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H1N1 Re-infections Raise Pandemic Concerns
Recombinomics Commentary 02:30
November 25, 2009
Dr. Debra Parsons, a pediatrician at Kid Care West in Cross Lanes, was met with reactions of doubt from local health officials last month when she said two flu tests had come back positive for H1N1, or swine flu.
Parsons first came down with the virus, complete with all the telltale symptoms, in August.
Her son became ill at the same time with the same symptoms. Figuring they had the same bug, Parsons tested herself to see what it was.
The test came back positive for Influenza A, so the lab at Charleston Area Medical Center sent it to be sub-typed. Parsons was positive for H1N1.
Parsons and her son recovered, but in October they started having the same symptoms, but they became much worse.
They were both tested this time, and the results were the same -- they were positive for Influenza A and then H1N1.
"It was swine flu both times," Parsons said.
The above comments on lab confirmed re-infection of two family members two months apart by swine H1N1. These confirmations are supported by many anecdotal reports of similar re-infections. The timing of these infections allowed for easy identification, because at the time there was no seasonal flu, so identification of infections was straight-forward. Moreover, such infections in school aged children and parents are common because H1N1 infections exploded when school began.
At the time however, the H1N1 virus was evolving slowly, reflecting an ease of infection of a naïve population. The jump from swine H1N1 into humans allows for infections with low doses of virus. Low concentration of virus produces a mild infection and a weak antibody response. The rapid spread creates widespread antibody, but the low level allows for re-infection from individuals with a higher viral load. A higher viral load can be created in a school environment, where some students could be infected multiple times because of frequent contact with infected students.
Thus, the increased viral load could overcome the weak immune-response and re-infect those infected earlier, leading to a second wave. However, the higher viral load leads to more serious infections, especially for these not infected in the first wave. Consequently more previously health young adults develop more serious symptoms, leading to an increase in hospitalizations and deaths. The higher viral load, especially when combined with receptor binding domain changes such as D225G can lead to the type of cases seen in Ukraine, where a high percentage of young adults develop infections that destroy both lungs in a matter of a few days.
In many areas, including Ukraine, this wave is subsiding, but the holiday season will lead to new infections by viruses with regional markers, leading to a third wave in early 2010.
November 24, 2009
The County of San Diego Health and Human Services Agency (HHSA) reports eight additional people have died and tested positive for H1N1. This does not mean H1N1 has been determined to be the cause of death, which is established by the attending physician or the Medical Examiner.
The deceased are:
A 44-year-old-male with underlying medical conditions
A 35-year-old female with underlying medical conditions
A 41-year-old female with underlying medical conditions
A 42-year-old female with no underlying medical conditions
A 47-year-old male with underlying medical conditions
A 67-year-old male non-resident with underlying medical conditions
A 46-year-old male non-resident with underlying medical conditions
A 48-year-old female non-resident with underlying medical conditions
The total number of people who have tested positive for H1N1 and died locally is 45. Thirty-eight individuals were San Diego County residents while the others seven were non-residents visiting our community at the time of their death. San Diego County has had 659 hospitalized cases of H1N1 to date.
Genetic Relationships among Human and Relevant Swine Influenza Viruses, 1918–2009.
Yellow arrows reflect exportation of one or more genes from the avian influenza A virus gene pool. The dashed red arrow indicates a period without circulation. Solid red arrows indicate the evolutionary paths of human influenza virus lineages; solid blue arrows, of swine influenza virus lineages; and the blue-to-red arrow, of a swine-origin human influenza virus. All influenza A viruses contain eight genes that encode the following proteins (shown from top to bottom within each virus): polymerase PB2, polymerase PB1, polymerase PA, hemagglutinin (HA), nuclear protein (NP), neuraminidase (NA), matrix proteins (M), and nonstructural proteins (NS). The genes of the 1918 human and swine H1N1 and the 1979 H1N1 influenza A viruses were all recently descended from avian influenza A genes, and some have been "donated" to the pandemic human H1N1 strain.
Originally posted by JJay55
reply to post by ecoparity
Oh Eco, we've been patient too with those who profess and flood threads with textbook material that we have shelved long ago.
No one is disputing the H1N1 origin. All governments have the thing in their stockpiles. Sorry you don't get it.
The release of H1N1 was indeed an error by the Mexican government. How it got released is still an open question. As is why. So if you have anything to add to that I greatly welcome it. Otherwise, have a nice day.