Category Archives: influenza

NC H1N1 swine flu cases, Hanover county, Wilmington, North Carolina, Gregory School of Science, Math and Technology, Snipes Academy of Arts and Design

Breaking news from the Wilmington, NC Star News Online, May 28, 2009:

“Breaking news: Four cases of swine flu confirmed in New Hanover County”

“New Hanover County has confirmed four cases of H1N1, also known as swine flu.

The cases involve four elementary school-age students — three at Gregory School of Science, Math and Technology, and one at Snipes Academy of Arts and Design, said Mark Boyer, New Hanover County’s public information officer.

The infected students have not been in school since late last week, county health officials said.

A notice is being issued Thursday to parents through the county’s AlertNow automated message service and a letter will be sent home with students Friday.

At a news conference Thursday, the New Hanover County Health Department said officials are still investigating a timeline of exposure to determine the order of infections.

The New Hanover County Health Department does not recommend closing Gregory or Snipes at this time. Health department officials also said they are working to determine who might have been exposed before the infected patients started displaying symptoms and that they are notifying people who were in close contact with the patients.

On Tuesday, North Carolina health officials reported a total of 14 confirmed cases in the state – one in Durham County, one in Orange County, seven in Craven County, two in Onslow County, two in Carteret County and one case in Rutherford County.”

Read more:

http://www.starnewsonline.com/article/20090528/ARTICLES/905289901/-1/stormpost02&tc=email_newsletter

Australia orders 10 million vaccines, H1N1 swine flu virus, Health Minister Nicola Roxon, pharmaceutical company CSL Ltd

From Medical News Today, May 28, 2009:

“10 Million H1N1 Vaccines Ordered By Australia”

“Reports are coming in that the government of Australia has placed an order for 10 million vaccines against the novel H1N1 swine flu virus, following a press briefing from Health Minister Nicola Roxon in Canberra earlier today, Thursday.

According to a report from Reuters, Roxon said the Australian government will also be ordering 1.6 million courses of the antiviral drug Relenza, bringing the national stockpile of antivirals to nearly 12 million courses.

The swine flu vaccine order has been placed with pharmaceutical company CSL Ltd who are planning to start clinical trials in a few months.”

“Earlier today, the Australian authorities reported they have officially confirmed 103 cases of H1N1 swine flu, up from 61 on Wednesday.

Australia is also gearing up for the regular flu season, which starts about now, as the winter months approach.

Most of the swine flu cases are believed to be in New South Wales and Victoria, the country’s two most populated states and which lie to the south east.

Three of the cases were passengers travelling on the cruise liner Pacific Dawn which is now not going to complete its journey north to Queensland.”

Read more:

http://www.medicalnewstoday.com/articles/151773.php

H1N1 swine flu, May 25, 2009, Bloomberg article, Swine Flu Is Spreading Wider Than Official Data Show, woman in her 50s died in New York over weekend

From Bloomberg, May 25, 2009:

“Swine Flu Is Spreading Wider Than Official Data Show”

“Swine flu is spreading more widely than official figures indicate, with outbreaks in Europe and Asia showing it’s gained a foothold in at least three regions.

One in 20 cases is being officially reported in the U.S., meaning more than 100,000 people have probably been infected nationwide with the new H1N1 flu strain, according to the Centers for Disease Control and Prevention. In the U.K., the virus may be 300 times more widespread than health authorities have said, the Independent on Sunday reported yesterday.

Japan, which has reported the most cases in Asia, began reopening schools at the weekend after health officials said serious medical complications had not emerged in those infected. The virus is now spreading in the community in Australia, Jim Bishop, the nation’s chief medical officer, said yesterday.

“I think we will see the number rise,” Bishop told Australian Broadcasting Corp. radio today after confirming the nation’s 17th case and saying test results are pending on 41 others. “This is going to be a marathon rather than a sprint.”

Forty-six countries have confirmed 12,515 cases, including 91 deaths, according to the World Health Organization’s latest tally. Almost four of every five cases were in Mexico and the U.S., where the pig-derived strain was discovered last month. Most of those infected experience an illness similar to that of seasonal flu. The main difference is that the new H1N1 strain is persisting outside the Northern Hemisphere winter.

Summer Disease?

“While we are seeing activities decline in some areas, we should expect to see more cases, more hospitalizations and perhaps more deaths over the weeks ahead and possibly into the summer,” Anne Schuchat, CDC’s interim deputy director for science and public health program, told reporters on a May 22 conference call.

The U.S. has officially reported 6,552 probable and confirmed cases, Schuchat said. “These are just the tip of the iceberg. We are estimating more than 100,000 people probably have this virus now in the U.S.”

There have been nine deaths and more than 300 known hospitalizations, she said. The fatalities exclude a woman in her 50s who died in New York over the weekend.

China reported cases today in Shanghai and the eastern province of Zhejiang, taking its tally of confirmed infections to 12. Taiwan confirmed the island’s first domestically transmitted case and reported two imported infections, giving it nine. South Korea confirmed 12 more cases, bringing its total to 22, while the Philippines confirmed a second infection today.”

“Community spread of the new virus in a second region means WHO’s criteria for a pandemic has been met, said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy of the University of Minneapolis.”

Read more:

http://www.bloomberg.com/apps/news?pid=20601087&sid=agHVPFaC5R.M&refer=worldwide

Obama, Baxter International, CDC, Dr. Robert Weinstein, corruption ties, Chicago, Weinstein, Levine, Rezko, Blagojevich, Obama

Are you sleeping well these days with the corrupt Obama in the White House and concerns about the H1N1 Swine Flu?

Flu epidemics or pandemics are scary enough under normal circumstances, but with the reputation of Obama and his long time ties to crime and corruption in Chicago, it is hard to trust anything coming out of his administration.

Remember Dr. Robert Weinstein? He pled guilty to corruption charges a few months ago, corruption charges that linked him to Stuart Levine, Tony Rezko, Rod Blagojevich and ultimately Barack Obama. Well, it turns out that there is a Dr. Weinstein that has ties to the CDC and possibly Baxter. Are these Dr. Weinstein’s related?

Now revisit the following article:

 Obama baxter ties in corrupt Chicago

To refresh your memory:

Dr. Robert Weinstein Indictment

Governor Rod Blagojevich Criminal Complaint

Citizen Wells request to Patrick Fitzgerald, Indict Obama

Dr. Robert Weinstein pleads guilty

Dr. Robert Weinstein and the CDC

Centers for Disease Control and Prevention

Past Issue

Vol. 7, No. 2
Mar–Apr 2001

“Controlling Antimicrobial Resistance in Hospitals: Infection Control and Use of Antibiotics

Robert A. Weinstein
Cook County Hospital and Rush Medical College, Chicago, Ilinois, USA”

“Dr. Weinstein is chair, Division of Infectious Diseases, Cook County Hospital; director of Infectious Disease Services for the Cook County Bureau of Health Services; and professor of medicine, Rush Medical College. He also oversees the CORE Center for the Prevention, Care and Research of Infectious Disease and directs the Cook County Hospital component of the Rush/Cook County Infectious Disease Fellowship Program. His areas of research include nosocomial infections (particularly the epidemiology and control of antimicrobial resistance and infections in intensive care units) and health-care outcomes for patients with HIV/AIDS.

Address for correspondence: Robert A. Weinstein, Division of Infectious Diseases – Suite 129 Durand, Cook County Hospital, 1835 W. Harrison St.,Chicago, IL 60612, USA; fax: 312-572-3523; e-mail: rweinste@rush.edu

Read more:

http://www.cdc.gov/ncidod/eid/vol7no2/weinstein.htm

October 24, 2006

“Yet the CDC refuses to endorse search and destroy. It is sticking to the mantra that hospital workers should wash their hands more carefully and frequently, and that in most cases patients should be isolated only after symptoms of infection with MRSA appear. Routine surveillance to find patients who may not be symptomatic, but are still contagious, is rarely practiced, and not recommended in the CDC’s new hospital infection-fighting guidelines, which were released last week after five years of deliberations. The guidelines do not include a routine recommendation for search and destroy.”

“This is a bitter pill for many infectious-disease experts, who have been joined by the relatives of dead patients, Consumers Union, and even a few Congress members in pressing the CDC. “Why are we spending millions if not billions on bird flu, a ghost that might not happen, when you have thousands being colonized by MRSA and dying of it?” asks Dr. William Jarvis, a top CDC hospital-infection expert until he resigned in 2003. At a March 29 hearing on hospital infections—which, all told, kill an estimated 90,000 patients each year—Rep. Bart Stupak, D-Mich., charged that the CDC had stood by, despite a steady rise in infections since the early 1970s. “During that time, hospital stays have grown dramatically shorter yet infection rates continue to go up,” Stupak said. “What do we have to do to motivate CDC?””

“The counterargument is made by Dr. Robert Weinstein, a hospital-infection expert at Cook County Hospital in Chicago, and a leader on the CDC advisory committee that issued last week’s guidelines.”

Read more:

http://www.slate.com/id/2152118/

Baxter International, H1N1 Swine flu vaccine, Obama, Chicago, May 18, 2009, British government orders 90 million dosages of swine flu vaccine from Baxter, Glaxo

From the Chicago Tribune, May 18, 2009:

“British government orders 90 million dosages of swine flu vaccine from Baxter, Glaxo

 

The British government this morning announced deals with vaccine manufacturers including Deerfield-based Baxter International Inc. to make up to 90 million dosages of a vaccine as a precaution against the swine flu.

The United Kingdom Department of Health today said this morning the deals with Baxter and GlaxoSmithKline Plc “will enable production of pre-pandemic vaccine to begin as soon as possible.” Financial terms of the deal were not available this morning

“The agreements could provide enough vaccine to protect the most vulnerable in our population before a pandemic is likely to arrive, without affecting our supply of seasonal flu vaccine,” the department said in a statement on its web site.

Baxter and other vaccine makers last week obtained strains of the A/H1NI virus from the World Health Organization, which is working with countries around the world. “The WHO has set up a pandemic vaccine supply group that meets weekly and Baxter is part of that group,” Baxter said this morning.”

Read more:

http://www.chicagotribune.com/business/chi-biz-swine-flu-vaccine-britain-baxter-may15,0,5442108.story

Obama owned stock in a company owned by Baxter International several years ago and  company employees were sizeable contributors to Obama’s campaign. Obama also warned of a global pandemic in 2005.

New York Reports Its First Swine Flu Death, May 17, 2009, assistant principal, New York City public school, Mitchell Wiener, experimental drug, Ribavirin, overwhelmed by the illness

From the NY Times, May 17, 2009:

“New York Reports Its First Swine Flu Death”

“An assistant principal at a New York City public school died of complications from swine flu in an intensive care unit of a Queens hospital on Sunday night, the first death in New York State of the flu strain that has swept across much of the world since it was first identified in April.”

“On Friday, Dr. Daniel Jernigan, head of flu epidemiology for the federal Centers for Disease Control and Prevention, said there had been 173 hospitalizations and 5 deaths reported to the agency. But he emphasized that most cases in the United States — possibly “upwards of 100,000” — were mild.”

““We are now seeing a rising tide of flu in many parts of New York City,” Dr. Frieden said. But he added: “Nothing we’ve seen so far suggests that it’s more dangerous to someone who gets it than the flu that comes every year. We should not forget that the flu that comes every year kills about 1,000 New Yorkers.”

Mr. Wiener, 55, had been “overwhelmed” by the illness, despite beginning a course of treatment with an experimental drug, Ribavirin, after he failed to respond to other antiviral drugs, according to Ole Pedersen, a spokesman for Flushing Hospital Medical Center, where Mr. Wiener had been a patient since Wednesday.”

“His wife, Bonnie, a reading teacher, blamed the city for failing to act sooner to close the school where she and her husband both worked. “I know we have a duty to educate the children of New York,” Ms. Wiener, who is not sick, said on Friday. But, she added, “something just doesn’t fit right.””

“A total of 105 students were documented with flulike illness at Middle School 158 in Bayside, Our Lady of Lourdes in Queens Village and a building in Flushing that houses three schools with a total of 1,320 students, including Intermediate School 25. All of the schools will be closed beginning Monday for at least five days, the department said.”

Read more:

http://www.nytimes.com/2009/05/18/nyregion/18swine.html?ref=health

CDC swine flu update, May 17, 2009, WebMD, Over 100,000 in US Have Flu, Half Have Swine Flu, Daniel Jernigan, MD, PhD, deputy director of the CDC influenza division

Here is an update from the deputy director of the CDC influenza division, Daniel Jernigan, MD, PhD, reported on WebMD on May 15, 2009:

“By Daniel J. DeNoon
WebMD Health NewsReviewed by Louise Chang, MDMay 15, 2009 —

More than 100,000 Americans probably have the flu — and at least half of these cases are H1N1 swine flu, a CDC expert estimates.

The comment came from Daniel Jernigan, MD, PhD, deputy director of the CDC’s influenza division, during a news conference.
Jernigan noted that the 4,700 confirmed or probable cases of swine flu reported to CDC represent a gross underestimate. When asked how many actual cases there were, Jernigan noted that 7% to 10% of the U.S. population — up to 30 million people — get the seasonal flu each year.

“So with the amount of activity we are seeing now, it is a little hard to know what that means in terms of making an estimate now of the total number of people with flu out in the community,” Jernigan said. “But if I had to make an estimate, I would say … probably upwards of maybe 100,000.”

The CDC’s most recent data, for the week ending May 9, shows that about half of Americans with confirmed flu had the H1N1 swine flu. If Jernigan’s off-the-cuff estimate is correct, more than 50,000 people in the U.S. have the new flu.

At a time when flu season should be ending or over, the CDC’s flu season indicators are going up instead of down. As of May 9, 22 states had widespread or regional flu.”

Read more:

http://www.webmd.com/cold-and-flu/news/20090515/cdc-100,000plus-in-us-have-swine-flu-half-swine-flu?src=RSS_PUBLIC

Thanks to commenter J.J. for the heads up.

H1N1 flu update, May 14, 2009, CDC, Pregnant women risks, population has little to no immunity, Mutations, risk that the viruses will exchange genetic material and get worse

Here is the latest report from the CDC. Three aspects of the H1N1 flu strike me as significant.

  • “The population has little to no immunity against it.”
  • “Pregnant women are at higher risk of complications of influenza.” “We are also seeing some severe complications among pregnant women in this year’s novel H1N1 virus problem” “I think that the H1N1 virus that we’re dealing with is novel, and so, we don’t think pregnant women have ever seen this before or would be protected from it from years past.”
  • “Unfortunately, reassortment happens. And this means that the viruses that we’re seeing can exchange genetic material with other viruses that are circulating. This can happen in humans, in pigs, in birds. And so, we do always have a risk that the viruses will exchange genetic material and get worse, or hopefully, get better, if they do that. So, we do think that the simultaneous occurrence in the world right now of this novel H1N1 strain that appears to be very transmissible, and very virulent H5N1 (Editor′s note – this is a correction) strains that are endemic in animals in certain countries of the world in the avian population, and the seasonal H1N1 strain that is oseltamivir resistant is an unusual circumstance.”

Do not panic. Stay informed.

If you are pregnant, take extra precautions and if possible limit your exposure.

A decision to take a vaccine must be carefully weighed.

 
U.S. Human Cases of H1N1 Flu Infection
(As of May 13, 2009, 11:00 AM ET)  States* Laboratory
confirmed
cases Deaths
Alabama 9  
Arizona 187  
California 221  
Colorado 44  
Connecticut 33  
Delaware 54  
Florida 58  
Georgia 8  
Hawaii 6  
Idaho 3  
Illinois 592  
Indiana 70  
Iowa 55  
Kansas 23  
Kentucky** 10  
Louisiana 33  
Maine 6  
Maryland 23  
Massachusetts 107  
Michigan 134  
Minnesota 31  
Missouri 18  
Montana 1  
Nebraska 21  
Nevada 21  
New Hampshire 17  
New Jersey 8  
New Mexico 44  
New York 211  
North Carolina 12  
Ohio 11  
Oklahoma 22  
Oregon 74  
Pennsylvania 22  
Rhode Island 7  
South Carolina 32  
South Dakota 3  
Tennessee 57  
Texas 293 2
Utah 72  
Vermont 1  
Virginia 17  
Washington 176 1
Washington, D.C. 9  
Wisconsin 496  
TOTAL*(45) 3352 cases 3 deaths
*includes the District of Columbia

**one case is resident of KY but currently hospitalized in GA.

Press Briefing Transcripts

CDC Telebriefing on Investigation of Human Cases of H1N1 Flu

May 12, 2009, 12:30 p.m. ET

Operator: Welcome, and thank you all for standing by.  At this time, I would like to remind parties in your lines are in a listen-only mode until the question-and-answer session, at which time, press star one to ask a question.  Today’s call is being recorded.  If you have any objections, you may disconnect at this time.  I’ll now turn the meeting over to Tom Skinner, you may begin.

Tom Skinner: Thank you for joining us for the update of an investigation into a novel strain of H1N1.  With us today is Dr. Anne Schuchat.  That is spelled A-N-N-E.  Last name is S-C-H-U-C-H-A-T.  She is the Interim Deputy Director for Science and Public Health program here at CDC.  She’s going to be providing some opening comments and then we’ll turn it over to reporters for Q&A.  So, Dr. Schuchat? 

Anne Schuchat: Great.  Good afternoon, everyone.  What I want to do is give you a quick situation update; talk little bit in more detail about a clinical group of patients, and then make some closing comments about where I think we are in this investigation. 

So, as of today, there are about 3,600 probable and confirmed cases in 46 states and the District of Columbia.  We have 3,002 confirmed cases in 44 states and D.C., with the most recent onset May 5th.  As you know, there have been three reported fatalities confirmed to be due to the H1N1 virus.  We have 116 hospitalizations that are being investigated at this point.  Most of those have been confirmed to be due to the H1N1 virus.  Our median age remains low at 15 years with a range, though, of 1 month of age up to 86 years.  Almost two-thirds of our confirmed cases are under 18.  Around the world, the case counts are continuing to increase.  There’s a total of 5,251 confirmed cases according to the World Health Organization, and those are occurring in 30 countries with Canada being and the United Kingdom having the largest number of confirmed cases after the U.S. and Mexico. 

In terms of our U.S. situation, you know we’ve had a active response with more than 100 field staff deployed to help with investigations in this country and Mexico.  We’ve deployed the test kits to the states, and I’m happy to report that as of today, 29 of the states are now doing their own confirmatory testing for the novel H1N1 strain.  We’ve sent the lab kits to a number of countries around the world, and testing is a critical part of understanding the situation around the world.  As we continue to investigate, we learn more and we want to share information as we get it. 

I wanted to say a few words today about this novel H1N1 influenza virus and pregnancy.  As many of you know, pregnant women are at higher risk of complications of influenza, whether it’s the seasonal influenza or pandemics of the past.  We are also seeing some severe complications among pregnant women in this year’s novel H1N1 virus problem, and I really want to make you aware of that, because I think it’s something that can have important clinical benefit.  We have about 20 cases under investigation right now where the H1N1 virus has been found in association with pregnancy.  We’re continuing to understand the illness in these patients, and a few of the patients have had severe complications.  As I think many of you know there was one fatality in a pregnant woman.  Influenza can cause worse complications in pregnancy than in people who are not pregnant.  Important complications include pneumonia and dehydration as well as complications for the newborn, like premature labor.  We think it’s very important when doctors are caring for pregnant women who they suspect may have influenza, that they issue prompt treatment with antiviral medicines.  Sometimes, physicians are reluctant to treat pregnant women with medicines, and sometimes pregnant women are reluctant to take medicines because, of course, they are sometimes risky during pregnancy.  The experts who have looked into this situation really strongly say that the benefits of using antiviral drugs to treat influenza in a pregnant woman outweigh the theoretical concerns about the drugs.  We think that either of the two medicines that this virus is susceptible to it be used for this condition.  So, while we don’t have lots and lots of experience yet with this H1N1 virus in pregnancy, it’s important to know, to look back on what we do know about seasonal influenza and pregnancy.  We strongly recommend pregnant women receive the seasonal flu vaccine to protect them from complications of influenza during pregnancy.  And for this novel H1N1 virus, we really want to get the word out about the likely benefits of prompt antiviral treatment in pregnancy when you’re suspecting influenza.  We are going to be issuing an MMWR report with some clinical and some data about the pregnancy cases that we’ve been investigating, and I think I would look for that to come out fairly soon with a little bit more detail than what I’ve shared. 

Yesterday at the media briefing, a few of you had questions about a recent article that came out in “Science Express.”  I think it came out two minutes before the press conference yesterday, so I wasn’t fully prepared, but I wanted to make a couple comments about this.  It’s an article by Christoph Frasier and colleagues called “Pandemic Potential of a Strain of Influenza: H1N1 Early Findings.”  This was a modeling analysis looking at data from Mexico in collaboration with investigators there.  And I think it’s very important that the infectious disease modeling community is aggressively responding to this novel virus and trying to share lessons learned in real time.  It’s important to say that uncertainty remains, that we’re learning more about transmissibility and attack rates.  In the article, the authors concluded that the virus characteristics in Mexico were not of the severity or transmissibility that we had seen in the 1918 pandemic, but they compared it with something of a magnitude of the 1957 pandemic.  It’s important to say that we may see changes as this virus is present in different countries, depending on the health care resources of the countries and the types of interventions that are carried out as well as potential changes that the virus goes through, as influenza viruses can mutate and evolve in the course of their spread.  So, I think this was an important report, and I applaud the authors for taking on this topic, and we hope that the international community will continue to collaborate to learn as much as we can about this new virus and how it behaves in large populations. 

I also want to comment about seasonal influenza.  We have been mentioning, and on our website, you see that we have cases of the regular seasonal flu strains, the seasonal A-H1N1, the seasonal A-H3N2 (Editor′s note – this is a correction), and the seasonal B viruses.  They are continuing to circulate now at a time when this novel H1N1 virus is also circulating.  One thing you can see from our flu view on the website is that there is an uptick of these other viruses in addition to the H1N1 virus.  We don’t think that there was a decrease in seasonal flu and then an increase in seasonal flu.  We think that pattern suggests that more people with influenza-like symptoms are being tested and more of those viruses are being studied so that our efforts to respond to this outbreak have led to recognition of more seasonal influenza.  It’s important to say that a large proportion of the strains currently being tested are due to this novel H1N1 virus, but there are other strains circulating.  So, that’s an important occurrence.  It maybe foreshadows what we have to face next fall, when seasonal strains of influenza are likely to circulate, and we may see this H1N1 strain come back, perhaps, in worse or milder form. 

The last comment is just to continue to say that vaccine development efforts have been of interest.  This is the time when we are growing up isolates to potentially identify a candidate virus that would be handed off to manufacturers to work on manufacturing or development stages.  CDC has sent five isolates to several different institutions around the world where candidate vaccines, viruses could be developed.  And there are active discussions being carried out across the U.S. government, including with manufacturers, to understand next steps and potential vaccine development and manufacturing.  So, in closing my prepared remarks, I just want to say that I think we are transitioning to the long view now.  We have a focus on the southern hemisphere, where illness may be on the upswing soon, and where we hope to learn as much as possible to help them respond and also to learn for what might be the case here in the northern hemisphere next year.  We’re also preparing for the fall, including exploration of vaccine development and manufacturing discussions.  We’re also trying to learn as much as we can from the experience of the past few weeks so that we can be better prepared going forward.  So, with that, I’d like to answer questions that you might have. 

Tom Skinner: First question, Rose? 

Operator: Our first question is from Elizabeth Weise, USA Today.  Your line is open.

Elizabeth Weise: Hi, thank you for taking my question.  I wanted to go back to your focus on pregnant women and the specific problems they face.  You said you have about 20.  Do you have any sense of percentages, about what percentage of pregnant women might be at risk for this?  Is pregnancy in and of itself the main, underlying condition, or is it pregnant women who also have other underlying conditions as well? 

Anne Schuchat: Pregnancy is a well-documented risk factor for complications of influenza.  It’s not that we think pregnant women get influenza, seasonal flu, for instance, more than other people, but we think when they suffer an infection with influenza, they can have a worse time.  For instance, they may develop pneumonia, they may develop dehydration, and their metabolic system may not be able to handle the infection as well.  So, there are a number of reasons that pregnant women can have a worse time, including some complications, such as preterm labor and complications for the newborn.  So, this is a group that we include among our populations at higher risk for influenza complications, and that’s why for the past several years we’ve been strongly recommending women who are pregnant receive the influenza vaccine, to protect them and to have a better outcome of their pregnancy. 

Elizabeth Weise: Follow-up question.  Is there then the sense that this H1N1 novel influenza is any worse or better than seasonal flu when it comes to pregnant women, or is it just you’re trying to reiterate to women that they shouldn’t be afraid to take antivirals and to see a doctor if they get it? 

Anne Schuchat: You know, I think that the H1N1 virus that we’re dealing with is novel, and so, we don’t think pregnant women have ever seen this before or would be protected from it from years past.  Many years with seasonal flu strains circulating, a lot of pregnant women may have some immunity to the strands that are circulating.  We still think vaccination’s a good idea for pregnant women, but I think because of this — because this H1N1 virus is targeting younger people and because it’s totally new and because we know that pregnancy is a risk factor for worse complications, we really want to focus our attention on it and make sure that pregnant women and their health care providers have this concern in mind.  Next question? 

Operator: The next is from Jennifer Corbett, Dow Jones.  Your lone is open.

Jennifer Corbett: Yeah, hi.  I have two questions.  The one — do you recommend for seasonal flu that women, pregnant women, take antivirals or is this specific to the H1N1?  And then the other question I had is at the top you mentioned that there’s been a death of a pregnant woman.  Was that one of the women in Texas?  Was she the one in Texas? 

Anne Schuchat: That’s right about the fatality we do think that when influenza occurs in pregnancy, it should be treated with antivirals.  The message today, the time of year we’re at right now, the majority of what we’re seeing that is influenza-like illness, or half of what we’re seeing is this H1N1 strain, so it’s in this circumstance that we’re really trying to remind people that treatment of influenza-like illness in pregnancy is appropriate.  We don’t know as much as we would like to know about the H1N1 virus that we’re seeing.  And certainly, every day we’re learning little bit more.  As we’ve accumulated some experience with this illness, we are trying to share clinical, interim clinical recommendations.  So, I think that things could change as we get further along in the investigation, but so far, of course, one of our three fatalities was a very sad story in a woman who was pregnant.  Next question, please? 

Operator: The next is from Mike Stobbe, Associated Press. Your line is open.

Mike Stobbe: Hi, thanks for taking the call.  Doctor, that “Science” article had an estimate about when the virus might have first appeared.  Can you tell us, you know, as this has been going on, what’s science telling you at this point about when it first appeared?  Did it first appear in a pig?  Who infected who?  Do you have any update on that?  And I have a second question. 

Anne Schuchat: Yeah, the paper in “Science” talked about beginning — there’s a virus emerging in the middle of February, and I think the working hypotheses for much of the influenza community right now is that this strain was circulating in pigs somewhere, and eventually, you know, reassorted and was able to infect humans easier, the people got it and then it became easily transmitted between people.  That’s a working hypothesis, but of course, the scientific community and CDC included is very open to other hypotheses.  We don’t have new information about the specific origins.  We think that’s an important investigation that the scientific and public health community is taking on, but so, the clinical illness — that paper suggested mid-February, and we don’t have reason to believe that humans were having a large problem with this before that.  But of course, you know, investigations are active in a number of places. 

Mike Stobbe: Okay.  My second question — we’ve begun to see announcements from companies about the availability of commercial tests for this novel virus coming online.  Can you assess those for me?  Are those good tests?  Are they solid?  Are they starting to contribute to the case counts? 

Anne Schuchat: I won’t — I don’t have the information to be able to answer the question.  I’m sorry.  I think that it’s — you know, we have disseminated information on sequence and the primers and probes that can be used to identify this virus.  We’ve also distributed agents and test kits for the public health laboratory network to be able to recognize this.  It’s very possible for manufacturers, biotech companies, to make kits that would work similarly to the ones the CDC has distributed.  There’s usually a validation process that goes forward, and I’m not — I don’t know whether there’s any systemic evaluation of the commercially produced kits that — I don’t know if CDC’s involved in any of that.  So, sorry about that.

Tom Skinner: Next question, Rose.

Operator: The next is from Michael Smith, Med Page Today.  Your line is open.

Michael Smith: Dr. Schuchat, you talked about antivirals in connection with pregnant women.  On the Hubra press conference earlier today, they said that antivirals are being aggressively used in Europe, where they’re mainly employee cases, and were being reserved really largely for serious cases in the U.S. and Mexico.  Can you comment on how antivirals are being used in the U.S.? 

Anne Schuchat: Yes, that’s right.  The circumstances in the U.S. are very different from the circumstances in a number of European countries.  We have this virus in every — pretty much, almost every state in the country, and suspected it’s likely already to the states that haven’t confirmed it yet.  We don’t have a situation where we can contain the virus’s geographic distribution, and our focus is on reducing illness and death and mitigating the impact that this virus has as well as focusing our efforts on areas where they can have the most impact.  So, the priority here is for antiviral drugs for treatment of influenza, where we think the treatment will make a difference, and that’s for people with severe illness presentation or for people who have underlying medical conditions or pregnancy, where the complications of an influenza infection might be worse than in other people.  So, our focus for antiviral drugs is primarily on treatment.  And we are aware that there are some other countries where there’s a lot of preventive use of antiviral drugs around the traveler, around the first case that they’ve seen.  That circumstance is not likely to have a benefit here in the United States based on the transmission patterns we’re seeing and the stage of the outbreak that was present by the time we recognized this virus.  Did you have a follow-up question, or —

Michael Smith: No, that’s good.  Thank you. 

Anne Schuchat: Okay.  Is there another question? 

Operator: The next is from Emma Hitt, Medscape, your line is open.

Emma Hitt: Yes, hi, thank you for taking my question.  You talk about the novel H1N1 virus coming back during the fall.  Is that a certainty?  And will it definitely pick up back in the fall?  And also, do you expect the H1N1 virus to be more robust during the summer months than the seasonal flu strain? 

Anne Schuchat: We wish that we knew what was going to happen in the fall.  Influenza is usually seasonal, and usually, there is very limited circulation in the northern hemisphere during our summer months.  But there is increased circulation in the southern hemisphere during that same time period.  We don’t know whether the novel H1N1 virus will circulate in the U.S. next fall, and if it circulates, whether it will be more severe, of similar severity or less severe than now.  We think that if we have good information coming from the southern hemisphere and we see a lot of disease or severe disease associated with this virus, that that would increase the likelihood that we would continue to see problems in the fall.  But we, unfortunately, cannot predict.  The other thing is that these viruses continue to change.  Because we have seasonal influenza strains, including an H1N1 strain that is resistant to oseltamivir and zinamivir.  But because we have an H1N1 strain that’s circulating that’s resistant and we have this novel H1N1 strain, we also don’t know whether there might be a reassortment between the human seasonal flu strain and the novel strain.  So, there’s a lot of unknowns, a lot of uncertainties and a real priority to have good laboratory surveillance and monitoring of the circumstances in the southern hemisphere and the ongoing occurrence here in the U.S.  Next question? 
Operator: The next is from Allen Miranda.  Your line is open. 

Alan Miranda: Hi.  Well, I would like to follow up on what you just said.  You said also at the beginning that there are also other kinds of viruses circulating.  And I was about to ask you, if this virus could reassort with any other kind, any other strain, Avian flu, for instance. 

Anne Schuchat: Unfortunately, reassortment happens. And this means that the viruses that we’re seeing can exchange genetic material with other viruses that are circulating.  This can happen in humans, in pigs, in birds.  And so, we do always have a risk that the viruses will exchange genetic material and get worse, or hopefully, get better, if they do that.  So, we do think that the simultaneous occurrence in the world right now of this novel H1N1 strain that appears to be very transmissible, and very virulent H5N1 (Editor′s note – this is a correction) strains that are endemic in animals in certain countries of the world in the avian population, and the seasonal H1N1 strain that is oseltamivir resistant is an unusual circumstance.  Certainly, our efforts to control seasonal influenza with our annual immunization campaign will be important, and of course, there are discussions going on about vaccine development and potentially manufacturing and even use, eventually, of an H1N1 virus vaccine.  Those are important discussions, as well as the ongoing efforts to try to control the Avian H5N1 problem in birds in some of the world.  Next question? 

Operator: I’m showing no questions at this time. 

Tom Skinner: Okay.  Rose, thank you, and thank you all for joining us for this update.  Please stay tuned and continue to go to http://www.cdc.gov for updated information, and we’ll keep you apprised as developments warrant.  Thank you. 

End

####

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC H1N1 Flu Update, May 8, 2009, Illinois, IL largest reports, US Human Cases of H1N1 Flu Infection, Obama and Baxter International Chicago, IL connections

** Update, The lastest CDC numbers are at the bottom. 5/08/2009, 12:15 PM ET **

I, like many of you, am watching reports of the Swine flu, H1N1, more carefully each day. I have been visiting the CDC site with regularity and due to my math background and inquisitive nature, something  in the data stood out this morning. It may mean nothing, but it is a curiousity, and given Obama’s connections to Chicago and Baxter International being located there, there is cause for more scrutiny.

Notice in the CDC report of confirmed flu cases by state that Illinois has almost twice as many cases as the next highest state. Illinois has 204, California, with a much higher population and located adjacent to Mexico has 106, Texas with a large population and located adjacent to Mexico has 91 and New York with a much larger population has 98. The more I have pondered these numbers and logistics, the more curious I have become.

CDC Human Cases of H1N1 Flu by state:

http://www.cdc.gov/h1n1flu/update.htm

Let me know what you think

 

 

U.S. Human Cases of H1N1 Flu Infection
 
 
 

 

States

 

 

 

 

Laboratory
confirmed
cases

 

 

 

 

Deaths

 

 

 

 

 
Alabama    

4    

   
Arizona    

48    

   
California    

106    

   
Colorado    

17    

   
Connecticut    

4    

   
Delaware    

38    

   
Florida    

5    

   
Georgia    

3    

   
Hawaii    

3    

   
Idaho    

1    

   
Illinois    

204    

   
Indiana    

15    

   
Iowa    

5    

   
Kansas    

7    

   
Kentucky*    

2    

   
Louisiana    

7    

   
Maine    

4    

   
Maryland    

4    

   
Massachusetts    

71    

   
Michigan    

9    

   
Minnesota    

1    

   
Missouri    

4    

   
Nebraska    

4    

   
Nevada    

5    

   
New Hampshire    

2    

   
New Jersey    

7    

   
New Mexico    

8    

   
New York    

98    

   
North Carolina    

7    

   
Ohio    

5    

   
Oklahoma    

1    

   
Oregon    

15    

   
Pennsylvania    

2    

   
Rhode Island    

2    

   
South Carolina    

17    

   
Tennessee    

2    

   
Texas    

91    

2    

 
Utah    

8    

   
Virginia    

11    

   
Washington    

23    

   
Wisconsin    

26    

   
TOTAL (41)    

896 cases    

2 deaths    

 
(As of May 7, 2009, 11:00 AM ET) 

 

U.S. Human Cases of H1N1 Flu Infection

States*

 

Laboratory
confirmed
cases

 

Deaths

 

 
Alabama 

   
Arizona 

131 

   
California 

107 

   
Colorado 

25 

   
Connecticut 

   
Delaware 

39 

   
Florida 

   
Georgia 

   
Hawaii 

   
Idaho 

   
Illinois 

392 

   
Indiana 

29 

   
Iowa 

   
Kansas 

12 

   
Kentucky** 

   
Louisiana 

   
Maine 

   
Maryland 

   
Massachusetts 

83 

   
Michigan 

49 

   
Minnesota 

   
Missouri 

   
Nebraska 

   
Nevada 

   
New Hampshire 

   
New Jersey 

   
New Mexico 

   
New York 

174 

   
North Carolina 

   
Ohio 

   
Oklahoma 

   
Oregon 

15 

   
Pennsylvania 

   
Rhode Island 

   
South Carolina 

29 

   
South Dakota 

   
Tennessee 

36 

   
Texas 

93 

 
Utah 

24 

   
Virginia 

14 

   
Washington 

33 

   
Washington, D.C. 

   
Wisconsin 

240 

   
TOTAL*(43) 

1639 cases 

2 deaths 

 

(As of May 8, 2009, 11:00 AM ET) 

 

CDC, Press briefing transcripts, May 7, 2009, 4 PM ET, New England Journal of Medicine Articles on H1N1 Flu, 1918 flu pandemic, H1N1 Virus, Triple Reassortant Swine Influenza A (H1)

Read the following transcript and provide your thoughts:

“Press Briefing Transcripts

CDC Telebriefing on New England Journal of Medicine Articles on H1N1 Flu

May 7, 2009, 4 p.m. ET”

“>>> Welcome and thank you for standing by.  At this time, all participants are in listen-only mode until the question and answer period of today’s conference call.  During the question and answer session, you may press star one to ask a question.  At this time, I’ll turn the call Over to Mr. Dave Daigle.  You may begin. 

>> Hi, this is Dave Daigle, with CDC Media Relations, thank you for joining us on this short-notice telebriefing to discuss two “New England Journal of Medicine” publications: The Emergence of Novel Swine-Origin Influenza A H1N1 Virus in Humans and Human Infections with Triple-Reassortant Swine Influenza A (H1) in the U.S. from 2005 to 2009.  Joining us today are Drs. Michael Shaw, Lyn Finelli, Carolyn Bridges and Fatimah Dawood. I think we’re going dispense with opening statements and just go right into the questions.  So can we have the first question, please? 

>> Thank you, again. If you would like to ask a question, please press star one.  Our first question comes today from Donald McNeil with “The New York Times.” You may ask your question. 

>> Hi.  In reading over the article about the triple-reassortant swine influenza A. I’m assuming this is tracing infections that do not include the Eurasian swine sequence found in the patients in the current outbreak, and I wondered if you can tell us more about whether or not that Eurasian swine strain had ever been found in the United States, whether you can tell from genetic sequencing where it got into the combination along with these triple reassortants or give us any details of that.

>> Those genes had never been seen in the Americas before. 

>> Wait one second, this is Dr. Michael Shaw.

>> Thank you.

>> This was the first time they had been seen in any virus in any human or animal.  And the genetic lineage of the virus we can trace back, there’s clearly a gap in the surveillance because there are no really close relatives, nothing that we can say was an immediate precursor.  Because of this new finding, a lot of researchers in the field are going back through their archives now, digging through their freezers to see if they had something that was overlooked but there’s absolutely nothing in the literature, nothing publicly available and nothing that our colleagues knew about when this was first found. 

>> This is Carolyn Bridges.  I think it’s also important maybe to just point out and maybe you want to take questions over to USDA as well, but from our understanding, there were no importation of pigs into the United States from Eurasia.

>> Next question, please.

>> Our next question comes from Maggie Fox with Reuters. 

>> Oh, darn, I wanted someone else to ask some first.  Can we go back over that, what is it that’s new and any hint as to whether somebody might have carried this reassortant to Mexico or whether it emerged there considering the surveillance we have is of people who had that triple-reassortant in the U.S. 

>> This is Michael Shaw again.  Genetics are indicating that the origin of this virus apparently happened before anyone was aware of it occurring in animals or humans.  It was six of the genes were similar to what had already been seen in the Americas circulating in pigs and that we knew about.  The acquisition of these two new Genes from the Eurasian lineage have never been seen in the Americas.  There is importation of pigs, the way I understand, too to Europe and Asia for breeding purposes, but not the other way around.  So whether it might have come into this hemisphere by a person or an animal, we have no idea.  There’s just not — we’re not in a position to say right now. 

>> Thank you, Maggie.  Next question, please.

>> Thank you, our next question comes from Mike Stope from Associated Press.  Ask your question. 

>> Hi, thanks, doctors, for doing this.  Two questions.  The first one, I saw in one of the articles, we saw this in I think the MMWR2, 38% of cases in the U.S. looking at the U.S. cases also involved vomiting or diarrhea.  That’s not typical of seasonal influenza.  What explains that in this virus?  Can you give us any information about what is it about this virus that’s causing those symptoms at a higher amount? 

>> Yes.  This is Fatimah Dawood.  We did find in the first 642 cases or patients who are diagnosed with swine-origin influenza virus infection that 25% either had diarrhea or vomiting.  This is a new virus and we’re still learning how transmission occurs.  But because we’ve made this observation, we are recommending that clinicians think about transmission not only through a respiratory route but also through the gastrointestinal route as fecal-oral transmission, but it’s not fully understood what role those symptoms played yet.

>> Thank you, Mike.  Next question, please. 

>> Thank you.  Our next question comes from Heidi Sloot with “Internal Medicine News.”  You may ask your question.

>> Hi.  Thanks for taking my question.  This is sort of a follow-up to the previous question.  What right now is the take-home message then for clinician relating to this as far as symptoms to watch for or what to tell patients? 

>> This is Fatimah Dawood again.  In our paper, again we looked at the first 642 cases and we found that the majority of people with confirmed swine-origin influenza virus infection had symptoms that are typical of seasonal influenza.  Those would include fever, cough and sore throat, which are the three most common symptoms observed.  As mentioned previously, diarrhea and vomiting were prominent symptoms as well, so what I would say is that clinicians and people should be aware of those symptoms and I think that as members of the community have symptoms that are concerning to them, they should discuss that with their clinician.

>> Thanks very much.  Next question, please.

>> Thank you, our next question comes from Daniel Denude with webmd.

>> Thanks for taking my question.  I have to push beyond this.  Perhaps you all noticed there was also a paper published at the same time about the signature features of pandemic flus in the past and it strikes me that these flus continually seem to have some of the features that we’re seeing here, striking younger people, and that there is a wave phenomenon.  I wonder if you could comment on the risk groups that you’re seeing for this virus and what we might expect looking forward from our experience with pandemic flu about what future waves of viruses tend to look like as they tend to become pandemic.  I know that’s a wide question but I appreciate you addressing it.

>> This is Fatimah Dawood.  You know, I would say that this is an evolving outbreak and we’re still learning about how this virus works, but what we observed in our paper is that 60% of confirmed cases occurred in people who are 18 years of age and younger.  Now there may be several possible explanations for that. One is the possibility that younger people are more susceptible to the virus, but there may also be a bias in the way that we are finding cases right now because the numbers of cases were identified in school outbreaks and still more young people are being tested right now.  There is also the possibility that older people may have some antibodies to other influenza viruses that give them cross protection against the current virus.  I think it’s difficult to make predictions at this point. 

>> This is Dr. Carolyn Bridges. In terms of the second part of your question about what we might expect, of course we’ll have to sort of wait and see, that’s always the tricky part with influenza.  We never sort of know what we’re going to get until we get there.  But with past pandemics where there’s been a novel strain where there has been initiation or introduction of that virus, the initial outbreaks if they occur in the summer are generally milder.  We know that the influenza virus, in general, prefers lower humidity, lower temperatures for transmission.  So as we’re in the summertime, we expect it to be seasonal influenza but what we’re likely to see is some transmission that occurs over the summer with the possibility that in the fall when the weather turns cooler again that we might see an increase in cases that will be looking closely toward the southern hemisphere, during their winter that is coming up to see what happens and that may give us some clues as to what we might expect in the upcoming winter months here in the United States.

>> Thank you very much.  Next question, please. 

>> Our next question comes from John Warren with Bloomberg News, you may ask your question.

>> Hi.  Thanks for taking my question.  Yeah, I was wondering if you could talk more about whether the ancestors of this virus may have been circulating in people before it was in pigs and whether that might have given immunity to older people.  Thanks.

>> This is Michael Shaw.  Well, ultimately all of the ancestors of this particular swine strain and circulating seasonal H1N1 can be traced back to the 1918 pandemic.  That virus established itself both in humans and in pigs.  And they’ve been evolving along separate tracks.  And in the process being both mammalian species they’ve maintained the ability to go back and forth, which is what we’ve seen obviously, for example, in the other paper we’re talking about today that they are able to make the jump.  What’s unusual about this particular case, is that it’s able to apparently establish sustained transmission.  What’s clear from what we’re seeing genetically and just the behavior of the virus, it was already well-adapted for transmission in humans before it popped up in this particular case.  But ancestors are the same.  You can trace them all back to 1918. 

>> Thank you, John.  Next question, please.

>> Thank you.  Our next question comes from Elizabeth Weiss with “USA Today.”  You may ask your question. 

>> Hi.  Thanks for taking my call.  This is follow-up on that then. You talked about there may be a missing link in observation or surveillance.  How much observation and surveillance is there worldwide and how likely is it that you would actually see something close to real-time virus like this popping up? 

>> This is Carolyn Bridges.  I think what we can say is that we certainly are much better prepared this year than we would have been a few years ago.  And although what we were preparing for most urgently was potential emergence and spread of H5N1, the avian virus, those investments have paid off in spades.  And so we have invested from the U.S. government with many colleagues from different countries.  Other donors in increasing laboratory capacity in countries around the world.  So I can’t tell you for sure how early we might be able to identify — have identified this virus, but we certainly are in much better shape than we would have been even just two years ago.

>> Thanks.  Next question, please.

>> Thank you, our next question comes from Mary Manning with “Las Vegas Sun.”  You may ask your question.

>> Yes.  Thank you for taking my question.  I’d like to know if there’s been any studies done on how long this virus lasts when it gets out in the environment? 

>> This is Michael Shaw.  There have been no — we haven’t had the virus long enough to do studies on this particular one.  All I can go by is past experience with other influenza viruses.  It depends on the environmental conditions.  It survives better on a hard surface than a porous surface, for example.  It’s inactivated quickly at higher temperatures.  Those are just general facts about flu.  But these particular strains, people are working on it.  We haven’t done — don’t have that information yet. 

>> Thanks very much.  Next question.

>> Thank you, our next question comes from Brian Thompson with KS public radio.  You may ask your question.

>> Hi.  Thanks for this opportunity.  As for the predecessors of this virus that emerged in pigs in the late 1990s, the humane society of the U.S. has made the argument that intensive factory farming is responsible for the shift in the genes that caused all this to happen.  I’d like you — Juergen Rick at Kansas State University, by the way ,argues that backyard pigs would be more susceptible because they are exposed to more viruses left by bird droppings and such.  So I would like you to weigh in on that, please. 

>> This is Carolyn Bridges.  I’m not sure we can really speculate about that, given what we believe based on the data that we have available from the genetic databases is that we don’t have any precursors like this in the United States despite tremendous amount of surveillance that goes on here in the U.S.  So I can’t speculate.  I wouldn’t able to say one way or the other. 

>> Thanks very much.  Next question.

>> Thank you.  Again, I’d like to invite parties who would like to ask a question, press star one.  Record your name prior to asking a question.  Our next question comes from Carrie Peyton with Sacramento Bee newspaper.  You may ask your question.

>> Hi.  Thanks for taking this question.  As we continue to do genetic analyses of these virus throughout the southern hemisphere flu season, what markers, if we start seeing changes in different markers, which ones would be especially troubling.  What areas of the genome do we not want to see change or would be early signs of it changing in ways that could make it much more prominent? 

>> This is Michael Shaw, there’s several critical parts of the genome that we look at.  Obviously the one primary concern right now is the determinants of resistance to the antiviral agents.  That’s going to be a high priority to continue monitoring.  Also any potential changes in the surface proteins that could potentially complicate selection of a vaccine strain.  As you know, under ordinary circumstances circulating influenza varies a great deal which is why the vaccine has to be updated every year.  There is the possibility that once it starts circulating more wide lane and different populations that you’re going to see, subpopulations popping up that could not be reactive with whatever vaccine strain might be chosen.  So we just have to keep an eye on changes in general, but the ones we look for in particular are the ones that are affecting the genetic makeup of the proteins that react with the vaccine and antiviral resistance or susceptibility.

>> Thanks very much.  Next question.

>> Thank you.  Our next question comes from Mike Shope with Associated Press.  You may ask your question.

>> Here’s the second question I was trying to ask earlier.  There’s a little bit more detail on the chronic conditions that the severe cases in the U.S., especially in the cases of the two deaths, the 22-month-old child had it looks like four conditions and a pregnant woman had several including autoimmune disease that was under treatment.  Can you tell me about those constellations of underlying conditions.  Would seasonal flu have killed those patients given those conditions?  Or are you learning anything about the patients who suffered severely who had underlying conditions?  What’s working together there? 

>> This is Fatimah Dawood.  I think we’re still learning about what patients are still most at risk for swine origin influenza virus and complication of that infection.  But what we do know from seasonal influenza is there are groups of people with characteristics with a higher risk.  That includes children younger than age 5, people with chronic underlying medical conditions.  Pregnant women and adults older than 65 years of a and one thing that we looked at in the 642 patients that were described in this paper and then in the subset of patients who were hospitalized, we had data for 22 patients.  About half of those patients had one of those characteristics.  Which does suggest that those groups of people may be at higher risk.  Those groups may not be the only groups but certainly we are seeing that those groups are well represented amongst the people who are hospitalized at this point. 

>> Thank you it, Mike.  Next question.

>> Thank you, our next question comes from Elizabeth Sweeth with “USA Today.”  You may ask your question.

>> Thanks again.  Just a quick question, I’m reading these paper, some of the facts are actually from May 5th.  I’m wondering when are these going to published and have you all ever done this quick a turnaround before I don’t recall having seen it.

>> This is Lyn.  I may be here the longest of anyone at this table.  I have never seen such a paper come out so quickly, I don’t think.  Is that what the question was? 

>> Right.  I mean there’s data in there from two days ago.  When I’m wondering when is it going to come out in print?  From your memories, some of the AIDS papers came out quickly, but quickly went three or four weeks.  I have never seen anything show up two days later.

>> I think print of both of these papers is going to come out the first week of July. 

>> This is Carolyn Bridges, but I understand these version are available online to anyone, not just by subscription, anyone would have access to these papers. 

>> This is Fatimah Dawood.  I would just add to that this paper is an effort by so many people in county and state health departments as well as CDC to really make this information available as soon as possible to people. 

>> Yeah, and this is Michael Shaw.  I want to emphasize we were getting this genetic information out basically as soon as we had it.  We had the first gene segments up there in April 25 and made special arrangements at NCBI and NIH to have them released essentially as they were submitted so.  April 27th, things started to getting up on the NIH, NCBI website right away as soon as we had the data.  There was no holding back of it.

>> Operator, this is Dave.  I think that was our last call.  So I want to thank everybody for taking the time to join us today to ask questions.  We’ll plan another daily update briefing tomorrow, regular CDC press briefing.  Thanks, everyone. 

>> Thank you.  At this time, that does end this conference.  All parties may disconnect. 

End

####

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Link to transcripts:

http://www.cdc.gov/media/transcripts/2009/t090507b.htm