By Joanne Silberner

OK, we're addicted, and it's a pretty sick addiction. Literally. We jones for ProMED, a listserv about exotic diseases, far and wide.

Some people like going to see scary movies. Some people like reading murder mysteries. We're fascinated by up-to-the-minute reports about exotic infections, like bluetongue disease and chikungunya fever, that ProMED sends our way.

ProMED covers more common diseases as well. We've been following H1N1's travels around the world through the postings on ProMED, for instance.

Continue reading "Spanning The Globe In Search Of Disease" >

by Deborah Franklin

News stories have a way of firing up old debates. So maybe it was predictable that scarcely had the feds broken open the money-laundering-kidney-smuggling corruption ring in New Jersey last month, when some economists started clamoring once again to legalize the regulated sale of human organs for transplant. Their basic argument: Banning the legitimate sale of organs merely forces willing sellers and buyers into a dirty and dangerous black market.

The Freakonomics guys weighed in early, with their observation in a New York Times column that "it is hard to find an economist who agrees with this policy" of banning kidney sales. (This follows a previous column last fall, where they noted that many organ donors in the U.S. don't have health insurance).

Dr. Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute, has been widely quoted, too, based on her experience of having to ask a friend for a kidney when her own failed several years ago. Satel wrote a book about it, and the woman who donated the kidney, writer Virginia Postrel, explains her own support of financial reimbursement for traded organs in this month's Atlantic.

Meanwhile, the New Yorker and Mother Jones are weighing in with their own stories about the downside of organ sales. And the Jewish Daily Forward quotes ethicist Art Caplan's central argument against legalization:

The people who sell are almost always incredibly poor. They're usually up to their eyeballs in debt....past the point of desperation. They're not making a calculated decision.

Continue reading "Why Not Buy A Kidney?" >

by Richard Knox

Psst, have you heard, boys? We're going to the big time /CDC

Who would have thought the declaration of a flu pandemic would be an anticlimax?

But that's the way it feels as WHO gets ready to certify the first flu pandemic in 41 years. Most people expect Director-General Margaret Chan to make the announcement today after she teleconferences with a 20-member emergency committee.

She'll probably call the new H1N1 pandemic of 2009 "moderate." But she'll warn its impact on vulnerable populations can be severe. And she'll caution the new strain could get nastier as it circulates through millions of people over the next few months.

What does the formal declaration mean?

Probably it'll goose vaccine manufacturers... and assure them of a market. Beyond that, it doesn't alter much. Paradoxically, WHO officials hope some countries will ratchet down severe measures (i.e. quarantining mayors, killing swine) to keep the new flu virus out.

" With a pandemic declaration," one official says, "we're saying the virus is widespread and virtually unstoppable."

by Deborah Franklin

Dr. Zibin Guo leads a tame version of wheelchair tai chi in Beijing, but he envisions a more competitive version someday /University of Tennessee at Chattanooga

 

Wheelchair athletes have been racing the pavement -- and basketball, rugby, and tennis courts -- for years. NPR's Joe Shapiro says that when you spend a little time with these jocks, as he has for a number of stories, your image of life in the chair changes fast.

"Think about what it takes to propel a manual wheelchair around all day," Shapiro says. "A gym membership and hours of dumbbell curls couldn't get you a ripped body any better."

Some colleges, he says, now offer athletic scholarships for players of "quad rugby," the full contact sport immortalized in the 2005 movie "Murderball."

Recently we learned of a slightly less murderous variation on that theme out of the University of Tennessee at Chattanooga.

Continue reading "Taking Wheelchair Tai Chi To China" >

By Richard Knox

Up close and personal with the new H1N1 virus. CDC

 

Margaret Chan, the World Health Organization's director-general, has decided not to declare that the world has entered the first flu pandemic of this century.

But she's leaving open the question -- for now -- of changing the definition of a pandemic.

Chan declared on April 29 that a flu pandemic is "imminent." But she's been under increasing pressure from WHO's member-states to hold off declaring that a pandemic has arrived, based on the WHO's own definition.

Chan now says there's no doubt swine flu will continue to spread -- within the 42 countries already affected and beyond.

By saying that, Chan essentially acknowledges what many have been saying: This genie is out of the bottle.

Continue reading "Why No Flu Pandemic? Define Pandemic" >

by April Fulton

Kazuhiro Nogi/AFP/Getty Images

Many countries are questioning why the WHO has not moved the new swine flu pandemic threat level from an imminent pandemic to an actual one.

The H1N1 situation in Japan now seems to qualify for a WHO move to "Phase 6." That is, there is evidence of ongoing transmission among people in the community, not just among close family members.

But as NPR's Richard Knox reports today:

This isn't a question of semantics or science; it's mainly a question of politics within the WHO.

Plus, a redefinition of pandemic may be in the works. Stay tuned.

by April Fulton

Can eating star anise protect you against swine flu? We don't know, but it's tasty. Louisa Lim/NPR

 

When Egypt slaughtered its pig population to protect the country against swine flu a few weeks ago, many scientists dismissed it as an overreaction. There is no evidence eating pork gives you swine flu.

However, as NPR's Louisa Lim reports today on Morning Edition, the sweet and smoky licorice-flavored spice known as star anise may have an actual link to swine flu -- a potentially powerful one.

As a result, the price of the spice in China, where 90 percent of the world's star anise is produced, has shot up.

Turns out that an important ingredient in Tamiflu -- one of the key drugs being used to fight symptoms of the swine flu and many other flus -- is a specific acid developed from star anise called shikimic acid.

Lim reports that shoppers in China are using more star anise because the health minister Chen Zhu suggested at a news conference recently that using star anise while cooking pork would be "a very good option to deal with swine flu."

We don't know about that, but pork and star anise are an excellent flavor pairing.

By Frank James

Why do outbreaks caused by flu and other viruses often seem worse initially than they turn out to be?

That's the question Jon Hamilton examines in a report on All Things Considered this afternoon.

As Hamilton explains, it all has to do with how many people are in the denominator and how sick they are. The relatively fewer there are and the sicker they are, the worse the situation looks. Hamilton talked with Dr. Rob Fowler, a critical care physician in Toronto, to understand what doctors there saw when SARS struck in 2003.

HAMILTON: At first, it appeared that SARS was killing nearly 50 percent of the people who got infected. But as the outbreak progressed it became clear the true death rate was closer to 5 percent.

Fowler says it took awhile before doctors started looking for SARS in people who weren't critically ill. And that made the disease look even more frightening than it turned out to be.

Continue reading "Why Are Virus Outbreaks Often Not As Bad As First Feared?" >

By Frank James

Not to pick on Egypt but that nation continues to exhibit among the most extreme reactions to swine flu to be seen internationally.

Egypt's health minister has reportedly told Muslims to avoid pilgrimages for the next three weeks as well as closed-in mosques, urging them to pray in open areas so as not to spread the new H1N1 virus.

Of course, there hasn't been a single swine flu case reported in Egypt. But that hasn't stopped the government from ordering the early slaughter of all the nation's 350,000 pigs. And now there's this recommendation for outdoor prayer.

It would seem if there's this much official worry in Egypt over the virus, there would've been an order by now to avoid planes, trains and buses. But for a nation that depends as much on tourism as Egypt, the discouraging the use of public transportation could have a very real economic impact, which is maybe why the government hasn't taken that step.

The Los Angeles Times' Babylon & Beyond blog reports on Egypt's latest reaction ( some might say overreaction) to the swine flu. An excerpt:

Egypt's health minister has called on Muslims to refrain from going on pilgrimages for the next three weeks and to avoid closed mosques. A similar call was made to the Christian community, which was asked to hold services in open areas to help ward off the spread of the H1N1 flu virus to Egyptian territories, according to al-Masry al-Youm.

Continue reading "Egyptians Told To Pray In Open Areas To Thwart Swine Flu" >

By Frank James

This Russia Today report on the swine flu is a weird mash-up of several flu-related stories ranging from the humorous to the super serious. It all makes sense when you take into account that the Russian news channel's slogan is "Any story can be another story altogether."

By Frank James

A Mexican official reported today that the swine flu's financial impact on his nation's economy was more than $2 billion so far.

That's a relatively small hit relative to Mexico's estimated $1.6 trillion 2008 gross domestic product. But Mexico, like its neighbor to the north, had already been hurt significantly by the world-wide recession, including the fall in oil prices which hurt one of Mexico's top exports.

The nation's central bank, Banco de Mexico, recently predicted the country's GDP would decline 4.8 percent this year, so swine flu really hit Mexico when it was already down.

Fortunately for Mexico, its swine flu outbreak seems to have leveled off, which allowed authorities there to reopen businesses today before the economic impact could get any worse.

Here's what the Associated Press is reporting:

MEXICO CITY (AP) - Mexico's finance secretary says the swine flu outbreak has cost the Mexican economy at least $2.2 billion.

Agustin Carstens says the government will implement a $1.3
billion stimulus package, aimed primarily at small businesses and
the tourism industry, the sectors hardest hit by the epidemic.

Continue reading "Swine Flu's $2.2 Bln Hit To Mexican Economy" >

Egyptian pigs with their backs against the wall. KHALED DESOUKI/AFP/Getty Images

 

By Frank James

Why hasn't Egypt slaughtered its entire poultry population?

That question arises because of reports that avian flu has been a bigger problem in Egypt than swine flu. Avian flu is linked to the deaths of at least three people in the last month according to at least one report while not a single case of swine flu has been reported in Egypt.

Yet the Egyptian government ordered the slaughter of the nation's entire 300,000 pig population. And while the keeping of birds in populated areas has been officially banned, according to a piece on the Radio Netherlands Worldwide website:

... People are still keeping chickens, ducks, geese and pigeons in populated areas, in both rural and urban areas. It is mostly young women who feed the fowl, that contract the disease.

Continue reading "Why No Avian Flu-Related Poultry Slaughter In Egypt?" >

By Mark Memmott

Looking to bring its quarantined citizens home, Mexico sent a jet to China today. As the Associated Press puts it, "the chartered Mexican plane (was) hopscotching China Tuesday to retrieve stranded residents."

CNN.com writes that the "Aeromexico flight was making several stops throughout China to collect nearly 70 citizens who were being held in quarantine across the communist nation as part of its strict swine flu-control measures."

Mexican citizen Robert Arcuate arrives at his nation's embassy in Beijing today. Mexico is repatriating citizens from China, where many have been quarantined. Frederic J. Brown/AFP/Getty Images

 

By Mark Memmott

"She has had her temperature taken and she is not sick, her only problem is that she was in Mexico," a man identified as Francis St. Louis tells the Canadian Broadcast Corp. at CBCNews.

St. Louis describes what he says happened when his wife, on a business trip, arrived in China a few days ago. He reports that when she tried to travel from Hong Kong to Szechuan, his wife was "refused entrance based on her passport being stamped with a Mexican entrance stamp. .... On returning to Hong Kong she was not allowed access and isolated and keep (sic) first on board the ferry for several hours then (sic) she was placed in a lock down room for several more hours." Later, "she was sent off to an isolation camp."

Authorities have kept her in quarantine and St. Louis is frustrated. "I really would like to know what the Canadian government is doing to protect its citizens," he says.

Speaking of the Canadian government, the Canadian Press reports that the countries officials are pressing China to explain why about two dozen Canadians have been quarantined in China.

By Mark Memmott

"Up to 20 countries worldwide have banned imports of pork and other meat," Reuters is reporting. The news service says that the World Health Organization has collected a list of nations that have taken that action. It adds that:

Although the H1N1 strain is not food-borne, fears that it may spread through animal products have prompted restrictions on live pigs, pork, cattle, poultry, livestock, feed and animal semen from countries with reported infections, according to the list.

As we wrote earlier, though, WHO's leading flu expert -- Dr. Keiji Fukuda -- said again today that "pork and pork products. when they are handled right and cooked properly do not pose a risk of infection to people."

Prosciutto, such as the slice that envelops this fig, will not give you swine flu April Fulton/NPR

 

by Richard Knox

The World Health Organization's daily swine flu briefing on Sunday dealt with a burning culinary question du jour --- at least among the European press. What about cured ham products?

Dr. Peter Ben Embarek, a WHO food safety scientist, had just repeated the stock speech that pork products are perfectly safe to eat as long as they're properly cooked.

"What about ham this is not cooked?" asked Brad Clapper of the Associated Press. "Millions of people eat ham in different ways, including raw. Do they now have to fry up prosciutto (air-dried Italian ham) or jambon cru (raw ham)...in order to be safe?"

Continue reading "Please Don't Fry That Prosciutto!" >

By Juan Forero

BOGOTA, Colombia -- Here in the South American country closest to Mexico, authorities scrambled to stockpile antiviral medication to fight swine flu and told schools to send home children who show up to classes with symptoms of the virus.

So far, no one has been confirmed to be infected in this country of 45 million, though Health Ministry officials have placed nearly 60 people under observation and say a handful of them are suspected of suffering from swine flu.

The deputy health chief in Bogota, Edgar Zambrano, told reporters that several of those placed under observation had arrived in Bogota from Mexico with flu-like symptoms, prompting fears that the virus could get a toe-hold on the continent.

At the Vermont school, a private institution for 1,400 students outside Bogota, teachers who have developed colds are being asked to wear face masks, just in case. Before new Education Ministry guidelines were issued, Vermont administrators also sent parents a written explanation of the pandemic, asking them to keep children home if they become sick.

Continue reading "Swine Flu Eyed Warily In South America" >

By Julie McCarthy

ISLAMABAD -- It's not like Pakistan doesn't have enough problems; now the Health Ministry is taking on swine flu.

The views expressed were not surprising in this Muslim country where pork is considered "haram" (a sin)

Ministry officials said there is no immediate threat to Pakistan largely because there is no "pig rearing industry" or "domesticated pigs" here.

"Although no country bordering Pakistan has reported any infection from the swine flu virus, precautionary measures have been taken by the Ministry of Health," a statement reads.

The only threat is from passengers arriving from overseas who may be carriers of the swine flu, the statement continued.

All airports have been asked to screen passengers entering Pakistan. It seems pretty feckless, however.

Continue reading "Pakistan Takes On Swine Flu, Sort Of" >