Swine Flu Update: Prepare for Third Wave

It ain't over til its over. The H1N1 Swine Flu pandemic which captured headlines since last spring has been circulating the globe for almost a year. In that time there have been thousands of deaths and hundreds of millions of people infected. The virus has generally proven to cause only mild illness, but there has been a wide-spread mutation, D225G, which is associated with deep destructive lung infections that often prove fatal. Spreading from the Ukraine to other parts of the world, now there are clusters in the United States. Look out for the third wave of this epidemic as winter gives way to spring. It could prove deadly if the D225G mutation becomes predominant. Do not let down your guard. It ain't over yet.

H1N1 Increases on North Carolina College Campuses

Recombinomics Commentary

February 03, 2010

After staying low for awhile, the number of H1N1 cases is slowly climbing again, said Dr. Zack Moore, an epidemiologist with the N.C. Division of Public Health.“We’re starting to see an upswing on college campuses in the last week or two,” Moore said.“(The first wave) was a very big wave, and it definitely affected students and young people more than the seasonal flu,” Moore said.It’s possible that the numbers could climb as high as they were last fall, but there is no way to predict that now, he said.The above comments on increases in pandemic H1N1 on college campuses in North Carolina are consistent with reports of an uptick in severed cases at UNC medical Center in Chapel Hill, NC. An increase in H1N1 activity in the northern hemisphere at this time of year is not unexpected, and the above cases support the spike in Pneumonia and Influenza deaths in the US, including the South Atlantic region.Moreover, there is concern about oseltamivir resistance in the region due to transmission at a summer camp followed by a fatal outbreak at Duke Medical Center. The Duke outbreak involved at least three fatal cases. Five sequences with H274Y were released and all five isolates had the rare marker, Y233H, while three had D225G or D225N, suggesting that those sequences were from the fatal cases. In addition, another isolate, which matched the Ukraine sub-clade had D225G. The status of that patient was unknown, but the collection was from North Carolina and in the same time frame as the Duke outbreak.The recent reduction in H1N1 has raised concerns that a new wave in the winter/spring would have a higher frequency of D225G which would generate more severe and fatal cases. The linkage with D225G/N with fatal cases in Ukraine is strong, and recently released sequences have a higher frequency of D225G/N, conversion of D225E to D225G, and an increase in isolates with both D225G and D225N. These increases may be linked to the Mill Hill designation of a Ukraine isolate with D225G as a "low reactor".Sequence data from the current college cases in North Carolina would be useful.Media Links
Recombinomics Presentations

Swine Flu Virus Breaking All the Rules!

Swine Flu Re-Infection is a scarey and an unexpected development!

Here is a documented case of re-infection with H1N1 in a pediatrician from the US. She was infected, along with her son, in the summer and then got re-infected later raising concerns that the H1N1 virus can make a second circuit through a population previously infected. Could that lead to a 'second wave phenomenon' similar to what was seen in 1918 and 1919? Couple that to the mutation at D225G which permits infection deep into the lungs causing very severe illness and even death. We don't like what we are looking at. This is a virus that is breaking all the rules!
H1N1 Re-infections Raise Pandemic Concerns

Recombinomics Commentary



November 25, 2009



Dr. Debra Parsons, a pediatrician at Kid Care West in Cross Lanes, was met with reactions of doubt from local health officials last month when she said two flu tests had come back positive for H1N1, or swine flu.Parsons first came down with the virus, complete with all the telltale symptoms, in August.Her son became ill at the same time with the same symptoms. Figuring they had the same bug, Parsons tested herself to see what it was.The test came back positive for Influenza A, so the lab at Charleston Area Medical Center sent it to be sub-typed. Parsons was positive for H1N1.Parsons and her son recovered, but in October they started having the same symptoms, but they became much worse. They were both tested this time, and the results were the same -- they were positive for Influenza A and then H1N1."It was swine flu both times," Parsons said.The above comments on lab confirmed re-infection of two family members two months apart by swine H1N1. These confirmations are supported by many anecdotal reports of similar re-infections. The timing of these infections allowed for easy identification, because at the time there was no seasonal flu, so identification of infections was straight-forward. Moreover, such infections in school aged children and parents are common because H1N1 infections exploded when school began.At the time however, the H1N1 virus was evolving slowly, reflecting an ease of infection of a naïve population. The jump from swine H1N1 into humans allows for infections with low doses of virus. Low concentration of virus produces a mild infection and a weak antibody response. The rapid spread creates widespread antibody, but the low level allows for re-infection from individuals with a higher viral load. A higher viral load can be created in a school environment, where some students could be infected multiple times because of frequent contact with infected students.Thus, the increased viral load could overcome the weak immune-response and re-infect those infected earlier, leading to a second wave. However, the higher viral load leads to more serious infections, especially for these not infected in the first wave. Consequently more previously health young adults develop more serious symptoms, leading to an increase in hospitalizations and deaths. The higher viral load, especially when combined with receptor binding domain changes such as D225G can lead to the type of cases seen in Ukraine, where a high percentage of young adults develop infections that destroy both lungs in a matter of a few days.In many areas, including Ukraine, this wave is subsiding, but the holiday season will lead to new infections by viruses with regional markers, leading to a third wave in early 2010.

Ukraine Mutated Virus the Same as 1918 Spanish Flu Killer Virus

Respected mainstream virologist, Henry Niman, who would probably consider me to be one of the 'wild conspiracy theorists', in this latest report details the meaning for all of us of the now documented genetic changes occurring in the swine flu in Ukraine and other locations. Essentially, this mutated virus has survial advantage for the virus and virtually duplicates the clinical picture of the killer flu epidemic of 1918 and 1919 that killed upwards of 100 million.

In short, this is very bad news for the world.

In addition to media reports quoting WHO spokesperson, Ukraine also came up in WHO weekly teleconferences on Nov 5 and 12. These notices were carefully worded to exclude large changes in the virus, but left open small changes, including receptor binding domain changes. Such changes were of interest because hundreds of patients had died at a rate and level markedly higher than any other European country, and the descriptions of the fatal cases were detailed, noting severe hemorrhage, as well as the total destruction of both lungs.

Patients had been arriving at emergency departments coughing up blood and dying within a few days. Moreover, most of the patients were previously healthy young adults.The gruesome descriptions and the large number of fatal cases led to wild speculation by conspiracy theorists on one hand and media and political reports such as the one above, claiming that the Ukraine outbreak was small and not unusual.

However, the careful wording of WHO updates clearly left open the possibility of small changes including the receptor binding domain and the D225G change had been predicted, based on the high number of fatalities involving lung hemorrhaging and disintegrating.Yesterday, the sequences from 10 isolates were released at GISAID by Mill Hill and the predicted change, D225G was confirmed. This change had been "in play" and was appearing on multiple H1N1 genetic backgrounds signaling recombination and selective advantage. The recent update of demographics for the 10 patients demonstrated that the four isolates with D225G were the four patients who had died, further raising concerns that D225G on a Ukrainian H1N1 background, or other H1N1 backgrounds could lead to more severe cases and deaths. Moreover the same change had been observed during the 1918-1919 pandemic, which also involved swine H1N1 jumping and adapting to humans.Thus, the genetic change(s) in H1N1 in Ukraine is of considerable concern, media reports and Senator comments, notwithstanding.

One Million Flu Cases in Ukraine!

Presumed swine flu cases continue to explode exponentially in the Ukraine and is now spilling over into Belarus and Bulgaria. This epidemic in Ukraine looks very much like the historical accounts of the 1918 Spanish Flu.

What's really going on?

WHO continues to hide vital information about possible changes in gene sequences of H1N1

OR

could this be an entirely different virus altogether!

Get ready and stay ready with your flu prevention.

Reported Ukraine Cases Top One Million

Recombinomics Commentary 18:41November 9, 2009

1,031,597 Influenza/ARI

52,742 Hospitalized

174 Dead

The latest update for Ukraine includes more than 1 million reported cases (see map). The fatalities have jumped from 155 to 174 and almost 53K have been hospitalized. The biggest jump in fatalities was in Lviv, where reported deaths rose from 63 to 74. However, the largest jump in cases was in Kiev, raising concerns that the infections were spreading east.The increase in cases and deaths continue to support a genetic change in the H1N1 virus. However, there have been no updates on samples which were sent to London over a week ago. The sequence silence continues to increase concerns that the large number of cases and deaths in Ukraine is linked to changes, which may involve the receptor binding domain in general and position 225 in particular.

H1N1 Nightmare Scenario Now Possible

The following report from Dr Henry Niman of Recombinomics is the most up to date information on the evolution of the H1N1 Pandemic that is sweeping the world.

Now comes this: H1N1 has jumped multiple species barriers!

Why is that big news- big scarey news? Because normally, viruses that cause the flu are species specific. They do not infect many different types of animals along with humans. They usually stay put within one species.

That is good because if they jump into another species, then all of the viruses normally found in that other speices have a chance to mix or recombine into another virus that is altogether new. A new virus that now shares some or all of the characteristics of all of the viruses involved in the mix.

My nightmare scenario has always been:

What would happen if you mixed H1N1 with H5N1?

H5N1 is the bird flu and is endemic among all birds on this planet. This means that practically 100% of all birds carry this virus, which does not make them sick. They just carry it.

But!-occasionally the H5N1 will jump into a human host and cause a severe infection that is about 60% fatal! Fortunately, the H5N1 in a human is not easily transmitted to another human, so it does not spread to cause an epidemic of H5N1. Whew!

Wait- not so fast. What would happen if you got H5N1 and H1N1 present at the same time in either a bird or human being? Would those two viruses mix?

And what would the resulting mixed virus be like?

Here's the nightmare scenario:

The new hybrid mixed virus could have the high kill rate of H5N1 and the easy transmisibility from human to human of H1N1.

Now you have a killer virus on the loose all over the planet that in all likelihood would out do the 1918 'Spanish Flu'.

Remember, the 1918 flu killed 100 million world-wide with a mortality rate of only 2%. How many would die if you had a virus with a mortality rate of 60%? In simple terms, a kill rate that is 30 times higher would produce 30 times the deaths.

The simple math is: 100 million X 30 = 3 billion dead people!

Now to be sure- this has not happened yet and may never happen.

This is theoretical and speculative.

But do you see why I call it the nightmare scenario?

Let's now leave the theoretical and the speculative and take a look at the real world evwents unfolding right now in the Ukraine.

We don't know much yet- but -

according to preliminary reports from the Health Ministry there -

a mutated H1N1 virus or an entirely new virus is speading at an exponential rate- doubling daily- with a mortality rate that is 10 times that of the regular H1N1 in the United States!

This is shocking terrifying news.

We must pray that this will all fizzle out and not spread widely. If this goes global, then we have according to the simple math- 1 billion possible deaths!

So, get prepared and stay prepared. We have a long bumpy road ahead. May Allah bless us all to make it through the storm.

H1N1 Jumps to Pets Raise Pandemic Concerns

Recombinomics Commentary 23:23November 7, 2009

As human infections become increasingly widespread, transmission of the virus from humans to swine is likely to occur with greater frequency.In addition, pandemic H1N1 infections have been reported in turkeys in Chile and Canada and in a few pet animals in the USA. Again, these infections were isolated events and pose no special risks to human health.The above comments from the WHO update on H1N1 in farmed animals suggests the infections in turkeys and pets pose no special risks to human health, However, this statement would be true only in the narrowest sense. Pandemic H1N1 is widespread in humans and the vast majority of infections of humans are from virus in other humans. However, the ability of this virus to jump species increases viral interactions that can result in the exchange of genetic information via recombination and reassortment.Transmission to swine has been reported at an increasing frequency. Yesterday a jump to swine in Taiwan was reported and today a jump to swine in Hong Kong was reported. Multiple examples in North and South America, as well as Europe, Asia, and Australia have been reported previously, and as the level of H1N1 in humans increases, the frequency of such jumps will likely increase.However, the pandemic H1N1 is a swine virus, so there have been prior opportunities to acquire genetic information from viruses that co-infect swine. The report of jumps to turkeys however, increased concern that the virus was quite promiscuous and could jump to multiple species.The concerns were increased by two reports of jumps to pet ferrets. Last year a virus from the first reported natural infection in ferrets was found to be an H1N1 classical swine virus. Therefore, a jump of swine H1N1 to pet ferrets was not unexpected. However, these jumps were accompanied by assurances about jumps in other pets, since H1N1 had not been previously reported in cats or dogs. However, the ability of the virus to jump to other mammals was increased by the reports of jumps to avian species , such as the turkeys described above.Moreover, the pandemic H1N1 had a high attack rate. The explosion of cases in the fall was tightly linked to school openings. The virus would quickly spread in schools leading to double digit absenteeism and associated infections of teachers and staff. In schools that had absences in the range of 20-30% for periods of 1-2 weeks attack rates approaching 100%. This high attack rate in schools has also been reported in anecdotal reports of family attack rates of 100%.The high attack rates are facilitate by multiple exposures within a families residence. However, this frequent exposure would also apply to family pets that were kept indoors.The concerns were supported by the recent report of H1N1 in a pet cat. This was the first reported case because of the availability of testing and not due to a unique association / exposures. Concerns that such transfers might be common were supported by anecdotal reports of cats and dogs developing flu-like symptoms following infection in owners and family members. These anecdotal reports suggest that testing of these symptomatic pets will identify a number of such jumps, which raises concerns of interactions with other animal virus.These interactions can lead to rapid evolution, and the proximity and transmissibility of pandemic H1N1 will lead to frequent transmission to humans.Extended surveys of sequences from pet isolates should be a top priority