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Ukraine reacting strongly to flu

47 replies

OhYouBadBadKitten · 30/10/2009 16:00

news link

Seems a very strong reaction to the pandemic to close schools for 3 weeks and limit travel. I wonder what the real reason is? flu related or not?

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Frrrightattendant · 31/10/2009 10:02

Oh Po. I understand what you mean. I think this Russian thing sounds like something else tbh. Plus their medical facilities are apparetly terrible so you wouldn't stand a chance really over there whilst if it was here it would prob be Okish.

pofacedandproud · 31/10/2009 10:04

Hope your ds is better today FA.

Frrrightattendant · 31/10/2009 10:06

Thanks...one is moaning a LOT but the other is surprisingly alright. I am sure we'll have another restless night with the nurofen poised though

pofacedandproud · 31/10/2009 10:12

We've had a few of those lately. Fantasising about leaving the country.

Frrrightattendant · 31/10/2009 10:15

Seriously, I was invited on a sailing trip to Venezuela yesterday, if I could bring the kids I'd do it.

My landlord lives abroad most of the year and I think he is very healthy because of it. Vitamin D and all that. Do you take it? I think I might get some when we are able to go out....I was dreading this winter and I was right!

pofacedandproud · 31/10/2009 17:53

You said no? Children are so inconvenient sometimes
I take cod liver oil. No idea if it works...

Musukebba · 01/11/2009 21:20

Please all remember the initial reports for death rate in Mexico turned out not to be anything like as severe when properly investigated. Don't be too swayed by unsubstantiated news reports until someone objective like WHO gives an opinion...

OhYouBadBadKitten · 01/11/2009 21:30

That is true. Will be interesting to see what WHO say, they are sending a team in according to news reports. I still think it is probably a political thing, but it is interesting.

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OhYouBadBadKitten · 01/11/2009 21:32

(and here I can discuss it, I'm not sure my real life friends find it interesting tbh, they are tolerant people!)

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OhYouBadBadKitten · 24/11/2009 16:19

bumping to help Musukebba find it again...

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sarah293 · 24/11/2009 16:22

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ZZZenAgain · 24/11/2009 16:29

good grief - that link about the mysterious flu in the Ukraine is scary.

very scary

OhYouBadBadKitten · 24/11/2009 17:17

Remember this link was some time ago and I think understanding of what is going on has moved on somewhat. Musu has some info that she said she would post. (wondering if it is about D225G)

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Musukebba · 24/11/2009 17:21

Thanks OYBBK: I will try and find the links later, but for now I hope you can trust a quick summary...

Although a disproportionately large number of deaths have been reported from the Ukraine, further investigation by the WHO and NIMR in the UK has determined that the virus circulating there is essentially not significantly different from strains found in other countries at various times over the last few months. In other words; thankfully there is nothing new.

The apparent higher death rate is thought to be due in part to the limited health-care facilities, and also that the average time that fatal cases took to seek medical help is between 5-6 days. So there will be people that have recovered from swine flu but not feature as mild cases in the calculation of the death rate; which then becomes disproportionately high. It is a familiar problem with early epidemiology, when you can't be sure exactly how many people have been infected, and seems a similar scenario to that in Mexico and other regions where swine flu first took off.

Sequencing analysis - performed at NIMR - of virus from several Ukraine fatal cases has shown the presence of a mutation D225G (an amino acid substitution for D (aspartic acid) to G (glycine) at position 225)), which is strongly suggested to provide a better replication in the lungs than the upper respiratory tract. However, this mutation has also been found in several other countries, including Mexico and the US many months ago, and does not seem to be enough of an evolutionary advantage for it to persist. In fact, the selection of the mutation may only occur in individual patients, and because the replication is going on deep in the lungs, is less likely to spread to others from the upper respiratory tract.

OhYouBadBadKitten · 24/11/2009 17:28

Thanks, thats a good summary of what I've read. I also figured that if there really was an evolving problem in the Ukraine, we would probably see it spread pretty quickly.

I saw that the Norwegians have had a cluster of cases with the D225G mutation recently too. I guess it may explain why, when in the large majority of people it is a mild infection, in some it is a fatal one? One to keep an interested eye on.

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OhYouBadBadKitten · 24/11/2009 17:35

One thought though, do you think that the increase in hospitalised cases in England (particularly looking at it as a percentage of those infected atm) is linked to this change, or could it be that this is the time of year for other infections to coexist, especially as it seems to be the 'under 5s' being disproportionately hit?
or do we not know why yet?

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LeninGrad · 24/11/2009 17:46

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OhYouBadBadKitten · 24/11/2009 17:55

Hopefully, it will help somewhat. The adjuvant is though to help the vaccine protect against drifted strains. Hopefully Musu will be able to explain more.

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LeninGrad · 24/11/2009 17:58

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Musukebba · 24/11/2009 17:58

Hi OYBBK: we know that this occurs over winter with seasonal flu so it seems reasonable to suppose that environmental factors also potentiate the clinical effects of swine flu. We have no suggestion here that co-infections are responsible for more severe disease - since in the lab we are also looking for all other likely viruses RSV, paraflu, etc - but there are people getting one thing after another.

The 225G mutation may also be selected for in critically ill patients in the UK, but I don't know yet from here. Probably we will see some deposition of UK sequences in GenBank soon.

Musukebba · 24/11/2009 18:10

LeninGrad: Pretty much what OYBBK said.

Like any other influenza virus, swine flu mutates naturally so what you have is a swarm of viruses all slightly different from each other. This variability is due to the RNA polymerase which cannot accurately replicate the viral genome, and this process also occurs when the vaccine virus is being grown in eggs prior to being inactivated and turned into vaccine.

The adjuvant in Pandemrix boosts the immune response against all these natural variants, so that you do get some immunity to them. However the function of the vaccine is firstly to stop you being infected, or at least that a mild infection will occur. Vaccinating against a pathogenicity mutation like D225G is a bit controversial since it may well be that that mutation is not great anyway for replicating in the upper respiratory tract: that is, you are less likely to become infected by a 225G strain than a wild type 225D. The tissue tropism of the virus is often determined by the receptor, and the cells of the lungs are different to the nose and throat.

LeninGrad · 24/11/2009 19:14

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