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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Keeping up With the Swine Flu Pandemic

Published April 27, 2009 5:17 PM by Glen McDaniel

You cannot turn on the TV or log onto any popular website like AOL without being greeted by the latest update on the swine flu pandemic.

Over the weekend, I spoke with friends who were planning a vacation to Mexico next week and are now concerned about the wisdom of making that trip. Others are just scared to travel anywhere away from home now that there are several incidences of the swine flu (up to 40 as of  writing this blog) in the US.

Swine flu is caused by Influenza A (H1N1). Since swine flu can be definitively diagnosed only by a lab test, it makes sense that clinical laboratorians should be able to provide some basic information to friends, family, neighbors and so on.

Here's what the CDC's web site says about swine flu symptoms: "The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea."

The World Health Organization (WHO) today said there are "gaps in knowledge" about the new swine flu virus -- which actually contains a mix of swine, human, and bird (avian) flu viruses into a brand-new virus.

The WHO has asked all countries to be on the lookout for the new virus, but it's not yet ready to bump up the pandemic alert level from phase 3 to phase 4

Many credible news organizations have culled information from public health authorities and published pretty good Q and A lists for the general public.

 The latest credible information (including a case count) can always be found on the CDC Swine Flu website.

Other considerations: has you facility made any plans to deal with increased ED visits and the lab processing more specimens? Will you send every positive influenza specimen to the state public health lab for confirmation and genotyping? Has your lab developed or changed protocol to testing all Flu specimens under a hood? Is the lab involved in any preparedness plans your organization is making regarding swine flu?

The scenario is far from over and we can play our (vital and appropriate) role in educating the public and health care colleagues. I certainly do not advocate giving incomplete or incorrect information. So I urge you to keep up with the facts from the most credible sources and feel free to advise others within the comfort level of your competence.


Sanofi Pasteur a world leader in vaccine production has received H1N1 seed virus from the CDC with the goal of producing a vaccine.%0d%0a%0d%0a

Glen McDaniel May 29, 2009 12:08 PM
Atlanta GA

There seems to be some confusion about the so called swine flu virus including claims by some in the media that the name has been "changed to H1N1".  This is incorrect; it was always technically H1N1

The virus is not entirely of porcine origin. As stated in the original blog the virus in question is actually a subtype of Influenza A and is a mixture of swine, human and avian flu strains.

The "H" refers to the hemagglutinin molecule, which is a protein molecule on the surface of the virus that allows it to key into its target cell.

"N" refers to neuraminidase, which is another molecule, also on the surface of the virus. In this case, it allows the virus, once replicated, to key out of the cell that it’s been replicated  in.

There are 16 different types of hemagglutinins and 9 different types of neuraminidases. Viral srains vary because of rapid mutation causing different protein structures and arrangement.

Influenza viruses are assigned H and N numbers depending on the actual forms of those proteins present.

Incidentally, H1N1 is the same virus that caused the 1918 influenza pandemic, which killed 20 to 40 million people around the globe. This is, of course, a descendent virus.

The fact that the new "swine flu" has H1N1 molecules doesn't make it identical to the 1918 strain, however. As indicated, it has genes from swine flu, avian flu, and human flu.

A successful vaccine will have to target unique parts/sequences of its genetic structure.

Glen McDaniel April 30, 2009 6:32 PM

I just read an article saying that researchers in Hong Kong hope to release a new PCR test to diagnose swine flu within the next week. This new test will help diagnose patients within hours instead of days. Here's the article:

Amanda Koehler, , Assistant Editor ADVANCE April 28, 2009 10:20 AM
King of Prussia PA

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