ALLERGY, RESPIRATORY
Keep Asthma, Allergies at Bay for the Holidays
Asthmatics Who Quit Smoking May Reverse Lung Damage
Overweight Moms More Likely to Have Asthmatic Kids
ALTERNATIVE MEDICINE
Pain-Relieving Powers of Acupuncture Unclear
Could Chinese Herb Be a Natural Viagra?
Acupuncture Eases Breast Cancer Treatment Side Effects
ANIMAL CARE
Animals Respond to Acupuncture's Healing Touch
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Separation Anxiety, Canine-Style
BONES & JOINTS
Brazilian Mint Tea Naturally Good for Pain Relief
In Elderly Women, Hip Fractures Often Follow Arm Breaks
Rheumatoid Arthritis a Threat to the Heart
CANCER
Many Cancer Patients Turn to Complementary Medicine
Herb May Counter Liver Damage From Chemo
Vitamin D May Lower Colon Cancer Risk
CAREGIVING
ER Less Likely to Diagnose Stroke in Younger Folks
U.S. Mental Health Spending Rises, But Many Still Left Out
3 Steps Might Help Stop MRSA's Spread
CIRCULATORY SYSTEM
Obesity Linked to Heart Failure Risk
Secondhand Smoke Quickly Affects Blood Vessels
Health Tip: Are You Anemic?
COSMETIC
Gum Chewing May Cut Craving for Snacks
Study Evaluates Laser Therapies for Hair Removal
The Acne Drug Accutane More Than Doubles Depression Risk
DENTAL, ORAL
Gummy Bears Join Cavity Fight
Most Insured Adults Worry About Health Care Costs: Poll
Acid Drinks Blamed for Increase in Tooth Erosion
DIABETES
Lifestyle Factors Tied to Older Adults' Diabetes Risk
Doctors Urged to Screen Diabetics for Sleep Apnea
Exercise Protects Black Women From Type 2 Diabetes
DIET, NUTRITION
Soluble Fiber, But Not Bran, Soothes Irritable Bowel
Antioxidants Abound in Cereals, Popcorn, Whole-Grain Snacks
An Apple a Day May Help Keep Heart Disease Away
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Traffic Seems to Make Kids' Asthma Worse
Pesticides Linked to Parkinson's
Prenatal Exposure to Traffic Pollution May Lead to Asthma
EYE CARE, VISION
Clues Found to Brain Mechanism Behind Migraines
Half of U.S. Adults Lack 20/20 Vision
Retinal Gene Is Linked to Childhood Blindness
FITNESS
Exercise May Prevent Prostate Cancer: Study Shows
When It Comes to Lifting, the Pros Have Your Back
Research Confirms How Valuable A Healthy Lifestyle Can Be
GASTROINTESTINAL PROBLEMS
Bowel Prep Harder on Women Than Men
Japanese Herbals May Ease Gastro Woes
Olive Oil May Protect Against Bowel Disease
GENERAL HEALTH
Pesticides and How to Affordably Eat Organic or Reduce Pesticide Consumption
Tune Up Your Health With Music
Go To Work But Skip The Car
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
Combating Myths About Seasonal Allergies
E-Mailing Your Way to Healthier Habits
Save Your Aging Brain, Try Surfing The Web
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Using Light Therapy to Silence Harmful Brain Activity
Rheumatoid Arthritis a Threat to the Heart
Laughter Can Boost Heart Health
INFECTIOUS DISEASE
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
More Medicinal Uses for Pomegranate
Poor Restroom Cleaning Causes Cruise-Ship Sickness
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Breast-Feeding May Protect a Woman's Heart
St. John's Wort Doesn't Work for ADHD
Working Intensely Early on May Help Autistic Kids
MEN'S HEALTH
Strenuous Daily Workout May Keep Cancer at Bay
Exercise May Prevent Prostate Cancer: Study Shows
More Vitamin C May Mean Less Chance of Gout
MENTAL HEALTH
Love Hormone May Ease Discussion of Painful Topics
Using the Mind to Heal the Heart
Drink Away Dementia?
PAIN
Tai Chi May Help Ease Fibromyalgia
Alleviating Rheumatoid Arthritis
Acupuncture, Real or Fake, Eases Back Pain
PHYSICAL THERAPY
PREGNANCY
Calcium Supplements Cut Blood Lead Levels During Pregnancy
Before Conceiving, Take Folic Acid for One Full Year
Heart Defects in Newborns Linked to Antidepressants
SENIORS
The Healthy Habits of Centenarians
Any Old Cane Won't Do
For Older Walkers, Faster Is Better
SEXUAL HEALTH
SLEEP DISORDERS
Daylight Savings: Not a Bright Time for All
Moderate Aerobics May Ease Insomnia Symptoms
Sleeping Could Help Women Lose The Baby Fat
WOMEN'S HEALTH
Acupuncture May Relieve Acid Indigestation In Pregnancy
Exercise During Pregnancy Keeps Newborn Size Normal
Rheumatoid Arthritis Rising Among U.S. Women
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Study Supports Swine Flu's Pandemic Potential

By Amanda Gardner
HealthDay Reporter

MONDAY, May 11 (HealthDay News) -- The swine flu epidemic does have pandemic potential and is likely to be comparable to other 20th century pandemics, at least in terms of its spread, a new analysis concludes.

The report also suggests that the true number of -- largely unreported --swine flu infections in Mexico, the outbreak's epicenter, possibly had already reached 32,000 by the end of April. The World Health Organization's official tally for Mexico currently stands at 1,626 confirmed cases.

The situation could be similar in the United States. During a Monday afternoon news conference, Dr. Anne Schuchat, interim deputy director for science and public health programs at the U.S. Centers for Disease Control and Prevention, said that the 2,618 confirmed cases in the United States are likely just the tip of the iceberg. Many people who become ill don't seek medical attention and are never tested for this strain of flu, so "the numbers we are reporting are a minority of the actual infections that are occurring in the country," she said.

The authors of the study, released online Monday in the journal Science, estimated that the current H1N1 swine flu outbreak is likely to wreak less havoc than the 1918 Spanish flu pandemic that killed more than 500,000 Americans.

Instead, it may prove similar to the much less lethal 1957 pandemic of Asian flu, which killed about 70,000 people, according to U.S. government statistics.

For reference, about 36,000 people die in a typical flu season.

However, the authors are basing their conclusions mainly on infection rates, not on severity of the disease or number of deaths, added Dr. Ghinwa Dumyati, an associate professor of medicine, division of infectious diseases at the University of Rochester Medical Center.

"Not every pandemic is severe, and that's the issue," she said. "Severity does not depend on the number of people infected but on the fatality ratio."

Another expert agreed. "The most important unknown is the clinical severity of the illness, although the accumulating evidence is that the severity is no worse than that of the seasonal flu," said Dr. Christopher Crnich, an assistant professor of medicine in the division of infectious disease at the University of Wisconsin School of Medicine and Public Health. However, "no mathematical model is going to be able to predict [severity]," Crnich added.

So far, the swine flu does not seem to have the level of sustained human-to-human transmission of a "true" pandemic, Dumyati added.

The World Health Organization (WHO) recently raised its global pandemic alert to phase 5 -- just shy of the highest level possible, which is phase 6, signifying a global pandemic.

According to the WHO Rapid Pandemic Assessment Collaboration, which produced the new Science paper, the new analysis supports the phase 5 decision, and indicates a certain level of person-to-person spread.

Another expert agreed.

"The information we have is still incomplete, but this can help lay out a scientific basis for political decisions," said Dennis M. Perrotta, associate director for emerging infectious diseases at the National Center for Emergency Medical Preparedness and Response. "The characteristics of the ongoing epidemic they examined, mostly in Mexico, clearly has sustained human-to-human transmission and we know this is also true in the U.S. It says that, yes, it was an appropriate response on the part of WHO to move the alert to level 5."

But the hallmark of this outbreak has been the large number of unknowns -- including how virulent the virus is and how it spreads -- and that is true of this analysis as well, the authors warned.

Nevertheless, such information is necessary to inform public health decisions, experts say.

Confirmed cases of H1N1 swine flu in the United States climbed to more than 2,600 across 43 states by Monday, including three deaths, and the United States now surpasses Mexico as the country most affected by the outbreak, according to WHO figures. The vast majority of cases remain mild, however.

So far, U.S. deaths linked to swine flu occurred in individuals with underlying health problems.

On Monday, the WHO was reporting 4,694 confirmed cases of swine flu in 30 countries, with Canada, Spain and the United Kingdom having the most cases outside of the United States and Mexico.

For every confirmed case, however, there are probably hundreds of unconfirmed cases, noted Dr. Gordon Dickinson, chief of infectious diseases at the University of Miami Miller School of Medicine and the Miami VA.

Three influenza pandemics swept across the globe in the 20th century: the so-called Spanish flu epidemic of 1918, the "Asian" flu in 1957 and "Hong Kong" flu in 1968. Pandemics are labeled as such whenever a new flu virus appears and has sustained human-to-human transmission.

Based on an analysis of confirmed swine flu cases in Mexico and its international spread, the WHO researchers estimate that 23,000 individuals (possibly up to 32,000) had been infected in Mexico alone by late April, with a death rate of about 0.4 percent.

That's much less lethal than the 1918 pandemic, which killed 2.5 percent of people infected.

But it may be too early to breathe a sigh of relief, experts said. The swine flu outbreak could be dying down or it could simply gearing up for a deadlier resurgence in the fall and winter.

"It's too early to say," Dumyati said. "At this point, it doesn't look like it has sustained transmission, but you don't know, in the winter, what will happen."

"People need to stay tuned and see what's going on, and the medical community needs to work fast and hopefully, a vaccine will be prepared," Dickinson added. "What bothers me is that, in 1918, the influenza emerged in the spring then sort of melted away during the summer. Then it came back as a very lethal process. This gives one pause as we see this current H1N1 epidemic spreading . . . The cases continue to emerge. It just hasn't hit with a major force yet."

U.S. public health departments are so overwhelmed, Dickinson said, that they are asking facilities not to send samples for testing unless there is a cluster of outbreaks or a particular clinical need.

"They can't keep up," he said.

More information

Visit the World Health Organization for more on the current H1N1 swine flu outbreak.



SOURCES: Ghinwa Dumyati, M.D., associate professor, medicine, division of infectious diseases, University of Rochester Medical Center, N.Y.; Gordon Dickinson, M.D., chief, infectious diseases, University of Miami Miller School of Medicine and Miami VA; Dennis M. Perrotta, associate director, emerging infectious diseases, National Center for Emergency Medical Preparedness and Response, Texas A&M Health Science Center; May 11, 2009, press teleconference with Dr. Anne Suchat, interim deputy director for science and public health programs, U.S. Centers for Disease Control and Prevention; Christopher Crnich, M.D., assistant professor of medicine, division of infectious disease, University of Wisconsin School of Medicine and Public Health, Madison; May 11, 2009, Science, online

Last Updated: May 12, 2009

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