Talk:2009 swine flu pandemic/Archive 5

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92%

A Detroit newspaper claiming that "...92% of the 109 U.S. infections came without travel to affected areas, the U.S. Centers for Disease Control and Prevention reported." [1] I can't find any other source carrying that claim. Is this more media misinterpretation? Rmhermen (talk) 14:54, 4 May 2009 (UTC)

I don't see anyone backing up that number. But I do see this: As of 2,May NYC Health Of all the cases in NYC (then 62), there is only one case not known to be associated with the outbreaks either in Mexico or the St. Francis Preparatory school in Queens. St. Francis had a number of students recently return from Mexico. --PigFlu Oink (talk) 16:50, 4 May 2009 (UTC)

As an added benefit, using neither name saves us from arguing about which name is better. If we get a second notable flu outbreak in 2009, we can figure out how to name them at that time. Cross that bridge when we get to it. Right now, this is the only one, so the title is utterly clear and correct. Jehochman ^Talk 20:37, 4 May 2009 (UTC)

Why did you move the article? We haven't reached a consensus yet. Pleas do not move articles around without checking the talk page for discussions on the topic.D^rew S^mith 22:38, 4 May 2009 (UTC)

I think his comment above was misplaced in the discussion page. It was a mistake on his part regarding the indefinite move restriction placed on the page, and was corrected by another admin. Flipper9 (talk) 22:41, 4 May 2009 (UTC)

"Swine Influenza" or "Swine Flu" (A/H1N1-2009)

The virus was initially DETECTED in Mexico... Not originated in Mexico.

Also this virus is a MUTATION of the euro-asiatic influenza virus already knew years ago and from which Mexico never had cases of infection... i mean the virus scientifically named as "Influenza A virus subtype H1N1", responsible for the 1918 flu pandemic, that killed some 50 million to 100 million people worldwide (A/H1N1-1918).

Now, if you refer to the "swine flu" (A/H1N1-2009) as "mexican flu"... also there are many people who refer to it as "American flu" (refering to USA) or "North American Flu" (refering to the region of North America) or "A/California/2009" or "hog flu" or "pig flu"... so add these too or just refer to it as "swine flu".--. 18:05, 4 May 2009 (UTC) —Preceding unsigned comment added by OyashiroSama (talk • contribs)

U.K. update

27 are ill in the U.K. now, including victims in Gloucestershire, Merseyside, Dulwich, Redditch and Oxfordshire. [2]!--86.29.246.3 (talk) 19:38, 4 May 2009 (UTC)

Portuguese update

Another Portuguese bloke has fallen ill now- [3]

Bloke? --PigFlu Oink (talk) 00:26, 6 May 2009 (UTC)

Guatemala update

The map should be updated for El Salvador and Guatemala.[4] (in Spanish)--Vrysxy ¡Californication! 22:11, 5 May 2009 (UTC)

video attached

In this video, Dr. Joe Bresee, with CDC's Influenza Division, describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention.
See also: See this video with subtitles in YouTube

• • cough* Wikipedia:Medical_disclaimer, please change the video caption so it concurs with Wikipedia policy. Thanks —Preceding unsigned comment added by 190.232.86.231 (talk) 01:55, 5 May 2009 (UTC)

Wikipedia isn't giving advice. The CDC is. --PigFlu Oink (talk) 02:20, 5 May 2009 (UTC)

the caption reads as it tells the user what to do, advice. --200.106.22.152 (talk) 04:40, 5 May 2009 (UTC)

Name?

I read the source of the information about "scientific name" of the new flu strain and I really could not search any "California" within this page. Also there were described a "vaccine" from South Hemisphere; and as everybody knows I began in the North Hemisphere. —Preceding unsigned comment added by Hedleypanama (talk • contribs) 03:18, 5 May 2009 (UTC)

Antibiotic vs. antiviral drugs

My purpose to remove the use of antibiotics for "dual infection" is to reduce confusion and not foment the popular misconception of using abtibiotics to treat viral infections. I am aware that the "dual infection" mentioned in this article implicitly referred to bacterial pneumoniae + flu virus, however, one can not expect a casual reader to know that or to understand that the word pneumoniae could be a pathology or a bacteria, especially without the article explaining this and while the article is focused on a virus. If somebody feels the compelling need to compare treatments of viral pneumonia with a bacterial pneumonia, Fungal pneumonia, Parasitic pneumonia co-infection, please explain so in the apropriate section or article and remark that the use of antibiotics by itself is not effective against any virus, especially the H1N1. Cheers,BatteryIncluded (talk) 06:50, 5 May 2009 (UTC)

Historical context

I added a section on historical context to talk about the cyclical nature of influenza pandemics and how this has lead to an increased level of alertness on the part of public health officials. It's a little rough but I think its necessary to put this outbreak in context. Please read it and make it better.--Hdstubbs (talk) 16:39, 5 May 2009 (UTC)

One more Name Change.

Hello,

Just suggesting another name change. As the WHO is now calling the disease by it's Scientific name Influenza A(N1H1) to avoid confusion with pigs, should the title not be change to 2009 Influenza A(H1N1) Outbreak? Thanks!--gordonrox24 (talk) 11:31, 4 May 2009 (UTC)

Read all the past name change proposals. Let me put it simply. When you searched for the article, did you search for Influenza A(N1H1), or swine flu? Most people would search for swine flu, because that is what most people call it. That is how we name articles here. By their common name.D^rew S^mith 12:05, 4 May 2009 (UTC)

Actually Drew, this is a great idea! <sarcasm> I can't believe no one thought of it before!?!!</sarcasm> I suggest we discuss this ad nauseum.BFritzen (talk) 12:51, 4 May 2009 (UTC)

Please assume good faith, BFritzen. Sarcasm gets us nowhere in this debate. hmwithτ 17:37, 4 May 2009 (UTC)

When you want info on heart attack do you search for heart attack or do you search for Myocardial infarction? We name medical articles by their medical names not by their common name.   Daniel.Cardenas (talk) 14:34, 4 May 2009 (UTC)

Why not move the article to the proper name, and then redirect from the common name to the proper name? It would then allow both the common name to be used for "common-man searches", and would also reflect the official name? Why the resistance and insistence on perpetuating an incorrect name? Flipper9 (talk) 13:15, 4 May 2009 (UTC)

Looking at the prior discussion above there seems now to be a majority support for changing the name. Regarding "common name", there are a lot of exceptions to the "common name" rule. Like neutrality and ambigouity. Following common name should not conflict with other more specific Wikipedia:Naming conventions which are more important. To quote "Except where other accepted Wikipedia naming conventions give a different indication, title an article using the most common name". One example, the article influenza, not "flu". Another very important example which should be a precedent. Influenza A virus subtype H5N1, Transmission and infection of H5N1, and Global spread of H5N1. Not "Bird flu".Ht686rg90 (talk) 13:25, 4 May 2009 (UTC)

An important difference with bird flu is that unlike H5N1, H1N1 is also found as regular seasonal flu, so something like Influenza A virus subtype H1N1 would not be suitable.--Pontificalibus (talk) 13:28, 4 May 2009 (UTC)

In that line of thinking, so is "Swine Flu"...it is a generic category to refer to a group of particular strains of influenza virus. While the common man calls it "Swine Flu" or "Pig Flu", there is little gained by perpetuating the common-man term in an encyclopedia article other than to list those common names that are used and ensure that the proper redirects are in place to ensure the "common man" or anyone else can find the appropriate article. Flipper9 (talk) 13:35, 4 May 2009 (UTC)

I think of it as Wikipedia being "educational", informing the public about what is considered correct about a topic and presenting facts as best that we know them. The WHO wanted the name change because of the slaughter of pigs and the erroneous public perception that pigs and pig meat will give them the flu. Perpetuation of a name that many sources are using seems to be the wrong course. I do agree that there is a lot of confusion, even amongst the "official sources". I wish they'd standardize the name like other virus strains used in flu vaccines, such as "A/Brisbane/59/2007 (H1N1)" (part of the current flu vaccine in N-America), but there is no source that I know of that's come up with such a specific name (if someone could find that, it'd be great). I'd just stick with what the WHO designates it as the official name, and then list and redirect all of the varied common names currently in use or sadly we'll just have to wait until one official name is found. Flipper9 (talk) 13:51, 4 May 2009 (UTC)

Looking at the prior discussion above there seems now to be a majority support for changing the name. The only summary I've seen is in one section that said there were 16 editors in favor of changing the name, and 12 opposed. That's a majority, but not the desired "rough consensus" for a change. And it's not clear that the editors in favor of a name change agree as to what that name change would be.

It would be very helpful if someone wanting a change were to put together a subpage that including links to all the talk page sections (including those archived) where the name change had been discussed), and listed the editors in favor and opposed to such a change. -- John Broughton (♫♫) 14:04, 4 May 2009 (UTC)

Wikipedia isn't a vote. As WP:COMMONNAME is superseded by MOS:MED, it may be prudent to discount any COMMONNAME-based opposition. Sceptre ^(talk) 14:42, 4 May 2009 (UTC)

You can't just discount any argument you disagree with. At this time, the name used by the preponderance of reliable sources is still swine flu and that should still be the name IMO. Regardless of how you stack-rank naming guidelines, common sense trumps them all. Oren0 (talk) 17:21, 4 May 2009 (UTC)

There is no common sense. "Common sense" is really only used as an argument when people don't have any others left. Sceptre ^(talk) 22:47, 4 May 2009 (UTC)

Diving through Pubmed and Genebank, they entitle sequences for the various strains sequenced from this viral outbreak, they are using the term "2009 H1N1 influenza outbreak" [5][6]. That's a sourced, official name from those that track the sequences available for testing. Flipper9 (talk) 14:15, 4 May 2009 (UTC)

I don't see the problem. All it would take is a page move and a redirect.--gordonrox24 (talk) 04:58, 6 May 2009 (UTC)

The problem is that not everyone agrees on the correct name for this page. Thus it could just be moved back and forth forever. Besides causing unnecessary confusion, this would break dozens of redirects as double redirects don't work properly. --ThaddeusB (talk) 05:08, 6 May 2009 (UTC)

North African update

So Tunisia, Algeria and Morocco and Egypt have prepared for the worst and are screening any on coming from Mexico. Egypt has also seen riots over the resent pig culling- [7] / [8] / [9]!

The Egyptian health ministry said on Thursday "That the decision to cull quarter of a million pigs was not a measure against swine flu but a general health measure." "[10]"--86.29.248.49 (talk) 03:50, 6 May 2009 (UTC)

Well of course they say that now. Egyptians never like looking like complete morons. --PigFlu Oink (talk) 03:53, 6 May 2009 (UTC)

I agree, the Egyptians never like looking like complete, hysterical, morons!--86.29.248.49 (talk) 03:57, 6 May 2009 (UTC)

See- [11] [12]--86.25.55.164 (talk) 09:40, 6 May 2009 (UTC)

Update image

Hi. Please update the image with the following:

Change to red

• PR China (either just Hong Kong or the entire country
• Portugal (http://economico.sapo.pt/noticias/portuguesa-infectada-com-virus-da-gripe-a_9516.html) Marco SOusa (talk) 16:00, 4 May 2009 (UTC)

Change to orange

• Malaysia

Thanks. ~AH1^(TCU) 22:44, 3 May 2009 (UTC)

It is a great difference between whole China and China Hong Kong okay? Please stop doing this, it is quite threatening to the zh-wiki users --Ryusakura (talk) 14:25, 4 May 2009 (UTC)

In that case, please at least paint Hong Kong in red. Anyone with a good knowledge of geography and the correct software should be able to do that. ~AH1^(TCU) 19:55, 4 May 2009 (UTC)

There's also a difference between the whole of France and a few localised outbreaks, and there's a difference between the whole of the UK and outbreaks in a few towns. Perhaps we should just do dots? Is that what you're suggesting? --79.65.74.154 (talk) 18:54, 5 May 2009 (UTC)

No, but they really are basically different countries. It is a little like making France red when French Guiana has a confirmed case of swine flu. Hong Kong and China are not the same place. Same governments, technically, completely separate societies, passports, and healthcare systems. In tracking an epidemic a case in China means something very different from a case in Hong Kong. --62.69.130.82 (talk) 12:00, 6 May 2009 (UTC)

External links

Why was the timeline removed from External links? It's not against RS as every event appears to be sourced, either a local news source, university/college website, or something like LATimes/NYTimes/AP. It was a good source to quickly ctrl+f through, and it's also listed on DMOZ GTNz (talk) 03:09, 5 May 2009 (UTC)

Its also in the template. Which makes it internal navigation, not an external link. --PigFlu Oink (talk) 00:27, 6 May 2009 (UTC)

I meant http://trancy.net, not the internal GTNz (talk) 00:52, 6 May 2009 (UTC)

Treatment & Prevention - Vitamin D

It should be noted that many people have suggested vitamin D as both treatment and prevention for this and other types of influenza (see http://www.vitamindcouncil.org/science/research/vitamin-d-and-influenza.shtml and http://www.healthy.net/scr/news.asp?Id=8826 and http://www.lewrockwell.com/miller/miller27.html and www.naturalnews.com/024982.html and http://journals.cambridge.org/action/login;jsessionid=C971FC31034D3FECE9F481FD109C6D2D.tomcat1 I can only wonder why none of this is mentioned in the article under prevention and treatment. 201.230.106.3 (talk) 18:18, 5 May 2009 (UTC)

These don't appear to be reliable sources. The only reliable reference I could find (http://www.ncbi.nlm.nih.gov/pubmed/16959053?) only indicates that a deficiency of vitamin D may lead to a greater rate of influenza infections. This is no surprise that unhealthy people are more likely to suffer from flu. I could find no evidence that even suggested that vitamin D may be a suitable medication to combat influenza infection. --Pontificalibus (talk) 19:25, 5 May 2009 (UTC)

It is not the goal of WP to dish out medical advice. BatteryIncluded (talk) 01:13, 6 May 2009 (UTC)

H3N2 detection along with H1N1

http://www.promedmail.org/pls/otn/f?p=2400:1001:2365278416456707::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,77349 Influenza A(H1N1) worldwide - 11: coincident H3N2 variation

British Columbia CDC has found some BC residents who have traveled to Mexico to have both A/H1N1 and a recently mutated form of H3N2 (see promed link).

The suggestion is that the presence of both viruses might explain the difference in Mexican and non-Mexican mortality rates. As such referring to it just as the H1N1 influenza might not be correct. 151.194.17.27 (talk) 00:59, 6 May 2009 (UTC)

Interesting.D^rew S^mith 01:49, 6 May 2009 (UTC)

Interesting and yet another argument against the h1n1 name. --PigFlu Oink (talk) 02:10, 6 May 2009 (UTC)

Alternately, it is an argument *against* keeping this under "swine" flu, since we need this sort of precision to define what people are suffering from. --Petercorless (talk) 02:31, 6 May 2009 (UTC)

Dam. I wrote this big response about how it had nothing to do with it, common name, blah blah blah, and then realised I was getting into the same name changing crap I decided to stay out of. Seriously I'm really glad they put a lock on the name. Seeing the same discussion over and over and over again was getting really tiring.D^rew S^mith 03:05, 6 May 2009 (UTC)

None of this is an argument against naming the article H1N1, though, as that was the name originally applied and is how the outbreak is most widely and 'correctly' known. Certainly it is more correct than the current "Swine Flu". Everyone knows The Hundred Years War really wasn't, they just decided to call it that. 139.48.25.60 (talk) 15:09, 6 May 2009 (UTC)

The Holy Roman Empire was neither Holy nor Roman... Discuss--PigFlu Oink (talk) 19:24, 6 May 2009 (UTC)

Further info on the variant H3N2. In BC it causes more severe flu than the H1N1 strain from NPR. http://www.npr.org/blogs/health/2009/05/second_strain_might_have_cause.html 151.194.21.159 (talk) 19:21, 6 May 2009 (UTC)

Historical chart

I deleted swine flu from this table earlier because there are no active epidemiological studies for the infection rates and death rates of swine flu. Media reports and passive detection methodologies are not a replacement for such data. By including swine flu in this table we imply that we have as good a handle on this data as we have on 20th century pandemics. A qualifier of 'early data' is not enough and is in addition seriously misleading. The data we have to date is almost totally useless compared to that we have for the 20th century pandemics. I have deleted swine flu again from the table. Please do not add a swine flu line again without a properly conducted epidemiological study to back up the figures we give (and a formal announcement of a pandemic). (Also note that swine flu has not been declared a pandemic and did not occur in the 20th century so should not be included in a table who's title is 20th century flu pandemics). When/If a study is carried out and swine flu added as a line the table would need to be renamed. Barnaby dawson (talk) 08:06, 6 May 2009 (UTC)

Pandemic flu

An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in recent history. Pandemics can cause high levels of mortality, with the Spanish influenza estimated as being responsible for the deaths of over 50 million people. There have been about three influenza pandemics in each century for the last 300 years. The most recent ones were the Asian Flu in 1957 and the Hong Kong Flu in 1968.--86.25.55.164 (talk) 09:41, 6 May 2009 (UTC)

What are you saying? cyclosarin (talk) 12:19, 6 May 2009 (UTC)

I think he's saying that we should add a link to this article to the last sentence of the intro of the pandemic article. hmwithτ 14:15, 6 May 2009 (UTC)

A major link is needed, there closly related.--86.29.249.180 (talk) 16:03, 6 May 2009 (UTC)

If you think an addition should be posted on another article, you'd be best taking it up on that talk page. However, I doubt there will be consensus for it to be added, because WHO never officially labeled this situation as a pandemic. hmwithτ 18:00, 6 May 2009 (UTC)

Wikipedia Totals

Where did the Wikipedia totals section of the table come from?

Have the words 'original research' occured to anyone?86.16.117.213 (talk) 12:09, 6 May 2009 (UTC)

It has always been there, but was simply labeled "Totals". Since a "WHO Total" was listed as a separate source to contrast with the older total generated by 140+ sources below and from other "swine-flu"-related pages, it needed to be clarified that the "Total" row was actually a Wikipedia generated one. I brought up the point that the Total row was original research, but consensus disagreed with that issue (and attempts at adding a warning tag to the table about issues with sourcing were met with an edit war, a block, and administrative action, as well as tag-teaming). You are welcome to join the discussion on the table's discussion page (it's not here, it's on the table discussion page, scroll to the top of this one and then click on the appropriate link), but beware that there are people there that will vehemently disagree against the point you are making. Flipper9 (talk) 12:28, 6 May 2009 (UTC)

The link so the editor can fid it easily :) Template talk:2009 swine flu outbreak table. hmwithτ 14:14, 6 May 2009 (UTC)

The name was reverted back to "Total" by another user. I added a "*" to clarify that the total is generated by the values in the Table. If that note is reverted, then the reader will be left to assume that the value is somehow properly sourced. I will be unable to inform the reader of this issue due to the insistence of other editors that WP:NOR doesn't apply and/or doesn't need to be followed and WP:3RR tactics. Flipper9 (talk) 14:28, 6 May 2009 (UTC)

Yes, Flipper, we all know that you believe that only the "high holies" of the WHO can apply the arcane science of arthimetic to the totals declared by the national health agencies. It's just that many of us don't agree with you. If WHO was actually doing their own independent testing and verification this might be an issue. Rmhermen (talk) 16:42, 6 May 2009 (UTC)

Regardless of people's political beliefs about the WHO; they are a single organization, and the totals reflect 140+ independent viewpoints/sources. Just by sheer size, one organization tasked with tabulation is more authoritative than 140+ organizations/sources that are not. Either way, both values are shown which allows the reader to decide. If there are other organizations publishing totals other than the WHO and Wikipedia, those should probably be included as well. Flipper9 (talk) 17:33, 6 May 2009 (UTC)

It is factually inaccurate to call it a "Wikipedia total." Wikipedia has done nothing to generate the totals. All we have done is adding individual RS. Adding is not OR. Also the "note" is completely unnecessary. Our readers are intelligent enough to release a total is a sum of the numbers in the table. There are tens of thousands of similar summary tables across Wikipedia -- do ANY of them have a disclaimer that the total is the sum of the parts??? --ThaddeusB (talk) 16:44, 6 May 2009 (UTC)

No; and there normally wouldn't be for "stable" data that is not likely to change from day-to-day. However, this is a fast-moving situation where the large number of references are changing, and are all out of sequence...and you have multiple editors having to manually tabulate values across multiple wikipedia pages (re: the table carries over tabulations from other template tables). There is a huge chance that the Total value presented is inaccurate, both from a point of simple addition mistakes/oversights as well as out-of-order references that may or may not be up to date. The total numbers cannot be trusted without a huge effort and vigilance on the part of dedicated Wiki editors. If it were a simple table and tabulation, like in the "historical table" being discussed right here, that's no problem. Easy to verify, easy to tabulate, no issues. My only real issue is that very few people can trust that the totals are verified...and it's very difficult for someone to verify over 100+ references for accuracy...especially with so many edits going on. Peace. Flipper9 (talk) 17:18, 6 May 2009 (UTC)

Just a side note; it would be good if Wikipedia supported some sort of simple addition/tabulation functionality to sum up numbers like this for simple tables. That would, at least in part, fix one of the issues I'm having, though a minor one. Flipper9 (talk) 17:25, 6 May 2009 (UTC)

Example: let's assume that every state health agency in the USA publishes their totals every single day on schedule. We could easily pop in the numbers for all 50 states, and do a single tabulation to generate a USA total. No issues with that; a user or editor could easily click on the ref link for each one and tabulate it themselves, and all data is up-to-date. That falls apart when some states decide to update today, some haven't updated in a couple days (or haven't posted it yet), they have different methods/ways of tabulating the data or have different definitions and choose to only release part of the data and not update others, or maybe a news source gets it wrong. Make sense? Flipper9 (talk) 17:45, 6 May 2009 (UTC)

• Note: This discussion doesn't involve the artual article. Please take it to the template page. :) hmwithτ 17:58, 6 May 2009 (UTC)

Time line / SPAM

Here is a good time line of events and infections , not the internal! --86.29.249.180 (talk) 16:11, 6 May 2009 (UTC)

This particular site (trancy.net) and similar websites have previously been removed as they exist to cash in on traffic attracted to the advertising displayed. The information is freely available from official sources and there is no guarantee that this anonymous website will be maintained or is accurate. Consequently it fails to meet WP:RS and would also fall under WP:SPAM if linked.—Teahot (talk) 16:30, 6 May 2009 (UTC)

That site in particular, unlike a lot of the other adfilled sites removed does have some semi useful things like though - CSV CDC data CSV PHAC data with no advertising on it GTNz (talk) 18:36, 6 May 2009 (UTC)

Negative cases

What the heck does it mean when there is a negative number of cases? Common sense would indicate that the confirmed case count will be a smaller number than the probably or suspected numbers. After all, weren't the patients who were confirmed suspected and likely to be infected? Now the chart has negative numbers. What in the world does that mean? I think an explanation of what the numbers in the chart mean is needed. Victor Engel (talk) 19:07, 4 May 2009 (UTC)

I believe the "-" was meant to be that there was no available data? i.e. that the cited source doesn't reveal that specific data point. Flipper9 (talk) 19:18, 4 May 2009 (UTC)

I suppose that makes sense. May I suggest some symbol other than a hyphen? It looks too much like negative numbers in my opinion. Victor Engel (talk) 19:28, 4 May 2009 (UTC)

I agree. Go ahead and change the symbol. Any suggestions? Note that on the discussion page for the table template (it's separate from this discussion page for the main article) it was suggested that "---" be used, or maybe use "--" or something else? Flipper9 (talk) 19:31, 4 May 2009 (UTC)

I think I will let someone else do it, since this page has high visibility, and I'm not even sure how the template works. Victor Engel (talk) 20:03, 4 May 2009 (UTC)

The second death in the US should be dropped from the table. "Health officials stopped short of saying that swine flu caused the woman's death. State health department spokeswoman Carrie Williams said the woman had "chronic underlying health conditions" but wouldn't give any more details." The lady had swine flu but had chronic health issues aswell. It has been blown up, by the media, again, to make it look like it killed her. 90% of people I talk to are sick and tired of this media over hype on swine flu. —Preceding unsigned comment added by 202.37.96.11 (talk) 02:04, 6 May 2009 (UTC)

Malagasy update

Madagascar is in lockdown now! [13] —Preceding unsigned comment added by 86.29.240.235 (talk) 08:44, 7 May 2009 (UTC)

EU update

Denmark has just cleared 12 people of having swine flu [14], [15], [16], [17], [18], [19], Sweden has confirmed a case [20], [21] as has go one to Germany has [22], [23], [24], [25], [26], [27]! --86.29.249.180 (talk) 16:01, 6 May 2009 (UTC) --86.29.249.180 (talk) 16:02, 6 May 2009 (UTC)

• Poland - first case - [28] 74.125.57.33 (talk) 17:13, 6 May 2009 (UTC)
• Switzerland now has 1 confirmed case of swine flu. [29]

--86.29.240.235 (talk) 08:58, 7 May 2009 (UTC)

Irish update

Ireland has now got 4 pig flu victims. [30] The government has stated it has vaccine for over half the country so far. Airports are scanning every person entering checking of infections through thermal imaging and the minister joined a meeting in Luxemburg. --86.29.240.235 (talk) 08:36, 7 May 2009 (UTC)

Mexican update

Mexico has nearly 200 deaths now [[31]]/ [[32]]! --86.29.240.235 (talk) 08:42, 7 May 2009 (UTC) Mexico recons it is now in controll of the situation [33].--The 'reel' boffin man! (talk) 16:20, 7 May 2009 (UTC) 42 Mexicans are listed as dead! [34] [35]--86.29.250.97 (talk) 19:18, 7 May 2009 (UTC)

Here you can see the latest update: 44 deaths confirmed, and 1204 cases confirmed (not dead!). The "200 deaths" are not dead, but (only) 173 confirmed cases from 27th April (not up-to-date).--201.153.19.149 (talk) 21:19, 7 May 2009 (UTC)

Fijian update

Fiji has it's first case[[36]]!--86.29.240.235 (talk) 09:03, 7 May 2009 (UTC)

Argentine update

All flights to and from Mexico are suspended! [37] [38] [39] [40] [41] --86.29.250.97 (talk) 19:18, 7 May 2009 (UTC)

First confirmed case in Argentina [42]

S. African update

A South African is now ill with it! [43]--86.29.250.97 (talk) 19:18, 7 May 2009 (UTC)

That article says he tested negative which means he is not "ill with it." --Elliskev 19:33, 7 May 2009 (UTC)

Perhaps the random internet user was using 'ill' to describe something that he approved of. "Man this pizza is ill, Yo!" --PigFlu Oink (talk) 19:43, 7 May 2009 (UTC)

Brazil update

Brazil has confirmed its first case today, some minuts ago, I've just heard on televisionJoão P. M. Lima (talk) 22:31, 7 May 2009 (UTC)

The Minister of Health of Brazil confirmed the first 4 cases of swine flu in the country. Three of the confirmed cases are from people that were in Mexico and the other is from a person that was in the United States. —Preceding unsigned comment added by 189.107.24.45 (talk) 22:39, 7 May 2009 (UTC)

4 persons infected in Brazil were confirmed.

Source: http://g1.globo.com/Noticias/Brasil/0,,MUL1112949-5598,00-MINISTERIO+DA+SAUDE+CONFIRMA+QUATRO+CASOS+DE+NOVA+GRIPE+NO+BRASIL.html

+1 Source: http://www.bloomberg.com/apps/news?pid=20601087&sid=adZ_DpGY6JPs&refer=home 189.122.194.161 (talk) 23:24, 7 May 2009 (UTC)

Purpose of chart

There needs to be consensus here as to what diseases or epidemics, from what era, belong in the table. If it is a chart of "Pandemics" then remove the present H1N1 outbreak, since the WHO has not classified it as a "pandemic." It is still one step below pandemic in their criteria. Were the others all officially pandemics, like the 1918 flu? Or were outbreaks arbitrarily added? Otherwise it is an arbitrary and indiscriminate collection of information. The 1976 swine flu epidemic could also be included, since it may have similarities to this one in type of infection, and was highly publicized at the time, with 40,000,000 in the U.S. getting emergency vsccinations, resulting in 25 deaths from the vaccine side effects compared to 1 death from the flu. Is it certain that polio is spread exactly life influenza? Edison (talk) 23:29, 5 May 2009 (UTC)

Somebody went ahead and removed the current outbreak from the chart, which I subsequently reverted because, regardless of whether this is the end of the world or just a case of the sniffles, it is the subject of this article and therefore should be included in the table so that one can see a comparison, that is the reason for the table being there. RaseaC (talk) 00:24, 6 May 2009 (UTC)

I just took a look at the table in the article; and unfortunately most of the numbers are not found in the sources being cited. Can someone take a look at the table and sources and either add appropriate references or remove the table altogether. Also note that using the US seasonal flu rate statistic does not make much sense, unless one is citing other US-only figures too (which can be considerable different than the worldwide figures; see for example the US statistics for the 1918 Spanish flu in Johnson NPAS, Mueller J. Updating the accounts: global mortality of the 1918–1920 "Spanish" influenza pandemic. Bull Hist Med. 2002;76:105–15). Finally, I didn't find a source using the term "death rate" - is this backed up by any epidemiological sources ? Abecedare (talk) 03:55, 6 May 2009 (UTC)

The demographic of each epidemic was in parentheses next to the name to define what the totals were for. But as of the last revision, the Hong Kong and Asian flu show only U.S. totals, while the Spanish flu shows worldwide totals, yet there is no way for the user to know that.

Some sources: Seasonal flu, CDC; Asian flu Globalsecurity.org (see top right for others) --Wikiwatcher1 (talk) 04:33, 6 May 2009 (UTC)

I checked the sources included in the chart previously (this version), but the numbers in the table were not supported by the included citations. I corrected one citation (the wrong GlobalSecurity page was linked), and removed other references that failed verification. See the individual edit-summaries I left, for each change I made. I am pretty sure that some of these are citable, and that is the reason I only tagged the unreferenced rows/entries, instead of deleting the table.

Secondly: It doesn't make sense to mis worldwide and US-only statistics, since that is an apples-to-orange comparison (see the paper I link above). If we don't have worldwide stats for a particular pandemic, we should just include it in the table. Abecedare (talk) 04:45, 6 May 2009 (UTC)

I prefer Globalsecurity.org (i.e. Hong Kong flu) and find the CDC site too disorganized. A search on their site for "Hong Kong flu," for instance, brings back too much extraneous information unrelated to this well-known pandemic. In fact, comparing the two web sites, I feel that we're lucky to have a private organization that nicely put this information together. But as for having either all U.S. or all worldwide data, while that would be great, doesn't look too available. Flu case stats in the U.S. are estimates, so you can imagine how wild the estimates would be for the world, where there are numerous cities with over 20 million people, hence the earlier demographic notation for each epidemic.--Wikiwatcher1 (talk) 05:14, 6 May 2009 (UTC)

I am perfectly fine with using WHO, CDC or GlobalSecurity as the source for the table as long as (1) we use the same source for each row (i.e, don't mix and match numbers), (2) use global stats only.

You are absolutely right about all these numbers being gross estimates; I have looked for references for the 1918 flu pandemic in some details and have found reliable sources for 20, 40, 50, upto 100 million deaths, and 1/3rd, 1/2, upto 97% of world population (~1.5Billion) for the number of infections. You can imagine how widely we can make the mortality numbers vary, if we pick and choose. The case is even worse during this early stage of the swine flu outbreak. For example, see this Washington Post article, which says, "It may be that Mexico already has had hundreds of thousands, and possibly millions, of cases -- all but the most serious hidden in the "noise" of background illness in a crowded population." You can imagine what that would do to our "mortality rate" calculation, which may well be off by three-orders of magnitude!

In short, we should be very conservative in quoting hard figures without providing context, and err on the side of not including information, rather than providing risk incorrect/incomplete information just because it is convenient to find or calculate, and looks interesting to us laypersons. (From your past edits, I know that we don't really disagree on this). Cheers. Abecedare (talk) 05:36, 6 May 2009(UTC)

Is a U.S. chart valuable?

Continued idea from the last comment above by Abecedare:

It seems we have a catch-22 situation, as you say to "use global stats only" but agree that global stats are either unavailable or unreliable. That may leave only one option: a chart for U.S. only. I guess it would still be for pandemics (and maybe epidemics) but the title would state it was U.S. data only and the data is both available and verifiable. Any thoughts on this? --Wikiwatcher1 (talk) 06:03, 6 May 2009 (UTC)

The US stats may be worth adding to the US article. I am busy IRL over the next two days, but after that I can try searching the medical literature for worldwide stats. - when millions die, surely someone keeps a record (however rough it may be) Abecedare (talk) 06:33, 6 May 2009 (UTC)

Uncertainties on the mortality/ death rate - sanity check

The historical epidemics infected millions and killed at least tens of thousands, so the fractional random error from Poisson statistics alone can in principle be as low as 0.01 (since 0.01 = sqrt(1/10000)). The relatively recent ones with several hundred deaths also have fractional errors that are not too high for a popular level encyclopedia. There could be other sources of random error and certainly there are systematic errors that epidemiologists know about. But let's ignore those and just consider the Poisson error.

Template:2009_swine_flu_outbreak_table gives 31 confirmed deaths out of 1767 confirmed cases, which gives 1.8% (no longer 2.6%). The minimum fractional error (as i said, disregarding all the caveats about homogeneity of the samples, data collection in different countries, reporting biases, etc. etc.) is 1/sqrt(31) \approx 0.18. So the figure would be (as of 01:17, 6 May 2009 (UTC)) 1.8%$\pm$0.3%. So stating it without an error (for this encyclopedia) is probably not absurd.

However, we should at least put a footnote clarifying the calculation, such as "Global confirmed deaths/global confirmed infections", in which case it should be OK without qualifying as OR, since we are definining exactly what is calculated. BTW, i am not recommending adding uncertainty (error) estimates, since those are calculations beyond "routine calculation". They should come from epidemiologists. Boud (talk) 01:17, 6 May 2009 (UTC)

We can (on this talk page!) compare the "confirmed" rate to the "suspected" rate.

Confirmed deaths/confirmed infections gives 31/1767 = 0.018 = 1.8 +- 0.3 %

Suspected deaths/confirmed infections gives (31+101)/(1767+4112) = 0.022 +- (31+101)/(1767+4112) / sqrt(31+101) = 0.002.

So we have confirmed 1.8% +- 0.3% vs suspected 2.2% +- 0.2%. These are consistent with each other within the error bars. i'm not sure we (as wikipedians) should do anything about it, but the fact that they're consistent suggests that the "confirmed" numbers are probably not overly conservative and that the suspected numbers (as presently counted on the wikipedia template page) are probably not wildly wrong.

What would be interesting is the degree to which speed of treatment, secondary complications, etc. etc. affect this. Which is probably why epidemiologists are saying that nothing serious can yet be said about the future spread of the epidemic. Boud (talk) 01:32, 6 May 2009 (UTC), minor corrections Boud (talk) 01:42, 6 May 2009 (UTC)

I like the chart. Maybe it belongs on a Pandemics page and can be referenced in this article? I'd agree that it is not OR so long as it cites its sources and, I suggest, it should give ranges if there are historically widely different statistics and well-established estimates. For instance, it might cite a high-low range for certain incident or death rates. --Petercorless (talk) 02:27, 6 May 2009 (UTC)

Pigs infected with H1N1 in non-Smithfield Farm at Canada.

The Canadian Food Inspection Agency (CFIA) indicates that it has found H1N1 flu virus in a swine herd in Alberta. http://www.inspection.gc.ca/english/corpaffr/newcom/2009/20090502e.shtml http://investors.smithfieldfoods.com/releasedetail.cfm?ReleaseID=381309 —Preceding unsigned comment added by Lmgg170 (talk • contribs) 21:48, 6 May 2009 (UTC)

Old news, but changed section heading to non-Smithfield per their release: Smithfield has no farms in Canada. The Alberta herd is quarantined and has nearly recovered.LeadSongDog come howl 22:14, 6 May 2009 (UTC)

Per reliable sources, the pigs on this farm caught the flu from a farmhand, who caught the flu in Mexico. --Una Smith (talk) 18:14, 7 May 2009 (UTC)

Fatalities!

I think there is not going to be a repeat of pandemic flu because only about 5-7% of Mexican victims, 2 Americans and 1 Spaniard have died so far!--86.25.51.245 (talk) 04:06, 7 May 2009 (UTC)

It is hardly the wipe out Hong Kong flu or SARS were either!--86.25.48.106 (talk) 09:21, 7 May 2009 (UTC)

Is there a news link for the Spaniard death? Daniel.Cardenas (talk) 12:56, 7 May 2009 (UTC)

The UN’s opinion!

The UN and WHO reckon that the UN pandemic alert level should stay at level 5 and not be raised to level 6 in the near future- [44] [45] [46] [47]. Mexico recons it is now in control of the situation [48]. --86.25.51.45 (talk) 16:33, 7 May 2009 (UTC)

This outbreak is over. Thank god this wasn't another SARS. 206.47.141.21 (talk) 16:47, 7 May 2009 (UTC)

Wow, talk about misreading the refs! LeadSongDog come howl 18:11, 7 May 2009 (UTC)

Quoted WHO flu deaths numbers are mistakenly linked to H1N1 only

(related to this version) Please reread http://www.who.int/mediacentre/factsheets/fs211/en/index.html and change within lead section from Worldwide the common human H1N1 influenza virus affects millions of people every year, according to WHO officials, and "these annual epidemics result in about three to five million cases of severe illness, and about 250,000 to 500,000 deaths" annually.[45] to Worldwide common human influenza viruses affect ... --Aardappelmesje (talk) 20:37, 7 May 2009 (UTC)

Special Barnstar Available

I have created a special barnstar for swine flu related articles. I felt a special award was warranted due to the unusually large amount of effort required to keep these page up to date. Any user is welcome to award this barnstar to whomever they think has contributed a great deal to the various swine flu related articles.

I have handed out an initial batch, but I am sure I missed a number of deserving editor's. Please visit User:ThaddeusB/Swine Flu Barnstar and correct my oversights.

Thank you --ThaddeusB (talk) 20:56, 7 May 2009 (UTC)

Masks as a Preventative Measure

Are surgical masks of any value in preventing the spread or reducing the chance of contracting H1N1 flu, or any other flu, for that matter? Supplies of masks are being hoarded already, but I am quite doubtful about the efficacy of masks for the general public. Medical staff can wear respiratory masks, which may be much more effective than surgical masks. Comments? --DThomsen8 (talk) 21:14, 7 May 2009 (UTC)

Masks are to protect others, not you (unless it's a very specific type of respirator). Besides WP:NOTAFORUM and doesn't dish out medical advice. There are several articles out there that discuss this; maybe add a section to the article about them? Flipper9 (talk) 21:24, 7 May 2009 (UTC)

See Influenza#Infection_control and references therein. Tim Vickers (talk) 21:39, 7 May 2009 (UTC)

Historical context

The last two pandemics killed around 1 million people each, so why does the table only mention U.S. deaths? The key word here is "pandemic". cyclosarin (talk) 23:12, 7 May 2009 (UTC)

Are you referring to this table? –Juliancolton | ^Talk 23:47, 7 May 2009 (UTC)

Cuban update

Cuba is scared of it to- [49]

Oriental update

4 South Koreans are still being tested for the v ioruse [[50]] [[51]] [52] [[53]] and Thailand is checking out all air passengers arriving from Mexico. A Thai woman has now been found to be flu free [54]!

Chinese/Hong Kong/Macau update

China’s Inner Mongolia region has some cases of Swine flu now! China has also banned pork imports from the U.S.A. and Mexico [55]! Hong Kong has quarantined 300 people in a hotel [56],[[57]], [58], [59]! China has gagged nosy reporters in the infested regions our side Hong Kong and Macau[60]! 34 Chinese are now dead [61], [62], [63]

Mongolian update

Mongolia is Swine flu free! [64], [65], [66]!!! Sadly,Bird flu is in parts of the country [[67]].

New Zealand update

1st confirmed human victim!![68]!

There has now been a death in Canada (Northern Alberta)

Somebody needs to change the color image to black for Canada.

Thanks. —Preceding unsigned comment added by 142.94.25.62 (talk) 14:39, 8 May 2009 (UTC)

It isn't confirmed yet. Until someone does confirm it, we have to leave it suspected. If the death is caused by the flu, we'll hear about it in a few days. 204.81.98.230 (talk) 15:50, 8 May 2009 (UTC)

A Canadian with swine flu died but it does not mean that her death was caused by swine flu. 206.47.141.21 (talk) 15:59, 8 May 2009 (UTC)

Death now confirmed to be caused by the virus. First death in Canada confirmed [69] —Preceding unsigned comment added by Ericleb01 (talk • contribs) 23:46, 8 May 2009 (UTC)

Norway

Norway has got two confirmed cases, according to the latest news. (http://www.focus-fen.net/index.php?id=n180474 and http://nrk.no/nyheter/1.6602215) —Preceding unsigned comment added by 81.166.72.98 (talk) 20:08, 9 May 2009 (UTC)

Laboratory confirmed cases

The WHO reports just an hour or so 896 confirmed cases for the United States. However, in the table we are already counting 1,714 cases. I mean.. this is nearly 100 percent in difference. Why is the WHO so slow? Or do we have mistakes? -- Grochim (talk) 18:38, 8 May 2009 (UTC)

WHO is slow because they are WHO. The CDC is the authority for disease control in the United States has counted (as of May 8th): 1639. That number is the aggregated total of all state reported cases. Some states have since updated their totals to now 1740. All confirmed cases are sourced with state health agencies Template:2009 US swine flu outbreak table --PigFlu Oink (talk) 18:45, 8 May 2009 (UTC)

It takes time for the numbers to be filtered, verified, and submitted by all of the various countries to the WHO. They will differ depending on how often each country sends updates, and may even go up or down sightly as mistakes are corrected on all sides. Flipper9 (talk) 18:54, 8 May 2009 (UTC)

Yes they are slow. Well I asked because of the chart. However, I won't mix different sources in one chart, this is not a good idea. -- Grochim (talk) 05:16, 9 May 2009 (UTC)

Brazil: Country has more two cases of the new flu, announces Minister

Country has more two cases of the new flu, announces Minister

7-year-old girl is of SC and it had rise. Another patient is a friend of young person interned in the Rio de Janeiro

In the total, 6 persons infected with the swine flu in Brazil.

Might anybody update for me there in the article?

Source: http://g1.globo.com/Sites/Especiais/Noticias/0,,MUL1114606-16726,00-MINISTRO+DA+SAUDE+CONFIRMA+DOIS+NOVOS+CASOS+DE+INFLUENZA+A+NO+PAIS.html

--Rodfanaia (talk) 23:59, 8 May 2009 (UTC)

Updated. GaussianCopula (talk) 03:17, 9 May 2009 (UTC)

WHO total deaths 46

WHO totals 2500[2] N/A 44[2]

The ref says

Mexico has reported 1204 laboratory confirmed human cases of infection, including 44 deaths. The United States has reported 896 laboratory confirmed human cases, including two deaths.

And the WHO map of deaths and cases says 2,500 and 46 deaths.

http://www.who.int/csr/don/GlobalSubnationalMaster_20090508_1815.jpg —Preceding unsigned comment added by 94.194.211.181 (talk) 01:01, 9 May 2009 (UTC)

New update by the WHO will be soon. The reference will be updated accordingly. http://www.who.int/csr/don/en/ GaussianCopula (talk) 03:22, 9 May 2009 (UTC)

Oh the WHO is working weekends? I guess this really is a crisis... --PigFlu Oink (talk) 05:50, 9 May 2009 (UTC)

A death confirmed in Costa Rica and 7 more cases

Costa Rica confirmed its first swine flu related death (in Spanish) --Vrysxy ¡Californication! 17:36, 9 May 2009 (UTC)

Data sources

Going over some sources, the total infected numbers were apparently arrived at by taking a percentage estimate of the population, U.S. or world. That's why the three in the chart are around 50 million for the U.S. But there is no confirmed number of cases since most people don't report their flu. However, the total deaths were consistent among all sources. The one I'd recommend looking at is Globalsecurity.org which also has a ton of other useful material, including the current outbreak. In any case, we need to consider whether the mortality rates are accurate enough to put on a chart like this, especially in an encyclopedia. I personally don't think so. It's probably best to just include confirmed totals. And it's true that since the current outbreak is not officially a "pandemic," some footnote should be added. We could even add the 1976 Swine flu "scare," since it never became a pandemic but is of historical mention due to the 40 million vaccinations.

A modified chart without absolute figures. Feel free to modify it for other ideas. --Wikiwatcher1 (talk) 02:38, 6 May 2009 (UTC)

Chart of pandemics
Epidemics (avail. data)	Year	People infected	Deaths	Mortality rate	Data sources
Spanish flu (worldwide est)	1918-19	500 million	50 million		CDC
Asian flu (U.S.)	1957	45 million	70,000		Globalsecurity.org
Hong Kong flu (U.S.)	1968-69	50 million	33,000		Globalsecurity.org
Avian flu (worldwide)	1990-today	421	257		Globalsecurity.org
Seasonal flu (U.S.)	yearly average	50 million	36,000	.08%	CNN
Swine flu (worldwide) [confirmed deaths/confirmed infections]	as of 22:02, 6 May 2009 (UTC)	1893	31	1.6%	WHO

I really like the table but I think the death rate section is inaccurate. We should only use this information if it comes from a research or health care professional. I think it is WAY too early to tell what the death rate is and 1.8% is very high. That is twice the mortality rate of ordinary influenza and there is no evidence of that. --Hdstubbs (talk) 03:04, 6 May 2009 (UTC)

Agreed, even though we can all do math, on something as important as mortality rate we should source that figure, based on its scaryness and the likely underreporting of minor infections at this time.--PigFlu Oink (talk) 05:21, 6 May 2009 (UTC)

We already have a table that does identical math to show world-wide confirmed infections, probable infections, possible infections, probable deaths, and confirmed deaths that is just as scary. Why not this one as well? Flipper9 (talk) 12:06, 6 May 2009 (UTC)

i don't understand the sentences " I think it is WAY too early to tell what the death rate is and 1.8% is very high. That is twice the mortality rate of ordinary influenza and there is no evidence of that.". Are we talking about our Planet or about rich countries?

See the subsection "Uncertainties on the mortality/ death rate - sanity check" above. The Poisson error on deaths in the USA alone would make the uncertainty vey big: 2/831 +- (2/831)/sqrt(2) = 0.24% +- 0.17%, which really just means somewhere around 0.0% to 0.5%. If we include all the rich countries, this would be 0.0% to maybe 0.4% (i haven't calculated it.). If we wanted a separate figure for rich countries, then the Poisson error alone would make it unreasonable to put anything other than an upper limit.

However, en.wiki.x.io is not the USA/UK/Canada/Australia/NZ wikipedia. It's about worldwide knowledge, and that's what is claimed above anyway. The reality of medical services and typical health conditions of "healthy" people in most places in the world is that the same virus will kill off people in some (generally poorer) places at higher rates than others. 1.8% is very high, but it might be the reality for poorer countries. All the present numbers of different sorts in our summary table seem to agree within the roughly 0.3% Poisson error, despite the quite different biases (conservative vs vague):

• WHO confirmed/confirmed: 31/1893 = 1.6%
• "total" confirmed/confirmed: 44/2267 = 1.9%
• "total" (confirmed + suspected deaths)/(confirmed + probable + suspected): (44+100)/(2267+835+4100) = 2.0%

All agree with the previous estimate of 1.8% +- 0.3%. None of these are dropping down to e.g. 0.1% or lower.

i've added some stuff to the caveat in the table, though i'm sure it could be improved. Feel free to NPOV or source the caveats, but since they are mostly saying what we are not saying, probably they only need sourcing for people wondering what some examples are of what to be careful about in interpreting the value. Boud (talk) 21:59, 6 May 2009 (UTC)

No, I mean worldwide. No medical researchers are coming out and saying that this is the mortality rate because they are obviously missing a lot of cases - these are only laboratory confirmed cases not suspected cases or mild cases. Giving what we don't know about the virus we can't make estimations about the death rate. We should only put a mortality rate up there when we have a medical source that has researched this and made that decision. --Hdstubbs (talk) 07:09, 8 May 2009 (UTC)

Actually, i think i do see the interest of comparing to "seasonal flu", even though that's getting close to OR unless we have some serious sources. BTW, our table presently says that 2009/A/influenza/H1N1 is about 20 times deadlier (on average) than seasonal flu. If someone finds a decent reference showing independently e.g. in USA and Mexico what the relative death rates are for the seasonal flu vs 2009/A/influenza/H1N1, then that could be reasonably added in the caveat section. Boud (talk) 22:07, 6 May 2009 (UTC)

I looked at the source cited [70] but this is not a case-fatality rate. Calculating the number of known deaths / known cases offers many errors, positive and negative (missed mild cases and cases not yet progressed to death, for example). Calculating case fatality rates by simple division is definitely against Wikipedia "original research" policy. Mike Serfas (talk) 05:36, 7 May 2009 (UTC)

Condensing the lead

The lead is currently seven paragraphs and Wiki recommends no more than four. I took the first three, which seemed like they could be condensed, and rewrote them as one for sandboxing, (new verb?) below. Note that for easier editing, I trimmed out the citations and some wikilinks so it's easier to sandbox.

Existing:

The 2009 outbreak of influenza A (H1N1) virus is an epidemic of a new strain of influenza virus that was clinically identified in April 2009,[35] and is commonly referred to as swine flu.[36] It is currently a Phase 5 outbreak, one level below an official pandemic.

Although the exact origin of the outbreak is unknown, it was first detected when officials in Mexico and the United States suspected a link between an outbreak of late-season flu cases in Mexico and cases of influenza in Texas and California.[37] Within days, hundreds more suspected cases were discovered in Mexico, with more cases also showing up in the U.S. and several other countries.

By late April, officials from the U.N.'s World Health Organization (WHO), based in Switzerland, and the Centers for Disease Control and Prevention (CDC) in the U.S., were expressing serious concern about the flu outbreak, worried that it might become a worldwide flu pandemic.[38] As a result, WHO raised its alert level to "Phase 5" out of 6 possible, which it defines as a "signal that a pandemic is imminent".[39]

Condensed:

The 2009 outbreak of influenza A (H1N1) virus is an epidemic of a new strain of influenza virus identified in April 2009, and is commonly referred to as swine flu. The source of the outbreak in humans is still unknown, but cases were first discovered in Mexico, and U.S. officials soon suspected a link between this and an earlier outbreak of late-season flu cases in Texas and California. Within days, hundreds more suspected cases, many resulting in death, were discovered in Mexico, with more cases found in the U.S. and several other countries. Soon after, the U.N.'s World Health Organization (WHO), along with the U.S. Centers for Disease Control and Prevention (CDC), became concerned that it could become a worldwide flu pandemic, and WHO then raised its pandemic alert level to "Phase 5" out of 6 maximum, as "signal that a pandemic is imminent".

I think we can trim other lead paragraphs also but offer this one for comments. --Wikiwatcher1 (talk) 18:51, 7 May 2009 (UTC)

I like your suggested change a lot, it's far better prose. Well condensed. ~ mazca ^t|c 18:59, 7 May 2009 (UTC)

I just condensed the lead to four paragraphs and added a note requesting that editors to not make the lead longer than four paragraphs. This is the third time I've shortened it. I didn't do much in the way of editing, though. I just moved the paragraphs together. Wikiwatcher, your paragraph is really good and I suggest adding it to the lead. --Hdstubbs (talk) 07:30, 8 May 2009 (UTC)

Article needs section on predictions regarding likely course of the virus

What readers are really interested in is current and predicted contagiousness, spread, lethality, and morbidity —Preceding unsigned comment added by 66.167.95.139 (talk) 01:23, 8 May 2009 (UTC)

We should try to limit predictions per WP:CRYSTAL, in my opinion. –Juliancolton | ^Talk 01:39, 8 May 2009 (UTC)

Just saw this prediction by the WHO:

"With the current total population of more than 6 billion, that would mean an infection total of 2 billion, he said, but added that the world has changed since pandemics of earlier generations, and experts are unable to predict if the impact will be greater or smaller. We don't really know." said Fukuda. "This is a benchmark from the past. Please do not interpret this as a prediction for the future." "WHO: Up to 2 billion people might get swine flu" --Wikiwatcher1 (talk) 01:47, 8 May 2009 (UTC)

Julian, I think including widely reported predictions is perfectly fine, as wp:crystal discourages us from including unverifiable predictions. Including notable, verifiable, and widely sourced predictions is a part of our job, no?   user:j    (aka justen)   09:24, 8 May 2009 (UTC)

I resist the notion of including educated guesses predictions, even from a distinguished researcher. BatteryIncluded (talk) 03:19, 9 May 2009 (UTC)

Here are a number of authoritative predictions agreeing return in fall is likely with high confidence, and indicating that virulence in the fall is as yet impossible to know:

from http://www.usatoday.com/news/health/2009-05-09-swine-winter_N.htm :

Swine flu likely to return to U.S. next winter

...

"If you draw parallels to previous flu pandemics, the pattern has always been a mild epidemic in the early summer or late spring, then you see a larger epidemic in the winter," said Dr. Luis Z. Ostrosky, an associate professor of medicine and epidemiology in the division of infectious diseases at the University of Texas Medical School in Houston. "If this were to follow the pattern of previous outbreaks, we would see it again in the winter."

Ostrosky was referring to 1918 (Spanish flu pandemic), 1957 (Asian flu) and 1968 (Hong Kong flu).

This pattern of an initial "herald wave" followed by a second wave is common in the flu world.

"Sometimes we will see a little spike of flu towards the end of the season with that turning up next year. Maybe that's what this is. That would be very typical," said Dr. John Treanor, a professor of medicine and of microbiology and immunology at the University of Rochester Medical Center. "My guess would be that if this virus does not end up causing significant disease in the northern hemisphere over the summer, it will certainly do so in the fall."

So far, some of the most affected nations have been in North America and Europe, but the flu is spread more easily in the winter, and it's already fall in the Southern hemisphere. Experts fear public health systems could be overwhelmed if swine flu and regular flu collide in major urban populations, according to the Associated Press.

"You have this risk of an additional virus that could essentially cause two outbreaks at once," Dr. Jon Andrus, of the Pan American Health Organization's headquarters in Washington, D.C., told the wire service.

Two separate flu strains could also mutate into a new strain that is more contagious and dangerous. "We have a concern there might be some sort of reassortment, and that's something we'll be paying special attention to," World Health Organization spokesman Dick Thompson told AP.

In North America, the summer should slow down the spread of swine flu; neither viruses nor bacteria survive well at temperatures above 70 degrees Fahrenheit, explained C. Ed Hsu, an associate professor of public health informatics at the University of Texas School of Health Information Sciences at Houston and associate director of health informatics at the Center for Biosecurity and Public Health Preparedness at the University of Texas School of Public Health.

How and when the flu spreads is dependent on other factors as well: the fitness and efficiency of the virus itself along with its innate ability to replicate; the susceptibility of the host; and the environment, which includes not only the weather, but also human behavior (for example, groups of people confined together inside, making it easier for the virus to jump from person to person).

If a particular virus is especially robust, the weather and other environmental factors may play a lesser role.

"It may not care what the environment is like, because it doesn't need that assistance, or it may depend on environmental factors. It could go either way," Treanor said.

And while influenza virus needs a warm human body to replicate, it seems to sustain itself better in airborne respiratory droplets when it's cold, Horovitz said. Hence, the sneeze heard around the world.

"But, if it does go away, it will come back, he added. "I would be pretty sure of that."

A fall/winter resurgence may or may not be more virulent, said Ostrosky.

"We've been very lucky so far that it's appearing to be mild, at least in the U.S., as far as virulence and susceptibility to antivirals is concerned," he said. "It could change. That's one of the concerns."

"The severity depends on whether [and how] the genotype of the virus reassorts itself," Horovitz added. The reassortment may be so minimal as to make no clinical difference, or it could assert itself in entirely new ways."

But a vaccine will likely be ready by the time a second wave hits, Ostrosky noted, and the world is prepared in other ways as well.

"We have completely sequenced the genome of the virus, and it shows low virulence at this point. We know about it. We can prepare," he said. "If nothing else, this has been an extraordinary exercise in preparation."

Extra-terrestrials ?

While searching for sources for the Historical context section, I found this information through pubmed:

The epidemic behaviour of influenza has been so erratic and difficult to understand that there are still a few scientists who consider that extraterrestrial influences operate. These views are not taken seriously by most virologists but there are puzzling aspects of influenza that are not yet understood.

— Beveridge, W.I. (1991). "The chronicle of influenza epidemics". History and Philosophy of the life sciences. 13 (2): 223–34.

Should we add this critical content to our article ? :) Abecedare (talk) 02:09, 8 May 2009 (UTC)

God no. Nutjobs. Viridae^Talk 02:40, 8 May 2009 (UTC)

Of course not, I trust you are joking! Tim Vickers (talk) 02:41, 8 May 2009 (UTC)

I don't see why you are so dismissive. It seems to be true that some virologists have such theories. To clarify - they aren't suggesting that viruses are being sent down by little green men, they are saying that some viruses might enter the atmosphere from space. It seems an unlikely theory, but it is harsh to describe its adherents as nut jobs. I would be against mentioning it in this article, though. Possibly it might have a place in Influenza. GrahamN (talk) 02:52, 8 May 2009 (UTC)

Once again, no. I'm dismissive of this idea for the excellent reason that I have been reading the literature on influenza intensively over the last two weeks, to refresh my memory after bringing influenza to FA in 2006. This idea is not part of the literature on this topic, it is simply nonsense. Tim Vickers (talk) 02:57, 8 May 2009 (UTC)

Yes I was kidding; thought other editors might enjoy the diversion.
To be clear: I don't hink this belongs in any of the Influenza related articles; the fringiness can be covered adequately at the pages of its proponents Fred Hoyle, Chandra Wickramasinghe or perhaps at panspermia. Abecedare (talk) 03:04, 8 May 2009 (UTC)

Agree. But it has the makings of a great movie script, a la Jonas Salk story. Tom Cruise in a lab coat? --Wikiwatcher1 (talk) 03:08, 8 May 2009 (UTC)

Good choice. Cruise's sofa-jumping wide-eyed crazyness and and the idea of influenza by panspermia seem excellent companions for each other. Tim Vickers (talk) 03:11, 8 May 2009 (UTC)

Not only Influenza; SARS too! Abecedare (talk) 03:26, 8 May 2009 (UTC)

It is harsh to dismiss the panspermia theory out of hand as "simply nonsense". I don't buy it, personally, but there really are a few serious scientists who do. Fred Hoyle used to be keen on the idea, and it persists. Look at these articles and letters in The Lancet, for example. GrahamN (talk) 03:29, 8 May 2009 (UTC)

Panspermia is offered by some legitimate scientists as a hypothesis that explains almost every open question about life on earth. Except it explains nothing: it simply moves those questions outside the scope of terrestrial biology, into astrobiology, in the same manner as intelligent design moves those questions outside the scope of science. --Una Smith (talk) 14:22, 8 May 2009 (UTC)

It is posible that it was a anilen virouse.--86.29.243.170 (talk) 09:25, 9 May 2009 (UTC)

No its not possible, aliens may exist, but there is no such thing as a "virouse". --PigFlu Oink (talk) 09:28, 9 May 2009 (UTC)

Defining terms

On the other hand, depending on how you define "extra-terrestrial" agents, we can also note that they're already here. We've got cosmic rays, X-rays, gamma rays, uv rays, ozone holes, etc. which cause mutations, cancers, and a host of evolutionary unknowns. The sun is probably a key extra-terrestrial agent of change. But as Louis Brandeis said, sunlight is also the best medicine. Take your pick. --Wikiwatcher1 (talk) 03:48, 8 May 2009 (UTC)

Why isn't Argenina in red yet?

There is a confirmed case. --190.49.117.246 (talk) 14:30, 8 May 2009 (UTC)

No one cries for Argentina. --PigFlu Oink (talk) 18:49, 8 May 2009 (UTC)

Map Issues

1.) Color - I think that black is not a good color for confirmed deaths. Especially now that Canada is likely to have confirmed death soon this means that the entirety of North America is black for less fifty deaths. Maybe I've played too much Pandemic II but I think this is a little over the top. My suggestion is red = death, green = confirmed, and yellow = suspected

2.) Territories - Should territories be colored even if there are no cases there? Ex: Alaska, French Guiana, etc. --Hdstubbs (talk) 16:45, 8 May 2009 (UTC)

Note To keep colors similar on all the swine flu maps, I'm going to ask you achieve a wide-consensus before being bold (perhaps a link to this conversation on the other talk pages) --PigFlu Oink (talk) 18:52, 8 May 2009 (UTC)

Can you post a legend of what red, green, yellow you are going to use? And Alaska isn't a territory, for better or for worse, its a full and equal part of these United States. --PigFlu Oink (talk) 18:53, 8 May 2009 (UTC)

Agreed. I don't want to do anything without consensus. Also, I don't know how to make the maps. I think I don't have the program needed to edit them. I tried once and couldn't do it. It's not a huge thing but I just kept seeing these same issues brought both here and on the map talk pages so I thought I'd see what the consensus was before I did anything about them. The issue seems to be that the maps would be hard to change. I would look up the translations for the colors but I am not that great with computers to make the maps myself. --Hdstubbs (talk) 18:57, 8 May 2009 (UTC)

Wikipedia:Manual of Style (diagrams and maps)#Colors in maps --PigFlu Oink (talk) 19:08, 8 May 2009 (UTC)

• The "exclaves" issue has been gone over several times in the archives, without change. For one reason, the .svg file is essentially a text file in which the two letter country codes are used to control which country receives which color, and that would need to change to create this change. More to the point, the official sources don't generally break down cases within nations or states, making it difficult for future editors to maintain the file.
• The color scheme is admittedly arbitrary. When I painted a third color, black seemed appropriate.[71] But I really don't like the yellow -> green -> red procession suggested, because it is not sequential in terms of hue or brightness.
• I expected that additional colors might be added to the map over time. Initially I had hoped remotely that perhaps a shade of blue might mark countries in which the virus had been contained. Now I think perhaps a shade of green might eventually mark countries that begin mass vaccinations. Using a fourth shade to mark large numbers of confirmed deaths is problematic, because if the outbreak spreads further I think many countries will not prove conclusively by genomic sequencing that each new death is due to swine flu. Only a handful of cases may ever be confirmed to this standard, and for some countries we may need to rely on sources to infer a "confirmation" in the absence of data. So I think that for a threshold of more than one, we will need to use suspected or estimated deaths, not confirmed.
• If this disease continues to spread we may desire a second, independent map which uses different colors to express the numbers of deaths as a fraction of population. Probably a source will come along for us to base this on just as it becomes appropriate. Mike Serfas (talk) 00:28, 9 May 2009 (UTC)

• The present colors seem fine. Keep it simple. One useful thing with a map like this is to follow the progress by seeing the successive maps day by day. That seems to be sort of possible by going to the file history for the map, but it is not convenient. Edison (talk) 03:35, 9 May 2009 (UTC)

Congratulations

Congratulations to all the editors; in real life, I have received numerous compliments today about the quality and usefulness of this and related articles. Graham Colm ^Talk 21:42, 8 May 2009 (UTC)

We try. Perhaps we'll eventually get a mention in the New England Journal of Medicine re "informal media"!

http://content.nejm.org/cgi/content/full/NEJMp0904012

kencf0618 (talk) 23:22, 8 May 2009 (UTC)

'New England??' Its over 400 years old!!! --PigFlu Oink (talk) 23:23, 8 May 2009 (UTC)

For the first few days this article was so caotic I stayed away. You guys have done a good job. BatteryIncluded (talk) 02:34, 9 May 2009 (UTC)

Age

Whereas most influenza strains affect the elderly and young children worst, this strain has primarily caused deaths in people aged 25–50.[158] -- is this statement, which refers to that outdated report, still considered valid? By the way, it looks like the original report is slightly misrepresented here. Colchicum (talk) 17:44, 9 May 2009 (UTC)

Comparison chart

A chart I put together for some quick perspective and comparison. Feel free to revise or expand. --Wikiwatcher1 (talk) 01:42, 4 May 2009 (UTC)

Chart of pandemics
Epidemics (avail. data)	Year	People infected	Deaths	Mortality %	Death rate/10,000	Data sources
Spanish flu (worldwide est)	1918-19	500 million	50 million	10%	1000	CDC
Asian flu (U.S.)	1957	45 million	70,000	.16%	16
Hong Kong flu (U.S.)	1968-69	50 million	33,000	.07%	7
Avian flu (worldwide)	1990-today	421	257	61%	6100
SARS (worldwide)	2002-03	8,096	774	9.6%	960
General flu (U.S.)	yearly average	50 million	36,000	.08%	8	CNN
Swine flu (worldwide) [confirmed deaths/confirmed infections]	as of 01:17, 6 May 2009 (UTC)	1767	31	1.8%	180	WHO

I like this alot. I think we should make a historical context section and place it after the introduction. It would go over previous pandemics and outbreaks prior to this one. What does everyone think?--Hdstubbs (talk) 03:16, 4 May 2009 (UTC)

I put it in with Pandemic concern section. If someone wants to write some text to put it in better context that would be lovely. --Pontificalibus (talk) 10:05, 4 May 2009 (UTC)

Many people compare it to 1918 pandemic of H1N1 variant. H comes from hemagluttenin and N comes from neuroaminidase (sp?). I BLASTed most recent HA and NA sequences against their 1918 counterparts from 3 strains mentioned in flu database at NCBI. Neuroaminidase has 83% nucleotide sequence identity and hemogluttenin has 81% to their counterparts. That is pretty low. —Preceding unsigned comment added by 83.174.217.67 (talk) 03:30, 4 May 2009 (UTC)

It is pointless having both "Mortality %" and "Death rate/1,000". One should be dropped but I'm not sure which one. Nurg (talk) 11:06, 4 May 2009 (UTC)

It may seem pointless, seeing as the numbers are extremely similar, and they say basically the same thing. But keep in mind, we're not just writing for educated, or even semi-educated people. We're writing for everyone, and the 30yr old man from South Africa with a 2nd grade education won't understand percentages. (Not being racist, just an example. And yes, I know the odds of my example even seeing the page, but it was an example.)D^rew S^mith 11:18, 4 May 2009 (UTC)

I beg to differ. In the English Wikipedia we are writing for people with reasonable literacy and numeracy skills. In the Simple English Wikipedia we write for the man with a 2nd grade education. Nurg (talk) 11:51, 4 May 2009 (UTC)

What about having just Death Rate %? --Pontificalibus (talk) 11:27, 4 May 2009 (UTC)

Meh, good point. But that still doesnt mean everyone is good with math.D^rew S^mith 12:03, 4 May 2009 (UTC)

Wikipedia doesn't ban the use of numbers on account of the fact that some people are innumerate. --Pontificalibus (talk) 12:07, 4 May 2009 (UTC)

I removed the last column and renamed Mortality % as Death Rate % -- Pontificalibus (talk) 12:10, 4 May 2009 (UTC)

I need to point out that you need references for all of the numbers in this table, and all conclusions about mortality. And the numbers for "Swine Flu" cannot reference a Wikipedia article as a source, otherwise you would violate WP:OR. I would think that a simple mortality calculation from a single source would be acceptable under WP:OR, however. Nice Table; I think it'd make a great contribution as long as sourced properly. Flipper9 (talk) 13:11, 4 May 2009 (UTC)

For the version modified and used in the article, there's a big problem I see. Since the available figures include worldwide or U.S. totals, the other columns makes less sense as a comparison tool unless there is some ratio column with it, such as % or /1,000. I added both here since there was plenty of room. Some people are used to seeing stats as a % (i.e. investors) and others like the per thousand (i.e. crime rates.) In fact, the reason I added "(avail. data)" was because I only found accurate data for that demographic, although other estimates may be still be available.

It would also be easy to add another column as a place to include one or more source links to avoid OR issues. --Wikiwatcher1 (talk) 18:37, 4 May 2009 (UTC)

I went ahead and added a colum for sources to see how it might look. Note that the sources can easily be changed and other sources can be added, since the column will just expand to fit (but abbreviate the source name if possible.) --Wikiwatcher1 (talk) 18:45, 4 May 2009 (UTC)

This analysis seems to be a case of synthesis, with numerators and denominators from different sources. There is little accuracy or consistency in the number of "cases" since only the most ill come to be included. Mild cases resolve at home with chicken soup and no medical attention. The fatality rates for some varieties are absurd original rsearch. Edison (talk) 02:16, 5 May 2009 (UTC) Edison (talk) 02:16, 5 May 2009 (UTC)

All of the figures have come from verifiable sources and there was no mixing of sources in doing stats. I'll work on adding these to the new column. The only question I have is whether we should include non-influenza pandemics. If so, then polio and SARS would stay, and we should add some others, like smallpox, another viral disease. If the chart ends up including most pandemics of all sorts we might want to add it to the Pandemics article. --Wikiwatcher1 (talk) 04:02, 5 May 2009 (UTC)

Wikipedia:OR#Routine_calculations: "Routine calculations: This policy does not forbid routine calculations, such as adding numbers, converting units, or calculating a person's age, provided editors agree that the arithmetic and its application correctly reflect the information published by the sources from which it is derived."

Division is less simple than addition, but is still taught at primary school level in most countries AFAIK. So if there are sources either for the numerator and denominator (the two things to be divided) separately, or else for the result of the division, and if we wikipedian editors can agree on the result of the division in the former case, then either should be acceptable according to WP:OR, i.e. this is not considered an original "synthesis". Boud (talk) 00:13, 6 May 2009 (UTC)

Edison, your removal of Polio from the article chart gives more importance to the questions above. Especially since Polio is a viral infection which was transmitted in a similar way to influenza. But Bubonic plague, which you cited as comparably irrelevant, was a bacterial infection transmitted by flea bites. In any case, SARS is listed, which was not an influenza, so the editors should decide what the chart is for: i.e. influenza pandemics, virus pandemics, or all pandemics. --Wikiwatcher1 (talk) 04:53, 5 May 2009 (UTC)

If we can define what the criteria for the table are, we can determine if polio belongs. Edison (talk) 23:29, 5 May 2009 (UTC)

I think the basic consept of the chart is very good given resent events.--86.29.255.77 (talk) 08:46, 5 May 2009 (UTC)

Source of the virus

I have put an NPOV tag on the section re source of the virus. It is WP:SYNTHESIS at its worst. Also, the quality of sources is very poor. What happened to the original, reliable sources? This section now functions as a link farm for blogs. --Una Smith (talk) 18:12, 7 May 2009 (UTC)

I'll try to clean it up a bit. hmwithτ 18:33, 7 May 2009 (UTC)

What are your main concerns? I'm not sure what sources used to be there. You can try looking through the article's history. If they are better sources, feel free to add back, per WP:BRD. hmwithτ 18:39, 7 May 2009 (UTC)

For one the last sentance ', possibly due to the intensive farming carried out to maximize profits.' Cries POV. The sources used seem to wage war on evil mega meat corporations, however their evidence is collecitve non-scientific theories, unoffical reports, and dissimilar unconnected incidents wrapped together like a giant rubberband ball --PigFlu Oink (talk) 18:57, 7 May 2009 (UTC)

Indeed, although I'm a long-term reader of The Guardian, I would still hesitate to use an opinion essay from this newspaper as a source of facts about viral evolution. The source of this H1N1 strain is not known, and considering that the first case was identified in California, the speculations about one particular farm in Mexico are stretched very thin. Tim Vickers (talk) 19:53, 7 May 2009 (UTC)

I've taken a crack at balancing. Still have my doubts about some of the animal welfare activism sources from the UK...LeadSongDog come howl 20:07, 7 May 2009 (UTC)

Note in particular that, whatever you think about its applicability as a source, that Guardian opinion piece does not state that the current H1N1 strain is related to the strain that emerged in North Carolina, it states: "Since its identification during the Great Depression, H1N1 swine flu had only drifted slightly from its original genome. Then in 1998 a highly pathogenic strain began to decimate sows on a farm in North Carolina and new, more virulent versions began to appear almost yearly, including a variant of H1N1 that contained the internal genes of H3N2 (the other type-A flu circulating among humans)." The link between these facts and the origins of the current strain is never made clear in this piece, so interpreting this as a statement on the origin of the current strain is unsupportable. Tim Vickers (talk) 20:14, 7 May 2009 (UTC)

I've added a summary of a news article in Nature, which gives a useful perspective and is an unimpeachably reliable source on scientific topics. Tim Vickers (talk) 20:26, 7 May 2009 (UTC)

The information on viral origins in this Nature article is in box 1 ('The turbulent history of the A(H1N1) virus'), which in the on-line version is linked in the second paragraph. Tim Vickers (talk) 22:04, 7 May 2009 (UTC)

Whew, what a string of edit conflicts. Looks much better now, though. Is the Caroline Lucas piece a RS? As a Green MEP, antiglobalist, and RSPCA advocate she just might have an agenda.LeadSongDog come howl 22:00, 7 May 2009 (UTC)

---

Hello, I am fluent in Spanish language and I am a cell & molecular biologist. Ignoring the fact that La Jornada is an alarmist newspaper - one notch above tabloid. The quoted report by La Jornada is trash at its best. Some facts:

La Jornada quotes one La Gloria municipal town clerk who blames the outbreak on the farm and on flies. This clerk is no scientist and made the unofficial statement BEFORE the actual testing.

a) Not one pig in that farm, or in Mexico for that matter, has tested positive for H1N1.

b) Canadian and Mexican government scientists found no infected swine.

c) The American farm operator found no infected swine at the location.

d) La Jornada's article states that the vector (spreading) of influenza A are the flies, which is ferociously false and is a sTOopid baseless speculation.

e) The second reference (The Guardian) is only quoting La Jornada, so it is also useles. Besides, its title is not a news, nor a statement but an editorial question: Swine flu: is intensive pig farming to blame?

f) The source of the outbreak has not been identified.

g) Not because the "news" was published in La Jornada, it has to be quoted. Let me remind you, per WP:V "each fact presented by an article must be concretely verifiable, at the editor's discretion it is possible and appropriate to include as many proper and correct citations as desired to affirm the statements made. [...] And whether a citation is added in a required context or at an editor's discretion it must be accurate and should comply with the rules set forth in this guideline." Since the article is definitevly not accurate and is demonstrably based on unscientific speculation, any claim supported by it must be deleted at once. I don't think we do any service to Wikipedia by listing the fringe theories around this outbreak. Cheers, BatteryIncluded (talk) 22:39, 7 May 2009 (UTC)

The town clerk detail is one worth capturing. While nobody serious would still think the farm was to blame, the reports were widely repeated and contributed to the anti-pork reaction. It might be appropriate to move some of this down to the Media section. For clarity, the Guardian article BI mentions is the same one authored by Caroline Lucas.LeadSongDog come howl 22:57, 7 May 2009 (UTC)

It might still belong in the article, since this speculation has been picked up by the international media. I've reworded the section to match more accurately what you have said about this source. Tim Vickers (talk) 22:58, 7 May 2009 (UTC)

I am also fluent in Spanish (I live in Mexico) and I fully agree with you what you say, BatteryIncluded. I prefer this part to be removed because it is just misleading. It is already sufficient that the media published that misleading information all over and caused more panic than necessary (see eating pork etc.). The same happened with the so-called "patient zero" who was obviously not the origin of the outbreak (at least not worldwide). Those facts can appear in the media section to recall people who read the article how things were published at the time. However, for an informative article what the influenza is really about it is just confusing and misleading. I fully agree!--201.153.19.149 (talk) 13:51, 10 May 2009 (UTC)

I agree with with TimVickers' LeadSongDog's observation and edits. Cheers. BatteryIncluded (talk) 23:34, 7 May 2009 (UTC)

This section is now much better. --Una Smith (talk) 14:13, 8 May 2009 (UTC)

I was tempted to oppose this section last week, because it does seem a little absurd - but it is important not to jump to conclusions. See Kyoto Sawabe, Keita Hoshino, Haruhiko Isawa, Toshinori Sasaki, Toshihiko Hayashi, Yoshio Tsuda, Hiromu Kurahashi, Kiyoshi Tanabayashi, Akitoyo Hotta, Takehiko Saito, Akio Yamada, and Mutsuo Kobayashi (2006). "Detection and isolation of highly pathogenic H5N1 avian influenza A viruses from blow flies collected in the vicinity of an infected poultry farm in Kyoto, Japan 2004". Am. J. Trop. Med. Hyg. 75 (2): 327–332.{{cite journal}}: CS1 maint: multiple names: authors list (link).

According to the original reference,[72] the fly hypothesis was advanced by "Bertha Crisóstomo López, agente municipal del poblado". Wikipedia has no article on municipal agents in Mexico and I'd like to see more about them, but so far I infer that they seem to be something like a mayor appointed by the central government - an authority figure, in any case, who might be reporting someone else's work.

Whether or not direct transmission by flies makes any sense, I think that there is an indirect argument to be considered. A pig farm which is exceptionally smelly and generates flies may generally fall short of industry standards, and hence less likely to vaccinate, diagnose, or treat pig flu which then might spread via the workers in a more conventional way.

I asked a question earlier ([73]) regarding satellite photos of farms nearer to 'Patient Zero', as Perote is actually quite some distance away from La Gloria where the initial outbreak might have occurred. Mike Serfas (talk) 16:21, 9 May 2009 (UTC)

Hello, it is true we are not reviewers, however, a town clerk's POV before any testing, does not deserve to be highlighted over the massive amount of scientific reports stating otherwise. We do have a responsibility here for accuracy, and the scientists from at least 3 countries (USA, Mexico & Canada) in charge, have declared that they have not found the origin/source, and that certainly it was not La Gloria pig farm. Thank you for the very interesting paper you cite. I am glad to learn this and i trully find it wonderful. Indeed, domestic flies have been found to carry the virus in their outer body and gastrointestinal tract. They are capable of mechanical transport of the flu virus. However, I also noticed 1) the researchers did not venture to call this find a "vector", 2)virus survival in/on the flies is still unknown, and 3) no evidence was found that the contaminated flies infected any organisms. 4) I believe that mecanical contamination does not imply spreading the virus and causing active infections on any third organism. For all practical and scientific purposes, La Gloria location and swine tested negative for the virus. On the other hand, the nespaper report did seem to have caused some intense reactions, so it was moved to the 'Spread within Mexico' section. Again, thank you for the very interesting Japanese article. Cheers, BatteryIncluded (talk) 22:34, 9 May 2009 (UTC)

Logarithmic chart

Reported laboratory confirmed H1N1 influenza cases.

I also made a logarithmic chart, it shows better the numbers in the first days. But I think if we place it into the article, it's too much. Any ideas? -- Grochim (talk) 09:02, 8 May 2009 (UTC)

Support - replace existing. -- John (Daytona2 · Talk · Contribs) 14:18, 8 May 2009 (UTC)

N I like it but it probably fails the layman test, in that 98% of the people wouldn't understand a logarithm if it fell on their head. It will also fail WP:OR as no similar chart or summary of growth has been published by a recognized authority so your summary could be argued to be original particularly as it goes beyond simple addition. PS could you get rid of the extra "0:00" on the date axis?—Teahot (talk) 15:55, 8 May 2009 (UTC)

Yes I will try, but give me a little time. -- Grochim (talk) 17:08, 8 May 2009 (UTC)

I don't think it counts as original research - it is just presenting the same information in a different, useful, way. However I don't think it should replace the chart that is there at the moment. If it is possible to do this, I think the best idea would be to put it just beneath the existing chart, but hidden in one of those things where you have to click on them to open them up. (What are those things called, by the way?) GrahamN (talk) 17:58, 8 May 2009 (UTC)

Collapsed tables, they work by setting the class to "wikitable collapsible" or similar (you can also use template:hidden begin to do the same sort of thing by hiding text).—Teahot (talk) 18:12, 8 May 2009 (UTC)

 Done ... It's included in the table template now. -- Grochim (talk) 11:51, 9 May 2009 (UTC)

The vertical axes need labeling. Somebody's going to come along and get freaked out that the disease is 90% fatal. In fact, putting the deaths on the same chart with a different scale may be a bad idea entirely. -- Cyrius|✎ 20:30, 9 May 2009 (UTC)

Yes I'm not really satisfied with this solution, too. However, the deaths are important and I can't make thousands of charts. I will downscale the axis a bit. -- Grochim (talk) 10:51, 10 May 2009 (UTC)

WHO raising threat level to 6

The World Health Organization will be raising the threat level to 6 at noon tomorrow. —Preceding unsigned comment added by 24.137.110.9 (talk) 03:15, 10 May 2009 (UTC)

Source? Titoxd^{(?!? - cool stuff)} 03:24, 10 May 2009 (UTC)

There are sources that level 5 will be maintained:

• "The WHO still has found no evidence of community transmission of the swine flu virus outside North America, which would trigger the move from a pandemic phase 5 to phase 6," Sylvie Briand, a WHO influenza expert, told reporters today. "Most new cases outside North America represent imported infections linked to travel or infections in travelers' close contacts." CIDRAP - May 8, 2009
• The World Health Organization maintains pandemic alert of Phase 5. Pan America Health Organization - 9 May 2009 6:00 pm

-- Grochim (talk) 04:18, 10 May 2009 (UTC)

1976!

It will blow over, just like this one did![74] --86.25.50.119 (talk) 10:21, 10 May 2009 (UTC)

Dr 86.25.50.119 has spoken. Can we cite him in the article? --PigFlu Oink (talk) 10:23, 10 May 2009 (UTC)

LOL. -- Grochim (talk) 10:41, 10 May 2009 (UTC)

disambiguation page needed to trap searches for "swine flu"

For many searchers, "Swine Flu" is the only search term they know. That search delivers them to a technical swine flu page, not the 2009 outbreak page. —Preceding unsigned comment added by 69.3.11.186 (talk) 17:36, 10 May 2009 (UTC)

The top of the swine flu page points them to this article. What are you suggesting? Perhaps a bigger pointer? Daniel.Cardenas (talk) 17:41, 10 May 2009 (UTC)

Wikipedia is an encyclopedia, not a news source. The main focus article should be the disease, and the one on the outbreak should be title as the outbreak. The swine flu page also redirects to this page. There's no need for a disambig page. hmwithτ 00:17, 11 May 2009 (UTC)

autogenerated content and suggested links

see the links to ncbi genome page for updated flu sequences and the promed site for infectious disease information from workers in the field. It took forever to load so I posted to wrong page :) Nerdseeksblonde (talk) 21:00, 10 May 2009 (UTC)

Data Quality

I am concerned that some countries may seriously under-report cases to the WHO. For example, Mexico cases do not follow the epidemiological curves seen in other country data.

Under-reporting can be due to lack of lab equipment or access to labs and lack of medical screening / reporting infrastructure, but also due to local political / economical reasons. I would hope, that folks at WHO could comment on that.

Country listings: Instead of the current confirmed / suspected lists, it would help to break up data according to whether the subject caught the flu while visiting another country, or from catching it in their own country.

Country listings: It would help, to list the median age, +/- sigma.

Fk52b (talk) 00:49, 11 May 2009 (UTC)

Ideas like this are not hard to come up with. What is hard is finding reliable sources to back them up. Do you have any suggestions on that front? -- Avenue (talk) 09:50, 11 May 2009 (UTC)

Today the European Centre for Disease Prevention and Control (ECDC)reported that the European number of confirmed cases had reached 196. Of those, 42 individuals had not caught the flu upon return from North America. -- Fk52b (talk) 14:57, 11 May 2009 (UTC)

A new pandemic?

Aaaaaaaaaaah! It's the end of the world!!!!!!!!! —Preceding unsigned comment added by Pinkgirl411 (talk • contribs) 00:51, 11 May 2009 (UTC)

Don't worry, we got trough pandemic flu in 1918-1919 and medical science is even better now.--86.29.255.85 (talk) 02:10, 11 May 2009 (UTC)

Costa Rican update

A 53 year old man, who never went to Mexico [[75]] during the plague has now died!--86.29.247.157 (talk) 10:24, 11 May 2009 (UTC)

Macau up-date

A China/Macau/Hong Kong vidio confrence was held. Macau is flu free [76].--86.25.53.147 (talk) 11:04, 11 May 2009 (UTC)

Removal of chart http://en.wiki.x.io/wiki/File:Influenza-2009-cases.png

I do not see the value of a chart which has an aggregate of confirmed cases compared to confirmed deaths. First of all, the chart is unclear as to what it is tracking. Is it worldwide deaths or cases? It is not good enough to know that it is cases but my point is that the chart does not clarify this at all. Second, what is the reasoning in comparing suspected cases to deaths? This is not clear as to why it should be included in a single chart. Overall, the chart is ambiguous and should be removed. I request opinions on this since I am for removing the chart. GaussianCopula (talk) 03:47, 11 May 2009 (UTC)

To further clarify my point. We should have either a chart with aggregates and its subcomponents (Total deaths, deaths by country) or an aggregate compared with another aggregate (Total deaths, total confirmed cases). Having a chart which has total aggregates of deaths, plus total aggregates of confirmed, plus separate confirmed cases is ambiguous. Please provide arguments against its removal. GaussianCopula (talk) 03:59, 11 May 2009 (UTC)

Hmm.. please let us know first what kind of chart you wish. For example, it is not possible to illustrate the total deaths and total confirmed cases on one axis. If you suggest that example, how would you realize it? Furthermore the chart only includes confirmed cases, not suspected cases.

The chart includes 5 data series and one is printed on the right axis. If you want to show the figures by country in seperate charts, it will be much work to update. I can't do that alone so I would rather suggest to remove the data series of Mexico, USA and other. I invite you to create an alternative chart so that we can compare them directly and choose the better one. -- Grochim (talk) 04:43, 11 May 2009 (UTC)

Grochim, you seem to be the chart person and I am definitely not. My point with regards to this specific chart is that it is comparing an aggregate number (Total confirmed cases) together with another aggregate number (Total deaths) and adding subcomponents (Individual confirmed cases) within. If you notice the chart, there is some sort of jump that it takes. Now, this jump just happens to be near the deaths axis. I am sure you can see it.

The deaths number is buried somewhere in there.

What I am saying is that a chart that has aggregates vs aggregates makes sense. That is Total Confirmed Cases vs Total Confirmed Deaths. Also, Total Confirmed vs Confirmed by Country (Mexico, USA and other), also makes sense. The current chart has Total Confirmed plus Total Confirmed Deaths plus Total Selective Countries Confirmed.

I think the chart is confusing and should be split.

GaussianCopula (talk) 05:11, 11 May 2009 (UTC)

I can suggest to remove the Mexico, USA and other so that the chart only includes aggregate deaths and confirmed cases. Would you agree with that? We could show the seperate countries in a further chart, but right now I'm a little bit busy so that it may take some time. -- Grochim (talk) 09:35, 11 May 2009 (UTC)

That would be fine, IMO, however I don't really see a huge issue with the current chart either. --ThaddeusB (talk) 12:15, 11 May 2009 (UTC)

That would be better. Thanks. GaussianCopula (talk) 17:31, 11 May 2009 (UTC)

Egypt gose nuts

Some clerics blame "God's vengeance on the infidels" (or whatever people mean when they say things like that) for swine flu

[[77]] --86.25.53.147 (talk) 11:30, 11 May 2009 (UTC)

our 'clerics' usually blame these things on "the gays". --PigFlu Oink (talk) 12:52, 11 May 2009 (UTC)

I read this as Egypt goose nuts, it's a great typo. Here's that source article formatted

• Daniel Brumberg. "Georgetown/On Faith: Faith, Politics and Swine Flu in the Middle East". Washington Post. Retrieved 2009-05-11.

—Teahot (talk) 13:07, 11 May 2009 (UTC)

Human-to-human transmission (intra-national transmission)

Could someone add a list of those countries in which there were human-to-human transmissions? I know of Mexico, USA, Germany and Spain, but probably there are more.--Roentgenium111 (talk) 14:38, 11 May 2009 (UTC)

All the cases are human to human; except for the first one. --PigFlu Oink (talk) 14:45, 11 May 2009 (UTC)

Yes, but most people outside North America got infected while travelling to Mexico or the U.S. I'm interested in the countries in which the transmissions actually occurred. (E.g. in Germany, I think 8 of the 11 cases got infected in Mexico, one in the US and only two in Germany.)--Roentgenium111 (talk) 14:56, 11 May 2009 (UTC)

Then you want 'intra-national transmisson' and 'inter-national transmission' information; not 'human to human' transmission information --PigFlu Oink (talk) 14:58, 11 May 2009 (UTC)

Yes, that's what I meant.--Roentgenium111 (talk) 15:02, 11 May 2009 (UTC)

Do we have evidence that the mixing vessel was not human, or is PFO just saying we don't know that it was?LeadSongDog come howl 15:37, 11 May 2009 (UTC)

PFO? The only thing I read is that 'mixing vessels' for influenza are still theroretical. --PigFlu Oink (talk) 15:39, 11 May 2009 (UTC)

Imagine what I get 8-D The vessels may be theoretical in some sense, but it's pretty clear that genes from different strains are getting combined womewhere. AFAIK th species of the first host for the present novel virus strain has yet to be determined. The WHO doesn't seem to have much doubt about the theory, as evidenced by the results of this search query. The forward concern seems mainly to be that the Novel H1N1 will mix with the H5N1 Highly pathogenic bird flu (which is still endemic in both Egypt and Vietnam) to form a new highly pathogenic swine flu strain. For this reason, I'd admit a modicum of justification for the Egyptian pig cull, though a vigorous campaign of vaccination for the Egyptian and Vietnamese herds against the H5N1HPBF virus would make much more sense. Frankly, I'd worry more about the Vn herds because of the duck proximity to swine being so common there. LeadSongDog come howl 17:14, 11 May 2009 (UTC)

Back to the question at hand... we don't have this information in the article because it is by nature hard to determine and somewhat subjective. Not surprising, given these difficulties, it is not widely reported. --ThaddeusB (talk) 18:38, 11 May 2009 (UTC)

I started a list myself (in the chapter "International cases..."). Further additions are welcome!--Roentgenium111 (talk) 19:02, 11 May 2009 (UTC)

See this link - the CSI is where you are looking for http://www.invs.sante.fr/display/?doc=surveillance/grippe_dossier/index_h1n1.htm (AJvH (talk) 22:11, 12 May 2009 (UTC))

Historical context globalsecurity

why does every link go to globalsecurity.org ? —Preceding unsigned comment added by 94.194.211.181 (talk) 18:44, 11 May 2009 (UTC)

In the references or external links? hmwithτ 22:17, 11 May 2009 (UTC)

The charts says that the Hong Kong flu in 1957 killed 2 million people with less than .1% mortality. Which would mean that at least 2 billion people were infected, or more than 2/3 of the world's population (2.9 billion in 1957). It seems quite a lot, as only 1/3 of humanity was infected during the Spanish Flu.

The Global Security page says that in England, fatalities were in the order of 0.13% to 0.25%, and most death occurred in China were the population was already weakened by Mao's Great Leap Forward. I think that the 0.1% mortality is for the common flu, and not for pandemics. AtikuX (talk) 05:26, 12 May 2009 (UTC)

I've just added data from a May 11 publication in Science, placing the case-fatality rate of this outbreak at 0.4%. This source states that this is comparable to the 1957 pandemic. Another source quotes the HHS as stating that the 1957 and 1968 outbreaks had a Pandemic Severity Index of 2 (0.1% to 0.5% case fatality rate). [78] This and the simple arithmetic above convince me that the Global Security figure (which is in any case not specific to 1957) should probably be discarded. Mike Serfas (talk) 08:11, 12 May 2009 (UTC)

All still there, just a link to a website with no references or sources and some spelling mistakes in the article. And selling items from the US Cavalry store. Why is this the upmost site for the 1968 Hong Kong Flu for example? —Preceding unsigned comment added by 94.194.211.181 (talk) 13:02, 12 May 2009 (UTC)

auto-generated content and external links suggestions.

[ someone deleted this from earlier, lots of edits today]

I didn't know wiki covers current events and was impressed by amount of stuff here. Are there general means to auto-generate this type of content harvest from machine or even human readable sources? Also, the NCBI has a sequence library,

http://www.ncbi.nlm.nih.gov/genomes/FLU/SwineFlu.html

and these guys have some good resources, not sure of opps to coordinate,

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

and personal interest looking for coding opportunities for dealing with infectious diseases :)

Nerdseeksblonde (talk) 19:12, 11 May 2009 (UTC)

Hmmm. I added that NCBI link more than a week ago but someone must have deleted it. I'll put that back in and put your second link in External Links. Mike Serfas (talk) 08:15, 12 May 2009 (UTC)

I thought I may have missed it but I tried to check. Promed is a great resource and I'd like to think there would be a way to get automated counts- if they can tally votes and other stuff in real time, why not verified and putative case reports? Nerdseeksblonde (talk) 21:13, 12 May 2009 (UTC)

How?

How do I edit the table? I wanted to update that Canada now has 330 cases per the same source referenced but I didn't see the table in the article, nor was I able to bring it up as a Wikipage. CycloneGU (talk) 20:47, 11 May 2009 (UTC)

Follow the "e" at the bottom of the table. It's a template.LeadSongDog come howl 21:22, 11 May 2009 (UTC)

The table is transcluded from a template, which is located at Template:2009 swine flu outbreak table. hmwithτ 22:12, 11 May 2009 (UTC)

Ah, that explains it. I was trying to put the square brackets in - that is, wikipedia.org/{{2009 swine flu outbreak table}} (which clearly didn't work - but on saving my msg. this time, I found the table appeared as on the page...oopsie). I'll look for that "e" next time. Thanks to the person who updated it. =) CycloneGU (talk) 01:24, 12 May 2009 (UTC)

Finland

http://www.hs.fi/kotimaa/artikkeli/Suomessa+varmistui+kaksi+sikainfluenssatartuntaa/1135245884424

2 confirmed cases in Finland —Preceding unsigned comment added by 82.128.216.246 (talk) 06:42, 12 May 2009 (UTC)

Technical problem with WP:POPUPS?

I think that most of the time the External Links and templates following the References section do not appear while I view this page with User:Lupin/popups.js, using updated Firefox and Vista. I'm curious if anyone confirms this bug? Mike Serfas (talk) 09:37, 12 May 2009 (UTC)

It seems to be an intermittent browser rendering problem (at least in Firefox) when using {{reflist}} but does not happen when using <references/>. The end of the page always appears to be correctly rendered if you use the table of contents to navigate to the later sections. I'm not sure if this has been reported somewhere as a bug for reflist.—Teahot (talk) 09:47, 12 May 2009 (UTC)

Thanks - I've since been unable to reproduce the bug with POPUPS and peerreview scripts enabled, so I can't be 100% certain that disabling POPUPS was the reason the problem stopped. Mike Serfas (talk) 09:50, 12 May 2009 (UTC)

I have changed to {{reflist-2}} which uses a different method to paint the refs.—Teahot (talk) 10:08, 12 May 2009 (UTC)

FWIW, that might break reference rendering in Safari and Chrome, according to Template talk:Reflist#two columns. Amalthea 11:19, 12 May 2009 (UTC)

Noted, though as {{reflist}} has been shown to cause issues, perhaps someone could suggest a reliable alternative to both? Or do we accept that displaying multi-column references is unreliable?—Teahot (talk) 11:25, 12 May 2009 (UTC)

Tamiflu is useless due to viral resistance!

Regard this medical fact to [[79]]!!!

This fact has been regarded, we are the pig, Resistance is futile you will be assimilated!!! --PigFlu Oink (talk) 12:08, 12 May 2009 (UTC)

...okay then.  GARDEN  12:37, 12 May 2009 (UTC)

Someone deleted my mention of Wu et al... I've reinserted this, which suggests that the emergence of Tamiflu resistance in the new swine flu strain can be delayed considerably by using a second antiviral in even a fraction of cases. Mike Serfas (talk) 17:13, 12 May 2009 (UTC)

Palau update

Palau's Health Minister has issued a health alert and increased screening of passengers entering the country for swine flu [80]]!--86.29.253.163 (talk) 14:02, 12 May 2009 (UTC) I hope the tinny Pacific can cope with it all!

CDC - Mexican Cases

If someone would like to add this I think it could be beneficial to the article. The source is CDC http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm

As of May 5, using an updated case definition of fever plus cough or sore throat for a suspected case and real-time reverse transcription--polymerase chain reaction (rRT-PCR) or viral culture for a laboratory-confirmed case, Mexico had identified 11,932 suspected cases and 949 cases of laboratory-confirmed novel influenza A (H1N1) virus infection, including 42 patients who died.

The figure above shows the 822 confirmed and 11,356 suspected cases of novel influenza A (H1N1) virus infection in Mexico with dates of onset from March 11 through May 3, 2009. Both confirmed and suspected cases rose sharply from April 19 to April 26, then decreased sharply.

Daveonwiki (talk) 21:56, 11 May 2009 (UTC)

Couldn't this just be interpreted to mean that they had an uncontrolled backlog of cases to diagnose, improved their processes (including processes for managing the public and how to identify cases) and rapidly got back in control? I'm not sure it necessarily says that much about the nature of the virus.—Teahot (talk) 22:56, 11 May 2009 (UTC)

You are right, Teahot. And I would like to find a reference for the confirmed cases in March. I have never heard of any CONFIRMED case in Mexico before April. Anyone has a reference (apart of the report of the CDC that doesn't really mention anything about it)? As far as I know the first confirmed cases in March are from California only... I (and maybe others) would be interested in a reference confirming that.--201.153.19.149 (talk) 23:31, 11 May 2009 (UTC)

[81] discusses the earliest case in March. Rmhermen (talk) 00:10, 12 May 2009 (UTC)

I know this report, but it doesn't discuss the "March cases". It is the only source I have seen that mentions a March case (of course, counting from the onset) in Mexico anyway. The earliest onset of illnesses were 2nd April (the 4 or 5-year-old boy from La Gloria) and 4th April of the woman from Oaxaca, who died about a week after. Therefore I ask. The graph left more question to me than answers. In addition, I strongly agree that it should appear ONLY in the Mexican article (country), not in the main article. Otherwise people might get the impression that it is a "Mexican flu" (only in Mexico).--201.153.19.149 (talk) 13:59, 12 May 2009 (UTC)

I believe you are both misreading the data. It shows the date of illness onset. The chart drops off simply because it takes several days to identify new cases. Someone who catches the flu today may not appear on the chart for a week but when they do the date of illness onset will still be today. 209.213.169.71 (talk) 00:00, 12 May 2009 (UTC)

209.213 is correct. --ThaddeusB (talk) 00:08, 12 May 2009 (UTC)

BTW, this chart covers only Mexico, so probably doesn't belong in the main article. --ThaddeusB (talk) 00:09, 12 May 2009 (UTC)

Graphs of confirmed cases are meaningless and misleading, because both Mexico and the U.S. have virtually stopped confirming cases. They no longer test unless the illness is severe enough that it might represent a genetic change.67.101.142.160 (talk) 01:46, 12 May 2009 (UTC)OCDNCTX

Didn't they stop to count suspected cases? (Although there are reports: http://www.salud.df.gob.mx/influenza/index.php/component/content/article/34-avisos/99-reporte-estadistico.) As far as I know they still count (and publish) confirmed cases: http://www.prevencioninfluenza.gob.mx/.--201.153.19.149 (talk) 13:59, 12 May 2009 (UTC)

They stopped reporting suspect cases, but they obviously are still know how many there are - after all their test samples come from somewhere (the suspect pool). --ThaddeusB (talk) 14:44, 12 May 2009 (UTC)

Ah, ok, got it. Thanks.--201.153.19.149 (talk) 00:49, 13 May 2009 (UTC)

But also note that suspected cases may not account for all infections, by a long shot. Infections mild enough that the victim will not trouble to see a doctor (and for rural and poor people, this is often not easy) are not going to be registered as "suspected". -- Avenue (talk) 00:01, 14 May 2009 (UTC)

What you say is true for graphs of confirmed cases. This is not a graph of confirmed cases. Daveonwiki (talk) 01:56, 12 May 2009 (UTC)

This is a graph of confirmed AND suspected cases.--201.153.19.149 (talk) 13:59, 12 May 2009 (UTC)

New Map? File:H1N1 map by confirmed cases.svg

There's a new map available... File:H1N1 map by confirmed cases.svg

76.66.202.139 (talk) 05:10, 12 May 2009 (UTC)

This map is attractive, but I am concerned:

• Small nations will have smaller numbers of cases - is a per capita standard better?
• Even in the U.S. some health departments are no longer confirming every case. National differences in policy may overshadow the actual spread of the disease.

Mike Serfas (talk) 09:11, 12 May 2009 (UTC)

I agree. Large countires will always apear more heavily infected by raw number. It should be cases per million or whatever.

obviously as the flu spreads more it will become impossible to track the exact number of cases even if a every country reported all the cases the detect... it's something we'll have to put up with. —Preceding unsigned comment added by 128.243.253.113 (talk) 11:10, 12 May 2009 (UTC)

I also agree. However, it is better than the current map so should remain. But it would be better to have a map which does things by disease density. Barnaby dawson (talk) 17:19, 12 May 2009 (UTC)

Not to sideline the map conversation, but what evidence do you have that US health departments are no longer confirming every case? --PigFlu Oink (talk) 09:22, 12 May 2009 (UTC)

Ah, found it. See a Chicago Tribune story, which states that "The tally, as time goes on, will show largely the most serious cases because doctors are following the state's recommendation to test only severely ill patients. The virus has turned out to be milder than initially feared, so many mild cases may not be counted." This point was raised at Template talk:2009-2010 flu pandemic table/Archive 3#U.S. Mike Serfas (talk) 10:26, 12 May 2009 (UTC)

There's bias on the old map as well. The United States, or Canada, are both individually the same size as Europe, so the map is misleadingly indicating that North America is a pit of death, when it's not even close, and if you split Canada into its constituent provinces/territories, most of those are larger that every European country except European Russia. China is also the size of Europe, yet it's a uniform colour, while Europe is a patchwork. There's Australia which is also about the size of Europe, and whose states are larger than most countries in Europe except European Russia. 76.66.202.139 (talk) 09:31, 12 May 2009 (UTC)

I personally don't like either map for reasons stated above, and agree that unless a map shows cases per thousand then it's useless at best and misleading at worst. But even with cases/M, the stats are now already becoming questionable and troublesome: Mexico and Canada are now ignoring suspected cases; international politics are being affected; countries like China who once kept SARS a secret, are now possibly overreacting; countries like Egypt are slaughtering their pigs and have been accused by their minority (10%)Christian population of using the swine flu as a pretext for discriminatory injury; countries that rely on tourism will have an incentive to underreport after seeing how Mexico's economy was badly hit by world censure; countries, like India or most of the African ones, don't have the medical infrastructure to provide accurate data (i.e. AIDS); and some governments that decide they don't want to have their Wiki map colors turn black, like the U.S. and Mexico, may opt out of relaying accurate data. Anyway, as a minimum, if we want our numbers to be meaningful, we should only map cases/M IMO. --Wikiwatcher1 (talk) 18:42, 12 May 2009 (UTC)

The original global map with countries coloured for suspected, confirmed and fatal cases should be removed. The same data is more accurately rpresented on the page that has individual country breakdown: http://en.wiki.x.io/wiki/2009_swine_flu_outbreak_by_country I think there should be one global map that uses density of infection (cases per million population). This then shows the intensity of the spread on the global map, and the (as good as can be) locality of the spread. —Preceding unsigned comment added by 128.243.253.112 (talk) 14:20, 13 May 2009 (UTC)

+1 I prefer that map to the old one, but Cases/pop or Cases/area would be more significant on a log scale if possible so the 1 case country still at least visible. Even if testing politics around the world make these numbers pretty much biased to the limit of uselessness anyway. Iluvalar (talk) 15:36, 13 May 2009 (UTC)

In Canada

I have compiled a graph of the flu progress in Canada. Quite interestingly, from day 6 of the outbreak till now, the progress is very linear and doesn't seem to follow any exponential trend (even a weak exponential doesn't fit). This is rather strange, but looking at the global picture, the worldwide trend looks exponential. —Preceding unsigned comment added by 70.83.220.148 (talk) 18:43, 12 May 2009 (UTC)

Just speculating here, but a linear trend could be the result of staff and resource-limited labs performing at capacity. I have no idea whether that is the case, though. Victor Engel (talk) 19:53, 12 May 2009 (UTC)

Just guessing off the cuff here, but I imagine, especially at the lower levels of cases, that where/when the virus was introduced would have some play on who else is getting it. For example, in Nova Scotia, four students at the same school had come back from a trip to Mexico. So, whether it is at a school or workplace, or within a single family...and whether an area is small or large population, etc, probably skews some of the initial trends, until there is a larger sample base. Then again, I could be completely wrong. It's just a WAG (wild ass guess). Kavri (talk) 20:18, 12 May 2009 (UTC)

So linear until it hits critical mass, whereupon it goes exponential? Victor Engel (talk) 20:43, 12 May 2009 (UTC)

Correct - exponential is only when there is a lot of transmission within the country, due to report delays most of the cases are still infections imported from abroad - but this is expect to be changing.

Here is my data. I've tried to gather information from the 24th, and these data come from the CBC, Radio-Canada, La Presse (Montreal) and radio station CBF 690. First column is the date (day of the month). Second column is the day (from day zero, April 23th). Third column is the total number of cases from day zero to the specific day. The linear trend is established between days 6 and 7.

DATE; DAY; TOTAL CASES;
23; 0; 0;
26; 3; 6;
28; 5; 13;
29; 6; 19;
30; 7; 35;
1; 8; 51;
2; 9; 85;
3; 10; 101;
4; 11; 140;
5; 12; 165;
6; 13; 201;
7; 14; 214;
9; 16; 281;
10; 17; 286;
11; 18; 330;
12; 19; 358;

(author: Hugo Dufort) —Preceding unsigned comment added by 70.83.220.148 (talk) 02:02, 13 May 2009 (UTC)

My understanding is that few of the cases in Canada have been locally transmitted, almost all have been travellers or first-order contacts, reflecting good isolation practices (relearned after SARS) and the availability of chemotherapy for the known exposed. I'd expect linear growth for that as it's been limited by the number of travellers returning from Mexico. So far, there haven't been any uncontrolled community outbreaks there, which would be characterized by exponential growth. This will probably change as the U.S. numbers have surpassed Mexico and Canadian-American contact is generally closer and more frequent.LeadSongDog come howl 15:32, 13 May 2009 (UTC)

Pigs on Alberta farm, word choice

The article currently says 500 pigs were slaughtered. Is that correct? Word choice here is very important. Animals destined for human consumption are slaughtered, animals not fit for human consumption are rendered, and animals fit for no use at all are destroyed. --Una Smith (talk) 06:09, 13 May 2009 (UTC)

Good catch. They were culled and rendered with the renderings destroyed. A gross waste, but necessary to manage hysteria. See the refs.LeadSongDog come howl 06:59, 13 May 2009 (UTC)

(rendered with the renderings destroyed)? Is that a monty python process of risk management? "Those responsible have been sacked. We apologise again for the fault in the swine. Those responsible for sacking the people who have just been sacked have been sacked." --PigFlu Oink (talk) 15:00, 13 May 2009 (UTC)

The whole BSE debacle is still on people's minds when they think of rendering, even though we don't feed animals to animals any more. I suppose the renderings are just industrial process chemicals now. Perhaps for soaps. Hmmm, could make an interesting article.... LeadSongDog come howl 15:19, 13 May 2009 (UTC)

What is the sort order?

There is a table listing the number of confirmed cases and the number of deaths by country. If the U.S. has the most cases, why is Mexico listed first? What is the sort rule? It appears arbitrary. Edison (talk) 02:16, 10 May 2009 (UTC)

I suppose it is first, confirmed deaths, then for countries with no deaths, number of confirmed cases. Edison (talk) 02:19, 10 May 2009 (UTC)

You are correct. --ThaddeusB (talk) 02:33, 10 May 2009 (UTC)

In my opinion, as long as the WHO don't officially raise the pandemic threat classification to level 6, the chart should list firstly the confirmed cases, then the probable cases and (at last!) then the confirmed deaths. —Preceding unsigned comment added by Liberty Valence (talk • contribs) 20:42, 11 May 2009 (UTC)

The problem with that idea is that some significant countries, e.g. Mexico, no longer track your second sort field, probable cases. That makes sorting rather difficult. Victor Engel (talk) 05:42, 12 May 2009 (UTC)

That's correct, but the most important field is still the number of confirmed cases. And at a relatively low level of about 3, 4 confirmed cases, no country would stop reporting the PROBABLE cases. On the other hand, it's statistically very unlikely that two countries (e.g. Mexico and the US) will have the same number of CONFIRMED cases. Liberty Valence (talk) 09:01, 12 May 2009 (UTC)

I support the idea to sort in order of confirmed cases at first. In my opinion, number of suspected cases isn't a correct criterion for listing. Also, why is Costa Rica at the fourth position with just 8 cases? Comt Till (talk) 19:18, 13 May 2009 (UTC)

Surely splitting into three main catagories; countries with both confirmed cases and confirmed deaths; then countries with cases but no deaths and countries with suspectd cases last would be logical. It represents the natural progrssion of the flu within the country. Suspected cases is an unreliable perameter as countries such as mexico and canada have stopped reporting them. this makes them singly useful in the case of order for countries with no confirmed cases but just suspected. Thus, The current order is fine. Wuku (talk) 17:20, 14 May 2009 (UTC)

of course if two countries show the same level of infection with respect to all figuers (not very likely but possible in the newly infected countries, it is logical and also practical to just add them to the bottom of the table, therefore making it chronological. —Preceding unsigned comment added by Wuku (talk • contribs) 17:39, 14 May 2009 (UTC)

The current criteria is alphabetical in case of ties, which is a lot easier to maintain and not prone to reporting biases. --ThaddeusB (talk) 17:47, 14 May 2009 (UTC)

California questions the Mexican origin of the flu

Please read here: http://www.exonline.com.mx/XStatic/excelsior/template/content.aspx?se=primera&su=pulsonacional&id=590520&te=nota (it is in Spanish). In brief: There were earlier cases in California at the end of March (as we already know). Now health authorities of California question the Mexican origin, since those children didn't have contact to pigs, nor have a travel history to Mexico. The strain already existed in California, before it was detected in Mexico. Maybe something for the article, useful reference...?--201.153.19.149 (talk) 14:19, 10 May 2009 (UTC)

You would think it would be written in English if California said something.   Daniel.Cardenas (talk) 16:14, 10 May 2009 (UTC)

Probably just mexico trying to lay blame elsewhere.Drew Smith What I've done 12:45, 11 May 2009 (UTC)

Surely, it is to find in English, too, because the health authorities of Claifornia say so, not Mexico. I just came across this by accident, not because I looked for it. Weird, that you say that Mexico tries to blame. I have never seen anything like this (but the opposite: others blame Mexico and call it the origin of the flu with patient zero, who can obviously not be the first person who fell ill since there were evidently earlier cases - in California). I get quite sad with these kind of comments that just shows how biased people are with languages/nationality.--201.153.19.149 (talk) 15:13, 11 May 2009 (UTC)

I got sad over reading comments on the internet once. I got over it though. --PigFlu Oink (talk) 15:15, 11 May 2009 (UTC)

You don't expedct me to answer that, do you? ;) Anyways, I wanted to point out this article (there are others on the same topic) so it can be considered and added if it is of any use.--201.153.19.149 (talk) 13:29, 12 May 2009 (UTC)

Just a quick note, I don't have references at hand, but the general point was that since many people can have this flu in a mild form, it has probably spread a number of places before there were problems in Mexico. For unknown reasons, Mexico had more severe cases, and fatal cases. There is no reason to believe that it wasn't 'around' as a mild form for awhile, since no one would be testing for it. There does seem to be merit to it being ranging through Mexico/Southern USA more so, which makes sense, as flu doesn't generally develop/flourish in cold climates (most flu goes on a spring/fall cycle, and most flus develop in Asia). This flu could have started in Asia, for all we know. The only point we can draw is that Mexico, for reasons unknown, other than possibly being part of having less health care available, had more severe cases and more fatalities with a new virus. /okay, a 'quick' note, but not a short one. Kavri (talk) 21:03, 12 May 2009 (UTC)

Clusters of deaths involving influenza usually are due to secondary infections. Maybe the Mexico death toll reflects an intersection of this influenza strain with a nasty strain of pneumonia-causing bacteria. --Una Smith (talk) 06:18, 13 May 2009 (UTC)

That makes sense to me. Much was made of the fecal lagoons being in close proximity to those suffering from the outbreak in Mexico. My first reaction to those stories was, "What, flu is transmitted via fecal lagoons?" Don't viruses require a LIVING host to propagate? It makes sense, though, that the fecal lagoons could be an area where various bacterial contaminants would thrive. Perhaps they are a factor in the increased death rate. Victor Engel (talk) 19:43, 13 May 2009 (UTC)

The lagoon theory is silly, actually, because such environments are full of free-living bacteria that gobble up viruses along with everything else. To replicate, viruses need to get inside living cells of their host species. The usual intersection is in a hospital, and not necessarily a local community hospital. Patients in need of intensive care are likely to be transferred to a tertiary referral hospital. --Una Smith (talk) 02:43, 14 May 2009 (UTC)

Pandemic parity of articles

Pandemic parity of articles

I see that a lot was done on the swine flu outbreak. However looking at other pandemics (especially TB and HIV, which are ongoing and killing far more people) there does not seem to be parity of reporting on deaths, confirmed cases etc. Also the way they are separated is different.

It would be good if wikipedians could source in the same way and try and get accurate figures for these other pandemics. They might be useful for improving wikipedia's standing and commonality allows accurate comparisons as to how bad flu really is not in this case.

I am wanting that as an ENCYLOPEDIA ARTICLE there is a similarity given that all 3 are in fact current events this would be expected. —Preceding unsigned comment added by 212.246.66.223 (talk) 13:56, 11 May 2009 (UTC)

I'm all for common look/feel of articles where it makes sense, etc. However, I think the logic of grouping Influenza,AIDS, and TB together as an example, as they are all current epidemics is faulty.

First there are any number of epidemics in various areas of the world, cholera being one that is being seen quite frequently.

Second, any kind of 'comparison' really has no merit.

-Influenzas are RNA viruses that are primarily spread through the air, though surface contamination and body fluid contact are also major ways of transmission. There are vaccines, but much depends on which viruses are used, and when certain viruses make the rounds, in terms of efficacy. Influenzas can be caught by all populations, though those in a weakened state or without good medical access will likely have more deaths occuring.

-Tuberculosis isn't a virus at all, it is a mycobacteria, and someone that is vaccinated against it will not get it through exposure. Also, tuberculosis is often latent, with some people being asymptomatic and never developing it fully. Tuberculosis is also predominantly a problem in developing nations that don't have access to vaccines and anti-biotics.

-HIV is a virus, but it is one that suppresses the immune system, is transmitted by direct body fluid, and in many cases can be prevented with proper care taken in areas of sexual contact, medical procedures, etc. There is no 'cure' for HIV or AIDS, and until recently almost all HIV carriers developed full-blown AIDS, and almost all people with AIDS died. There is still much to be understood about the exceptions that have been appearing where some people are life-long HIV carriers, or where someone with AIDS is living a very long time.

/end of educational rant, but seriously, lets be careful about 'comparing' things... as the saying goes, apples vs oranges. Kavri (talk) 20:48, 12 May 2009 (UTC)

I note that apples and oranges are both fruits. They can be compared in all sorts of useful ways. Victor Engel (talk) 19:47, 13 May 2009 (UTC)

thanks very much for the comparison with HIV, TB and Flu which elegantly makes the point that they are diseases (not psychological conditions, and not taxonomically related, but still commonly causing illness in people with zoonoesis aspects) and thus can be compared in an epidemiological way. Cholera is not a pandemic, all the others are. How they manifest and the public health responses, media circus acts and information to the people show how they can be compared and usefully informed. Cures and treatments and biology are just part of that. —Preceding unsigned comment added by 212.246.66.223 (talk) 07:19, 14 May 2009 (UTC)

graph

found on the Spanish wikipedia:

76.66.202.139 (talk) 06:56, 14 May 2009 (UTC)

A cumulative bar graph is an odd choice. Currently we are using and updating two graphs here:

File:Influenza-2009-cases.png

File:Influenza-2009-cases-logarithmic.png

|→ Spaully^₪† 10:15, 14 May 2009 (GMT)

It has a good, clear and impressive colour scheme and authoritative style to.--86.25.53.120 (talk) 17:30, 14 May 2009 (UTC)

Table updates...

How often is the data table updated? I feel it should be a regular update eg. midnight everynight, so that the data shown is always up-to-date as far as the previous day. Of course i don't know whether someone has to read all the sources and do the update manually which makes my suggestion impractical. comments please wuku (talk) 10:40, 14 May 2009 (UTC)

Yeah, it has to be done manually. It's usually done when someone reads an article in the paper and sees a new number, and goes home and updates it. But I'm sure there are a select few who scour the planet every once in awhile to make sure every countries numbers are up to date.Drew Smith What I've done 10:57, 14 May 2009 (UTC)

Fringe theory: Human Created Virus

I reverted that entry. The CDC says there is no evidence to support that claim. Nothing in the reference says the WHO is taking it seriously. There is a long intro about the author of the theory that is not pertinent to the article. The contributor reverted the revert. I suggest it get removed again. What do you think? Daniel.Cardenas (talk) 17:07, 13 May 2009 (UTC)

A notable virologist who even participated in the creation of Tamiflu has shared a paper which the WHO has considered credible enough to consider investigating. It's been reported by Bloomberg, AP, and other notable news sources. Please refrain from removing it as a fringe theory; it has not been rejected and while it has not had a full critical review from the scientific community, the study's author is a noted virologist. If it were a fringe theory the WHO would have disregarded this researcher. He's a well educated with a long track history in this field. You might not feel comfortable with the idea, but the Virus has been called notable by many doctors for its unique genetic make up. This researcher has put together a paper detailing his findings and its being investigated seriously. Feel free to expand the section, but for now, it is notable, it's in the news, it is pertinent to the article and it provides an explanation for how its genetics came to be. Maybe I'm wrong but I would assume this to be important to the genetic aspects of it. Yawaraf (talk) 17:10, 13 May 2009 (UTC)

Agreed. You and your assumption are wrong. --PigFlu Oink (talk) 17:21, 13 May 2009 (UTC)

Better to be nice and not get personal. Daniel.Cardenas (talk) 17:35, 13 May 2009 (UTC)

People shouldn't take their wrongness personally. It would be wrong of them to do so. --PigFlu Oink (talk) 17:43, 13 May 2009 (UTC)

Instead of saying "you and your ... are wrong", i.e. personal attack, say "assumption is incorrect'. This is non personal. Daniel.Cardenas (talk) 17:51, 13 May 2009 (UTC)

Thanks Daniel for pointing out my error. I'll wait and see how this pans out in the scientific community which is what I should have done in the first place.Yawaraf (talk) 17:58, 13 May 2009 (UTC)

Meh --PigFlu Oink (talk) 17:56, 13 May 2009 (UTC)

Removed per WP:REDFLAG - exceptional claims require exceptional proof. A redlinked scientist publish in an "unnamed journal" do not constitute "exceptional proof." --ThaddeusB (talk) 17:27, 13 May 2009 (UTC)

Agreed. Once his research as been peer-reviewed and published, we can discuss this further, but until then this unpublished hypothesis is not suitable for inclusion. Tim Vickers (talk) 17:28, 13 May 2009 (UTC)

Agreed. Will wait on peer-reviewed and published paper. Yawaraf (talk) 17:57, 13 May 2009 (UTC)

Waiting for the peer-reviewed publication is probably a good idea. However, I think it should be noted that just because the author of the report is redlinked, doesn't mean that he doesn't exist. He does appear in Wikipedia, in fact, in the List of Fellows of the Australian Academy of Science for 1993. He's not just any John Doe out on the street. He does appear to be the real deal, as far as being a distinguished professor. He has a page here as a member of the Emeritus Faculty of the Australian National University. Looking on the internet, Adrian Gibbs' name surfaces many times in connection with virology and specifically with influenza genetics and molecular biology, including an apparently influential book from 1997 called Molecular Basis for Virus Evolution from the Cambridge University Press. Don't be too quick to dismiss something simply because Wikipedia doesn't have an article on the author. Wikipedia isn't yet omniscient. Age Happens (talk) 14:25, 14 May 2009 (UTC)

It doesn't matter if the author is red linked or not. What matters is how plausible the theory is, what evidence exists to back up the theory and associated references. According to the CDC there is no evidence to back up the theory. Daniel.Cardenas (talk) 14:46, 14 May 2009 (UTC)

I'm not disagreeing with the wait and see approach. I just want to make sure that being redlinked isn't somehow connected with an assumption of implausability. We should wait and see. After all, it is even possible that a distinguished professor can go off the reservation a bit in old age. Linus Pauling famously went just a little kooky towards the end of his life. It isn't impossible that professor Gibbs is just wrong. But it also is possible that the CDC is wrong. The CDC became somewhat political during the Bush administration and it isn't out of the realm of possibility that they are ignoring reasonable research for reasons other than scientific accuracy. We'll just have to wait and see.Age Happens (talk) 16:02, 14 May 2009 (UTC)

To clarify, I was saying that the guy wasn't notable enough that we could include something merely on the basis he postulated it. I wasn't trying to imply that it makes it untrue - just that it is not notable at this time. --ThaddeusB (talk) 19:26, 14 May 2009 (UTC)

WHO weighed in on this today:[82] They say it's not lab created and the theory is wrong, though they do acknowledge the virologist's past achievements. OcciMoron (talk) 22:04, 14 May 2009 (UTC)

Point of order: I've mentioned some number of CDC and WHO officials by name here, who do not yet have articles in Wikipedia. The "redlinking" of names has absolutely no significance, except to show that despite millions of articles, Wikipedia's coverage of the public health community is still quite poor. But regarding this hypothesis, Nancy Cox of the CDC also stated that proof was lacking,[83]... and she even has a stub article. Mike Serfas (talk) 02:49, 15 May 2009 (UTC)

What does 'human created' means?

I have listen several rumors about A-H1N1-2009 is a human created virus. Amazing! synthetic biology is believed to be very mature to design and create a new malevolent virus.

Human created does not necessarily means a human designed virus

A-H1N1-2009 is in fact a human created virus, it is the result of evolution by the interaction of birds, pigs and humans in farms.

Even if genetically designed, it does not necessarily means Malevolent created virus

Some research is done in studying virus sequences in order to predict future mutations. Given the predicted mutations it is possible to synthesize the new sequence to produce vaccines with `dead' attenuated viruses before the virus evolves to the predicted mutation. As far as I know this method is not mature yet.

 My suggestion is you can add information about 
 such theory in the article, just be careful 
 checking citations, being serious not alarmist.
 It means, be clear about the context in which 
 it may be true, and the possibility of 
 the hypothesis.

Suggested edits to "Symptoms and Severity"

This is a proposed revision to this section which I feel is warranted now that the flu is steadily growing. The links that were deleted were no longer needed as they dealt with timely news facts, dates, places, stats, etc. which are now mostly history. Because this section is one of the most important to visitors, I recommend keeping it simple and uncluttered. All of the facts are paraphrased from the CDC site and redundancy trimmed out. I also felt that bulleted lists are worthwhile.

==Symptoms and severity ==

See also: Swine influenza#In humans, for symptoms in previous cases.

The CDC has stated that the symptoms of this new H1N1 flu virus are similar to the symptoms of seasonal flu and include the following:

• fever,
• cough,
• sore throat,
• runny or stuffy nose,
• body aches,
• headache,
• chills and fatigue.

A significant number of people who have been infected with this new H1N1 virus also have reported diarrhea and vomiting. People at higher risk of serious complications include people age 65 years and older, children younger than 5 years old, pregnant women, people of any age with chronic medical conditions (such as asthma, diabetes, or heart disease), and people who are immunosuppressed (e.g., taking immunosuppressive medications, infected with HIV).

===Avoid contact with others===

If you show symptoms for the flu, expect them to last a week or longer. You should stay home and avoid contact with other persons, except to seek medical care, if necessary. If you leave the house to seek medical care, you should wear a mask or cover your coughs and sneezes with a tissue. In general you should avoid contact with other people as much as possible to keep from spreading your illness. The CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses and may likely be contagious from one day before they develop symptoms and up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods.

===Symptons requiring medical care===

Children - emergency warning signs

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

Adult - emergency warning signs

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough

Any comments or suggestions would be helpful to see if this would be good replacement text. --Wikiwatcher1 (talk) 02:47, 14 May 2009 (UTC)

This is guide-like writing that doesn't warrant outright replacement. While doing so, you also narrowed the scope of the section to cover only the symptoms and prevention (which is already covered in #Prevention and treatment), removing other key details that are more relevant worldwide such as mortality rates and demographics of deaths, all of which are referenced regardless. Also, keep in mind that this portion of the article is meant to be encyclopedic; there's a reason the external links section is there. - 60.50.246.240 (talk) 11:37, 15 May 2009 (UTC)

Guidelike, newslike, or hyrid?

I agree that the suggested layout and facts above, which you don't like, was more "guidelike" than before. But with a section called "Symptoms and severity," using primary sources like the CDC, which was aimed at the average visitor needing basic information, and which itself uses the "guidelike" format, I'm not sure it's accurate to say this is not encyclopedic. The article already has graphs, charts, and lists which are meant to keep the details organized for readability and reference. So it would seem that if there's a list of symptoms, then there's a purpose to keep those in a neat list also, even bulleted, due to potential the value to many readers. Being in the TOC means that anyone could just skip over it.

The alternative presentation of facts for this section are like the typical paragraph below, which you put back in. Are you saying that this sample paragraph is more useful and relevant to a topic on "symptoms and severity" than the earlier one? Personally, if I kept it in, I'd put it into a new article called something like "2009 swine flu statistics."

At a press briefing on April 27, acting CDC director Richard Besser stated that out of 40 confirmed cases in the United States at that point, only one individual was hospitalized. He also revealed that the median age was 16 years "with a range in age of 7 to 54 years". By May 5, with 642 confirmed cases in the U.S., the age of the patients ranged from 3 months to 81 years, with 60% of cases occurred in people less than eighteen years old. In all, 36 patients (9%) required hospitalization and two people died.

The alternative would be some hybrid of the two formats, but unless and until someone writes one out, then we should consider what we have. Any comments or suggestions? --Wikiwatcher1 (talk) 16:33, 15 May 2009 (UTC)

Like the genetics section, any information about disease symptoms and severity should be a general overview, then noting sourced information specific to this outbreak, and providing a link to the Swine Influenza artcile where detailed information should be listed. --PigFlu Oink (talk) 16:50, 15 May 2009 (UTC)

In trying to take the existing section and summarize it into a general overview, there wasn't much left. Almost all of it dealt with news stories and isolated events, as the sample paragraph above shows. So the end result would be a sentence or two discussing sniffles, coughs, etc. but without any easy list. As for putting this in Swine influenza, that may be a problem since that article covers equally both swine flu in swine and in humans, so putting this guidelike detail there throws off the article's balance.

One alternative would be to keep the guide format in this article and keep expanding this article with both news and more general information for a few months. Then once this article has a good structure with most of the important details about the human swine flu, we could create a new article called Swine influenza (humans). We'd use the "general" details from this one and keep the timely news-oriented details here. In any case, this article about the "outbreak" will eventually become history, so ideas for down the road are worth dealing with. --Wikiwatcher1 (talk) 23:40, 15 May 2009 (UTC)

Wikipedia censoring human made virus article

it was added as fringe.are you out of your mind.its mainstream news.WHO is investigating it and it is fringe. dont censor the truth —Preceding unsigned comment added by 122.163.8.212 (talk) 13:47, 14 May 2009 (UTC)

Here is a video about it: http://www.abcnews.go.com/GMA/SwineFlu/story?id=7584420&page=1

The truth is a Scientist said the sky might be falling. Wikipedia editors decided this isn't noteworthy at this time. See earlier discussion, titled: Fringe_theory:_Human_Created_Virus.   CDC and others said there is no evidence to support the theory.   Daniel.Cardenas (talk) 15:11, 14 May 2009 (UTC)

How does one locate such an earlier discussion? Victor Engel (talk) 15:20, 14 May 2009 (UTC)

See: http://en.wiki.x.io/wiki/Talk:2009_swine_flu_outbreak#Fringe_theory:_Human_Created_Virus   Daniel.Cardenas (talk) 15:24, 14 May 2009 (UTC)

Here is an article about Foot and Mouth disease escaping the laboratory: http://news.bbc.co.uk/2/hi/uk_news/7290078.stm   Daniel.Cardenas (talk) 15:24, 14 May 2009 (UTC)

Yes foot and mouth disease just got up and walked out of the lab. "Talk to you guys later, Bye" --PigFlu Oink (talk) 22:09, 14 May 2009 (UTC)

As I said above, it is an interesting hypothesis, but until his paper has been peer-reviewed and published there is nothing solid to base a discussion on. Tim Vickers (talk) 22:24, 14 May 2009 (UTC)

Wikipedia is an encyclopedia, and personal opinions generally do not get mentioned here, even if personals opinion of a notable person and published by a reliable source. Try wikinews, but be quick about it! Stale news isn't news. --Una Smith (talk) 23:33, 14 May 2009 (UTC)

The WHO has now come out in public opposition to this paper. See http://www.nytimes.com/2009/05/15/health/policy/15flu.html Daveonwiki (talk) 01:26, 15 May 2009 (UTC)

Suggested move of "Genetics" section

I think a brief summary of the genetic makeup of this virus should be kept in the article, but most of the Genetics section - oriented more toward biologists - should be moved to influenza virus where it seems to have a much more relevant context. However, if it's moved, it should probably go into the talk page so redundant material can be surgically removed and new facts grafted in by one of their resident editors. Comments? --Wikiwatcher1 (talk) 06:34, 15 May 2009 (UTC)

Agree, 2009 Outbreak should be a summary of the outbreak itself and the reaction, detailed medical information should be in the virus article. --PigFlu Oink (talk) 09:10, 15 May 2009 (UTC)

Agree. --Una Smith (talk) 13:46, 15 May 2009 (UTC)

Agree with moving, with a summary left behind and a link to the "main article" in the section. --ThaddeusB (talk) 13:57, 15 May 2009 (UTC)

Agree, it would be much more relevant in the infulenza article itself. Jozal ^(talk) 19:30, 15 May 2009 (UTC)

Disagree, influenza genetics in general are already covered in Orthomyxoviridae#Genome. Since this is information specific to one strain of influenza, it does not belong in the general article. This content could be merged into Influenza A virus subtype H1N1 however. Tim Vickers (talk) 19:49, 15 May 2009 (UTC)

Good idea, seems much more sensible. Jozal ^(talk) 19:57, 15 May 2009 (UTC)

The content referred to is about the genetics of a single specific strain at the point of its creation of a single subtype of a single species. It is far too specific to belong in any article other than this one. WAS 4.250 (talk) 21:15, 15 May 2009 (UTC)

I moved the section to the Influenza virus (aka: Orthomyxoviridae) talk page and tried to add back the key facts for this article. --Wikiwatcher1 (talk) 22:00, 15 May 2009 (UTC)

I have pasted all the text into a new article H1N1/Influenza/A/B96.3 as there is simply too much info for an existing article. The article needs some cleanup, ref fixing, and probably a better name, but its a start. --ThaddeusB (talk) 00:02, 16 May 2009 (UTC)

I moved the article to 2009 A/H1N1 as this name is more commonly used in scientific literature. --ThaddeusB (talk) 15:01, 16 May 2009 (UTC)

Number of infections map

Looking at the source, Australia and Thailand appear to be properly specified as "1+" infections, but they are showing up with the colour of the "50+" category. Anyone know what's going on? --π! 14:57, 15 May 2009 (UTC)

I'd assume it was a mistake. Perhaps contact the creator and let him know.  GARDEN  11:47, 16 May 2009 (UTC)

---

I think a map showing the number of infections in a country per 1000 of the population would be a good addition to this page. I think it would be very interesting to see which countries have the highest proportion of their population infected, this is generally far more interesting than the overall number of infections in acountry. Does anyone agree/disagree and would anyone be able to create it. —Preceding unsigned comment added by 83.217.164.171 (talk) 14:46, 16 May 2009 (UTC)

Why is this page not updated...

Why is this page not updated as soon as news about confirmed cases in countries not listed breaks. People use this page as a reference and need the page to be updated within minutes of news breaking

See subject line —Preceding unsigned comment added by 121.72.21.22 (talk) 07:37, 16 May 2009 (UTC)

Why aren't you providing examples of your stated lack of updates? You're a Wikipedia user, therefore one of the people responsible for getting updates done. 76.66.202.139 (talk) 11:07, 16 May 2009 (UTC)

Is the pandemic just getting to big for Wikipedia/Wikipeia users to handle? —Preceding unsigned comment added by 121.72.21.22 (talk) 07:48, 16 May 2009 (UTC)

If you'd like to post specific examples here, then I'm sure they will be added if they are properly referenced. --Pontificalibus (talk) 08:33, 16 May 2009 (UTC)

Is a random internet users un evidenced rant too insignificant to be answered? I love the use of false and loaded question arguments. --PigFlu Oink (talk) 11:35, 16 May 2009 (UTC)

Look, Wikipedia's purpose is that anyone can edit it. Even new users and IPs. This means that the information can only be updated when someone does it. We're not paid to sit here and type about pandemics. We do it as a hobby. Demanding the page be kept updated is pointless and using it as a source - particularly with ever-changing information - is more so. So why not cease complaining and start updating?  GARDEN  11:45, 16 May 2009 (UTC)

PS: shortened heading for use of using the history. The question is now below the headline.  GARDEN  11:45, 16 May 2009 (UTC)

Greenland

I was just wondering why Greenland is not marked when Denmark is? Like how Svalbard and Alaska are marked because Norway and the main US is.Aleco (talk) 13:46, 16 May 2009 (UTC)

It's the same as the difference between Hong Kong and China, since they're also marked separately. It shouldn't be marked in the same fashion. Interestingly, Greenland is also missing from the North American disease maps, where it should appear. 76.66.202.139 (talk) 21:04, 16 May 2009 (UTC)

Belgium

Can someone add to the list that in Belgium we have a 5th person infected. 91.180.26.13 (talk) 19:45, 16 May 2009 (UTC) —Preceding unsigned comment added by 91.180.26.13 (talk) 19:43, 16 May 2009 (UTC)

So much for accurate stats!

Bio-Medicine CDC says confirmed cases, including 2 new deaths, may not reflect true reach of the disease

"SATURDAY, May 16 (HealthDay News) -- While the official tally of confirmed U.S. swine flu cases topped 4,700 on Friday, experts at the Centers for Disease Control and Prevention now estimate the true number of infections at more than 100,000 nationwide." --

CDC Press Briefing, 5/15

Donald McNeil: Hi, Dr. Jernigan. There's a growing gap between the usefulness of that 4,714 confirmed and probable cases and the actual number of cases around the country. I know the teams aren't all in yet but do you have any sort of estimate at all about how many cases we're talking about across the country? Is it 10,000, 20,000, 30,000? Any sense at all of what the real number is like?

Dan Jernigan: Yeah, I agree with you regarding the utility of the numeric figure for influenza. And for that reason, we don't enumerate the numbers of individual cases each year in the United States. Somewhere between 7 percent to 10 percent of the U.S. population each year gets influenza, which is maybe 21 million to 30 million people a year. And so with the amount of activity that we're seeing now, it's a little hard to make an estimate about what that means in terms of the total number of people with flu out in the community. But if we had to make an estimate, I would say that the amount of activity we're seeing with our influenza-like illness network is probably upwards of maybe 100,000, but that's something we will have a much better estimate of once we get the information back from the field teams that are collecting that data.

Wikiwatcher1 (talk) 23:44, 16 May 2009 (UTC)

Why is the A-H1N1 virus just lethal in Mexico?

Concerns about the Mexican Health System Mexican public health system is oversaturate, an important lack of drugs forces physicians to prescribe what is available not what is needed. Physicians in the public health system never have time to upgrade their knowledge, no research is done. The IMSS (Mexican Institute of Social Security) used to do some medical research, a recent director forbid any research activity, in his opinion it was unnecessary.

Many people have died of curable diseases just because they did not got immediate attention. I know cases of people that have died of cancer because they got an appointment 3 months after they ask the service at the IMSS, at that time the curable stage changed to a terminal stage. Under this conditions as a patient would you ask help just for a cold? What could be your attitude as a physician working in an oversaturate clinic, when you receive a cold patient? Take paracetamol and go home!

This facts should be discussed in the article. The A-H1N1 is not the unique killer, a destroyed Public Health System not providing correct attention to public health. This irresponsible omission is a latent danger to develop new resistant strains of pathogen agents. Apart of all the people dying of curable diseases, just for lack of medical attention.

A bad quality and insufficient Health System is an important cause of diseases in this flu sprout.

Please include this information in the article.

Update the main page table - 2 more deaths in US TX and AZ. http://www.chron.com/disp/story.mpl/ap/tx/6425771.html —Preceding unsigned comment added by 151.194.21.159 (talk) 17:36, 15 May 2009 (UTC)

Is the WHO slacking?

Just a question, not a proposed addition or anything, but it seems we should be in alert level six. The criteria for level six is described as sustained community outbreaks in two or more WHO regions. Obviously North America is sustained, and now there are 100 confirmed cases in spain along with the various numbers reported by neighbooring European countries. Sounds like a sustained community outbreak in another WHO region to me. So whats up with this? Is the WHO sleeping?Drew Smith What I've done 10:32, 14 May 2009 (UTC)

Meh. I agree but they're the professionals. Anyway, this really isn't the place to be discussing this. Jozal (talk) 10:37, 14 May 2009 (UTC)

I do agree. I have read up on that and as far as i can see we are at phase 6. There has been human-to-human spread in multiple countries in multiple WHO regions. I don't know how they define sustained though... this may be the answer. It may be by time, or rate of spread... there could also be political reasons behind the delay. The fact that so far only 65 (<!%) have proved fatal cases, and/or not wanting to cause undue panic may affect how quickly they declare pandenic phase. wuku (talk) 10:49, 14 May 2009 (UTC)

Some proffesionals. Makes me think they switched out the band for the scientists. It'll cause more panic if it gets worse before they declare a pandemic. Think about it, if they wait till hundreds of thousands are dead before they call it, people are gonna freak and think its worse than it is. If they do it now, people will realise a "pandemic" really isn't as bad as it sounds. Drew Smith What I've done 11:00, 14 May 2009 (UTC)

Is it sustained? I don't think so. Look at the graphs on the main page. It looks like the rate of spread has been steadily decreasing for a while now. Take that in combination with normal weather trends, and I think it's likely this thing is going to peter out. Victor Engel (talk) 15:16, 14 May 2009 (UTC)

As far as I know, Spain (or anywhere else in Europe) is not "sustained", as the cases are mostly contacts of Mexico (or of late US) travellers who were mostly quarantined anyway. Most European countries quarantine contacts of cases. I do think the WHO was late in declaring 5, though.Geometer9420 (talk) 14:28, 16 May 2009 (UTC)

Meh. While this meets the criteria for level 6, we are probably seeing it kept at 5 for two reasons: One is the public reaction to a declaration of phase six, especially in regions just now starting to see the flu, the other is going to be the high mortality rate (or lack thereof) which the whole pandemic system is designed to combat. If this were a flu with a 90% or 40% mortality rate, we'd clearly be treating it in a very different manner. As is, that I can ascertain, the mortality rate is (currently) marginally higher than that of the seasonal flu. If you look at the seasonal flu from a 'pandemic level', we'd be at level 6 each winter. Yamagawa (talk) 18:04, 17 May 2009 (UTC)

Graph and fair use idea

Came across this nicely done graph and thought maybe it could be used in the article in place of ours (top right). I suspect that because it took Reuters a lot of time to create this, they'll update it continually. If others like it, we should consider some options: whether a screen capture would be "fair use" to upload; request permission; recreate our own; or just add a link. And of course they would get full credit mention so they might be more than willing to have Wiki post it.

Reuters graph

Any thoughts?--Wikiwatcher1 (talk) 22:12, 15 May 2009 (UTC)

Its highly unlikely to fall under Wikipedia's fair use policy (even if it could be used under the legal definition) as content that can be duplicated via user effort is normally always out. See WP:FAIRUSE, in particular #2. --ThaddeusB (talk) 23:48, 15 May 2009 (UTC)

And why do you think it's any better than what we have already? -- Avenue (talk) 00:02, 16 May 2009 (UTC)

Whether it's "better" depends on who's looking at it. But the simpler design, especially with the image and stats below, seemed more useful to what I feel is an "average" visitor. I also like the division of continents in the stats, since a flu epidemic in Europe, for instance, would probably be comparable to U.S. totals.

But personally, I don't like any of the graphs, including the two world graphs in the article now, since they don't show per capita per thousand (or other population size) stats, which I think is key when using colors. And the country list at the top of the article will eventually hit all 200 countries, so it would be nice if there were a "show" dropdown button added to keep the page leaner. --Wikiwatcher1 (talk) 00:31, 16 May 2009 (UTC)

We have had a graph showing number of cases over time above the table in the past, but it got moved down below it fairly quickly. You could try your luck with a map.

There has been some discussion of dividing the table by continent or by degree of spread on the template's talk page: Template_talk:2009_swine_flu_outbreak_table#When.2FHow_should_.27confirmed_human_cases.27_section_of_table_be_shortened.3F. I think we've almost decided on the latter. -- Avenue (talk) 01:40, 17 May 2009 (UTC)

H1N1 + H5N1

Some scientists seem to be very concerned about mutations of H1N1 mixing with H5N1 in Asia. Is this worth mentioning in the article anywhere? Perhaps a section dedicated to topics of concern? I mean the WHO made a pretty big deal about letting everyone know a new virus had arrived. This might be a good place to put such speculation. Just my 2 cents. Yogiudo (talk) 01:41, 16 May 2009 (UTC)

It's been mentioned in the "Genetic Makeup" section.--Wikiwatcher1 (talk) 05:17, 16 May 2009 (UTC)

Thanks, I didnt see that. Yogiudo (talk) 21:26, 18 May 2009 (UTC)

Proposal: Update on the US situation

Below is my proposal for a third section under the heading "Initial outbreak in the US and Mexico". An earlier version had been deleted by Abecedare who judged it OR. I have now added more and more authoritative refererences. I do think an update on the US situation is sorely needed. As my earlier attempt was controversial , I will post my proposal here first. Please check for problems (and please give concrete reasons and/or sources for your critique), and suggest amendations if possible. The following text (the proposed new content) has its html tags on the references removed so the references show in the text. This is because footnotes are apparently not visible on discussion pages and I wanted you all to be able to see the references. As you may note, I have given a number of quotations(later to show in the footnotes), if this isn't ok in WP please tell me.Geometer9420 (talk) 13:02, 16 May 2009 (UTC)

Ø ===US Situation in May=== By mid-May, the Virus appeared to be widespread and freely circulating in much of the United States. About half of all cases of influenza tested turned out to be swine flu, and in some areas, flu activity was reported to be as high as in peak influenza season, an unusual pattern for May. ref"The fact that novel H1N1 activity is now detected through seasonal surveillance systems is an indication that there are higher levels of influenza-like illness in the United States than is normal for this time of year. About half of all influenza viruses being detected are novel H1N1 viruses." CDC A(H1N1) update May 15th 2009; http://www.enewspf.com/index.php?option=com_content&view=article&id=7538:h1n1-flu-swine-flu-cdc-update-may-14-2009&catid=88888984:swine-flu&Itemid=88889934, accessed 5-16-2009,/refref" "But what we're seeing is that there are some areas that actually have reports of the amounts of respiratory disease that are coming into their clinics that are equivalent to peak influenza season, and so that's an indicator to us that there's something going on with the amount of influenza disease out there." Dan Jernigan of the CDC in the Canadian Press, http://www.google.com/hostednews/canadianpress/article/ALeqM5iSxR2p2Bjjs0h_PBiLSrhiVOA7kg, accessed on 5-16-2009). On May 6th, US schools closed because of flu outbreaks were encouraged to re-open, as the virus was then no longer perceived as a threat by officials. ref"Schools shut by flu can reopen: Outbreak may be milder than feared", Washington Post 5-6-2009, http://www.washingtonpost.com/wp-dyn/content/article/2009/05/05/AR2009050500719.html, acessed 5-16-2009./ref Ø According to a CDC report on May 6th, the US as well as the Mexican swine flu cases show an unusually high proportion of severe illness with hospitalization in the middle age group, while seasonal flu is a problem mainly for the elderly.ref"First, the percentage of patients requiring hospitalization appears to be higher than would be expected during a typical influenza season (3). Second, the age distribution of hospitalizations for novel influenza A (H1N1) virus infection is different than that of hospitalizations for seasonal influenza, which typically occur among children aged <2 years, adults aged ≥65 years, and persons with chronic health conditions (3). In Mexico and the United States, the percentage of patients requiring hospitalization has been particularly high among persons aged 30--44 years." Quote from: Update: Novel Influenza A(H1N1) Virus Infections Worldwide, May 6, 2009, Morbidity and Mortality Weekly Report.ref By mid-May, three schools in Queens, New York City were closed after an outbreak in one of them that caused life-threatening disease in an assistant principal. The school most affected is located within a two-mile radius of the prep school severely hit by the earlier NYC school outbreak (initiated by students returning from Mexico). According to the ill principal's wife, who is a teacher at one of the schools closed in mid-May, her principal had wanted to close her/his school as soon as a surge of flu-like illness among the students became known, but was told not to by city health officials, who said that would only cause a panic. Another of the schools was forced to stay open despite confirmed cases of swine flu among the students. refWashington Post, May 15threfrefhttp://www.nydailynews.com/ny_local/2009/05/15/2009-05-15_queens_assistant_principals_other_health_issues_preclude_treatmentswine_flu_cond.htmlrefrefNew York Daily News, http://www.nydailynews.com/ny_local/2009/05/15/2009-05-15_queens_assistant_principals_other_health_issues_preclude_treatmentswine_flu_cond.html, accessed 5-16-2009/ref Geometer9420 (talk) 13:02, 16 May 2009 (UTC)

The above text has significant synthesis and misunderstanding. An example is about half of all cases of influenza tested turned out to be swine flu; that reflects severe selection bias (selective testing of probable cases), not high prevalence. It does not belong in the article. --Una Smith (talk) 15:02, 16 May 2009 (UTC)

On your example of shortcomings of the text: There is no indication in the CDC text I used as a source that this could be selection bias. (On the contrary, the point is that the cases are detected by the normal flu surveillance system and not through following up of contacts of known cases or testing of suspected cases in people returning from Mexico). Is your assertion that this is selection bias your interpretation? Or do you have any source saying so? Then one might add that to the text. Please tell me where else the text is problematic. I cannot see synthesis up and above what is usual for an encyclopedic text.Geometer9420 (talk) 15:41, 16 May 2009 (UTC)

I have now carefully reread the text with Wikipedia's synthesis guidelines in mind. The only place where I see synthesis is the first sentence (although I did think I was only stating the obvious, but apparently stating the obvious may be synthesis too). Otherwise, the text stays extremely close to the sources (indeed as close as it can without infringing their copyright.) I suggest to change the first sentence, and leave the rest as it stands, possibly with an added sentence that the number might represent selection bias (although the sources give little indication they do). According to the guidelines, "Summarizing or rephrasing source material without changing its meaning is not synthesis — it is good editing. Best practice is to write Wikipedia articles by taking material from different reliable sources on the topic and putting those claims on the page in your own words, with each claim attributable to a source that explicitly makes that claim." I think that is what I did here.Geometer9420 (talk) 15:52, 16 May 2009 (UTC)

I have rechecked the part about the NYC schools where referencing is not statement-by-statement (the sources are given at the end of the paragraph.) I haven't been able to find my statement "within two miles of the prep school..." in the two sources cited, but have located it in a fox news web article (http://www.foxnews.com/story/0,2933,520337,00.html) That reference would have to be added.Geometer9420 (talk) 16:15, 16 May 2009 (UTC)

Let me (roughly) summarize what the proposed sections says:

1. Unusually high number of influenza cases in US for the month of may; about half of thsoe are swine flu.
2. On May 6th closed schools in US were encouraged to reopen.
3. May 6th CDC report says that more people and more younger people have required hospitalization due to the swine flue than is normal for the seasonal flu.
4. Discussion of 3 schools closing in NYC in mid-May.

The problem with this is that:

• There is no source that links the pattern of swine flu infection (points 1 and 3 above) with the issue of school re-opening and re-closing (point 2 and 4); and therefore the text as of present would fall afoul of WP:SYNT.
• This detailed discussion of observed pattern in the US in undue in this article, which deals with all aspects of the worldwide outbreak. Some of content could be ok in 2009 swine flu outbreak in the United States‎, although it would still need to be summarized, separated from the discussion of school closing/opening, and not placed in a section of its own.
• The detailed discussion of the closing of the 3 NY schools, including statements like, "According to the ill principal's wife, who is a teacher at one of the schools closed in mid-May, her principal had wanted to close her/his school as soon as a surge of flu-like illness among the students became known, but was told not to by city health officials, who said that would only cause a panic." would be undue even in the US specific article.
• Besides being undue, it is wrong to make the factual judgment that "Another of the schools was forced to stay open", in wikipedia's voice based on statements by the ill-principal's wife.

In summary, I think this section violates WP:SYNT and is undue her; although some parts may be relevant in 2009 swine flu outbreak in the United States‎ if the content is not already covered there. Abecedare (talk) 17:43, 16 May 2009 (UTC)

Thanks for the detailed discussion, Abecedare. I'm sorry, I hadn't realised that there was a separate article on the US outbreak, I thought "by countries" was all countries apart from Mexico and the US. I still don't see where the synthesis is, though, except in the first sentence. The rest is "linked" only by chronology and the fact that it's all US data; I cannot see any conclusions of my own not present in the sources (which from my apparently misguided understanding of WP:Synt is what makes something synthesis). But as the material is out of order for this article, and I haven't time to get familiar with the other one now (where the additon is probably not needed anyway because someone's already dealing with these things), I won't press it any further. It seems there are some things about Wikipedia mores and customs that I haven't fully grasped yet.Geometer9420 (talk) 06:19, 18 May 2009 (UTC)

real number of swine flu cases in the US

Mild U.S. Flu Cases May Exceed Official Tally

http://www.nytimes.com/2009/05/16/health/16influenza.html?hp

By DONALD G. McNEIL Jr.

NYT Published: May 15, 2009

The real number of swine flu cases in the United States could be “upwards of 100,000,” a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories.

The official, Dr. Daniel Jernigan, head of flu epidemiology for the Centers for Disease Control and Prevention, said at a news conference that the official number gave an inaccurate picture of the outbreak because so few mildly sick people were being tested.

... —Preceding unsigned comment added by 67.101.142.131 (talk) 00:03, 19 May 2009 (UTC)

Why is a satire site being sourced as fact

Remove [15] GTNz (talk) 05:58, 19 May 2009 (UTC)

15? --PigFlu Oink (talk) 06:03, 19 May 2009 (UTC)

Can you post a direct link? Daniel.Cardenas (talk) 06:04, 19 May 2009 (UTC)

Reference 15 is currently the BBC, and the page is unchanged since this was posted to talk and for a few hours before that. Unless the BBC has recently become The Onion, I think there's nothing to see here. If you meant a different reference, please post the link directly. Oren0 (talk) 06:12, 19 May 2009 (UTC)

GTNz is refering to "Large outbreak of swine flu cases in Japan". BBC. 2009-05-19. Retrieved 2009-05-19. which was being used to source 5000+ suspected cases in Japan. www.bbclatest.com is a "is a news satire and political satire web publication. All news articles contained within are fiction and fake news. " (see disclaimer at bottom left of the page.) Abecedare (talk) 06:15, 19 May 2009 (UTC)

Well would you look at that. That's what I get for just looking at the top of the page and then closing it. D'oh. Well it appears to have been removed now. Oren0 (talk) 07:40, 19 May 2009 (UTC)

bbclatest has been redirected. Site includes an apology. Can't say I've ever taken offense at satire; however the content isn't written as satire and isn't slightly humerous in any way. Its just fake news even duller than the real thing. Given our quick look when validaing sources, the mingleing of fake content imposed ontop of a direct copy of the real BBC page with real BBC links is unnerving. --PigFlu Oink (talk) 08:18, 19 May 2009 (UTC)

The information from the website lasted 53 minutes on wikipedia (added - removed). I have no idea how User:Xavier114fch found the "news" item, or how User:GTNz spotted the scam. I myself found the tiny disclaimer only because I was pro-actively looking for one after GTNz had expressed doubt about the source, and since the url was unusual. Guess we will be reading about the "hoax that fooled wikipedia" in some newspaper or blog soon. Abecedare (talk) 08:34, 19 May 2009 (UTC)

This site I think is responsible for the H1Z1 zombie flu outbreak in London joke article too, not sure though. You guys weren't the only ones.. almost every single forum out there apparently got the same (and it took them an hour to figure it out) GTNz (talk) 14:15, 19 May 2009 (UTC)

Typo

Towards the bottom of "Symptoms and severity" is a sentence which reads In all, 36 three people died. I'd fix it myself if I knew what it meant. A case for experts I think.Fainites ^barleyscribs 22:07, 19 May 2009 (UTC)

El Fixo --PigFlu Oink (talk) 22:17, 19 May 2009 (UTC)

8 deaths in the US

There are 8 confirmed death in the US, 3 in TX, 2 in AZ, 1 in WA and NY and Missouri and 1 is under investigation in NY ([84]..--Vrysxy! (talk) 23:10, 19 May 2009 (UTC)

Pandemic versus Epidemic versus Other

I see that in the article's opening sentence the word epidemic has been changed to pandemic. The WHO have not yet raised the Pandemic Alert level to 6: we are still at level 5, 'Pandemic preparedness'. Was there a reason to change from epidemic to pandemic at this point in time? --Dionliddell (talk) 09:03, 14 May 2009 (UTC)

To add to this. As soon as I saw that the article was now talking about a 'pandemic', I thought straight away that the WHO had raised the alert level. For others that view this page (sometimes obsessively as I do) they may also think that that is the case. I personally think that the article should be reverted back to epidemic, and only changed to a pandemic if we go to level 6. --Dionliddell (talk) 11:12, 14 May 2009 (UTC)

I agree. I just saw a recent article just a few minutes ago clarifying that the WHO has still not raised it to a pandemic, so it would seem that this page should either use epidemic or refer to the 'Pandemic Preparedness' state. I'd change it myself, but for the fact I'm a relatively new user on a massively viewed page. Lost puppies (talk) 17:37, 14 May 2009 (UTC)

Some WHO doctrine ("Pandemic influenza preparedness and mitigation in refugee and displaced populations" (PDF). 2008.) seems to have drawn from (Reynolds B, Seeger MW (2005). "Crisis and emergency risk communication as an integrative model". Journal of Health Communication. 10: 43–55.) (if someone can check that). Back in 2005, raised the issue of ambiguity in this definition, but it doesn't seem to have been addressed anywhere I can find.(WHO-AFRO Division of Prevention and Control of Communicable Diseases (April 2005). "Report on the 1st Consultation of the Technical Advisory Group on Measles and Rubella Control in the African Region" (PDF). WHO.{{cite web}}: CS1 maint: date and year (link)) LeadSongDog come howl 17:23, 15 May 2009 (UTC)

This paper sheds light. For transmission to be sustained, R₀ must be greater than 1. It takes several generations to confirm this, especially when it is only slightly greater. If enthusiastic application of control measures keeps intergeneration reproduction low it may not officially go to stage 6 for some time. Clouding the matter still more is the fact that we are only seeing reporting of new cases or of cumulative-total-to-date cases. Without seeing reports of recoveries, we don't get a perspective on how many current cases there are, the best we can do is look at trends in the newly-confirmed number, which is subject to distortion by sampling errors and laboratory bottlenecks.LeadSongDog come howl 21:41, 15 May 2009 (UTC)

Why does WHO have to say its a pandemic for us to say its a pandemic. If we used the definition of pandemic ourselves then we would call it pandemic. WHO's criteria for phase 6 are filled to be honest i don't know why it hasn't been declard yet. i say leave it as pandemic... as that is what swine flu now is. Wuku (talk) 08:15, 16 May 2009 (UTC)

I believe it is a pandemic, according to the definition on Wikipedia. It is an epidemic that has spread worlwide. Yellowlarakin (talk) 00:03, 18 May 2009 (UTC)

All this panic is senseless.More persons were killled by suicide, than for this kind of flu.Agre22 (talk) 03:47, 18 May 2009 (UTC)agre22

Panic could be senseless, but sometimes panic can cause people to make preparations for disasters they would have not have made otherwise.

Regardless, your opinion on whether the panic is senseless or not has little to do with whether it's a pandemic or an epidemic.Yellowlarakin (talk) 07:39, 18 May 2009 (UTC)

This obviously IS a pandemic. It doesn't matter what level the WHO says we are. We could be at level 10 million, it wouldn't change anything to reality. 206.47.141.21 (talk) 13:17, 20 May 2009 (UTC)

Unless reliable sources say it is a pandemic, it isn't one as far as Wikipedia is concerned. --ThaddeusB (talk) 14:15, 20 May 2009 (UTC)

[nods] Also, 206.47.141.21, we can't have any original research. hmwithτ 17:52, 20 May 2009 (UTC)

Individual cases

I'd be interested to see some mention of individual cases. What is the age group, how long was the patient sick before dying, did they go to the hospital, how long had it been since they got sick until it was diagnosed as swine flu. etc.. Hreinn (talk) 01:40, 18 May 2009 (UTC)

More individual cases are expand upon in more specific articles. Click links in the top right table to take you to 2009 swine flu outbreak in the United States, for example. hmwithτ 17:49, 20 May 2009 (UTC)

Death in the U.S. of person without serious prior medical condition

First can someone tell the bot to stop archiving so quickly?

I have undone the last archive & changed the archive period to 48 hours instead of 24 hours. --ThaddeusB (talk) 04:08, 18 May 2009 (UTC)

What do you think of the previously healthy person passing away? Did he seek medical attention early? Did he take care of himself? Was it cold in New York like it was in Mexico City? According to his family he had fairly mild pre-existing conditions which were gout and high blood pressure. http://www.washingtonpost.com/wp-dyn/content/story/2009/05/15/ST2009051503651.html Daniel.Cardenas (talk) 03:53, 18 May 2009 (UTC)

What I think of this is irrelevant. :) Since this is a US specific item, you might want to take it to Talk:2009 swine flu outbreak in the United States --ThaddeusB (talk) 04:08, 18 May 2009 (UTC)

I agree with Thaddeus and would go further and say what any of us think is completely irrelevant. What matters is what sources say. If sources say this is an important/unique case then we probably should mention it somewhere. If not, the fact that some random wikipedians may think it important is irrelevant. Remember this is for discussing ways to improve the article not random comments on the outbreak. If you want to ask factual questions you're welcome to ask at WP:RD/S. If you want to discuss opinions then wikipedia is not the place for you, try a forum or usenet Nil Einne (talk) 04:16, 18 May 2009 (UTC)

What we think is very relevant. We decide what is notable and how to categorize the content. The details of this case can have a big effect on the article. It may escalate the severity of the illness for example. Daniel.Cardenas (talk) 05:56, 18 May 2009 (UTC)

May I add the information that (except in media reports and soothing statements by health officials) there is no indication that severe disease is absent or rarer in healthy than in unhealthy people. Let me cite the CDC: "Information is available on the clinical course of illness for 22 patients with laboratory-confirmed illness who were hospitalized, including seven patients who died. Five of the 15 surviving patients and one of the seven patients who died had underlying chronic medical conditions."(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm)In other words, six of the seven dead had no underlying medical conditions. By the way, one US pregnant woman who died was reported to have been "chronically ill", but the case report (also published by the CDC) shows that her chronic illness, if any, certainly wasn't serious: "On April 15, a woman aged 33 years at 35 weeks' gestation with a 1-day history of myalgias, dry cough, and low-grade fever was examined by her obstetrician-gynecologist. She had been in relatively good health and had been taking no medications other than prenatal vitamins, although she had a history of psoriasis and mild asthma." (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5818a3.htm)Geometer9420 (talk) 06:50, 18 May 2009 (UTC)

Very good info. Didn't know that.   This should be in the article.   Daniel.Cardenas (talk) 12:30, 18 May 2009 (UTC)

Would you insert it then, Daniel? I have gotten a bit apprehensive about doing anything myself after earlier attempts of mine were judged to violate WP regulations by other and probably more seasoned users.Geometer9420 (talk) 11:30, 19 May 2009 (UTC)

Dont forget to mention the one in New York, who died yesterday.--Vrysxy ¡Californication! 07:12, 18 May 2009 (UTC)

Whoa there! Since when does "35 weeks' gestation" and "a history of psoriasis and mild asthma" translate to "without serious prior medical condition"? As far as I can tell, most of the fatalities have related to histories of asthma or other breathing impairments. Having her immune system on late-term hyperdrive would not have helped matters and concern for the baby might have constrained options for medical treatment of the mother.LeadSongDog come howl 14:01, 19 May 2009 (UTC)

Are you familiar with psoriasis? It is fairly benign. Do you think mild asthma is serious? That just leaves late term pregnancy as an issue. Daniel.Cardenas (talk) 14:57, 19 May 2009 (UTC)

Here is the husband saying something similar: http://www.valleycentral.com/news/news_story.aspx?id=301699 Daniel.Cardenas (talk) 15:12, 19 May 2009 (UTC)

We are talking about a severe respiratory infection that developed into a case of acute respiratory distress syndrome, so yes, in this context any asthma is serious. It reduces the body's ability to cope with the insult the influenza causes. Read the MMWR reference. and you'll see that it was implicated in the pregnancy case referred to as "Patient A" in that ref. Asthma was also implicated in the Alberta fatality and about one third of all hospitalized cases in the U.S. The type of psoriasis wasn't further described, but in many cases it reduces the integrity of the skin's protective barrier against infection. It can also make people less willing use soaps that help protect others from the virus, as they wish to avoid the drying effect of soaps. Further, psoriasis is widely thought to be an immune-moderated or auto-immune condition, though this remains a matter of debate. This too could be a complicating factor.LeadSongDog come howl 17:02, 19 May 2009 (UTC)

LeadSongDOG: I added the paragraph about the pregnant woman to show that "underlying medical condition" or "chronic disease", as reported by the media in the context of swine flu deaths, is not necessarily something perceived as a serious medical condition by normal people in everyday life. Also, if conditions like mild asthma, psoriasis, diabetes, pregnancy, arthritis, obesity or gout (the latter was the "underlying medical condition" some health officials reported for the NYC teacher) count as "serious underlying medical conditions", then I guess a majority of the American population over 25 suffers from at least one serious medical condition. The public perception now is that if you are not a bed-ridden invalid, and think of yourself as healthy, you are in absolutely no danger of dying of the flu, and that is clearly wrong for this strain, as shown by Mexican but also US data. The Missouri man who died (at 44!)was also reported to be in perfect shape by friends and family; whatever they may find at the autopsy. Geometer9420 (talk) 16:56, 20 May 2009 (UTC)

Agree that ho-hum perception seems to be an issue. MMWR 58e0518a1 gives a breakdown of underlying conditions for hospital admissions in California. Note that breathing issues are the usual cause, particularly asthma, often developing into lung infiltrates confirmed by xray.LeadSongDog come howl 18:37, 20 May 2009 (UTC)

h1n1

please expand h1n1 —Preceding unsigned comment added by 199.89.103.12 (talk) 15:48, 18 May 2009 (UTC)

• If you mean the Influenza A virus subtype H1N1 article (where H1N1 redirects), that's to be discussed on that article's talk page (located here).
• If you mean discussion on the name, that's located in the Name of the disease section.
• If you mean just this article in general, what do you think should be expanded upon? To me, it seems like a pretty thorough article, but feel free to add any information. However, only information found in reliable sources can be used. hmwithτ 17:47, 20 May 2009 (UTC)

Unsourced and at least partly incorrect information

Currently, "Symptoms and severity" includes the following:

"Differences in the viruses or co-infection are also being considered as possible causes. In 1918, influenza weakened the infected, and it was then lung infections such as pneumonia which killed 3% of them. In the current outbreak, the first deaths (13 and 21 April) were diagnosed as 'atypical pneumonias', a pneumonia which, helped by the flu, becomes more dangerous."

All of this, as far as I can see, is unsourced. It is also at least partly wrong and/or misleading.

1."In the current outbreak, the first deaths (13 and 21 April) were diagnosed as 'atypical pneumonias', a pneumonia which, helped by the flu, becomes more dangerous." This sounds as if the patients had died of a pneumonia causally unrelated to the flu. This is untrue. The patients died of viral pneumonia caused by the flu; eg, they died of the flu. "Atypical pneumonia" was the first (incorrect) diagnosis in the first patient and reflects the fact that seasonal flu does not normally cause severe non-bacterial pneumonia in healthy adults. They believed she had SARS, but it turned out she had swine flu.

2. "In 1918, influenza weakened the infected, and it was then lung infections such as pneumonia which killed 3% of them." That is the way influenza normally kills, especiually seasonal flu: bacterial pneumonia (a superinfection) is the usual immediate cause of death in seasonal influenza cases. What was special about 1918 was the fact that many especially among younger people died of viral pneuimonia (i.e. pneumonia caused by the flu virus itself) and/or a cytokine storm related to it. The statement is misleading in this context.

3. The pragraph is meant to explain why the disease was more fatal in Mexico than in the US.However, it is far from clear whether the disease was in fact more lethal in Mexico than in the US. US and Mexican lethal cases show the same young age pattern, and the fact that the US has a slightly lower rate of dead vs infected now may be due to sampling error or some other statistical artifact.Geometer9420 (talk) 18:51, 18 May 2009 (UTC)

Your critique makes sense so a lot of this can be revised. However, the bigger problem with this section, IMO, is that the average person hoping to get some clear explanation about "symptoms and severity" will probably only gain unwanted "complexity and confusion." --Wikiwatcher1 (talk) 20:17, 18 May 2009 (UTC)

A clearer and far shorter version of the "symptoms and severity" section would be the following:

The main symptoms of swine flu are fever (seen in 90% of patients) and cough (84%). Other symptoms reported include a sore throat(61%), diarrhea (26%) and vomiting (24%). Headache and a runny nose are also reported. The severity of the disease is similar to the seasonal flu in most patients. Severe illness, often with pronounced dyspnea (difficulty in breathing), is seen occasionally and requires hospitalization. Data up to mid-May indicate that in Mexico as well as in the US, people of young and middle age are more often hit by such severe illness than would be expected with the sesonal flu. (Update: Novel Influenza A(H1N1) Virus Infections Worldwide, May 6, 2009, Morbidity and Mortality Weekly Report, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm)

(Sorry, the footnote is invisible. The reference is to an official CDC report which includes all of the above information: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm.)

What do you all think? Geometer9420 (talk) 11:08, 19 May 2009 (UTC)

Clearer and easier to read. Don't know if the % stats are needed, IMO, since listing symptoms in order of probability seems good enough. --Wikiwatcher1 (talk) 19:06, 20 May 2009 (UTC)

Canada stopped reporting the total number of cases?

It looks like Canada has stopped reporting daily figures of A H1N1. Since last Saturday, all we can get is sporadic data from just a few provinces (Nova Scotia, Quebec mostly) with the local number of cases rising at a steady rate. But Health Canada has not updated its website since May 15th/16th, and the officials keep using outdated figures (from May 16th) in press conferences and press releases ever since. From local medias, we know that new cases were found in Nova Scotia, Quebec (at least 16 new cases Monday in Quebec). According to a linear growth model projections, the number of cases in Canada should reach 575 as of Tuesday May 19th. 70.83.220.148 (talk) 20:01, 19 May 2009 (UTC)

Do you have a reference?--Vrysxy! (talk) 20:24, 19 May 2009 (UTC)

More like a lack of reference (or silence at the federal level). Also, WHO figures for Canada and Health Canada data are from May 15th/16th. 70.83.220.148 (talk) 20:29, 19 May 2009 (UTC)

Since new cases reported by provincial authorities since last Friday were not published by the federal government, we should have a note somewhere in the data table saying that the current figure (516 cases in Canada) is from Friday May 15th. Otherwise we're mixing "old news" with fresh data. 70.83.220.148 (talk) 20:40, 19 May 2009 (UTC)

Hint Canada hasen;t reported since Friday the 15th. Monday the 18th was Victoria Day[85]. They're government workers taking a long weekend. --PigFlu Oink (talk) 20:42, 19 May 2009 (UTC)

They were still using Thursday and Friday's figures in recent press conferences and press releases (Monday and Friday), despite knowing that there were new cases in a few provinces. How come they can organize a press conference on Victoria Day, but not perform a simple addition in order to use updated values? Plus, most provinces kept publishing their figures through the week-end and even on Monday. I don't see that as a satisfying explanation. 70.83.220.148 (talk) 20:47, 19 May 2009 (UTC)

Canada sucks, get over it. (They're not even a real country anyway.) --PigFlu Oink (talk) 20:47, 19 May 2009 (UTC)

Is that meant to be funny or rude? In either case, I don't think it belongs here. sherpajohn (talk) 21:30, 19 May 2009 (UTC)

No, it's PFO's idea of irony. Follow the link. In any case, the PHAC surveillance figures are a composite from the respective provincial agencies report of the previous day. Since some provincial agencies didn't report on Victoria Day, PHAC won't have anything useful to say today. They said as much in this news release. Wednesday will be the first real update since Friday. Watch for the imminent equivalent farce in the U.S. following Memorial Day. LeadSongDog come howl 21:52, 19 May 2009 (UTC)

According to the Saskatchewan source we cite,[86] they will not update their figures until Wednesday, as they "move toward weekly reporting", and neither will the Public Health Agency of Canada. -- Avenue (talk) 21:48, 19 May 2009 (UTC)

It's a bit bizarre to hear Canada's chief public health officer saying this morning that "It looks at this point like we're over the worst of it in Canada for this season" while everything points towards a continuous flow of new cases on a daily basis. http://www.theglobeandmail.com/servlet/story/RTGAM.20090519.wflu19art02250/BNStory/National/?page=rss&id=RTGAM.20090519.wflu19art02250 Unfortunately, the medias seem to have interpreted these words as an indication that swine flu is on the decline, as seen on CBC news: " (...) swine flu is starting to wane for the season, the country's chief public health officer said Monday". It's nice to try to calm the population... but the partial data we get for the last few days point towards a sustained linear growth in the number of cases in Canada. Still, swine flu is not a killer and there is no exponential growth yet in Canada, but I believe it is important that our government gives us precise and up-to-date information, and not general comments that don't seem to correspond to the actual data. 70.83.220.148 (talk) 01:05, 20 May 2009 (UTC)

Biological Terrorism?

There were reports of this being Biological Terrorism, but I don't see any info here about that?-NootherIDAvailable (talk) 07:13, 21 May 2009 (UTC)

There were no such reports, just rumours without any evidence. The is a discussion about that already which resulted in a poorly sourced entry being removed from the article. See the archive under 'fringe theory'. 24.222.54.66 (talk) 11:16, 21 May 2009 (UTC)

Lead revisions

I made a lot of revisions to the lead so feel free to suggest or make any repairs. The goal was to trim out excess details already in the main body, to update with more current news summaries, and to simplify for readability. Adding the Bloomberg quote (with cite) was questionable but it seemed to be a nice summary of what might be happening in other cities, here and abroad. --Wikiwatcher1 (talk) 23:30, 21 May 2009 (UTC)

Doubtful information in the introduction

The introduction states that " there is mounting evidence that the symptoms are even milder than the seasonal flu." The statement is OR and I think unwarranted, certainly in this exposed position in the article. I have not seen a single dependable source saying that swine flu is milder than seasonal flu, and I haven't found the statement in the newspaper article given as the source for the paragraph, though admittedly I perused the article rather quickly; an LA Times article that cites Mayor Bloomberg as an expert is certainly not an authoritative source on the epidemiology of swine flu. On the contrary, available data currently points to a somewhat higher case fatality rate in swine flu. (Given as 0.4 vs. 0.1 by Science/WHO, although that is still very uncertain). Swine flu may be milder for people above 65. So far all of the US fatalities and most hospitalizations were of young and middle age, the reverse pattern is seen with seaonal flu. (The newly published immunological data show 33% immunity against swine flu in the oldest age cohort, and practically no immunity in the rest of the population.) Younger adults rarely require hospitalization with seasonal flu, but suffer disproportionatly in the current outbreak. So current data indicate that at least for adults below 60, swine flu seems to be more problematic than seasonal flu. Also, swine flu could affect more people as the population is largely immunologically naive; swine flu was thus judged to be more contagious than seasonal flu.

All in all, an unqualified statement that it swine flu is milder than seasonal flu is clearly wrong at this point in time.

The same (OR?) section in the introduction also states that of 201 confirmed cases in New York, only one was a fatality (and of 279 in Japan, none was); apparently citing this is as evidence that swine flu is less severe than seaonal flu. This does not makes sense statistically. Seasonal flu has a case fatality rate of 0.1%, i.e. one death per thousand cases. 201 New York flu patients do not a statistic make; but if they did, they would indicate a case fatality rate of 0.5, five times higher than with seasonal influenza. (Note that I am not saying that this is a valid statistic.) The sentence as it stands now is plain nonsense.

I think the whole statement including the part about New York and Japan needs to be deleted. The judgemental sentence about Japan overreacting (according to whose standards?) has no place in an encyclopedic article. If one does want to speak of the fatality rate or the severity in the introduction, it would be appropriate to say that the fatality rate is probably not very much higher than the one fatality per thousand seen in seasonal flu, although younger adults may be disproportionately affected. Geometer9420 (talk) 07:10, 22 May 2009 (UTC)

I move for removing the entire 'current status' section as it is unneeded and puts too much emphasis on non-special areas. Several American cities have just as many cases as New York if not more. As for Japan I have heard complaints of overreaction from people I know there, but the Japanesse alaways do that and without a media source its OR. As for all the statisitics for mortality, its too early for any of that without some offical medical assesments. I did add a statement from the CDC about of all the 5000+ US cases only ~270 were hospitalized and of those 70% had preexisting chronic medical conditions. Without offical, current numbers like that anything else would be synthesis. (added later)Furthermore, if more 'young healthy people' are getting ill, its likely because they go to schools and interact with 30 - 200 other kids (and at least some of those kids likely went on spring break). At 27 I goto work in my cubicle and see maybe 12 people all day. IMHO, it's not so much age or disease targeting the young thats a factor, its exposure. --PigFlu Oink (talk) 07:36, 22 May 2009 (UTC)

Agree. With 41 countries reporting cases and the international news media reporting constantly, there's no reasonable way to have a section like that kept managable and balanced. I think we should stick with updated general summaries of world cases. --Wikiwatcher1 (talk) 07:47, 22 May 2009 (UTC)

I agree that there is no room for OR, which is why I added 3 cites to the lead, even though other similar statements were in the body with their own, slightly older cites. In most of the general news sources, I read statements like this one: "In Mexico, the same virus appears to have killed over 149 people, however cases in the United State have been mild. Health authorities say they can't yet explain why." That situation still seems to be the case. I can't refute your statistical totals and don't think we should try with the flu growing exponentially around the world. But it's hard to avoid reading news stories, including CDC press releases, that try to avoid panic by stressing that the flu has so far been "mild."

If you decide to remove the material, or want me to, we can put it into a new discussion topic to let others check into this also and suggest modifications. In the meantime, I'll try to find some other authoritative opinions and include them here for reference. --Wikiwatcher1 (talk) 07:41, 22 May 2009 (UTC)

Non-topic but for anyone trying not to stress out over media reports this old film from your friends at Disney --PigFlu Oink (talk) 08:01, 22 May 2009 (UTC)

a few sources

CDC web site: "It’s uncertain at this time how severe this novel H1N1 outbreak will be in terms of illness and death compared with other influenza viruses."

WHO Press Conference, May 14th. "To characterize this, it is an event that is serious, that requires close monitoring, but most of the cases at this time continue to be mild cases, where people recover without needing hospitalization although there are some people that do get fatal and serious illnesses." [87]

DHS, May 6. "Despite this loss and despite the fact that others may still come, the science tells us that this is most likely a milder strain than we first feared. As such, yesterday the CDC revised their school closure guidance and the doors of classrooms are and will be reopening across the country. But as I said yesterday, now is not the time to declare victory. We continue to have cases. We continue to vigilantly monitor the situation. And even if the encouraging signs we are now seeing hold firm, we know that this virus could come back stronger in the fall." [88]--Wikiwatcher1 (talk) 08:08, 22 May 2009 (UTC)

Canada: "All the swine flu cases in B.C. continue to be relatively mild."[89]

AP: "Experts: Mild swine flu could quickly turn deadly" This particular headline also stresses the future, and the lead and article body both cover this mutability and possible worsening scenario. --Wikiwatcher1 (talk) 08:26, 22 May 2009 (UTC)

I have removed the following three sentences from the lede:

As of May 21st, for instance, despite 201 confirmed cases in New York City, most have been mild and there has been only one confirmed death from the virus. ^{"New York City officials struggle for balanced response to swine flu", Los Angeles Times, May 21, 2009}Similarly, Japan has reported 279, mostly mild flu cases, and no deaths.^{"Spread of Swine Flu Puts Japan in Crisis Mode", New York Times, May 21, 2009} And in Mexico, where the outbreak began last month, the government lowered its swine flu alert level as there have been no new infections for a week.^{"Mexico City ends swine flu alert, no cases in week" Associated Press, May 21, 2009}

which violated wikipedia guidelines againsts synthesis, by selectively and incorrectly citing examples to try to establish that "there is mounting evidence that the symptoms are so far milder than health officials feared." After all, why do we cite 1/279 deaths/cases in NY and not 3/500 deaths in Arizona ? Also the last example is simply wrong - the newspaper report is about Mexico city not the country as a whole!
I believe the earlier statements in the paragraph (as reworded by Wikiwacher1) are true, and therefore haven't removed them from the article. However we need to add a reference for those statements, and perhaps remove the POVish adjective mounting, unless it is specifically supported by the source(s). Abecedare (talk) 09:01, 22 May 2009 (UTC)

The new version as revised by Abecedare and Wikiwatcher is fine. Thank you both. "Milder than feared" is perfectly okay (because what virologists feared was Spanish flu or even bird-flu like virulence); what I objected to was "milder than seasonal influenza" which is not supported by current stats. Thanks for collecting the citations, Wikiwatcher, but note they don't say milder than seasonal flu. (By the way, the WHO's wording "most of the cases at this time continue to be mild cases, where people recover without needing hospitalization although there are some people that do get fatal and serious illnesses" would have been true even of the Spanish flu, which had a 97,5 % recovery rate yet still managed to kill millions of people.) I dont think anyone in the know still wonders "why the disease was worse in Mexico", Mexico has 78 confirmed fatalities, the US now has ten, simply because the epidemic started later, and at a time when normal influenza season was over. What you still read occasionally is that victims in Mexico were mosty healthy while most (but not all) US victims are reported having chronic disease, however, that is probably due to the fact that conditions like mild asthma, being overweight, pregnant or having sleep apnea were not counted as chronic disease in Mexico while with the US cases they were. (Which is of course OR which is why I won't post it in the article! ;-)) Cheers. Geometer9420 (talk) 12:06, 22 May 2009 (UTC)