Updated answers to two questions: What is CDC doing in response to the outbreak? What epidemiological investigations are taking place in response to the recent outbreak?

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(ChinaPost.com.tw) – The new H1N1 virus, which has caused the first pandemic of the 21st century, appears to have been circulating undetected among pigs for years, researchers reported on Thursday.

Although health officials have been watching for new influenza viruses in humans, animal health regulators have missed the opportunity to check swine, the researchers reported.

Britons Andrew Rambaut of the University of Edinburgh and Oliver Pybus of Oxford University, and Yi Guan of the University of Hong Kong examined the genetic sequence of the new H1N1 swine flu virus.

Like others who have done the same, they show it is a mixture of other viruses that had been circulating in pigs, one of which was itself a mixture including swine, human and avian-like genetic sequences.

“We show that it was derived from several viruses circulating in swine, and that the initial transmission to humans occurred several months before recognition of the outbreak,” they wrote.

“Movement of live pigs between Eurasia and North America seems to have facilitated the mixing of diverse swine influenza viruses, leading to the multiple reassortment events associated with the genesis of the (new H1N1) strain,” they added.

“Yet despite widespread influenza surveillance in humans, the lack of systematic swine surveillance allowed for the undetected persistence and evolution of this potentially pandemic strain for many years.”

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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.

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Acknowledging children’s concerns and reinforcing children’s coping are two key strategies to assist parents in managing their children’s worries over the H1N1 flu (swine flu), reports the Australian Psychological Society (APS). Professor Bob Montgomery, President of the APS says, “At this stage, many children are aware of the threat of the flu outbreak from conversations amongst peers, the local community, from overhearing adult conversations, or from daily updates in the media. Parents have an important role to play not only in helping their children to understand and follow the Government health warnings and advice, but also to help calm their children by acknowledging their concerns and by reinforcing their children’s coping. Worries and anxieties about threats such as swine flu can become difficult for children of all ages to deal with”.

Acknowledging children’s concerns

Some simple steps for parents include: 

- Acknowledging children’s concerns and worries. Given the current worldwide attention and Australia wide concerns over the H1N1 flu, it is understandable that children are anxious about what is taking place and how it might affect them. 

- Listening closely to children’s concerns. Are they looking for factual information, or are the questions expressing anxiety? 

- Responding to any obvious items of misinformation that they have picked up and help them to make sense of information or sort out truth from fiction. It can be very helpful to provide facts in these circumstances. 

- Reinforcing the recommended government health practices to reduce the likelihood of contracting swine flu. 

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By Simon Gardner, Reuters

A Chilean man has died from H1N1 flu, Chile’s government said on Sunday, the second death in the South American country from the new virus that has killed more than 125 people worldwide.

A Chilean health ministry spokesman said the 56-year-old man, who had a history of heart problems, died in the southern city of Osorno on Wednesday.

The new flu, a mixture of swine, bird and human viruses, has infected nearly 22,000 people in 69 countries, according to the World Health Organization’s latest toll.

Chile’s government announced on Friday that about 890 cases had been detected in the country. Many patients have already recovered.

SANTIAGO, June 2 (Reuters) – A Chilean man has died from H1N1 flu, Chile’s government said on Tuesday, the first death in the South American country from the new virus that has killed more than 100 people worldwide.

Chilean health ministry officials said the government had now confirmed 360 other cases of H1N1. Six people are in serious condition.

“Today we have confirmed the first case of the death of a patient due to human flu (H1N1),” Health Minister Alvaro Erazo told a news conference.

Chile’s first victim, 37-year-old Fernando Vera Maldonado, died in the southern city of Puerto Montt in the early hours of Monday.

The flu has spread fast in Chile, where temperatures are falling ahead of the onset of the Southern Hemisphere winter. Many patients are children with mild cases.

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As of 11 AM, June 3, CDC is reporting 11,054 confirmed and probable cases and 17 deaths in 52 states and territories (including the District of Columbia and Puerto Rico).

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As of 11 AM, June 1, CDC is reporting 10,053 confirmed and probable cases and 17 deaths in 51 states (including the District of Columbia).

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The natural reservoir for most influenza viruses is birds, especially aquatic birds, but some versions of the virus have also become adapted to the host cells of other species, among them sea mammals, horses, dogs and of course pigs and humans (among others). How long is the list? We really don’t know, as there has been little systematic inquiry into influenza hosts in the natural world. While human influenza is seasonal in the northern and southern hemispheres, where it goes in the “off season” is a matter of debate. Most flu experts think it remains at low levels in the community, spiking to outbreak levels during “flu season” for reasons that are yet to be agreed upon. Another possibility is that it remains in some unidentified non-human reservoir. And there is surprisingly little information about influenza in tropical climes (see this interesting piece by Declan Butler in Nature).

A paper just published in Emerging Infectious Diseases is a stark example that the virus could exist almost anywhere. The paper describes an outbreak with a human seasonal H1N1 virus in a colony of Myrmecophaga tridactyla, more popularly known as The Giant Anteater:

A colony of 11 adult anteaters (7 males, 4 females) and 1 neonate was housed at the Nashville Zoo at Grassmere, Nashville, Tennessee, USA. The colony experienced an outbreak of respiratory disease beginning in February 2007. The anteaters were housed separately in stalls in the same building with shared ventilation, with the exception of the nursing neonate who was housed with his dam. There was no contact with animals outside the colony. The primary caretaker of the colony had no contact with other animals housed at the zoo. No other species experienced respiratory disease at the zoo during the outbreak. Only the primary caretaker had sustained direct contact with any members of the colony.

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