angeles Times

There should be new numbers released on Friday (today) of U.S. infections and deaths. I don't know if the deaths reported on Thursday in CA, CT, the earlier one in MI and others will be included. The CDC can only report what state labs have confirmed for them to report.

I truly wish I had been wrong about this, but saw the patterns changing too early and too often. Thanks for putting up with my typos as my eyes are extremely tired when I add these posts, yet I've wanted to make sure those in ID could take the best precautions possible to protect themselves and their families. As I have mentioned previously, I am a native to Idaho and it actually matters to me if people are prepared for a wave of this virus.

FWIW, I talked to an MD recently who said most "moderate" cases were showing G.I. symptoms along with the high fevers.

It is on the CDC page and I also posted it earlier, but given a comment I read in a newspaper elsewhere, I feel I must stress this once again.

If you have a sick child, DO NOT GIVE YOUR CHILD Aspirin unless a healthcare provider approves it. Aspirin in kids can cause Reyes Syndrome. . Some people still don't understand and are putting their children at risk.

While some may want to get some supplies for G.I. and fever management, if they don't already have them at home, your safest course of action is getting information from your healthcare provider and YOUR BRAIN.

Every state has a health department which residents can access. Idaho has set up a special URL for A/H1N1. I have visited it for a while, as very honestly, I didn't find it to have the best sources of information. However, they may have changed. Regional health departments, large hospital chains, site like WedMD, Mayo Clinic and others have good information.

I wouldn't take my chances reading individual posts on various blogs for sources of my health information. ID is between WA State and UT - which had already been declared at PANDEMIC levels/capita- prior to the WHO raising the worldwide level. Plus, so many travel from CA and NV through ID, like Pimit2 said, this year the tourists (may) be bringing more than spending money to your local area.

Hand washing, covering one's mouth if they sneeze (or someone else does), plus using Clorox/alcohol type wipes on surfaces others may have shed virus on, all should help prevent more infections. The 6 foot distance rule, when talking with others, makes it less likely you could get the recipient of a sneeze, cough etc.

Please take precautions to either avoid this spread in your household, or minimize, if possible, how severe it can be. Long ago my colleagues and I decided the MOST INFECTIOUS AREA in our office was the door nob. That was years ago we decided that. We clean it religiously with Clorox wipes after every day we're there. One simply can't know where those who turn a nob have had their hand previously.....such as shaking hands of others, coughing, sneezing etc.

Get your minds out of the gutter, for those of you who thought anything else about the earlier paragraph. The truth is, virus can be shed anywhere from an infected person's body. Think of how that may put you or your family/friends/co-workers at risk.

Take care and be as well as possible.

MSR

[Mtn. States Resident]

Per chance you are thinking of taking a little vacation or break in UT right now, I'd reconsider my options. That is if you don't want to be exposed to A/H1N1.

H1N1 pandemic and Utah - Salt Lake Tribune

The graphic shows 713 cases in UT as of 06/08/09. Today is the 12th, so one can only guess the numbers now. However, I like the graphic as one again it shows how rapidly infections spread once they get into the community.


For the record, as I believe I posted my thoughts quite clearly here, my goodness, hasn't Dr. Sundwall changed his tune? To say more isn't wise for me, except to say I hope he is planning to retire and someone who understands true infection spread takes over.

Actually, I'll admit a colleague of mine in UT was so appauled at the lame information Dr. Sundwall stated when UT experienced its first death, this MD wrote Gov. Huntsman's office. The complaint was that UT was already behind in detection, and Gov. Huntsman's remarks along with Dr. Sundwall's set the state back about 50 years in infection control. (I'm not sure my colleague said 50 years or more. The point was decades behind, given what was known). PCMC has a world-class, CDC researcher, Dr. Andy Pavia. Was he ever included in press conferences? Not of which I'm aware when I scan the Internet. In fairness, he may have been asked to return to CDC to help with this Pandemic.

I've seen the email my colleague got from a physician I've never heard of, nor seen that doctor's name in any press releases. She claimed she was in charge. So perhaps I'm mis-guided to blame Dr. Sundwall for statements he made. He may have just been the "press secretary," of sorts. Nontheless, his comments today are about as opposite as they were a month ago.


We won't know how many cases UT really has or had, since the Utah Dept. of Health State Lab isn't collecting samples in community patients anymore, nor even keeping track of the number of people with symptoms, except for those in the hospitals. With 90 people in Utah hospitals, up 38 people since Monday - 4 days ago, I'm really tired of hearing how this flu is nothing 'cuz X's kid had it for a day or two etc. We also will know the final death count, which I sincerely hope won't be much higher in any state, but know that is will.

This article states during regular flu season a total of 236 UT residents were hospitalized. UT is close to half of that number already from A/H1N1, and will probably surpass 100 hospitalized patients by next Monday, if patterns continue. How I arrived at my guess is by using the numbers: 38 more hospitalizations in 4 days = 9.5 hospitalizations/day for an average. With 90 people hospitalized, if 9.5 people are hospitalized on FR, SA and SU, that would be an estimated 28.6 more people hospital. Roudning up, that is 90 + 29 ~ 119 hospitalized. That is half of the total hospitalized during flu season.

We will get to see first hand how Idaho prepares for a regional sweep of cases and hospitalizations.

For some odd reason WI is the leading state, or at least was - we'll see what the CDC puts out in a few hours - for infections/capita. However, UT was not far behind.

Some don't realize the Salt Lake City International Airport really is INTERNATIONAL. Besides flights directly to Canada and surprise, MEXICO, direct flights to Paris and starting last week (I think, or maybe the week before), direct Delta service from SLC to Japan began.

Not to put you on the spot or anything, but I'm wondering what you are thinking, NCM, about the side trips to the airport and back? You may want to use some masks, although the literature is mixed on whether regular masks work. Lava Hot Springs may be your best bet as I don't know if A/H1N1 can survive in high temperatures. One cannot kill a virus, so the goal is to attenuate it (somehow alter one of the major proteins so it can't continue to use hosts - like humans- to gather what it needs to reproduce more virus). Certain chemicals, temperatures and other will attenuate a virus. The problem is if those things we know will attenuate a virus were used on humans, people would die of the treatments. We don't want that.

Everyone, stay safe and be grateful we live in the ERA of the Internet! Think of how much information we wouldn't have, or would have to go to high risk situations (like hospital E.R.'s) to obtain. Plus, you have time to get OTC medications if you want and/or contact YOUR healthcare providers for your family to prepare.

Take care,


MSR

[Mtn. States Resident]

Since it has been about 41 years since the WHO raised the WORLD to the highest level of Pandemic Alert it can, truly we are living in days that will be talked about for years in the future.

For those who are interested, check out the info about the work in Alaska where some who died from the 1918 flu were found. It was Alaska where
H1N1 was uncovered in the last decade or so. No surprise to me that the director of public health in Alaska resigned his post a couple of weeks ago to return to the CDC to work on A/H1N1.

Because this is a part of history, this is the data the CDC put out on
12/JUN/2009 with a link to the WHO showing the press conference and answering questions of why they raised the level now.

CDC H1N1 Flu | CDC H1N1 Flu Update: U.S. Human Cases of H1N1 Flu Infection

Idaho showed 29 confirmed cases. Of interest to me was WY with 80.

The number deaths is closer to 50 than the 45 reported on the CDC graph.

A day I'm willing to bet Dr. Margaret Chan doesn't forget in the near future.

WHO | World Health Organization

You may want to write what you were doing, how you felt and what you thought as you some states (like WI and UT) truly at pandemic stages and other states having a more mild spread of cases to date. Somewhere down the road, others may benefit from reading what you did or didn't do, and why you made the choices you did.

Stay as well as possible.

MSR

[Mtn. States Resident]

A colleague asked me to explain a fact that s/he felt many were missing about the Pandemic.

Even if every case in the state or region is mild, the fact that so many people are needing services at one time is a huge part of the problem. If you look at the SL Trib's article I posted yesterday, it tells how many health care workers to date have been hospitalized.

Using the UT projection, think about the Pandemic like this: If 1/3 people get this flu even a mild case, how will businesses stay open, if employees have to miss time to care for themselves and.or family members? Will there be enough well employees to run businesses appropriately? Could yout employer remain provided goods and services with 1 out of three employes gone?

If 1/3 of the healthcare work force becomes ill, sho will care for patients both in outpatient and inpatient settings? Will elective surgeries be delayed? Will there be enough blood donated that is "clean" for trauma season?

Many haven't thought of the implications to others, even if all additional cases are mild.

When one calculates the 36K who die each year in the U.S., during flu season, calculate the percentage of the total population vs. how many are infected. Then when looking at either total U.S. numbers or individual state numbers, calculate the percentage of patients who are ill and how many are hospitalized. As I showed in UT, by Monday about 1/2 of the number of patients hospitalized for flu during flu season, will be hospitalized in UT for this novel, non-flu season, A/H1N1.

Perhaps if you can think about medical supplies running out if 300 people show up at an E.R. instead of the usual 50-60/day (or whatever each E.R.'s numbers are), then you may get an idea of how thinly stretched the medical, nursing and medical supportive technicians, like respiratory techs, are already. For how many more cases can each provider.hospital or health dept provide adequate care?

While my own personal DVM hates to talk about this, when I brought the issue up a few years ago with Bird Flu threatening a pandemic being 60% lethal, the contigency plans are for Veterinarians to use their equipment such as ventilators, I.V.s etc. to care for humans. I'm not saying the DVMs will provide human medical care, but I am saying under whatever UN rules there are, the DVM's equipment can be used for humans in a Pandemic.

Hopefully, this helps explain why medical professionals have monitored this so carefully (ok, some of us have, while others blew it off and now have a lot of sick patients), as the professionals wanted to make sure their patients could obtain the correct medications and even hospitalization, if necessary.

We do not have to have all patients near death to create a major problem in healthcare using up supplies of medications, breathing treatments etc.

I'd encourage ANYONE who has asthma or a related pulmonary illness to either ask your doctor for a new prescription and whether or not you should be on a prophylactic dose of an anti-viral. Make sure you get your medicine while it is available.

UT has once again done something new and good, in this case. I hope other states will do the same. Sometimes rules governing healthcare professionals need to be relaxed or waived for a period of time, to benefit the public. If the public only knew how far the rules are being bent to make sure patients are cared for..............some may think more of government officials within their states. I know I do after reading the emails from this morning.

Early on someone said they couldn't see stores closing due to a mild flu. I say great if there is a workforce to staff those stores, who are well.

PLEASE take care of yourselves and those close to you. And stay informed.

MSR

[cleosmom]

Yep, MSR I work with the public on a daily basis and it's hand washing, hand washing and more hand washing. Not to mention this time of year the windows open to bring in the fresh air and hopefully remove anything bad.

[Mtn. States Resident]

These are not the links I wanted to post today. I wanted to focus on Novartis being ready to go for clinical trials and another subject.

Sadly, we learn our neighbor state to the south, UT, has experienced two more deaths from A/H1N1.

I'm posting two articles as there is important information in the KUTV one, and the Desert News article is a little bit more thorough.

Deseret News | H1N1 virus claims 2 more Utahns

2 More Utah Deaths from H1N1 Virus | KUTV - Utah News - 2News

Please note this change as reported by KUTV: "One person did contact 2News today, saying his sister, identified as 47-year-old Francine Rushton, died after she contracted the flu about two weeks ago. He also told us she initially tested negative for the H1N1 virus, also known as the swine flu."

First, I offer my condolences to the families and friends of the two people who lost their battle with A/H1N1.

Secondly, I am glad the brother of one victim talked to apparently more than one television stations stating specifically, "(she) died after she contracted the flu about two weeks ago. He also told us she initially tested negative for the H1N1 virus, also known as the swine flu."

Third, this is NOT the first time I've personally known of someone to test negative on a quick swab test, and later be positive for A/H1N1. I was actually told about 3 weeks ago one company who supplied certain A flu rapid tests sent Urgent Letters to practitioners saying they couldn't guarantee their brand of product would test positive for A/H1N1, given its unique characteristics.

Per chance someone you know has a negative test but symptoms persisten, PLEASE insist that person get back to his/her physician for further evaluation! That is one of the novel factors of this strain of the flu. The incubation period is changing, or patients have mild symptoms at first then suddenly get much sicker - enough to require hospitalization.

Fourth, Europe has now had their first death from A/H1N1, a patient in Scotland. This marks another continent reporting a death. I don't think the WHO acted too soon bumping the world to a Pandemic Level 6, if anything, I think they should have declared it when they met in their emergency meeting the week before.

Finally, please do not let your vigilence down. The 45 reported deaths to CDC don't seem to include the police officer in MI, others in PA and two more in WI and these two more in UT, along with others. While the U.S. expects more deaths, this week discourages me for the probably number of deaths we will see.

When I think of the probability of a regional spread of A/H1N1, I ask myself, "Why wouldn't people listen or take precautions a few weeks ago?" If anyone has answers, please share. It would help me sleep at night to know why so many dismissed what the CDC, WHO and others warned would result in some very sick patients and some patient deaths, in the non-flu season.

Take care of yourselves, your families, your neighbors, co-workers (even if they are a pain at time - think of it as keeping yourself safer) and others who matter to you. Each person who posts here or reads this thread matters.

MSR

[Western gal]

This is the statement that bothers me from the Tribune article this weekend:

H1N1 has spread so quickly that last week the state announced it would stop tracking the number of confirmed cases. Health-care providers can assume that any patient who tests positive for influenza A strain has H1N1, and can begin treatment with antivirals, officials said.
The state will continue to track the numbers of patients who are hospitalized. As of Thursday, 90 people in Utah had been hospitalized with the flu.

Two more deaths in Utah tied to new flu - Salt Lake Tribune