[CanadaSue]

My bet is that we're going to be looking at this within 5 years, possibly a lot sooner. Gonna do a thread here on as many aspects of getting ready to deal as I can. That will cover what will likely be your first warnings that this is occuring or about to hit, HOW you're likely to find out & what you can/can't expect from government & health care at all levels. I'll cover symptoms, liely complications & how to cope whether you're alone or are in various family situations.

Fell free to PM points or questions or start a separate thread. I'll cover points raised as they fit in or go back & addres anything I've missed in items already covered.

[CanadaSue]

Figuring that out & hopefully getting a bit of a heads up on the rest of the world can save a lot of grief for all. We're talking H5N1 here, so let's see what signs we'd have that that puppy is about to go pandemic.

First, we'd see a surge in avian cases in south east Asia - where it's becoming endemic. Countries would begin reporting outbreaks in domestic flocks - those countries already suffering sporadic outbreaks would report more & nations which have been free of it might start reporting cases. Such reports would be found in the news but crucially, the details of WHEN reported, where & the number of animals as well as their final disposition will be found here:

http://www.oie.int/eng/en_index.htm

Bear in mind, reports are sometimes late - they depend on OFFICIAL government reports from member nations but the information is generally pretty detailed.

More timely reports, although often initially lacking in detail would be found here:

http://www.promedmail.org/pls/askus/f?p=2400:1000

ProMed would also probably be the first 'semi-official' place to hear of cases in new species or in humans. The information is gleaned from press reports as well as emails from volunteers.

Both these sites are free & have yet to put anything nasty on my computer - I've been using them for a number of years.

Between the time we see reports of increasing numbers of outbreaks in poultry & cases beginning to appear in people, we can expect a time lag of a few weeks. That makes perfect sense - first poultry must be infected in sufficient numbers over a wide enough range of areas for many people to become exposed. Lately, many nations with outbreaks have been trying to educate their populace about measures on how to avoid becoming ill, so it may take longer for human cases to happen or be noticed.

Initially we'll see what we've seen so far - sporadic human cases across a few nations & it the poultry outbreaks aren't quickly & ruithlessly controlled, more & more human cases. The WHO has a system of 'Pandemic Planning Stages' where their monitering & advisory roles are detailed. They give extensive descriptions of when they declare each stage officially, (there would be notices across most of the major world press, especially if we're really, REALLY looking at pandemic flu) & what they do as well as what they hope member countries involved would be doing. Currently we're at "Phase 0, Preparedness Level 2; "human infection confirmed". What they do during this phase is described here:

http://www.who.int/emc-documents/influenza/docs/index.htm/sec3.htm

The description of each Pandemic Preparedness Phase can be found here:

http://www.who.int/csr/resources/publications/influenza/WHO_CDS_CSR_EDC_99_1/en/

Now, when they announce Phase 0, Preparedness Level 3 - that's when you REALLY have to start paying attention - that's when human to human transmission is CONFIRMED. Confirmation is checked, rechecked, cross checked, etc. before being announced. It's the 'final phase' before we're into pandemic panic.

Then what do you look for or do?

That's next.

[revtaz]

Thanks CanadaSue. :)
You are one of the reasons I like this new place. :tup:

[CanadaSue]

SPECULATIVE, SPECULATIVE, SPECULATIVE

It's early to mid-winter & outbreaks of H5N1 have been occuring across south east Asia for about 6 weeks. About 3 weeks ago, human cases began being reported & while details are sparse, it's known a number of patients have died or seem likely to do so. About a week ago the WHO confirmed 3 human to human cases. The scary part of that is that this has occured in TWO countries - Thailand and Malaysia. The WHO has gone to Phase 0, Preparation Level 3 & rumours abound that with human cases increasing by the day - both aquired directly from poultry & increasingly it seems, human to human,that they will soon declare Phase One of Pandemic.

Currently the WHO is deploying teams across those nations already affected &, with permission, to neighbouring nations where H5N1 is likely to be seen next in poultry & people. Your nation may & probably WILL be, already carefully checking arriving passengers from the nations affected & possibly from any nation in the affected area. Your nation is also making people aware of flu symptoms; what they are & how to differentiate them from colds or other respiratory illnesses. Depending how nervous the world is feeling, nations may already be setting up flu hot lines so that members of the public who have reason to believe they MAY have contracted avian flu can call to try & sort that out. Far better this is done by phone rather than going to emerg or a doctor's office & possibly infecting others or, if you had something else, contracting H5N1 from another patient who has it!

You can bet your behind your governments & health agencies will be doing a LOT of frantic work behind the scenes. Stocks of antivirals will be counted & medical practitioners asked to NOT use them as much as possible. Medical supply companies MAY be planning to put on extra shuifts in order to increase manufacturing of such medical suplies as masks, gloves, gowns, basic intravenous fluids & tubing, syringes & needles, isolation supplies of all types...

Hospitals will be asked to review their bed capacity, especially how many more beds & gurnies they can squeeze into their facilities. Municipalities may discretely be looking at what they might be able to use as field hospitals and eventually... temporarily, morgues. Staff availability will also be looked at - who's working & who could be called in. Recently retired staff would be valuable assets.

Hospitals might at this point, urge all employees to get vaxed against flu - not that human strains are going pandemic but God forbid a reassortment of H5N1 & any human strain add unwelcome complications. Inservice into mass care may be held. In the event of hospitals bursting with cases, a lot will not, cannot be done but staff may have to be made aware of this, get used to the idea.

Garbage & laundry contracts as well as incineration may be looked at, tendered & signed. I'd be surprised if all of this would happen quickly but it WOULD be examined. Different levels of government are going to dust off pandemic & other emergency plans. Infrastructure repairs which really are crucial might be speeded up.

Public health units would also be preparing; looking at staffing health hot lines of differing types, trying to add temporary staff & doing a LOT of printing - information flyers, posters, etc. They may start public service announcements - quite a few agencies might & next I'll look at what you MIGHT see with those.

Much if not most of this, may occur behind the scenes but if you keep your eyes open & are involved in printing, waste management, maintenence of civic fleets of LEO vehicles, etc. you might get a heads up if tenders, contracts & extra maintenence begins to occur. It's little signs like this that may be telling...

[DarkRose]

Thanks, Sue. :tup:
I'll be printing this thread out as it fills with your information.

[Pepper]

Thank you Sue. I am already seeing posters in several doctors offices telling of ways to avoid the flu. They aren't telling you to get a flu shot but instead suggesting ways to avoid it by frequent hand washing, etc. Last year the few posters I saw where reminding you to get a flu shot. This year just telling you ways to avoid it.

[CanadaSue]

Sorry - have to find a way to redo the chart of flu versus cold symptoms.

I totally flugeled it up; that is: it didn't post as nice & neat as it typed - lol

I'll have to think about how to best do this.

[CanadaSue]

In the earliest days of pandemic, even before such is announced for what it is, you'll likely have plenty of indication that's what's occuring or being prepped for on a govt. level. If this occurs at about the same time we're into human strain flu season, charts such as the one I reproduced above might be seen in local/community newspapers & prominently posted at doctors' offices, health clinics & hospitals.

These same locations might also begin actively discouraging 'unecessary' visits, encouraging you instead, to call newly set up health hotlines for common questions. It IS true that a great many visits to emerg & clinics are minor matters which could be dealt with at home with the correct information. In the face of pandemic, not only is it more convenient all around to cut down on health care setting visits, it can literally save lives.

As it becomes more evident that avian flu has become a concern, expect more phone lines with easy to remember numbers such as: 1 - 800 - CALLFLU. If flu vax is avaialable people will be encouraged to get it - especially the high risk groups. In a short time frame, expect elective surgeries & procedures to be cancelled & health care setting staff holidays to be delayed.

Politically trhere will be an attempt by some to grandstand the issue with lots of: "I told you so!" Hardly the time or the place as some damned tough calls have to be made. So many matters will becomes of the utmost priority in short order, there will be possibility of managing everything at any level of government.

Your job is to try & set up your life so that no matter what happens to you in terms of health, you can deal with a rapidly developing situation & feel as though you retain some element of control. That alone eases an awful lot of stress & remember, stress itself is a big weakening influence on the immune system.

There are preparartions you can undertake at the physical, mental & emotional level for pandemic. There are no guarantees but you can sure imcrease the odds in your favour, no matter how well off you are, where you live or who with. You don't have to be Super Parent or a degreed Flu Fighter. Remember, it wasn't all that long ago that almost everybody took it as a matter of fact that stuff like this happened periodically. They dealt, they cleaned up, they moved on. We are no less capable - just need to be armed with a little information & a few practical skills. If you've had or have small children or babies, you've already got a lot of the practical skills.

You don't have to spend a whole lot of money & in terms of looking after yourself or someone in your household who's ill, don't sweat being squeamish. When we have to, we DO & we will. You have ONE & ONLY 1 priority in the face of pandemic - survival of you & yours. Matter of lifestyle, hobbies, being a neat freak - toss it all out the window. You can resume all that AFTER a crisis is dealt with. Don't let fear rule you. Let caution & good, common sense guide you. You'll do just fine.

Let's start with getting the family ready before this hits your town or neighbourhood...

[CanadaSue]

Sorry, I do lousy computer. My symptom chart - I just noticed - os totally bolluxed up.

Let me try & clean it up...

Sorry.....

[fruit loop]

Flu is an EASY disease for which to prep.

Flu itself does not cause death. Death occurs from secondary infections such as bronchitis and pneumonia in a patient already weakened, or one with a compromised immune system.

Unless you're elderly or have a compromised immune system, don't worry. You won't die. You'll only wish you would.

The health care system gets "overwhelmed" during flu epidemics largely because of stupid people who don't realize that it's A WASTE OF TIME TO GO TO THE DOCTOR WHEN THEY HAVE THE FLU.

Unless you have bronchitis or pneumonia, which have definite symptoms, all a flu patient does is exactly that - overwhelm the health care system and hog appointments that the real patients, the elderly and compromised immune system folks who have secondary infections, need.

All a person can do is treat the symptoms. There are anti-viral drugs, but all these do is MAYBE cut the illness short by a few days.

Antibiotics won't help. Dont' bother stocking them for the flu.

On the other hand, if you're like me, and KNOW YOU WILL ABSOLUTELY get a secondary infection, stock up on some amoxicillin, Cipro, etc. If you're used to getting bronchitis/pneumonia, you'll know the symptoms. Administer the same dosage your doctor would give you. For me, that's ten days of the Cipro I buy in Mexico sans script.

otherwise:

Stock fever reducing drugs - aspirin, acetominophen, ibuprofen, naproxen, or herbs such as feverfew, sassafras and licorice.

Cough syrup. I don't recommend OTC cough syrups because they're frankly crap. Make your own natural cough syrup. Chop onions fine and simmer with honey, or get a standby script from your doc. (I do both)

Cold and flu meds. Theraflu is an OTC wonder that really does make you feel better, and it's easy to swallow. Contac Severe Cold and Flu is also good.

Throat spray.

Kaopectate. (The docs say you don't get diarrhea or vomiting with the flu. Bull because I always do. Stock some of this)

Vaseline or Vicks for sore, chapped runny noses. Lip balm for ditto on the mouth

OTC nose drops (but be careful, these are highly addictive, and quitting cold turkey is hell)

Boxes of Kleenex.

Anti-bacterial soaps. wash your hands often.

Lotion. Fever dries out skin

Bleach and anti-bacterial cleaners. This virus wants to live. It'll cling to anything. If there are well people in the house, tell them to clean everything and OFTEN. The average dishwasher is hot enough to sterilize dishes, but when someone is sick with flu or especially strep throat, I add some bleach to the dishwasher. Clean countertops and surfaces. Anything the sick person may touch. Don't forget the garbage cans where they're throwing their soiled kleenexes!!

Canned soups, stews, bouillon. You'll need to eat but you'll be too weak to cook. Stock lots of canned foods that can be nuked quickly.

Crackers

Fruit juices, frozen or bottled. I recommend bottled because they're easily chilled in the fridge. Frozen you have to take time to mix up when you may be too weak to stand a long time.

After the person gets well, wash their bed covers in hot water. use bleach if they're white, it kills those buggies. Also washing the curtains and all the rugs towels, etc in the bathroom they've used is a good idea. Air out the sickroom, spray Lysol, clean every surface you can with the anti-bacterial stuff or bleach. That did it for me when folks kept getting sick in my house. One would get well, another would fall ill. I finally declared war on bacteria and did my best to kill every single one in my house.

watch sales at Eckerd especially. Every three or four months they run Eckerd name brand OTC meds at half price. Stock up. To avoid the "only six per person to prevent amphetamine production" give every person in your family the allotted six, and have each person check out separately.

Good luck staying well

[CanadaSue]

It's what you've itemized here I'll be elaborating on.

To be fair, for many ir's not to much a case of stupidity as simply not knowing what to do. And as you'll see, isn't complicated.

[CanadaSue]

Sorry again - my skills here are limited to typing, cutting & pasting & a deleting files/cookies/history - lol. Charts? Spread sheets? Nope. My typing sucks too...

Let me do this in small chunks, that way anyone who already has some of the info can happily skip what they don't need & move replies they needed to their own personalized file. I'll provide references & WHEN I forget - thump me. I'll edit them in.

Assuming I'll miss stuff, let something sit a day or so before copying it ou - that gives me time to edit in, (or out), info I missed or mesed up for any one section.

I'll start with a quick & dirty version of what flu is... & isn't.

Gimme 15...

[CanadaSue]

Influenza is a small virus consisting of 6 genes in 8 gene segments, one of the few segmented virus we know about it. That has implications for its ability to mutate quickly.

We characterize - for convenience - 15 types of flu based on a compound called hemagglutinen. Thus types are are known as H1, H2, etc, through 15. A sixteenth is about to be described - not human, I don't think.

We further SUBTYPE flu based on another chemical in it known as neuraminidase - there are 9 of those. So strains of flu are described thusly:

H1N1, H3N2, etc.

Until recently the only known types which caused ILLNESS in man were H1, H2 & H3 types. A few others caused nonsymptomatic INFECTION. Humans were exposed, developed antibodies but didn't becomes ill - happens with a surprising number of other viruses as well.

In the mid 90s we began to see that OTHER H types COULD sicken humans - namely H5N1, H7N7 & H9N2. With the exception of H5N1, such infections & illnesses were rare & minor.

For those not familiar with genetics our genes consist of DNA - sorry, not going to sweat over the spelling of the full name - lol. DNA can be thought of as a ladder with each HALF rung being different. 4 chemicals make up the half rungs - short forms are A, C, G & T. A is ALWAYS paired with T & C is ALWAYS paired with G. The 4 chemicals can go in any order & can repeat: AATCGATTCG, etc.

When cells split, the ladder splits down the middle like this:

A T
C G
C G
T A
A T

When each half ladder is matched with new bits of matching chemical, you end up with this:

AT AT
CG CG
CG CG
TA TA
AT TA

Each new cell is genetically identical. Very few 'mistakes' are made as each A etc. MUST be matched with its proper mate. The only error happens when more of the bases, (the letters), are added, left out or somehow switched.

It don't work that way with flu. Flu is an RNA virus & RNA genes are dingle stranded - single bases only, no pairs. There's lot of potential for 'error' there & it happens. Take the string:

ATTCGCGTAACTCA

It may be incorrectly copied as ATTCCCGTAACCA.

As long as the 'error' doesn't affect the structure or function of the virus, it will slip through.

These errors are what mutations consist of - copying errors - for the most part.

With flu genes occuring in SEGMENTS, an entire genetic SEGMENT can be switched out. Either it switches position on the gene, (like moving a small town along a country road so it's east of another instead of west) or, if ANOTHER & different flu virus is in the same host cell reproducing itself, they can trade a segment. That is known as REASSORTMENT.

Enough for this part.

[CanadaSue]

Viruses are weird little critters. The jury is still out as to where they come from or even if they're truly alive. They can do NOTHING by themslves, consisting only of genes wrapped in an envelop which has various sizes & shapes of protrusions... They don't eat, breathe, reproduce, excrete - not anything by which we normally define life. For a virion to extend the family tree, it has to make a host cell do the work for it. Virus are the ultimate parasite.

How does flu do that? In people, it gets in to respiratory epithelial cells as follows: The 'H' acts as the 'key' fitting into receptor cells on the surface of the epithelial cells. Through a series of neat chemical tricks, that joining causes a 'bubble' to form which surrounds the entire flu virus & draws into the human call. While that is going on, the envelop of the flu virion, (single virus particle), dissolves & once the little bubble package gets inside the cell completely, its wrapper dissolved. This frees up the virion's genes.

Think of those genes as armed highjackers. Different genes get busy, forcing the human cell to start the process of reproducing thousands of flu virus particles. Lots of RNS copies are made. They are 'herded' together into individual virions which then migrate to the edge of the human cell in little globs. Please, PLEASE don't make me go all biochemical & explain that. It makes MY eyes glaze... We really need a biochemist or virologist on board.

One of the important functions of the N part is helping the new virions in final asembly & getting them out of the human cells. How does it do that? Um... I get a tad confused on that part to be honest but one of the things it DOES do is rip parts of the cell coating away from the human host cell to wrap the flu virus genes in. Talk abou highway robbery - the virus exhausts & often kills its host cells & to add insult to injury, steals its clothing on the way out!

THe thousands of new virions exit back outside the cell & start hunting for new host cells in which to repeat the process - that's how flu gets in & reproduced. Next - how that causes illness & symptoms.

[CanadaSue]

If you've ever had the flu, genuine, dyed in the wool IN-FLU-EN-ZA, you probably know what I mean. It's a miserable illness & even if you 'only' feel like crap for a few days, it can feel like forever. Here are the symptoms you MAY get from flu - how often they occur is also mentioned:

Fever: It comes on suddenly & is high - often ranging between 102 & 104 degrees. Between feeling ready to boil, you can feel as though you're freezing to death & get teeth chattering periods of chill. If you take your temperature you're often surprised to see you still have a high fever, even though you swear you'll never be warm again. It can last 3-4 days.

Headache: A usual symptom & can be severe.

General aches/pains: Are usual & are also often severe. I swear your eyelash roots hurt.

Fatigue/weakness: Also usual & can flatten you, often for several weeks. It can be severe - 'weak as a kitten' can be a good description. Yet because of the aches, sleep is hard to come by.

Runny/stuffy nose: A common symptom but pales in comparison to everything else happening.

Sneezing: Can occur.

Sore Throat: This is quite common.

Chest discomfort/coughing: This is usual & can become quite severe.

Complications: Flu CAN lead to pneumonia, can worsen a current chronic condition & in these ways, can be life threatening.


In comparison with colds; fevers & headaches are rare. If you have a headache, you may also have a sinus infection. Aches, pains, fatigues & weakness can happen but are generally mild & pass within a few days. You see more sneezing with colds than with flu. Colds lead to fews complications, usually limited to sinus songestion or infection and earaches.

[CanadaSue]

Being airborne, flu is easily transmitted by inhaling exhaled or sneezed out particles from a sick person. The bummer of it is - a person can be transmitting flu before they feel the least bit off or display any symptoms. 24 hours before you start feeling like death warmed over, you're already transmitting it, if you're around people.

You can also contract flu by touching surfaces on which are found virus particles. It's a tough little bug & can live in Kleenex, on clothing & linen, bathroom fixtures... more contract it directly from inhaling it, but this kind of transmission also happens a lot. You touch something, then brush your hand by your eyes, nose, mouth.... you may now have the flu.

You pass on flu for up to a week after you break with symptoms yourself. Add a few more days for kids & no, I don't know know why that is & have had no luck finding any info explaining that. Some people becomes INFECTED & can transmit flu but never themselves have symptoms - lovely!

Flu has the wonderful ability to happily live in any part of the world... & does just that. It's seasonal in the sense that it generally prefers cool, damp weather - it lives loger in such an environment & combine that with more of us indoors, often in stuffy rooms & you can see why winter tends to be our flu season.

After you're exposed & infected it takes 24 - 96 hours to start feeling ill. MOST people start feeling awful - ish in about 48 hours.

http://www.cdc.gov/flu/about/disease.htm
Officially we call mid-Octiber through the end of March flu season. In the S in MOST years, flu season peaks in February - survey says! It can hit & wne earlier though - we saw that last year.

Next, your symptoms explained - why you feel so awful & why that's not always a bad thing.

[CanadaSue]

They're rotten, nasty, evil & make you feel about as socially inclined as a hormonal hyena. I'm talking about flu symptoms. They DO serve a purpose, although it's sometimes the purpose of the virus & not us.

Most people first feel rather bleah, tired... & hope a good night's sleep will set them straight. Nope. The tired feeling is generally your first sign that your immune system is kicking into overdrive. An invader has arrived & your body does NOT want it there. Various systems speed up in an attempt to beat back the virus before it's too late.

Various components of your immune system are marshalled to the site. Macrophages, (the name literally means honking 'big eaters'), arrive first usually. Their job is to ingest, (fancy word for eat), any cells not belonging to your blood stream or the fluids which surround your cells. They get quite a few. Cytokines are summoned & their prodution increases. One of the things they do is regulate your immune system responses - acting like referees if you will. They also act as a head coach - different cytokines stimulate the production of different types of immune cells, determine how much of an inflammatory response the infected area produces. They do a lot, much of their functions aren't that well understood & for anyone REALLY interested in cytokines, try this:

http://www.microvet.arizona.edu/Courses/MIC419/Tutorials/cytokines.html#activities


By the time you feel really icky, the infection has set in & flu virions are busily replicating away. Each reproduction cycles takes roughly 4 hours & 1 virion can produce tens of thousands of copies of itself. If you initially inhaled a few hundred, by the time 48 hours have passed, you've got a boatload of flu aboard.

Fever is your friend - yes it really is. Often, pathogens don't replicate as well in higher temperatures & by raising its own temperature, your body 'hopes' to either outright kill some invaders or at least slow down their reproduction. Some fever may even prevent some secondary infections but that was a momentary guess & based on nothing whatsoever.

I'm not sure wbout the headaches - that may be related to the inflammation your body sets up in response to flu. If there's a practical purpose for such vile headaches, I'd love to know.

The general aches & pains as well as fatigue are basically your body telling you "something's wrong - REST!" No doubt there are other metabolic things going on but I'm not a virologist nor a doctor. Resting is good though. It saves YOUR strength & if you're lying down, you're not out there 'spreading the joy'.

The runy nose, sneezing, sore throat - well you're running an upper respiratory infection so that's pretty much self explanatory. Your throat is fairly swollen too.

Chest discomfort & coughing. Your body is trying to expel virions before they can get into more of your cells. It works for the virus too - it can only infect others once it leaves YOU. The coughing can be terrible - people have literally cracked ribs from the effort of coughing. It can lead to very sore diaphragms & soreness of any muscle group in the chest area. If the discomfort turns to pain or you're having trouble breathing:

PHONE YOUR DOCTOR!

He'll probably tell you to head in to be checked out, but call first. Severe discomfort of pain combined with any quick change in symptoms can mean a nasty secondary infection - often pneumonia.

And remember with influenza, it's pneumonia & other scondary infections that usually kill & they usually kill the elderly, very young, immune compromised & really weak. So why is the WHO increasing the "Dire Scale" of their warnings?

That's next, then more on actual prepping for flu.

[CanadaSue]

Every year & more & more publicly, the WHO wamrns about the 'next' pandemic of influenza - what's up with that? Traditionally they warn us it's coming but hedge their bets & don't say when. The latest warnings say: "maybe even this year." HUH? Where is THAT coming from?

Okay if you want to nitpick, every year sees a pandemic of flu. A pandemic simply means a strain or more of influenza makes the rounds every year, makes a lot of people sick & facilitates the death of SOME. The types of flu we're accustomed to seeing, H1, H2 & H3 aren't exactly new to the neighbourhood & the death rates for these types aren't frighteningly high. Most years, flu kills 0.1% of victims. Bear in mind, that's not the death rate among ALL the population but holds for ALL THOSE WHO CATCH FLU. THat's an important distinction.

Spanish Flu upped the ante & killed 2.4% of those infected. The high total number of deaths were due to the fact that it infected so many. Still, that's not a stunningly high death rate for any disease. Smallpox kills 33% of those who catch it & Ebola Zaire substrain Mayinga nails 97% of its victims before the disease burns out.

What's the WHO been smoking this year?

What they know is that every time a new TYPE of flu crosses from birds into humans, it's a brand new ball game. While flu in general may have common symptoms, when a new type hits human populations it can do interesting things. Spanish Flu caused, (strongly suspected), a post infection form of encephalitis which left millions permanently changed. It would appear it had hemorrhagic components. Each new flu types represents a new package of foreign genes hitting our systems & new symptoms are not unexpected.

H5N1 has 'always' been a birds only strain of flu - that is, until 1997 when it stuck 18 patients in HOng Kong. 6 of them died & that placed it right up there with smallpox. Hong Kong health authorities & international health agencies freaked. Here was a strain that had jumped straight to humans, killed 1/3 of them & struck across the age range. As well as the usual flu symptoms, those who died suffered complications involving their hearts, livers & kidneys.

Hong Kong is a very crowded community, flu is airborne & what if this sucker went postal? The implications were terrifying & a lot of international travel occurs going both ways. H5N1 certainly wasn't new in poultry but it most certainly was the first time it had appeared in people. How long has H5N1 been in birds; I don't know - still looking but the implications from the reading I've done so far is that low pathogenic varieties have been around for decades.

Hong Kong authorities bit the bullet & culled everything remotely resembling a bird in HK. Everyone held their breath & ... it worked. No more cases in poultry, none in humans. And while the world breathed a sigh of relief, frantic research efforts began - what had turned this one so nasty? We're still finding out but answers are coming.

More worryingly, those answers are showing that the 'new' H5N1 is still mutating at a fast clip, beginning to infect more species & knowing that, it's hard to fault the WHO for putting out more 'red flag' warnings.

Earlier this year, H5N1 exploded among poultry in southeast Asia. Staggering numbers of various types of poultry were affected & unfortunately mainly in countries least able, ready or willing to deal as Hong Kong had previously chosen to do. Then, more human cases & this time... CHILDREN. And they died, oh how they died. In the 10 months since this has begun, outbreaks have waxed & waned, almost 4 dozen people have become ill with H5N1 & 70% of them have died. Not all sticken or killed have been children nor have most of them had pre-existing medical conditions.

What of the argument that these are basically third world countries; that this may explain the high death rate? It might to some degree account for the high death rate, but not all of it. I like to hope that many cases simply didn't get very sick - that they got a mild case, suffered through it & recovered without ever seeking medical attention. After all in poor nations, who's got money for medical care? That would lower the death rate considerably - I hope. Conversely many may have been stricken & died without medical attention. Either there was none to be had or no money for it. We simply will never know.

So should this 'cross over' & gain the ability to easily infect people through poultry or directly person to person, we currently have no way of knowing how bad it would be. The WHO MUST plan for the worst. Think the numbers they're giving us now are frightening? What if we get a 'lowered' death rate of 50% & an attack rate of 50% because it's going to be so new to us? That's 1.5 BILLION people potentially dead. Yes, that's grossly exaggerated but if you're planning sceneraios, you have to at least look at the extremes. And even looking at non-extreme events & potentials, the WHO has every reason to be concerned.

Specific reasons to be worried next...

[BearWash]

CS: Boy, am I glad to find you again (and very timely with the bird flu on the horizon).

Am going to spend the rest of this weekend catching up on your posts. Thanks.

[CanadaSue]

Okay we have had, since February this year, continued outbreaks of H5N1 in poultry throughout southeast Asia. Some nations have dealt with it more sauccessfully than others. Few countries have entirely stamped it out.

We have seen close to 4 dozen human cases with 30+ deaths. The cases & deaths have crossed the age range, but the young - presumably healthy people have been hit hard. Maybe that's because they're the one's dealing with poultry more than elders or the ill - makes sense.

Highly pathogenic H5N1 is or is almost endemic throughout much of southeast Asia.

Many of the nations affected are poor and/or corrupt politically. They have little health care or surveillence infrastructure so we don't know what's really going on out there. Background death levels from "I dunno" are high, making it difficult to see upticks due to flu like illnesses & the resulting deaths.

Influenza produces pandemics of a serious nature several times a century - we're due for a doozie.

The planet is crowded & is accustomed to rapid & frequent travel - flu can go global in a mere 6 weeks. Crowding means the air travel related 'jumps' quickly lead to widening circles of flu around index cases in any community affected.

Much of the world does not enjoy a decent level of basic health or sanitation.

Much of the world has no access to health care, never mind the kinds of medicines which would prove useful in a serious flu pandemic.

Nobody can accurately predict the symptoms & typical complications of a human H5N1 but based on what we've seen so far, we can extrapolate a very hefty demand on even the most flexible health care system.

Western health care systems as they're currently constituted aren't that flexible - they have little surge capacity in terms of beds, bodies to work & treatments to use.

We'll run out of what we have quickly in terms of materiel & exhaust the bodies able to work a pandemic.

If it strikes in a compressed fashion, very little will work well after a short time. Schools, banks, grocery stores, manufacturing, transport, all infratructure, gummint - all be be negatively impacted.

Pandemics often bring social, political & cultural chaos.

Few nations have done realistic pandemic plannng & they've certainly not done so considering international concerns.

It will probably start where we're least likely to notice it is jumping into humans. By the time we know what we're dealing with, stopping it will be impossible & slowing it will be next to impossible.

There is & won't be a vaccine in time to prevent spread. There won't be enough to so much as protect SOME health care workers.

I suspect it's these matters among others that have the WHO concerned.

I've also heard from several people FOAF stuff & no details, that this one is mutating at a high rate of knots. I don't know the nature of those mutations.

[CanadaSue]

In short, not yet. Whatever you happen to think of the WHO, they don't want this H5N1 out there any more than anyone else does. In some nations, H5N1 could cause absolute catastrophe. But that depends entirely on what symptoms it dends up having in humans & what complications.

If, IF the age range of the affected holds up, everybody will be vulnerable to catching it. For most, I suspect it would 'simply' be a matter of getting through a rather nasty bout of flu. I have personal experience with an H1N1 as well as an H3N2. Don't want H5N1 - gimme pneumonia again, any day. I had no problems with 2 bouts of that in my younger days.

I'm concerned about what happens if we end up with a compressed flu season as we did last year if/when H5N1 pops up in people. A/Fujian was a subtype familiar to our systems & that wasn't pleasant.Younger kids who'd never been exposed to H3N2 strains - which have not been seen in huge numbers in the past 5-6 years, really were hit hard. As a parent, it's frightening, especially as gevers can soar so quickly. Often you get conflicting advice & there are times, especially at oh dark thirty, when you swear they won't make it through the night.

Keep in mind when all was said & done, no one in the flu world THINKS A/Fujian killed more than the expected number of people. They are this year, attempting to track pediatric hospitalizations & deaths due to flu & related complications. That will ar least give us baselines.

If H5N1 crosses over & quickly behaves like any other fl;u strain we're accustomed to, we have nothing to fear, just the usual concerns anyone would have with flu - depending on their personal circumstances.

Now next set of replies I'm gonna go right paranoid & lok at what MIGHT happen if this one crosses over & retains a high death rate.

[Hansa44]

CanadaSue,
Thank you for so much valuable info. This has answered quite a few of my questions about the difference between flu and colds.
In one of your posts you mentioned headaches and could see no reason for them. This may seem like a ridiculous possibility, but I believe it actually could be a possibility for some.
When we come down with the flu I usually start with total weakness and sore throat and maybe fever. I also, at that point, quit drinking coffee and eating sugar products and junk food in general. So when we come down with the flu we are also putting our bodies into withdrawal from caffeine and sugar. This can give you a terrific headache and can last for one to five days.
Anyone who doubts this should try it when they are healthy. For me the headache may start 15 to 24 hrs. after refraining from it.
I'm reasonably sure there are also other reasons but thot I'd mention this
hansa

[DarkRose]

What are the physical mechanics of a headache? Could it be the body's method of protecting the brain?

[MamaWolf]

Hansa44, I have to agree with you on that! When my dh and I had strep throat 2 yrs ago it was a NASTY bout of it - I thought I was going to die, and my dh was even throwing up! (Yep, it can happen with strep, just not common) On Day 3 of our strep, with the world's worst headaches, I realized we hadn't had coffee in 3 days. As soon as we "re-caffeinated" ourselves, our headaches went away. LOL!

[CanadaSue]

I'm going to look the physical workings of headaches. There are probably several different ones. Different things may factor into flu headaches.

Know where you're coming from with the 'deprivation headaches'.

They're also known as rebound headaches, btw.

[Deb Mc]

C.S.,

Thank you VERY much - your guidance has always been top notch!


(Howdy to everyone here! Wishing you all the best.)

[CanadaSue]

I'm warped enough to enjoy looking up & posting this stuff.

I like to think that information is power & I'd rather KNOW what to worry about than worry about the wrong things.

But I'm taking a break. Never did see The Return of the King & it's about to come on.

Viggo Mortensen can park his broadsword under my bed any old night but that's besides the point - should be a great finish to a great trilogy.

If I'm still awake after, got more to go up. If not, that's what mornings are for...

[fruit loop]

If you've got clogged sinuses, you're gonna get a whale of a headache. Try taking a decongestant as well as a pain reliever.

Fever causes a fierce headache. Fever can also cause brain damage. That's how fever kills - it literally bakes your brain!

[EchoSource]

Hey CS (and all the others here), I drifted over to check this board out from Mutterings and I like what I see here.

CS are you going to touch on dehydration and proper hydration when a flu hits really hard? If I am not mistaken the symptoms of dehydration and how to treat it are some of the biggest problems in a pandemic illness.

In a pandemic situation there may not be any stores with Pedialyte (sp) or Gatorade and the hospitals will be over crowded and unable to give I.V. fluid so it might be down to the old fashioned raw sugar and salt remedy? I believe I read something about this in the book called Where There Is No Doctor? It is basically like oral ringers from what I remember.

Anyway, it's just another area you might want to add to a very large and worrisome subject. Thanks for the info and your time...Echo

[CanadaSue]

Will do up a 'care section'. Hydration is vital & won't be ignored.

[CanadaSue]

I like to start with 'worst case' & work backwards to reasonable. As it happens, some concerns which would be large factors in worst case would also come into play in less virulent pandemics. Because the WHO is looking at H5N1, I'll go with that one & quickly go through the 'early evolution' of a "oh sh*t!' pandemic involving an H5N1 strain that's mutated to go directly human to human. Start date of 'pangenesis" - in humans - January 15th. I'll start today with what happens until then.

Remember, this is:

@@@SPECULATION, WILD A$$ GUESSING, NOT PRESENTLY OCCURING @@@

Over the past few days, spontaneous & concurrent outbreaks of H5N1 in poultry have been occuring in Thailand, Malaysia, Indonesia & South Korea, near the border with NK. Some have been spotted right away & the official reporting process is underway. In some districts of some countries - culling is already occuring. Cullers are being forced to reuse masks, etc - simply not enough to go around. Some small farmers & families are hiding birds which appear well.

By the end of this week, (Dec. 3rd), the OIE:

http://www.oie.int/eng/en_index.htm

is reporting outbreaks in Indonesia, Mayalsia, Thailand, Cambodia, South Korea & Vietnam. A rough total of 25 million domestic poultry of various breeds are contained within flocks infected & the OIS is urging they ALL be culled.

The WHO puts out a warning statement, urging affected nations to send specimens for testing & urging nations to be on guard for human cases.

By Dec. 10th - South Korea is reporting 4 admissions of suspect HUMAN cases. Three are cullers & one is the wife of a culler. He remains well & under observation. Thailand is rumoured to have a dozen or more - mostly children. Indonesia is officially reporting 7 suspect cases - all ages. The epidemiology to determine source of exposure is underway & the WHO has sent teams to examine possible patients, their clinical records & to obtain samples for testing. Japan is reporting avian cases as well across 3 prefectures.

Dec. 17th - 3 of SK's cases are confirmed including the wife of a culler. Her husband is well & blood samples show no antibodies to H5N1. The family does not normally have contact with poultry. Thailand is now openly reporting 30 or more cases - 5 of whom have been confirmed. They're asked the WHO to send help - they can't do the testing & the populace is close to a state of panic. Japan is reporting 3 cases - one confirmed. Frantic contact tracing efforts are underway.

The WHO warns member nations it's close to changing its pandemic preparedness level & urges nations to check all travellers coming in from affected areas. Alost the entire world has banned ALL imports of poultry & poultry products from affected nations. The CDC. Health Canada & EISS puts out urgent members to its associated agencies & public service announcements begin to go out. These give people appropriate warnings about symptoms, precautions to take & when to call the health care system for advice. They urge people to visit their website, determine if they NEED to call local public health & state they're curently reviewing pandemic preparation plans. The websites where such warnings WULD be posted if this were really happening:

http://www.phac-aspc.gc.ca/fluwatch/index.html (Canada)

http://www.cdc.gov/flu/ (USA)

http://dev.eiss.org/ (Europe)

Dec. 24th - More of the suspected cases are confirmed across all nations reporting them. More suspected cases being reported or making their way to whatever health care is available. The first death is recorded in Thailand - a 12 year old girl in otherwise good health. The WHO is frantic trying to deal with too many aspects developing at once. They're able to confirm most cases ARE H5N1 & in roughly 20 cases - 2 clusters, there are no indications of ANY contact with poultry - only other ill with suspected or confirmed H5N1.

Dec.31st - More human cases & increasingly, they're confirmed H5N1. Worse, an increasing number report no contact with poultry of anyone who has any contact with poultry. Across the world, nations go on alert & anyone who so much as LOOKS a bit off coming into any nation from those nations affected are closely scrutinized. The culling of poultry is proceeding but in very hit or miss fashion.

The WHO publishes a list of symptoms & their progress, as seen so far & as follows:

next post...

[CanadaSue]

My typing is inexusable. I do, sort of, halways, edit, sometimes. But it's not good enough.

I've had an offer of spellchecking/editing from a fellow ,member which I'm gratefully accepting. That will slow up posts by a bit but shouldn't do so by much.

I can't stand checking something I previously posted & finding such clangers.

Thanx for your patience.

Sue

[CanadaSue]

Couple of bad nights - still not quite 100% here... sorry. I'll finish the 'what if? worst case' stuff then crank it back to reasonable & what people can do to prep. I'm not unduly worried about grammar/typos for this part but when it comes to practical considerations & concerns for a real time event, my editor will get this stuff first - lol, then I'll post it.

Jan. 3rd - The WHO formally announces they feel pandemic is imminent. A number of human H5N1 cases in different affected nations clearly show human to human transmission. Alternative explanations may have been feasible if only a few cases were suspected of being human to human but by this point there are well over 300 suspected/confirmed cases across several nations & socio-economic groups & as a result of this, the WHO formally declare Phase Zero, Preparedness Level 3. The following conditions for this level as follows, have been met:

***This Preparedness Level will exist when human transmission of the new virus sub-type has been confirmed through clear evidence of person-to-person spread in the general population, such as secondary cases resulting from contact with an index case, with at least one outbreak lasting over a minimum two week period in one country. Identification of the new virus sub-type in several countries, with no explanation other than contact among infected people, may also be used as evidence for significant human transmission.

Before WHO announces this Preparedness Level, the WHO task force will have ensured that an international consultation has occurred: first, to ensure that the assessment of the new virusÕ pandemic potential is not overlooking any other explanation, including artificial exposure of humans in several locations to an influenza virus (e.g., an act of terrorism), or an unusual ecological situation with an animal vector spreading virus to humans in different locations; and second, to be assured that the potential of the virus to cause lower respiratory tract disease or other complications is evident.

WHO with the help of its task force and after international consultation announces this Preparedness Level 3.

WHO will disseminate the case definition to be used in surveillance for the new virus sub-type.

WHO will facilitate the distribution to all interested manufacturers of candidate vaccine viruses developed as part of the Preparedness Level 2 activities.

WHO will convene its experts for influenza vaccine composition to develop, disseminate and encourage co-ordinated clinical trials of vaccines against the new strain.

WHO will convene its experts for vaccine composition to develop ways most likely to make vaccines widely available throughout the world, with recommendations for their use appropriate to the populations, health care delivery systems and environments in different regions.

WHO will further enhance its information dissemination to provide timely reports of the status of investigations of the new virus, its spread, and the development of responses to it.

WHO will contact vaccine manufacturers and national governments about capacity and plans for production and international distribution of a vaccine to the new virus.

WHO will encourage international co-ordination for purchase and distribution of vaccine among different countries.

WHO will provide general guidelines to national health authorities based on the best available information to assist individual countries that are determining their course of action. Guidance is expected to be helpful, particularly with regard to the following aspects:
Types of surveillance most likely to reliably document spread and impact of the new virus;

Risk groups for contracting infection or suffering severe morbidity;

Situation with regard to plans for manufacturing vaccine against the new virus;

Other approaches to control; and,

Case management.***

This has of necessity, occured very quickly. Influenza is an airborne, easily transmissible virus & with human cases springing up across southeast Asia, there's no time to waste.

They offer the following case definition of human H5N1 influenza infection - people meeting some or all of these criteria are considered SUSPECTED cases & once lab testing shows H5N1 that in confirmed:


Exposure within the week before medical consultation to poultry, especially in currently affected areas.

Travel from an area where H5N1 is now endemic & ongoing.

Exposure within the last 5 days to a person suspected to known to have H5N1 influenza.

- sudden onset of fever ranging between 39 - 40 degrees C, (102 - 104 F)

- headache, possibly severe

- general malaise, may be severe

- extreme fatigue

- chest discomfort & cough

The WHO urges dissemination by all nations of this symptom list & urges increased monitering of travel & the setting up of pandemic contingencies.


Some form of such a statement would occur & far more detail would be available to anyone checking the WHO website. Of course government authorities in a great many nations would be working at a feverish pace behind the scenes making sure flu doesn't come in to their borders. Knowing it's likely to do just that regardless of any/all efforts, other steps are being taken.

In the US & Canada, doctors & hospitals would be advised to try & limit admissions of patients for reasons other than absolute necessity. Early discharge of as many patients as possible would be recommended. Staffing lists would be updated & might do so to include recently retired staff who could be called back in case of an emergency. The smarter nations might start, (if they haven't already done so), stocking up on the supplies & equipment they'd need to handle pandemic flu.

Phone lines to deal with calls would hopefully already be contracted for & being installed. Some might be operational & hot line staff are being trained as to what questions to ask & what to advise clients - depending on symptoms they discuss & answers to questions. Local & national media might begin to feature flu & crank up reporting on on possible pandemic. I'd expect to see some solemn reporter at a busy airport showing some of the screening & solemnly saying something to the effect of: "It could start right here!" Hey, drama & trama - they thrive on it.

So this is where we're at, less than 2 weeks before pandemic IS here. The WHO & different levels of government are preparing - what are you doing?

[CanadaSue]

I needed to rough out several places to take this bearing in mind that different people live in different areas, with different types of family groups & with varying types & amount of resources available to them. I'm going to start all predictably with a family group - your milage may vary. I will then look at considerations for those alone as well as those who may find themselves in the position of caring for small groups of people not related to them. There are plenty of people out there who may be single or who have no nearby family to be concerned about & who may choose to look after for example, people in a group home setting. These settings might include developmentally handicapped people, small groups of teen mothers to be - with or without very young babies, seniors in small private care settings... you get my drift.

I will inevitably forget certain matters, if only because I'm not familiar with certain settings or considerations. Please DO email or PM me & I can immediately correct these defecits. I'll also invariably remember something I forgot & will add those later. So anyone wanting to extract sections they need might be adivsed to wait a day or until I'm sure a section is complete. I'll try to keep sections small & narrow in focus so that no one is stuck extracting miles of drivel.

Not all of this will make pleasant or comfortable reading. Pandemic is not pleasant & I suppose it's a small comfort that influenza is not the 'grossest' of diseases. Smallpox, plague & a number of others are literally revolting to work with & while flu has its nastier aspects, it could be worse. Death is a given, whether it be in your household or close by. You'll have to be prepared to deal with that as best you could.

This may or may not help but priorities & sensibilities change based on the circumstances we face. Matters which would normally horrify us, be 'unthinkable' suddenly are anything but. We may find ourselves, acting, thinking & feeling in ways we hadn't expected. But in pandemic - what's normal? While certain types of pandemic patterns can be [redicted, much remains situational & what I may have to cope with will be very different from what you need to consider.

Often, there are no absolutes, no one wa of dealing with certain situations. YOu know yourselves & your situations best & must plan accordingly.

Let's go... I'll be running theses by my editor first - lol.

[CanadaSue]

Technically influzena is a yearly pandemic. It spreads around the world in season, making millions sick & killing up to half a million people every year. What we are concerned with here is a novel strain of influenza - one which will not have been seen in large numbers previously. It may be H5N1 - that would appear to be the most likely candidate at this time. It may not respect seasonality as much as strains we're accustomed to seeing but within the bounds of modern transportation we will probably see it change its areas of prevelence depending on climate & seasons.

It would possibly start a bit slowly but once it became well established in at least 1 population, would spread very quickly - far faster than any government or agency could handle. Stopping it? In your dreams. The best that could be managed would be a temporary slowdown of spread.

A vaccine might be available in limited quantities after 5 or so months but by that time the strain which started the pandemic MAY have mutated to the point where the vax is no longer effetive against one or more newer, mutated strains. In a worst case scenario, someone who became ill & recovered at the start of the pandemic might catch pandemic flu again - a newer strain much later in the pandemic. Hopefully they wouldn't get as sick but that would depend not only on the strain but other matters. Were the otherwise well? Had they been able to eat properly? Underlying medical conditions?

It would MOST likely start in Asia or far eastern Europe & partly because of this not be noticed until it reached a part of the world where surveillence & testing capabilities are better & faster. While to me it's a given that it would spread very quickly because of air travel just how quickly it would spread would depend on when it showed up. If for example, it 'came home' with a lot of post Christmas travellers, expect full bore pandemic across most of the west by the ned of March at the latest & I think I'm being optimistic. It has a short incubation & 24 hour 'silent' transmission period so it may be much faster.

The safe bet is to assume, if you hear of a case in London or the nearby area that came in via Heathrow or Gatwick, is that it's already in the US. We'd see it in & around cities with major international airports, followed in short order by areas where airports which act as regional hubs are located. Then trace it down rail lines, interstates, busy border crossing areas - pull out a large scale map on the US or better - international air route map & you'll see just how fast & easy it is.

How long might it be with us? Too many factors involved to call that one accurately but no less than a year for full blown pandemic. 1918 Spanish Flu didn't instantly disappear. It petered out over about a 5 year period & boy, don't I wish we had viral samples from different parts of the world for those years. I'd love to see how much mutation occured. I'd also love to see world wide maps of geographic distribution, (as known), combined with months & avian migration routes. Some post grad student or ten somewhere has probably done this - I just can't begin to think how to go about finding such.

Okay, now we'll look at prepping.

[CanadaSue]

You didn't travel for Christmas this year. Both you & your wife were tired from a hectic fall at your respective jobs & you decided travelling was crazy. Yeah, it would have been nice to go to your brother's farm. A week in the country would have been great but this time of year, travel back & forth can be dicey. The 3 kids would have no doubt been bored to tears & your mother in law who's been living with you since June probably didn't need the stress. Thankfully her angina is stable & daily, you thank your lucky stars she's not the mother in law from hell.

You've already cleaned up from Christmas & this weekend, before returning to work should be, should have been, a breeze. There are loads of leftovers in the fridge & you've bluntly told everyone they can fend for themselves - just clean up after themselves. You'd planned a weekend spent soaking in the tub with some of your new Christmas novels but recent events may mean different reading.

You've closely followed the H5N1 flu outbreaks & are getting increasingly nervous. It strikes you that it's a matter of time - perhaps very little - before it lands on your doorstep. That worries you for several reasons. You're a senior loan officer at the bank & as well as dealing with your own clients, you're often called in by more junior staff to go over their paperwork & speak with their customers. Your bank is a busy downtown branch with lots of traffic. Your husband teaches history & geography at a large, consolidated high school. The student body numbers about 1000 & they're bussed in from a few rural communities near your suburb. Your 15 year old son & 13 year old daughter attend a high school a little closer to home, slightly smaller but with a large intake area as well. Your 9 year old luckily attends a small & excellent local public school but between the 4 of them & you, you're exposed to hundreds if not more, of people on a daily basis. Lukcily your mother in law isn't due for any medical appointments until some time near the end of January & if memory serves, it's simply to see 'how she's doing' - her GP is excellent that way.

You've always paid attention to health issues - you're a wife & mother & between the jobs both you & hubby have & 3 kids in school, many colds & other cases of sniffles find their way home. Your 13 year old daughter has very mild asthma, rarely having any problems but when she does have a head cold it often hits her a bit harder. The rest of you are disgustingly healthy compared to many of your work mates & neighbours & you work conscientiously to keep it that way. Oh, you don't go nuts about it but meals are generally balanced, you all get out & excercise. The kids are all involved in extra curricular sports, hubby plays old timers hockey, baseball & jobs & you prefer walking - often with your mom in law & have a nice little home gym set up downstairs.

Nevertheless, the information you've read about this new flu doesn't make you feel any better about your lifestyle being something that will be of much help. You've heard of too many otherwise healthy people catching it & having a terrible time with it. Far too many are dying. You sit at the kitchen table finishing your tea & thinking hard. Your youngest is out snowboarding at the hill a few blocks down the street with his friends. Your daghter is on the phone - where else at 13 & your 15 year old son is still asleep. You'll be lucky to see him by noon & he said something about having plans for the evening. Your daughter will be sleeping at her best friend's & the 9 year is supposed to be spending the night at his cousin's - payback for when you looked after your brother's kids so your btoher & his wife could do last minute shopping.

Right now hubby has driven your mom in law to a friend's for a visit & is planning to stop & pick up a few Saturday papers. They should be home in an hour or 2. You get up, pour more tea for yourself & head for your computer. It's time you think, to seriously work through the impact pandemic flu might have on your family, what you would do, how you would cope. You have some things going for you but definitely some worries & concerns too. This evening might be a good time for the 3 adults to sit down & discuss what might have to be done, what might happen.

You strat looking around for more flu news & what you find isn't terribly reassuring.

[moonshadow]

How does one go about stocking up on antibiotics? Our doctor will not give out scripts for preparedness antibiotics- how do animal grade work? Do you just go to a retail feed store and ask for such and such antibiotic?

[fruit loop]

You'd have to take monstrous doses to get the proper dosage for a human. Dont' waste your time.

Don't bother with antibiotics anyway unless you have a secondary infection such as bronchitis or pneumonia. Flu is a virus and antibiotics are worthless. Your body will cure the infection itself.

Try medsmex.com

I just got a nice shipment for Cipro from them. Tell them to add a note for Customs that this is a drug that your American doctor regularly prescribes for you and they'll let it through. I've never had a problem.

[goatlady]

Hey folks, I have bought and used Vet antibiotics for years and they work just fine. You only have to double the amount usually, as with the fish antibiotics. I get extras from my Vet everytime I have to take an animal in and I can buy some off the shelf at the local feed store and the main stock I buy on line from Vet supply places in the manufacturer's original sealed bottles which I have compared to what is on my Vet's shelf and they match. I personally would rather buy locally than from a foreighn company/pharmacy where I cannot tell the manufacturer and I would rather not take a chance on getting a pseudodrug that has been repackaged. Most folks with animals/livestock pay attention to their own health problems and know what they usually get as an illness and what the doctor usually prescribes so it does save time and $$ doing it yourself. By the way doxycycline does the same job as the more expensive Cipro especially for anthrax. If you vacuum pack the pills and throw them in the freezer they keep their potency for 10 years or more.

[moonshadow]

Thanks for the response. I do have allergies & asthma and almost always end up with secondary infections especially broncitis.

[CanadaSue]

I'll definitely be addressing that.

Keeping an eye on a VERY local hazmat situation right now & until they get those cars back on the rails & outta here, my attention is a bit split.

[Shadowfane]

Goatlady/fruit loop....

You can use Vet meds, just need to know what the NORMAL dosage PER KILO is in humans and then do the math.....

[CanadaSue]

in many ways mirrors many modern middle class families. The parents are in their 40s, both work & the have kids who are no longer little ones. In this case an aging relative is also part of the family. Other 'common' family groupings these days included many blended families, single parent families & increasingly, 2 or more friends sharing housing. The makeup of families has or can have, a large impact on what you can do to prepare & how. Where you live is also hugely important. Let's start with the 'easy' bit - setting & how it affects what you can do to prep & what you need to be concerned about.

While many have the ability to bug out to 'safer' locations, I'm going to assume for the most part that for different reasons, you are going to be coping in your current location. As 'bad' as your living situation may be for different reasons the big advantage is that you KNOW the area or can more easily find out what you need to know. Here are matters you should familiarize yourself with before pandemic rears its ugly head.

Community demographics... how large is your community & what is the age distribution? A retirement town with a high percentage of elderly... count on medical services being swamped immediately. A more mixed community probably applies for most of us. The larger the community, the harder it may be to get straight & timely information. This is a factor of confusion for the most part as opposed to a deliberate attempt to conceal. If your city has 58 hospitals & unpteen clinics, it will take longer for that city to come up with accurate numbers of cases, etc. They have to wait for the data themselves.
Conversely, there may be more telephone hotlines & local internet resources from which to obtain LOCAL information.

How close are you to interstates, airports, etc? The more travel occurs through your community, the faster flu will show up. It MIGHT mean easier access to needed supplies or commodities but may also mean all that stuff just trucks right on through. The bigger & more urban the community, the harder it may be to find food after about a week.

What are local first response services like? Paid, all vounteer - how well trained? What about 'civilian auxilliaries' to these services? What sort of emergency plan does your community have? What about surge capacity? Find out. Attend city council meetings & ask, or email local government. Keep asking until you get an answer. If the answer is unsatisfactory - start pushing. Perhaps you can help in some way to formulate some aspect of the plan. You may know of available resources your community might not have considered.

What about local weather? If you live in an area which experiences winter, heating is a concern & you need to assess the feasibility of staying if you can't heat your home. What of water, sewage, electricity, communications? You have to consider these matters both for yourself & in terms of the community at large. How will rare & valuale resources be guarded - if they are? No matter how unwelcome answers to these questions are, you NEED to know.

Do you live in an area where you judge people are likely to stay put or leave? What about refugees trying to come into your area - figure out the liklihood of those possibilities. Are essential, (essential in pandemic), industries & occupations clustered in your area? Check it out.

You need plans & alternatives for all these considerations & more, many of the 'more' personal ones. You need to try & guess how it would play in you area with pandemics both relatively minor & major. It's possible that no matter how personally prepped you are, your community & how it's set up, what lans it may have, work against you. In that case, you need to figure out if you're going to stay & tough it through or leave. If you're leaving - where & how. Many alternatives may be necessary depending on different circumstances.

There are never going to be solutions that fit everybody - that's completely unrealistic & even the best crafted pandemic plans developed by any size of community can't address every single need. You have to try & figure out what's a show stopper for you as opposed to what you can work around. Pandemic plans are built to consider 'the needs of the many' & it's a given that 'some of the few' will inevitably die as a DIRECT result of overall pandemic planning Weep, wail, wring your hands & exclaim: "Oh that's AWFUL!", as much as you like, as long as in the end you accept that this is inevitable. Every decision will save lives, yet cost lives. The overall emphasis of pandemic planning is not to save ALL lives, but to save as many as possible.

And in the end it comes down to this. YOU & only you can make detailed plans for you & your family. If those fit within overall pandemic planning parameters - great. In all likelihood, some aspects of any pandemic plan will make day to day life tougher for you. That's just the way it's going to be. Your mayor, local police officer & National Guard Units... they have no interest in upping the body count, no interest in taking lives. They will be just as vulnerable as anyone else, possibly more so depending on the nature of specific tasks. Their loved ones are also susceptible to the flu so believe me, they're as motivated as anybody is getting as much of a grip on it as possible. Protective clothing the military has will provide SOME but not complete protection & the nature of some of their tasks may over ride that. I'm not trying to come out as a one woman cheering scetion for any authority or authority group. I just want people to consider that they're not simply faceless planners. They have as much at stake as you or I do. Effectively, most will have no more warning than we do - perhaps a few days, a few hours - not enough time reallt to secure the safety of their loved ones. Ain't no 100% safe place anyway. Most government & agencies are comprised of ordinary people bringing home biweekly paycheques - juts as we do. Few will have greater knowledge than we can muster. And if it gets bad enough, many may end up saying: "screw it!" & return home to tend to their loved ones, leaving their jobs & responsabilities behind.

Like I said, ultimately it's up to you.

[y2kmisfit]

Canadasue
I joined the forum today.
You're nemero uno in my book when it comes to analyizing infectious threats and disseminating it into easy to understand terms.
I, on the other hand, am only good at looking for off the wall thoughts and ideas that others might miss and maybe do some number analysis like I did for the SARs outbreak.
Anyway...sure am glad there's a Canadasue. :yes:

[CanadaSue]

You & several others were absolutely invaluable in helping all of us sort the wheat from the chaff during the early days of SARS.

There WILL be another SARS type disease entity - this winter I think with the same initial fears, hype, etc.

Actually I like to scoop up stuff from all sorts of sources, not the least valued of which is 'off the wall'. Individual bits of meaningless info sometimes form interesting semi-coherent wholes.

There IS something strange going on with SOME flu this year. I just can't find more right now than obscure 'sideways' references & info with no sources. THere's SOMETHING there - I just can't tackle the sucker.

Am going to the mall tonight to people watch, as they shop for Christmas. That often results in off the wall light bulb moments.

We'll see.

[CanadaSue]

Look, we don't know when this will hit & it's all well & good for me to yammer on about what to do in different specific situations. However some of the absolutely essential stuff you may need to prevent illnes may become unobtainable within a few days or hours of a pandemic strain being announced & the early stages of pandemic developing. Or you may not want to leave the house & fight crowds to get this stuff. This is what you'd need & I'm trying to put highest priority items first, to hopefully NOT get ill & to mitigate illness if you did:

Masks - N-95. They're available at drug stores, WalMart & north of the Maple Syrup Line - at Canadian Tire. Other stores probably have them. There are ways to 'recycle' them for longer usage but buy as many as you can get your grubby paws on. They don't take up a lot of storage space. Dust masks or painters' masks won't cut it.

Disposable gloves AND dishwashing gloves. Both are handy, both are cheap & can be bought at drocery & drug stores as well as hardware stores. They too can be 'recycled'. Later on that.

Bleach - the cheapest version of household bleach you can get your mitts on. If anyone knows how to obtain & mix/dilute pool bleach - chime in & I can add that to the later cleaning/disinfecting post.

Garbage bags - big & little. Go for bulk, go for cheap - lots.

If your funds can swing it - disposable dishes, paper & styrofoam bowls, plates, cups, utensils. At some point, doing dishes may be too time consuming or water may become an issue.

Flashlights - a half dozen or so of your favorites - windup or battery.

Small radios for news - windup or battery.

Batteries - don't forget batteries for your smoke detector - lots of fires happen during pandemics.

Soap - dish soap, shampoo, hand soap. Laundry detergent. Remember for the most part, soap is soap is soap. I can & often do use liqid hand soap as shampoo as well as dish soap. It works. Liquid laundry detergent is easier for laundry though.

Rubbing alcohol - lots. It's cheap.

Hydrogen peroxide - lots, it's also cheap.

Whatever OTC meds/herba;s/homeopathics/etc turn your crank & work for you in terms of symptom relief & what you feel might work as a preventative. Sambucol, ginseng, zinc lozenges or spray, ecchinacea - not all work as well on everyone. Get what's best for you.

Sugar & salt - a fair bit. "Huh?" you may ask... Medicinal AND for comfort foods. But some brandy or whiskey too - whether or not you drink. You don't need a ton & don't really need it but under certain circumstances, it can help.

Linens. Make sure you have sheets, blankets, towels, washcloths, quality isn't the concern as much as quantity - time & laundry issues & they're handy for all sorts of other stuff.

Several changes of loose comfy clothing - for you & patients. Lots of undies & socks.

Thermometers, a couple of urinals & bedpans...

That will do for starters & yes there are certainly a great many more items you can & probably will get. However, these are really the must haves. You can work around pretty much every other shortage but these you need. And look, I live stony cold broke myself so when I state must have, believe me, I've considered it carefully.

You don't NEED more than 1 radio or flashlight but at least a spare is handy - things break. If you can cobble together a substitute for a bedpan or urinal -great. In fact - SHARE! A whole bunch of gandy supplies can be obtained free; they may not pretty but they'll work.

The tiems I mentioned are those I would not be comfortable facing any pandemic without. I will certainly expand on those lists, discussing specific items & uses for them & trying to stress multiple use items. THat helps financially & in terms of storage & I'm going to try to work in items you already have at home.

Suggestions & practical experience are invaluable. Many here have home nursed aging relatives or spouses ir have kids that tend to be sickly. You already know cheap, convenient shortcuts. Email me at VariolamajorYahoo.com so I can incorporate this very valuable information into the appropriate sections. It would be great if people only copy/print what's absolutely usefull or potentially so to them & if we keep to themesm that makes it easier.

Anyway, must get back to work - here & cleaning my fridge...lol

[rb.]

Just to simplify *my* initial flu symptoms, over and above the list Sue's provided, here's a good rule of thumb. If you suddenly feel like you've been suddenly dropped into the Arctic with the worst hangover you've ever had, you have the flu, not a cold. This is how I differentiate between the two.

Sue, I'm a faithful elderberry user for virii. Can you speak to over-stimulating the immune system and the 1918 flu, and how that kills? What I'm really wondering is: 1. Will I know in time not to use elderberry on the kids, (ie. would it always show as killing the healthy more?) and 2. what can be used in it's place to help lessen the effects of the virus, if anything is known. Vinegar, peppers, etc.

My biggest fear with an upcoming pandemic is that my usual treatment, the elderberry, will cause or hasten a death that could very well be unneccesary had I not intervened.

[goatlady]

rb, the elderberry does NOT stinulate the immune system - it encapsulates the virus in the tissue cells and prevents it from replicating there by basically killing it. Not to worry about a "whatever" "storm" as with immune boosters. Works entirely different and should be extremely safe for children and all humans for that matter.

[Shadowfane]

cytokene storms are the body's own response....

As GL says, this is NOT a problem with the way Elderberry (and most antivirals) works....

Elderberry would be my attack of CHOICE with kids because of the minimal side effects....unless you are using elderberry WINE in which case... YMMV.....

[goatlady]

Thanks shadowfane, I just couldn't remember that word!

[fuzzychick]

Chiming in here black elderberry extract is sold in health food stores and in some natural food sites in grocery stores...oscilliococcinum is also a wonderful thing.....you can get it a Wally World, Walgreens or any drug store......stock up....other essentials gingerale for nausea and hydration, pedialyte pops for hydration, Advil, motrin...for temps.........Chips for the sodium loss due to nausea, diarrhea, and fever...and my favorite....Native honey to immerse freshly cut onions into it for a very effective cough/expectorant remedy......Great grandparents had this and other goodies and nobody died on their watch....I will be adding later or you can p.m me for rememdies they used and worked for them....

[y2kmisfit]

Here are a few random ideas of mine to avoid picking up the flu virus when shopping.

1. Bask carts - the handles are loaded with germs! Bring a disinfectant wipe for these.
2. Shop only on the "off hours" (after 8:00 PM) on Monday - Thursday when there are far less shoppers. Of course they will probably be restocking shelves then, so you will have to navigate around boxes in the aisles.
3. Avoid using human check-out personel. I've seen too many times when they were sick and coughing into their hands while handling my food and change. I've seen them lick their fingers before getting my change from the register. Use "U-Scan" machines if at all possible.
4. Pay with credit/debit cards. This avoids having to get money back from them. If using debit don't get extra cash for yourself. Go to an ATM for that.
Use you own pen...don't use theirs!
5. When you get home, wipe off the packages with a disinfectant. Assume the person who stocked the shelves was sick.

These are common sense steps, and except wiping the baskcart handles, no one will even notice.

[rb.]

Thanks Goatlady and Shadowfane. I knew that about elderberry, I must have been having an almost senior moment! :cool:

[jeffleer]

Hi folks,

I am trying to put together an avian flu kit for myself, family and friends. One major criterion is that all ingredients can be administered nasally if necessary.

From reading through your lists, I seem to understand that the flu has two phases: the onset phase and the cytokine-storm phase. Does anyone know how long each of these two phases might be expected to last? What are the symptoms that tell you when you have moved into storm phase?

1. For the onset phase, I am considering using the following combination:

Water
Vitamin C (administered according to the Vitamin C Foundation guidelines)
Vitamin A
Vitamin E
Alpha-lipoic acid (ALA)
Zinc
Selenium
Elderberry extract
an anti-viral tincture (including Cat's Claw, Astragalus, licorice)

2. I am not sure about the storm phase. Should any of these (such as zinc and selenium) be discontinued? I have seen the following mentioned as possibilities for the storm phase:

Omega-3 Fatty Acids
Gammalinoleic Acid (GLA)
Eicosapentaenoic Acid (EPA)
Resveratrol (from grape skins)
Ginger
Cat's Claw
Curcurmin (turmeric)

Most of these seem loosely classifiable as anti-inflammatories.

How am I doing so far? I'd sure appreciate some feedback.

Jeff Leer

[Shannon]

And you don't need a prescription for fish and other animal antibiotics.

[Zephyr]

rb, the elderberry does NOT stinulate the immune system - it encapsulates the virus in the tissue cells and prevents it from replicating there by basically killing it. Not to worry about a "whatever" "storm" as with immune boosters. Works entirely different and should be extremely safe for children and all humans for that matter.

Is this true even for Sambucol that also contains Echinacea?

[LMonty911]

we later determined through other resources that elderberry does increase cytokines. perhaps not significantly enough to implicate it in triggering storm- but its all conjecture at this point.

since it does decrease viral load and that IS proven to trigger storm, many of us are still planning to use it. but add an immune modulator to help stave off storm. also conjecture- but heh, we do what we can, when theres few/no other options in alleopathic medicine open to us...

[StL Bill]

cytokine inhibitor that one might use?

I am convinced that I am going to use Elderberry prophylactically and when I think I may have been exposed.....

I plan on taking 'something' that will dampen immune response once it seems certain that the flu is progressing and storm seems likely.

I don't know what best to include in my preps for this AND I don't quite yet know how to recognized the switch point from elderberry to the 'something'...

What are other's thoughts.

[PrepNut]

Any thoughts on the old timey concoction of honey, apple cider vinegar and hot water?

My grandparents always drank this, and I was getting tired of tea on my sore throat so I mixed some up. Tablespoon of honey & vinegar in a large mug o' hot water. It actually tasted good, and felt good on my throat. Not sure if there are any medicinal qualities involved or just the effects of a warm bevvie.

--PrepNut

[Shannon]

The strongest cytokine inhibitors I have found are are, curcumin and piperine, green tea, propolis, nettle and cats claw (this one is still on the perhaps list as it does boost immune system fuction as well as act as an antiinflammatory).

I have others as well but for various reasons have not added them to my list, or have not shared them with everyone else as they have some "interesting" side effects and contraindications, or in a few cases have not yet done enough research to evaluate their efficacy; Goldenseal, bucho leaves, yarrow, witch is both an antiinflammatory and stops bleeding (this one can be very dangerous however!), ground ivy.