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Easing nearer the truth...


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I'm not familiar with "My Way" News, but this was posted in the Drudge Report...

 

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State labs: US swine flu cases likely higher

Apr 30, 6:25 PM (ET)

 

By MARILYNN MARCHIONE

 

MILWAUKEE (AP) - A hundred cases of swine flu in the U.S.? Health officials say there are likely more. Just how many is not important, they say. As the world faces a potential pandemic, swamped labs are not testing all possible cases. Getting an exact tally has taken a back seat to finding new outbreak hot spots or ways to limits its spread, health officials said.

 

"The specimens are coming in faster than they can possibly be tested," said Dr. Jeffrey P. Davis, state epidemiologist in Wisconsin, where a lab helped spot the nation's first known case, in a 10-year-old boy from San Diego.

 

New York, which has more cases than any other U.S. location, also has had to limit the samples it tests, said Dr. Don Weiss of that city's health department.

 

"Sure, we'd want to diagnose every case, but we don't have that resource," he said. Instead of trying to confirm every sign of the virus, "we're focused on where else is it going and how do we prevent it."

 

On Friday, the Centers for Disease Control and Prevention will start shipping kits so states can do their own swine flu tests. Until now, state labs could only rule out previously known flu strains and send suspicious samples to CDC.

 

With the new kits from CDC, states will be able to declare presumed swine flu cases, allowing doctors to start treatment. Medicines to fight the virus, such as Tamiflu and Relenza, must be taken within 48 hours of first symptoms to do any good.

 

Until now, many busy labs have been so overrun that they could do preliminary tests only on samples that meet a strict case definition or that involve people who traveled to Mexico.

 

"The capacity of the state laboratories to test all the swabs is being exceeded," said Dr. Paul Jarris, executive director of the Association of State and Territorial Health Officials.

 

Initially, labs just needed to detect the virus, he said. "Once it's in the community, it's not as important to detect every single case. You can actually treat based on the clinical picture."

 

Sending samples to CDC was "getting to be a challenge," said Alabama State Health Officer Don Williamson. The first eight were negative, and the state lab had 29 more to test on Wednesday, he said.

 

Without a confirmed case, state officials still took the precaution of ordering 1.5 million face masks and other supplies.

 

"We are preparing for the worst while praying for the best," Williamson said.

 

CDC has had to be selective, too. The agency generally can process about 100 samples a night, said Michael Shaw, associate director for laboratory science. CDC has not said how many specimens they have received for testing.

 

"As the number of specimens increases, the time slows down," Shaw said. "It's not just a matter of running tests. It takes time to unpack boxes, make a record of receiving, enter into the database."

 

The CDC added just 18 new cases to its official list on Thursday, and its acting director said it may stop doing confirmatory testing as the virus becomes more common in a community.

 

"We may move away from case updates," Dr. Richard Besser said. "The numbers become a little murkier, and we'll focus more on where things are occurring and what that tells us about the spread of infection."

 

The public may be surprised to know it's not so important to have an exact tally, or to tell a person whether he or she has the germ, said Sharon Shea. She is director of infectious disease programs at the Association of Public Health Laboratories, the network of labs that work with CDC.

 

"It's not what people want to hear. As an individual, you want to know what's making you sick," she said.

 

Each state's epidemiologist will have to decide what samples should be tested, said Scott Becker, executive director of the lab association.

 

The common cold and other viruses are also circulating and cause similar symptoms.

 

In the last two days, the Wisconsin State Laboratory of Hygiene "had a huge spike," about 150 samples of suspected swine flu cases, said its communicable disease chief, Pete Shult. Wisconsin has five probable cases awaiting CDC confirmation.

 

Through a fluke, his lab helped confirm the nation's first case. A private company doing a study of an experimental rapid flu test it wants to sell had agreed to send any samples that could not be typed to a more experienced lab - in this case, the Marshfield Clinic Research Foundation in Wisconsin.

 

The clinic, in turn, had agreed to alert the state to any flu viruses that did not match a known strain.

 

"I got a call on Good Friday. They had such a specimen," he said. That was from the boy in San Diego who was the first known U.S. case of swine flu.

 

The sample was tested on Monday, April 13, and shipped overnight to CDC, which confirmed it as the novel swine flu on Tuesday, April 14.

 

The San Diego boy had fallen ill on March 30. Since then, the CDC and the public health lab association have suggested that state labs go back through samples since February to look for signs of the virus. At CDC, stored samples show no earlier sign of it, Shaw said.

 

"That's the odd thing about this. It just appeared out of the blue the last week of March," he said.

 

Shult said the hunt now is "an academic exercise" and a lower priority than testing the hundreds of samples that might help contain the outbreak.

 

"I'm going to be trying to stay afloat" of the crush of current samples, he said.

 

---

 

Associated Press writers Mike Stobbe in Atlanta, Sara Kugler in New York, and Desiree Hunter in Montgomery, Ala., contributed to this report.

 

 

http://apnews.myway.com/article/20090430/D97T2ALO1.html

 

 

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According the the CDC testimony in the special hearing televised yesterday, they are not experiencing a backlog of testing yet. The samples are supposed to go to state labs first, then the CDC. These new test kits I think are supposed to remove the need for the extra step, sending the samples to Atlanta.

 

I watched the hearing for over an hour yesterday. Of course the usual political grandstanding took place. I guess they couldn't help themselves.

 

It left me wondering, though...how are all these samples being transported? In the mail? Are the samples themselves contagious? Are they "live"? Seems life the transportation process is moving the virus around the country in a big way. How's that for a tin-foil question?

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And more truth leaking out...?

 

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AP: Most states have fewer drugs than feds suggest

 

By ALEX DOMINGUEZ

45/1/09 updated 1 hour, 51 minutes ago

 

BALTIMORE - With a swine flu outbreak spreading across the nation, more than half the states have yet to stockpile the number of flu-treatment doses recommended by the federal government, an Associated Press survey found.

 

States that are falling short cite budget constraints, or say it's better to spend health-care funds on preventing the spread of disease than on antiviral medicines that may or may not work on a particular flu strain.

 

"You don't have any guarantee that if you purchase a large amount of drugs that they would be effective in the future," said Gwenda Bond, a spokeswoman for the Kentucky Cabinet for Health and Family Services. "Drugs do have a shelf life, and so you don't want to spend a lot of money on drugs that may expire before you need them."

 

The strain of swine flu that began appearing in Mexico and has since spread to 19 U.S. states is treatable — but not preventable — using Tamiflu and Relenza, each of which has a shelf life of about five years.

 

The U.S. Department of Health and Human Services recommends that each state have enough antiviral medicine on hand to treat 25 percent of its population. But an AP survey of all 50 states and the District of Columbia found that 29 were below that threshold.

 

Several were just under it, but 15 states had enough medicine on hand to treat fewer than 20 percent of residents. Seven states — Arizona, Colorado, Connecticut, Florida, Idaho, Massachusetts and Montana — could treat about 15 percent.

 

Wisconsin has 399,000 courses of treatment on hand as of this week, or enough for about 7 percent of its population. Another 204,000 courses are expected to arrive in the next week from the federal stockpile, which will increase the supply to cover 10.7 percent of the population.

 

If you count the rest the federal government has earmarked for the state, Wisconsin's share rises to enough for about 21 percent of the population, said Department of Health Services spokesman Seth Boffeli.

 

"We took a prudent course on this," he said. "Drugs cost millions of dollars. When they are stockpiled they begin to near their expiration dates, which means, if unused, they must be replaced."

 

Despite that, the acting head of the U.S. Centers for Disease Control and Prevention said no state is expected to experience shortages because the federal government is racing to fill states' stockpiles with millions of additional doses from its own strategic reserves.

 

Dr. Richard Besser said Thursday that the CDC had deployed drugs to nine states so far, and that all 50 states would receive allocations from the national reserve by Sunday.

 

Besser said the deployment is being done "as a forward-leaning move ... in case this becomes something much bigger than it currently is."

 

Federal officials also said there was no shortage of the medicine in regular pharmacies.

 

A course of antiviral medicine contains enough doses to treat one person. In 2006, as part of its own pandemic flu preparations, the federal government created a stockpile of 44 million courses, which would cover about 15 percent of the U.S. population.

 

It then recommended that states purchase additional courses so the combined stockpiles would cover one quarter of each state's population, and offered subsidies covering 25 percent of the cost. Because some states passed on the subsidies, other states were able to use the federal aid to go beyond 25 percent coverage.

 

The AP's tally includes both drugs currently on hand in the states and those earmarked for them in the federal strategic reserve, as well as some that are en route from the drugs' manufacturers.

 

Hawaii has enough for nearly 29 percent of its population. It bought more than the recommended amount because of the year-round stream of tourists who boost its population.

 

Bill Hall, a spokesman for the Department of Health and Human Services, said the federal government based the 25 percent figure on past pandemic outbreaks in which about a quarter of the population became infected and "made it clear this is shared responsibility with the states."

 

The swine flu outbreak is a road test of sorts for battling an outbreak with antiviral medicine, said Trish Perl, an infectious disease expert at the Johns Hopkins University School of Public Health.

 

"None of us have ever really done this practically," she said. "Right now is the first time that we've been able to really test it with some of the prevention strategies that have been used in states where they have had some of these cases. So, I think the good news is that we're going to know relatively soon."

 

However, the drugs' effectiveness is limited. Tamiflu, the more commonly stocked of the drugs, needs to be taken within in first 48 hours of the onset of symptoms, according to its manufacturer, The Roche Group. It generally only reduces the duration of symptoms.

 

Georgia Gov. Sonny Perdue had originally proposed spending $15.7 million for about 2.2 million courses in 2007, but the spending was cut to $7 million by state lawmakers and the state ended up purchasing 460,000 courses instead. Combined with the 1.3 million currently allocated by the federal government to Georgia, that's enough to cover about 18 percent of the state's population of 9.7 million.

 

Kentucky health officials' decision to get half the amount recommended under the federal guidelines came down to both a policy and financial decision, Bond said. Health officials did not want to buy too much medication that may not be able to treat a pandemic or could eventually expire and go to waste.

 

"But at the same time, we did feel that it was prudent to ... have some on hand, because they are effective against many flu strains," she said.

 

So Kentucky spent about $3.6 million on antiviral courses, which is "no small expense" for a state that's facing massive budget woes, Bond said. Kentucky has enough to cover just over 20 percent of its population.

 

Colorado and Maine are among the states that chose not to stockpile treatments, deciding the money would be better spent on hygiene education, canceling large gatherings and other precautions against a pandemic flu.

 

"Since this is the biggest gain for the dollar, this is where we have put our efforts," said Chris Lindley, division director for the Colorado Department of Public Health and Environment.

 

In Massachusetts, where the state has enough antivirals to treat slightly more than 15 percent of the population, health department spokeswoman Jennifer Manley said the state's decision not to buy the recommended amount was based in part on the fact the state had to pay out of pocket for the drugs and if a virus becomes resistant, the antiviral courses would be wasted.

 

"It's not a silver bullet," Manley said. "If we ordered a million doses, and it becomes resistant, that is a lot."

 

Hall, the HHS spokesman, said the federal government left it up to the states to decide whether they needed to purchase the full amount available to them, and some opted against it.

 

Jeff Levi of the Trust for America's Health, which compiled a recent state-by-state report on the stockpiling of antiviral medicine, criticized that decision and said the federal government should have purchased the full amount itself.

 

"I think what we're seeing with swine flu, with the virus being susceptible to the drugs in the stockpile, I think it demonstrates the importance of doing this," Levi said.

 

http://www.msnbc.msn.com/id/30516404

 

 

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Small wonder the response may have seemed slow... beafraid.gif

 

 

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Politicians won't spend state funds on disaster prevention, because it won't get them the immediate votes like welfare and other feel-good projects will. The voters can't "see" or "touch" the prep projects.

 

Think New Orleans, before Katrina.

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