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Father, I know that all my life
Is portioned out for me,
And the changes that are sure to come
I do not fear to see;
I ask Thee for a present mind,
Intent on pleasing Thee.

I would not have the restless will
That hurries to and fro,
Seeking for some great thing to do
Or secret thing to know;
I would be treated as a child
And guided where I go.

Wherever in the world I am,
In whatsoever estate,
I have a fellowship with hearts
To keep and cultivate .

Mark your calendars: Wednesday, January 28th at 2 PM

And this webcast on Pandemic Influenza is somewhat of a mystery. I am sure that it will be interesting and timely.

Previous PlanFirst Webcasts are located at the PandemicFlu.gov/AvianFlu.gov website located here as well.

Other videos and webcasts are located at the website.

The U.S. Department of Health and Human Services has done an excellent job of keeping this citizen informed about avian flu and the preparedness that needs to get done in order to be ready for a pandemic.

I have said this before, I struggle with the preparation part of all of this. It takes a long time to get ready. Slowly but surely I am reaching some goals and I have to set new ones all of the time.

So if the budget is tight like mine please don’t hesitate to prepare.

I know that when you first hear about a pandemic what it truly means takes some getting used to but I have found that action is better than inaction. Truth be told, we have been preparing for over four years and if you were to look around my house you would never know it. We buy “twosies” of everything but lately we have been eating what we buy. So my goal now is to purchase “threesis” of essentials and cut back on non-essentials. There really is no room for failure here so I just keep plugging at this.

Sometimes I fear that if I delay, I will run out of time and my family won’t have what we need to endure. We do have some of the basic disaster essentials, it is the food that is a challenge (remember to rotate what you do purchase…at first I didn’t. I made that mistake so I will pass along the tip.

But I digress…..

There is a good deal of information at the Pandemic Flu website that helps to understand just what a pandemic is, stockpiling, workplace and individual preparation…and so much more.

For leaders in a community there is the “Take the Lead” page, also an excellent resource!

I hope that you make it to the PlanFirst Webinar!

Type A Strep with Toxic Shock Syndrome is a serious disease. School and health officials are doing a good job in their diligence to control the spread of this within the school. While one case does not an epidemic make, this is a good reminder for us to pay attention to what is circulating in our communities and how we respond when these illnesses occur. Vigilence and diligence are the key words and this community has both.

My prayers are for the young student and his family and prayers of thanks to a proactive town in following up and being diligent.

Here is the recent headline of this story from East Bernstadt, Kentucky

Mystery Disease of Local Student Diagnosed

Posted: 9:31 PM Jan 13, 2009
Last Updated: 9:31 PM Jan 13, 2009
Reporter: Dara Rees
Email Address: dara.rees@wymtnews.com

School officials say doctors have finally diagnosed an East Bernstadt student’s illness. The school’s principal says the seventh grader from Laurel County has “Type A Strep with Toxic Shock Syndrome”.

School custodians started taking extra cleaning precautions last week when the student first became sick. School officials say they are cleaning every day and even between classes to make sure the school is safe for students.

School nurse Ronda Bundy says, “The doctor said there were no additional precautions to be taken, to proceed as you normally would.”

The custodial staff at East Bernstadt say they have cleaned every surface they think a student could come in contact with, using commercial grade cleaners.

“The desks have been bleached, we mopped with a lot of extra bleach, we went through lockers, we did the carpet areas, we did an extra cleaning on the carpet areas, water fountains, doorknobs. Inside, outside doorknobs!” says custodian Rosemary Callahan.

Classmates created cards for the boy and his brother who also attends the school. Some students then asked teachers if they could join together to pray for the family.

“The kids have mostly been in school with the student for a number of years and they just want to voice their concerns. And since they can’t go to the hospital and bombard the hospital, we’ll just get together and offer prayer and thoughts on his behalf,” says Principal Jim Meding.

He says there are no other students in the school with the same symptoms.

Principal Meding says the seventh grader is still in serious condition, but he believes after weeks in the hospital, the student will recover.

Just a reminder – a sore throat should be cultured by a physician early.

“An ounce of prevention is worth a pound of cure”.

Protecting the Public’s Health from Disease, Disasters, and Bioterrorism

December 2008

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released the sixth annual Ready or Not? Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report, which finds that progress made to better protect the country from disease outbreaks, natural disasters, and bioterrorism is now at risk, due to budget cuts and the economic crisis. In addition, the report concludes that major gaps remain in many critical areas of preparedness, including surge capacity, rapid disease detection, and food safety.

The report contains state-by-state health preparedness scores based on 10 key indicators to assess health emergency preparedness capabilities. More than half of states and D.C. achieved a score of seven or less out of 10 key indicators. Louisiana, New Hampshire, North Carolina, Virginia, and Wisconsin scored the highest with 10 out of 10. Arizona, Connecticut, Florida, Maryland, Montana, and Nebraska tied for the lowest score with five out of 10.

<snip>

click this link for the rest of the story..

New Report: Massachusetts Earns Grade of 6 out of 10 on Disaster Preparedness

Economic Crisis Hurting U.S. Preparedness for Health Emergencies; More Than Half of States Score 7 or Lower out of 10 in Readiness Rankings

Washington, D.C., December 9, 2008 – Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) today released the sixth annual Ready or Not? Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report, which finds that progress made to better protect the country from disease outbreaks, natural disasters, and bioterrorism is now at risk, due to budget cuts and the economic crisis. In addition, the report concludes that major gaps remain in many critical areas of preparedness, including surge capacity, rapid disease detection, and food safety.

Massachusetts achieved 6 out of 10 possible indicators for health emergency preparedness capabilities. More than half of states and D.C. achieved a score of seven or less out of 10 key indicators. Louisiana, New Hampshire, North Carolina, Virginia, and Wisconsin scored highest with 10 out of 10. Arizona, Connecticut, Florida, Maryland, Montana, and Nebraska tied for the lowest score with five out of 10.

Over the past six years, the Ready or Not? report has documented steady progress toward improved public health preparedness. This year however, TFAH found that federal funding for state and local preparedness has been cut 25 percent since 2005, and that these cut backs coupled with the cuts states are making to their budgets in response to the economic crisis, put that progress at risk. In the coming year, according to the Center on Budget and Policy Priorities, 33 states are facing shortfalls in the 2009 budgets and 16 states are already projecting shortfalls to their 2010 budgets.

<snip>

The rest of the MA story is here.

Score Summary:

For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials. More information on each indicator is available in the full report on TFAH’s Web site at www.healthyamericans.org and RWJF’s Web site at www.rwjf.org. The report was supported by a grant from RWJF.

10 out of 10: Louisiana, New Hampshire, North Carolina, Virginia, Wisconsin
9 out of 10: Alabama, Arkansas, Indiana, Michigan, Pennsylvania, South Carolina, Tennessee, Vermont
8 out of 10: Delaware, Georgia, Hawaii, Iowa, Minnesota, North Dakota, Ohio, South Dakota, Washington
7 out of 10: California, Colorado, D.C., Illinois, Kentucky, Missouri, New Jersey, New Mexico, New York, Oklahoma, Oregon, Rhode Island, Utah, West Virginia, Wyoming
6 out of 10: Alaska, Idaho, Kansas, Maine, Massachusetts, Mississippi, Nevada, Texas
5 out of 10: Arizona, Connecticut, Florida, Maryland, Nebraska, Montana

*Note: Arkansas’s score has been revised. The state provided information confirming they have a Medical Reserve Corps Coordinator after the original release of the report.

Check it out: http://www.cdc.gov/vaccines/

In the Spotlight

• Recommended Adult Immunization Schedule now available (Jan 8)
• January is Cervical Cancer Awareness Month–Help protect yourself and your loved ones by learning more (Jan 7)
• Register now for NetConference on January 29: Antiviral resistance among influenza A(H1N1) viruses and interim guidance for antivirals (Jan 6)
• MMWR: Recommended Immunization Schedules for Persons Aged 0-18 Years now available (Jan 1)
• New status of M-M-R vaccines and updated status on supply of hepatitis A vaccine (Dec 16)
• ACIP Provisional Recommendations for Use of Pneumococcal Vaccines (Dec 8)
• View all …

Check it out, a wonderful website full of information!!

I have known too few true peacemakers in my life. Why is this such a rare find when we all value peace so highly? It is true that in order to be peacemakers we must first turn away from all evil. Is this what makes true peace such a rare prize?

We enjoy our evil ways, we have since the garden.

We are unable to reject what we cannot see for something we cannot obtain apart from a cleansed heart that is given to us by the power of the Holy Spirit when we first believe the truth about the man Jesus Christ who is the Son of God. I know of no other way to be a peacemaker.

Those who have found this truth are unable to truly tell another who has not. This marvelous gift of love given to us by God, in order to be understood, the seeker must find it on his own. Words cannot describe the fullness here.

And this is a frustration for those who love, who deeply love others with the type of love that caused Jesus Christ to die on the cross as our Redeemer. As imperfect humans, perhaps we are incapable of such love. In loving for this capacity, praying for it, I do believe that we are given a taste. A taste of what is ahead for us.

Those who seek true lasting peace must come to that place of trust alone. The seeker must step off the cliff alone — and that is truly what it is like before that step, we fear that we are stepping off a cliff into the great unknown. Like Nicodemus, we ask how will we be changed once we are born again. We fear the upheaval such a change will bring to our lives — this is pride, soft pride.

We do not want this change.

We do not want to give up control.

But just like we are born alone, we die alone, we must come to that place of faith alone. And it truly is that evil veil over our eyes that lures us away from the decision and no decision is a choice away from peace and this choice to flee keeps us listening to the siren song that pulls us back from walking off that cliff into faith.

This fear must be rejected because it is what keeps us from finding true peace in our soul – the peace that can be shared with others. The spark of something so desirable but also so intangible. When we step out and off, we do not fall from the cliff, we walk across the bridge that is the cross of Jesus Christ, we walk to the other side — we walk into new life, we become born anew.

The barrier to peace is the human ego, and our pride can be such an evil thing. That beautiful angel Lucifer, the most handsome and desirous of all that was created in heaven illustrates for us how seductive evil truly can be. That desire to be right, to be seen as a step above one’s peers, to be praised, to be admired as a thing of beauty, a thinker, an intelligent academic, someone to be sought after, to be desired. We want the wrong kind of love, the love from our fellow man is valued above the love from God.

We want somehow to be more than God, we want to be like a god at least in our own lives or our own sphere of influence. It was this that caused Lucifer’s fall from grace. And it is the subtle siren song sung to us even today.

So many ships have crashed upon the rocks following the lure of that deadly song. How hard an illusion this must be to maintain—to constantly think so highly of oneself. What pressure, the antithesis to peace. The slightest mistake brings on a rush of fear that the illusion will be shattered.

This self delusion that is steeped heavily in our own fears of losing control, this is why I hate that false praise, I shun it because it wears my soul down. It steals all peace and robs me of my joy. Such an oddity I become when I deflect praise. I have heard my own words over the years and I know my friends have not understood my ways. This is my attempt to once and for all explain what has been on my heart.

How can we have peace with one another if we think more highly of ourselves than we do of each other? This is a barrier to true peacemaking. It is a desire for power over others that is the peace breaker. We see this reflected in the headlines of today and over the years. We see this in some of our politicians whose grandiosity would be laughable if it weren’t so sad, and so dangerous. There is that desire to control again, to be lauded. And this control, hopefully once it is recognized for what it is the allure will be gone, for it can be rejected.

After years of my own searching for truth I found only one true path…and it is narrow. It is this love story that I have spent years trying to tell my friends about.

What do we become if we do not recognize that a loving God has given us His Son as a sacrifice for the sin that we must reject? We become nothing. We remain empty shells at our very core. The hole in our heart remains. The one that is God shaped, God designed and can only be filled by God if we truly desire peace.

Yes, at the end of it all we become nothing if this void remains.

As for peace in this life, as I said above, my search has led me to realize years ago that it is impossible to have peace apart from a relationship with the true peace giver. This is the perfection of God. He knows us so well. He gives us a deep desire for peace and only one true way to obtain it, how brilliant.

When we finally see that perfect man, the Messiah who has come, we see how perfectly small we are. Our ego is not shattered, it is made whole. We are dead to our old self and born anew. All that we are, all that we have, all that we must become is found in Christ Jesus. He is the only true righteous One. He is the only bringer of lasting peace. And this truth applies to every person anywhere on this earth. Jesus died for us singly and corporately whether we embrace this truth or not. He did the work. We have only to recognize and believe this truth. God loves us all equally – that is peace.

In my belief I am not a barrier to peace. I say to reject all that is evil and that list is quite long. I am so busy spending my time attempting to remove the mote from my own eye that removing the splinter from yours is not high on my list unless that splinter is so grievous that it preys upon the innocent. And yes, there are innocents among us. There are some glaringly evil things that we do as human beings that must be rejected through a social conscience. And some may very well be on my list, although I believe that I have long ago rejected the worst of them and repented. But I do not forget their lure and I grieve for those still caught up in what is pulling at them. I am not above the human condition to sin, I recognize it in myself, and in others as the joy stealer that will always be with us to some extent at least this side of heaven.

When we fail to discuss evil, when we turn a blind eye to it civilizations fall. When a society cannot define that which is evil we have consciously decided to allow it free reign. Do not believe the lie that we must not judge that which is evil. There is evil and people are capable of doing evil.

It is Jesus Christ the Messiah who is the bringer of peace to all who believe. So I speak of His peace, and for that I am hated because there is a created one who despises and works against this true peace. That one is the liar, the soothsayer, the one who mocks this truth — he is the god of this world and an enemy of the One True God.

So is this truth, and the telling of this truth, peacemaking? I think that it is and it is with love and courage that I speak what is in my heart for all to see and all to accept or reject.

This truth is a sword that divides and it rends the heart of those who are not willing to give up their pride in order to see it. It seems so much like hatred but it is a gift of life and love. It is a truth that we recognize having crossed that barrier from death to life and a truth that we cannot communicate fully to others. It must be experienced in order to be grasped by the seeker of true peace — by recognizing fully the Messiah who has come, Jesus Christ, the Son of God.

But do not take my word for this. These are the words of peace…..

"That all of them may be one, Father, just as you are in me and I am in you. May they also be in us so that the world may believe that you have sent me. I have given them the glory that you gave me, that they may be one as we are one: I in them and you in me. May they be brought to complete unity to let the world know that you sent me and have loved them even as you have loved me." ~John 17:21-23

"Blessed are the peacemakers, for they will be called sons of God." ~Matthew 5:9

"Peacemakers who sow in peace raise a harvest of righteousness." ~James 3:18

"He must turn from evil and do good; he must seek peace and pursue it. For the eyes of the Lord are on the righteous and his ears are attentive to their prayer, but the face of the Lord is against those who do evil." ~1 Peter 3:11-12

"Let us therefore make every effort to do what leads to peace and to mutual edification." ~Romans 4:19

"Do not repay anyone evil for evil. Be careful to do what is right in the eyes of everybody. If it is possible, as far as it depends on you, live at peace with everyone." ~Romans 12:17-18

"Make every effort to live in peace with all men and to be holy; without holiness no one will see the Lord. See to it that no one misses the grace of God and that no bitter root grows up to cause trouble and defile many." ~Hebrews 12:14-15

Once this truth is discovered, there is no turning back, there is no desire to turn back. How wondrous a thing it is to know that when you have truly forgiven all and have been forgiven all – past, present and future.

What joy!

What peace!

"Nothing is so cruel as the tenderness that consigns another to his sin. Nothing can be more compassionate than the severe rebuke that calls a brother back from the path of sin." ~Dietrich Bonhoeffer, Life Together

With Much Love,
Catherine "Jackie" Mitchell

An awesome site for an equally awesome bunch of people. This will be a short post but I wanted to make sure that this group and groups like them get the attention that they deserve.

The site is called The Kitchen Table and it is focused on the firefighting community at large.

Welcome to The Kitchen Table

The Kitchen Table blog is a place for the growing online firefighting community to get the daily buzz. As the firehouse kitchen table is where firefighters in a station gather, The Kitchen Table blog brings firefighters together for a global conversation.

and today’s post was about H5N1 which is how I discovered the site.

This is ONE AWESOME WEBSITE!

Kudos!

Sometimes issues just seem to pick us. I never really set out to learn all there is to know about influenza, bioterrorism, infectious diseases (and I certainly have not even come close to achieving that end)….this life path just opened up somehow and I find myself trudging along trying to avoid the potholes and major obstacles that crop up from time to time.

My friend Debi @ A Pandemic Chronicle pointed us to an article written by Peter Sandman, another highly respected gentleman whose writing I have been fascinated by over recent years. He is a personable gentleman who is down to earth and he really knows risk communication.

I read what my fellow bloggers had to say today, even the Reveres weighed in, and DemFromCt @ Daily Kos had a wonderful article, Helen Branswell, Mike at Avian Flu Diary, (as I referenced in my previous post) and I am sure, though I haven’t checked yet, Crawford Kilian has had some wonderful insight.

I had to push back from my pc and take a breath.

There is a profound dialogue going on here.

An equally profound message is working its way through the many posts on the subject by all of us. None of us are claiming any expertise, not that I am aware of. I think that for the most part what we are trying to convey here is a message of deep caring and concern for our fellow man and we are all healers of a sort trying to prevent tragedy. So maybe I shouldn’t be putting words in my fellow flu blogger’s mouths. They do an excellent job on their own. But this is the impression that I have of all of them. A deep caring and commitment to their readers. And the fact is, we may not always get our messaging right but when you read between the many lines of flowing dialogue a caring heart of shows through.

Not one person, and I know most of these folks personally as friends, wants to “get it wrong” not one wants to add to anyone’s burden or stress. Not one would want to harm a single hair on anyone’s head and all of them are doing their utmost to educate and inform because each and every one of us know that this imparted information can be a benefit to you, the reader.

On my end, and for my contribution, I have to work very hard at understanding these technical studies so that I can attempt to convey what I think they are saying in order that I can translate that into some sort of workable action on our parts. I may not be so good at this. But what I try to do, what “voice” I try to have, is the one where I am explaining what I am reading to my better half, my husband, and my family and how if we do *A* we many not feel the effects of *B*.

This has been an ongoing effort by a great many people in greater “flublogia”, as we like to call ourselves, and we reside all over the globe. We have come together in order to think through some of these issues that will eventually effect us all.

So if I get any part of this wrong, if I misspeak, or misunderstand, and then misadvise, please know that I have done so with no ill will and certainly no intent to hurt a single person.

When it comes to advice, I really have no sure way, no certain path to see our way through a pandemic let alone a flu season. All I can do is point to the issues and who is speaking about them. I can tell you what advice I am taking and why and this by no means should be taken as my advice to you or an admonishment to you for not doing what I have chosen.

There is value in awareness and education. But I learn from each of you as much as you hopefully learn from me.

Onward, Upward and thanks for reading,

Catherine

Or as my friends know me as “Jackie”

According to the CDC website the formulations for the 2008-2009 flu seasons for both the injectable and intranasal flu vaccine  2008-09 include protection against

• A/Brisbane/59/2007 (H1N1),
• A/Brisbane/10/2007 (H3N2), and
• B/Florida/4/2006 strains.

If you had influenza B Malaysia last year and a flu shot this year kudos to you, you may have the antibodies to resist this years circulating strain. Oddly enough, B/Malaysia/2506/2004-like virus was the 2007-2008 component.

A little bit about Influenza B viruses…Influenza B has a limited host range only infecting humans and seals. Influenza A viruses have a much greater host range. More about influenza B infection toward the end of this post.

Influenza B viruses also mutate by genetic drift and reassortment at a much slower rate (2 to 3 times slower) than A viruses. This is important because when they get the vaccine right, it will typically stay right for the entire flu season. Influenza A viruses are highly mutable so at the tail end of any flu season we are at more risk even though immunized.

What my response is: Non pharmaceutical interventions must also remain in the forefront of all of our efforts. And forced vaccinations of children or anyone else is not a guarantee of safety. It is an overreaction. Education and awareness are the best weapons in our arsenal.

So what is being discussed….

According to the website FluWatch Canada this is what is currently circulating in Canada:

December 28, 2008 to January 3, 2009  (Week 53)

Overall influenza activity in Canada remains low; an influenza outbreak in a hospital was reported in Ontario

During week 53, influenza activity in Canada remained low overall with the majority of the influenza surveillance regions still reporting no activity.

Sixteen regions (in BC, AB, ON & QC) reported sporadic influenza activity and localized activity was reported in 2 regions (central region in AB and in Toronto, ON) (see map).

Note that no data for 2 regions in SK were received this week. Eighty-seven specimens tested positive for influenza in Canada this week (percentage positive = 3.3%; 87/2,633) (see table).

The majority of influenza virus detections to date this season were influenza A viruses (54% or 165/304); however influenza B detections have slowly increased over the last several weeks.

In week 53, the ILI consultation rate increased to 23 ILI consultations per 1,000 patient visits (see ILI graph), however it remains below the expected range for this week. The sentinel response rate was low at 37%. An outbreak of influenza in a hospital in ON was reported in week 53.

Other Respiratory Viruses: RSV detections for Canada as a whole continue to increase while detections for adenoviruses and parainfluenza viruses remain at fairly low levels (see graph).

Antigenic Characterization:
Since 1 September 2008, the NML has antigenically characterized 33 influenza viruses:

10 influenza A/Brisbane/59/2007(H1N1)-like (from BC, AB, ON & NS),

1 influenza A/Brisbane/10/2007(H3N2)-like (from BC),

3 influenza B/Florida/4/2006-like (from ON and AB) and

19 B/Malaysia/2506/2004-like (from ON and AB).

A/Brisbane/59/2007(H1N1), A/Brisbane/10/2007(H3N2) and /Florida/4/2006 are the influenza A and influenza B components recommended for the 2008-09 influenza vaccine.

****B/Malaysia/2506/2004 was the influenza B component for the 2007-2008 season vaccine

Regarding Antiviral Resistance, this was noted in Canada…

Antiviral Resistance:

Results from the NML: (my note: National Microbiology Lab of Canada)

Since the start of the season, the NML has tested 11 influenza A isolates (6 H1N1 and 5 H3N2) for amantadine resistance. All of the H1N1 isolates were susceptible; however all of the H3N2 isolates were resistant to amantadine (resistance = 100% or 5/5). The resistant isolates were from ON, AB and BC.

The NML has also tested 24 influenza isolates (5 A/H1N1, 2 A/H3N2 & 17 B) for oseltamivir (Tamiflu) resistance. All of the A/H3N2 and B isolates were sensitive; however all of the A/H1N1 isolates were resistant to oseltamivir due to the H274Y mutation (resistance = 100% or 5/5). The resistant isolates were from NS, ON and BC.

All 22 influenza isolates (3 A/H1N1, 2 A/H3N2 & 17 B) tested for zanamivir resistance to date were sensitive to zanamivir.

Oseltamivir resistance findings from Provincial laboratories:

To date this season, 24 influenza isolates in BC have been sub-typed as A/H1 and were assessed genotypically for oseltamivir resistance using an SNP assay. Eighteen isolates tested positive for the H274Y mutation (resistance = 100% or 18/18), with the other 6 specimens still pending confirmatory testing.

Influenza-associated Paediatric Hospitalizations:
No laboratory-confirmed influenza-associated paediatric hospitalizations have been reported through the Immunization Monitoring Program Active (IMPACT) network for the 2008-09 season.

It is interesting to note that last flu season there was a mismatch to the circulating B strains. According to CIDRAP last year, “93% of the circulating influenza B viruses analyzed so far belong to the Yamagata lineage, which doesn’t match the influenza B component of this year’s vaccine. The B component is a B/Malaysia/2506/2004-like virus, which belongs to the Victoria lineage.”

More on Seasonal Flu Activity around the world…

from the WHO

Seasonal influenza activity in the world, weeks 51-52 (as of 7 January 2008)

During the weeks 51-52, the overall level of influenza activity in the world began to increase in some countries in Europe. Ireland, Portugal and the United Kingdom of Great Britain and Northern Ireland reported widespread activity with influenza-like illness (ILI) above threshold levels. France also reported increased activity while regional activity was reported in the Netherlands, Spain and local activity in Italy. Activity in many other countries remained low. The majority of viruses identified this season have been influenza A (H3N2).

Ireland: Widespread influenza A activity has been reported.

Italy: Three influenza A H3N2 influenza isolates were reported during week 52.

Netherlands: In week 52 a substantial proportion of specimens from sentinel ILI patients contained influenza virus. To date all influenza viruses detected in specimens from sentinel ILI patients were A(H3N2).

Portugal: Widespread influenza A (H3N2) activity was reported.

Spain: Regional activity was reported. Influenza A (H3N2) viruses were detected.

United Kingdom of Great Britain and Northern Ireland: Influenza activity continued to be widespread across the country with GP consultation rates above the threshold levels in England and Scotland in week 52. The majority of the specimens have been positive for influenza A (H3N2), with low numbers of H1N1 and B detected.

Sporadic influenza activity was observed in Belgium (A), Cameroon (A, B), Canada (A,B), China (H1, H3, B), China Hong Kong Special Administrative Region (H1,H3,B), Finland (A,B), Germany (H1,H3, B), Greece (A) , Iran (H3), Israel (A;B), Japan (H1,H3, B), Latvia (A) , Luxembourg (A), Morocco (H1,B), Netherlands (H3), Norway (H1,H3,B), Russian Federation (H1,H3,B), Slovenia (H1,H3), Switzerland (H3), Tunisia (H1,B) and the United States of America (H1,H3,B).

Croatia, Czech Republic, Estonia, Greece, Lithuania, Malta, Poland, Romania and Serbia reported no influenza activity.

What is the difference to us between Influenza A infection, Influenza B infection and even Influenza C infection?

Influenza A can infect a wide range of hosts. Pigs, horses, cats, ferrets, wild birds, humans. This highly mutable virus is divided into subtypes and is named according to the two proteins on the surface of the virus – Hemagglutinin (HA) and Neuraminidase (NA). So when someone says H5N1 or H3N2 or H1N1 they are describing with specificity the two proteins that are in the Influenza A strain. There are 16 known HA subtypes and 9 known NA subtypes, not all infect humans. And currently only H1N1, H3N2 and H1N2 are circulating in humans. Rarely some of these subtypes cross the species barrier. H3N8, an influenza A virus that typically infects horses has recently infected dogs.

H5N1 is the subtype that scientists have their eyes on because it is crossing the species barrier from birds to humans, with other species also being infected from time to time. Only influenza A viruses infect birds. Some are low pathogenic and some are highly pathogenic. Of the H5 influenza A viruses there are nine subtypes. There are also nine know subtypes of the H7 influenza A virus. H7 infection in humans is a rare event. It is also broken down into high path. and low path subtypes. And then there is the H9 subtype which also has nine subtypes. This virus is only found in a low pathogenic form.

Pathogenesis:

Highly pathogenic or low pathogenic
Pathogenic means the ability to cause disease. A flu virus can be highly pathogenic or it can have low pathogenicity. A highly pathogenic flu virus can cause severe illness and death. A low pathogenic flu virus is much less likely to cause severe disease.

Typically H1, H2 and H3 subtypes are what have caused illness in humans. When each subtype first emerged it caused a human pandemic because people did not have antibodies to fight off the newly emerged subtype. This is what we are watching for with the H5 subtype. It is increasingly infecting more humans demonstrating that it is adapting to the human host.

An infection with an influenza A virus is pretty well known as to what we experience. It’s hallmark is high fever, cough, muscle aches, and frequently we develop secondary infections like pneumonia.

~~~~~~~~~~~~~

Influenza B viruses as I mentioned above are found in humans and seals. Influenza B viruses are not classified by subtype. They typically cause less severe epidemics than Influenza A and they do not cause pandemics.

Infection with a B virus usually causes less severe symptoms but it is still nothing to take lightly. Influenza B does have the potential to cause more severe disease in older persons and the very young.

Influenza C virus causes mild respiratory illness and is not thought to cause epidemics.

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So what is circulating in the US right now?

2008-2009 Influenza Season Week 53 ending January 3, 2009

Antigenic Characterization:

CDC has antigenically characterized 110 influenza viruses [68 influenza A (H1), 13 influenza A (H3) and 29 influenza B viruses] collected by U.S. laboratories since October 1, 2008.

All 68 influenza A (H1) viruses are related to the influenza A (H1N1) component of the 2008-09 influenza vaccine (A/Brisbane/59/2007). All 13 influenza A (H3N2) viruses are related to the A (H3N2) vaccine component (A/Brisbane/10/2007).

Influenza B viruses currently circulating can be divided into two distinct lineages represented by the B/Yamagata/16/88 and B/Victoria/02/87 viruses. Nine influenza B viruses tested belong to the B/Yamagata lineage and are related to the vaccine strain (B/Florida/04/2006). The remaining 20 viruses belong to the B/Victoria lineage and are not related to the vaccine strain. Seventeen of the 20 viruses belonging to the B/Victoria lineage were from two states.

Data on antigenic characterization should be interpreted with caution given that:

1. Few U.S. isolates are available for testing because of limited influenza activity thus far.
2. The majority of viruses antigenically characterized to date come from only three states and may not be nationally representative.
3. Antigenic characterization data is based on hemagglutination inhibition (HI) testing using a panel of reference ferret antisera and results may not correlate with clinical protection against circulating viruses provided by influenza vaccination.

Annual influenza vaccination is expected to provide the best protection against those virus strains that are related to the vaccine strains, but limited to no protection may be expected when the vaccine and circulating virus strains are so different as to be from different lineages, as is seen with the two lineages of influenza B viruses.

In other words….A flu shot for the 2008-2009 Flu Season is still a very good idea. And in the case of H5N1 causing a pandemic during this flu season (along with seasonal flu) the N1 component of the flu shot may offer us a little bit of benefit against the N1 part of H5N1. I will take any advantage I can get. We can do the best we can to avoid getting the flu by becoming aware of what it is that is circulating throughout the entire flu season, knowing what strains we have been vaccinated against (if that was our decision) and to keep our hands away from our mucous membranes. There is so much that we don’t know about the world of virology and infectious disease control, but there are some things that we do know. Let’s make the best use of what we do know in order to keep as many people safe and healthy as possible.

Resources:

Respiratory Virus Detections/Isolations in Canada – Quite a document!

DemFromCt is currently writing a three part series about the complicated nature of what we are dealing with. Dem is a good friend (for a Democrat :-) ). He is an excellent writer and can really explain much better than I can the ins and outs of all of this. His series is called “Flu and You” part 1 is here.

Mike at Avian Flu Diary has great information and he quotes medical writer extraordinaire Helen Branswell.

Google has realized that what people are searching for on the internet may be an early indication of what people are experiencing in any given area. Knowing this information may give us the first clue that a pandemic has begun. Certainly information from Google is not the only criteria, many other indicators are in place already. A sudden surge in purchases of over the counter medication in an area, a surge in emergency room visits, etc, these are all variables, things that experts are monitoring in order that we may all know when the best time is to hunker down. But how will that information reach the rest of the population if no one is really paying attention? And will this information be divulged to a largely unprepared population? Certainly, if we are not ready to receive the information it may not. Panic is something that no one wants to trigger. All the more reason for those of us in the general public to be prepared to receive this information.

For better of for worse we live in the information age. It is time that we put that information to use. It is time to make all the tools that are at our disposal work for us especially in regards to an infectious diseases outbreak or bioterrorism event. Information alone will not cause panic. What causes panic is information combined with unpreparedness. If we are ready to hear the news, while we may have some fear, we won’t become paralyzed in our fear.

Ah but it all seems so silly to prepare our homes for influenza to strike. I know this is what I think sometimes and I admit to thinking on occasion “why bother”. But it is this very inclination which will be our undoing. I have been getting a lot better at this preparedness thing. It took me admitting to myself that we are living in a dangerous world and I so much wanted our world to be the same as it has always been. And it no longer is. The balance of power IS shifting, there are groups of people who do want to wipe us off the map, and there are crazies out there who will commit suicide in order to kill as many people as they can. If these are not reasons enough for someone to prepare, then we add on top of this the threat of yet another influenza pandemic.

In order for me to not panic I had to ask tons of questions of the experts. I had to read report after report in order that I could understand so I would not panic. And I no longer feel as though I am on pins and needles waiting for something bad to happen. But I have grown up and grown into this new lifestyle….reluctantly. Now that I am here I try to encourage others to get “here” too. On hindsight, it wasn’t all that difficult. I just have never been that good at change.

A friend of mine is an expert in biosurveillance. You can read his blog here.

What the big question is….

Do you want to be given a head’s up if something major comes our way if that head’s up will increase your chances of survival?

I am working under the assumption that  “YES” anyone would want a head’s up and I am working my fingers to the bone in order to assure that head’s up for my readers. There are a few of us out here actively engaged in solving this problem.

So please prepare so that when the heads up comes you can hunker down and not go out there to start to prepare.

You can vote in my poll at polldaddy http://poll.fm/r4y3/

It has everything to do with us here in the US. It has everything to do with me sitting here at my computer in Monson MA. It has everything to do with you, the reader of this blog.

When we can close our eyes to the suffering of millions we have lost something. When we can hear the reports of heartache, death from disease, hardship, and not translate that into faces and individuals and their plight and wonder what God would have us do with the awareness, we have shut off a vital part of our humanity – empathy.

Most of us will never experience the suffering of Hemorrhagic Ebola, malaria, dengue, Chikungunya, Leishmaniasis, and so many of the more “tropical” diseases but billions of people on this earth do, and suffer….oh how they suffer.

We sit and wring our hands over a pandemic which will affect us (and everyone across this globe as well) but we turn a blind eye to that which is unlikely to come to our shores or find its way into our homes. AIDS sufferers the world over know this. They are the modern lepers. And what did Jesus Christ do? He walked among them, healing them, comforting them.

Is it the overwhelming need the world over that causes us to do nothing? Is it that fact that we will never eliminate these scourges? Or that we will never be able to personally save a life? Is that the point of what Jesus did? What Jesus Christ did was show us through His example that we must never withdraw from the battle. He demonstrated to us that we must not withdraw from the world, we must not define people by what they are, what they have, who they represent, and what defines them. We are reaching hearts not personalities, not who people think they are, want to be, or even what they do – that is God’s to sort through, and He will.

Ebola is ravaging central Africa. Without human intervention we do not have to worry about these tropical diseases. But we must not shut off our caring about those who do.

H5N1 is becoming endemic all over the world and it is slowly adapting to the human respiratory tract —- which means it will be OUR next great struggle. No one will be spared, death will visit each and every one of us in one way or another. If not our own, some family member near or distant will be struck down.

Is it time to tell you the truth about how very serious pandemic influenza is? Certainly something must shake the cobwebs off. Certainly something must help you to realize that we (those who plan and prepare and sound the alert for others) are not talking about the “flu”. We are talking about something on a par with hemorrhagic Ebola, on a par with Hurricane Katrina striking every city and town in this country, in the world, AT THE SAME TIME. We are talking about an illness that turns faces blue black from lack of oxygen and there are not enough ventilators to go around, not enough hospital personnel to assist, not enough of anything to see us through this other than our own presence of mind, our own preparedness, our own moral courage to not devolve into panic stricken idiots who prey upon others — and there will be those too. And the maddening thing about this — we don’t know when that final adaptation will take place. All these co-infections, people with bird to human H5N1 and a regular seasonal influenza are more fuel for that fire.

So, if you can turn off Ebola in central Africa, and AIDS pandemic that has been ongoing for decades, ask yourself this question…..am I also not seeing a pandemic of influenza coming? Because if you are not actively preparing, if you are laughing it off, if you are thinking that it’s the next y2k, then you are sadly mistaken.

And West Nile is nothing to sneeze at either. Our world is changing and man’s intervention has had an impact. Overuse of antibiotics has fueled disease resistance, not utilizing the vaccines that we do have has allowed childhood illnesses that we once under control to reemerge even stronger. Now these *new* vaccines, well, there are ethical issues that MUST be considered. Who is paying attention?

And as for coping with all of this…..We do have tools, we do have options, no one is without hope.

If it were not for my relationship with Jesus Christ, my Lord and Savior, I would not be coping with this myself. He is my strength, my sound mind, my focus and my reason for living. HE is my HOPE and it is to Him that I cling.

I pray that this post reaches in and touches each and every reader in a mighty way. Our Savior lives.

The truth is that the numbers of flu cases may actually decrease because human behavior is actually changing. So yes, we do hype influenza. And yes, we do hype what we can do to *mitigate” the season.

A low amount of viral shedding in healthy adults typically occurs for 24–48 hours *before* the illness onset During the beginning of the symptomatic period we shed more virus, typically our infectious period peaks during the first 24–72 hours of illness and then this declines over several days

Highly immunocompromised persons may shed viruses for weeks to months. Children shed viruses earlier than adults much before illness begins and then for longer periods if time once symptoms begin For children viral shedding peaks during the first 1–3 days of illness, and they shed more virus than adults and they can spread influenza for 7–8 days after illness onset and up to 21 days at the extreme atypical end.

Once influenza has resolve no viral shedding occurs.

By heeding this information we can stop spreading illness to others. If you know that you have been exposed stay home or keep your distance from others.

• Wash your hands frequently with soap and water – friction is the best to kill the bugs. Sing Happy Birthday twice to know that you have washed long enough.
• Dispose of tissues properly
• If you are sick, stay home. During local outbreaks-partially close schools by encouraging those who can to stay home. These are our children. They are most important to us. Teachers, be ready to send work home for the children who can stay home. For those with parents that must work class sizes will be greatly reduced.
• Keep you hands away from your eyes, ears, nose, and mouth
• Sneeze into the crook of your arm, not your hands.

H1N1 is currently spreading throughout the US. It is antiviral resistant. Let’s be prepared to be as safe as we can. H3N2 may be just around the corner and it’s a very bad strain. And all this is very good practice in case H5N1 becomes pandemic, no one will have any resistance to that strain. Knowing how to stay safe, knowing how to use the weapons that we do have, will benefit us then. A pandemic is not the end of the world. There is hope and we are not unable to fight it with proper infection control procedures. Let’s save lives.

The Tower of Babel – The height of human arrogance. The height of disrespect toward God.

As it was in the days of Noah, so it will be at the coming of the Son of Man. For in the days before the flood, people were eating and drinking, marrying and giving in marriage, up to the day Noah entered the ark; and they knew nothing about what would happen until the flood came and took them all away. That is how it will be at the coming of the Son of Man. Two men will be in the field; one will be taken and the other left. Two women will be grinding with a hand mill; one will be taken and the other left. "Therefore keep watch, because you do not know on what day your Lord will come (Matthew 24:37-42).

Let’s look again. Pre-flood people were eating and drinking, marrying and giving in marriage….the were not aware of the evil that was overtaking them.

In Genesis 10 we learn of a post flood world. The sons of Noah have spread out across the globe. The very genealogies point to the time of the gentiles and the time of faith in Christ Jesus. (Genesis 10:8-14).

The rise of Nimrod, a violent man who forced submission, persecuted the innocent, and took everything for his own. His arrogant desire was to rule all of the world. Do you see this mystery at work in the world today? Do you see what I see?

So Nimrod built his tower, his tribute to the arrogance of man.

Josephus wrote of this time…

Now it was Nimrod who excited them to such an affront and contempt of God. He was the grandson of Ham, the son of Noah, a bold man, and of great strength of hand. He persuaded them not to ascribe it to God, as if it were through his means they were happy, but to believe that it was their own courage which procured that happiness.

He also gradually changed the government into tyranny, seeing no other way of turning men from the fear of God, but to bring them into a constant dependence on his power…

Now the multitude were very ready to follow the determination of Nimrod, and to esteem it a piece of cowardice to submit to God; and they built a tower, neither sparing any pains, nor being in any degree negligent about the work: and, by reason of the multitude of hands employed in it, it grew very high, sooner than any one could expect; but the thickness of it was so great, and it was so strongly built, that thereby its great height seemed, upon the view, to be less than it really was.

It was built of burnt brick, cemented together with mortar, made of bitumen, that it might not be liable to admit water.

 

When God saw that they acted so madly, he did not resolve to destroy them utterly, since they were not grown wiser by the destruction of the former sinners; but he caused a tumult among them, by producing in them diverse languages, and causing that, through the multitude of those languages, they should not be able to understand one another.

The place wherein they built the tower is now called Babylon, because of the confusion of that language which they readily understood before; for the Hebrews mean by the word Babel, confusion…

Is that not what we are attempting today? Yes, I think so. All that we do apart from God is the very bitumen, brick and mortar in this great tower that is being built. The quasi religious theories and humanistic approaches that are embraced by man but not centered in God’s will for man. It is God who we must obey, that is what is healthy and beneficial for us. And that we are straying ONCE AGAIN….

This is the great mystery that must be revealed.

So add AI to the machines, allow them to learn, put all of our intelligence into the public domain, all music, art, thought, and teach it to the machines that we have built and presto Babel is built. Or so we think….for surely it will not last.

No testament to the arrogance of man has ever withstood the ire of God (thankfully so).

The “days of Noah” ended with a confrontation between good and evil, God being good and idolatry being evil. So continue to build this idol, this testament to man’s inability to be like God. Truly our days are like the days of Noah and the days of his sons too.

Go, my people, enter your rooms and shut the doors behind you; hide yourselves for a little while until his wrath has passed by. See, Yahweh is coming out of his dwelling to punish the people of the earth for their sins. The earth will disclose the blood shed upon her; she will conceal her slain no longer. In that day, Yahweh will punish with his sword, his fierce, great and powerful sword, Leviathan the gliding serpent, Leviathan the coiling serpent; he will slay the monster of the sea. In that day– "Sing about a fruitful vineyard: I, Yahweh, watch over it; I water it continually. I guard it day and night so that no one may harm it (Isaiah 26:20-27:3).

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So to all who hear the cry of the overcomers…the hour may be next, a year or five, ten or twenty away but His hour will come.

"Therefore keep watch, because you do not know on what day your Lord will come. But understand this: If the owner of the house had known at what time of night the thief was coming, he would have kept watch and would not have let his house be broken into. So you also must be ready, because the Son of Man will come at an hour when you do not expect him. "Who then is the faithful and wise servant, whom the master has put in charge of the servants in his household to give them their food at the proper time? It will be good for that servant whose master finds him doing so when he returns. I tell you the truth, he will put him in charge of all his possessions (Matthew 24:42-47).

"At that time the kingdom of heaven will be like ten virgins who took their lamps and went out to meet the bridegroom. Five of them were foolish and five were wise. The foolish ones took their lamps but did not take any oil with them. The wise, however, took oil in jars along with their lamps. The bridegroom was a long time in coming, and they all became drowsy and fell asleep. "At midnight the cry rang out: ‘Here’s the bridegroom! Come out to meet him!’ "Then all the virgins woke up and trimmed their lamps. The foolish ones said to the wise, ‘Give us some of your oil; our lamps are going out. "’No,’ they replied, ‘there may not be enough for both us and you. Instead, go to those who sell oil and buy some for yourselves.’ "But while they were on their way to buy the oil, the bridegroom arrived. The virgins who were ready went in with him to the wedding banquet. And the door was shut. "Later the others also came. ‘Sir! Sir!’ they said. ‘Open the door for us!’ "But he replied, ‘I tell you the truth, I don’t know you.’ "Therefore keep watch, because you do not know the day or the hour (Matthew 25:1-13).

Those who do not have their oil…the door will be closed. The Lord will not know you, as He does not know you now. You fear, you mock, you hate, you think these words foolishness, you do not know Him. Are you buying into the lies of the postmodern “progressive” world who thinks that they can make concessions with “the world”. Those who mocked and hated Him when He was with us, that spirit, that arrogance is still alive in the world today….and they will hate us.

But we do not hate, but love in Truth, we have found and kept to the very narrow way?

"Be dressed ready for service and keep your lamps burning, like men waiting for their master to return from a wedding banquet, so that when he comes and knocks they can immediately open the door for him. It will be good for those servants whose master finds them watching when he comes. I tell you the truth, he will dress himself to serve, will have them recline at the table and will come and wait on them. It will be good for those servants whose master finds them ready, even if he comes in the second or third watch of the night. But understand this: If the owner of the house had known at what hour the thief was coming, he would not have let his house be broken into. You also must be ready, because the Son of Man will come at an hour when you do not expect him" (Luke 12:35-40).

That servant who knows his master’s will and does not get ready or does not do what his master wants will be beaten with many blows (Luke 12:47).

Are you watching?

Are you ready?

Are you afraid to be mocked and hated by many? Overcome that.

Be ready to enter your rooms and shut the doors behind you. When He comes you can immediately open the door for Him.

What a glorious privilege it has been to be able to point to the Master who will come.

Stand firm, stand fast, and prepare the way, for our Master is truly coming.

Prepare but prepare because we have hope!

Prepare because we have faith!

Prepare most of all because we have love!