CDC Alert Sent Out to Physicians to Look Out for Hemorrhagic Pneumonia 11/20/09 6:25am

CDC Alert Sent Out to Physicians to Look Out for Hemorrhagic Pneumonia

alert sent out: (also linked in headline)


Physicians Asked to be on the Lookout for Possible “Hemorrhagic Pneumonia Cases” Among Influenza Patients

The CDC says that there have been some anecdotal reports of possible "hemorrhagic
pneumonia" cases among influenza patients who have died or been hospitalized for
severe illness.

The phrase "hemorrhagic pneumonia" is somewhat outdated, and most clinicians will not use the term to describe this condition, which can be a very rare complication of viral respiratory infection. Some other terms that can be used to describe this include diffuse alveolar hemorrhage (DAH), which can be caused by infections but doesn't have to be, and hemorrhagic pneumonitis.

In any event, it's a serious complication that will sometimes lead to acute respiratory distress syndrome (ARDS). It occurs very rarely as a complication of seasonal influenza, and there is some concern that it might be more common in H1N1 infections.


The CDC is asking state health officials to look out for possible cases that may involve clusters of patients who might have these symptoms, or a large proportion of cases with these symptoms (e.g., 4 of 5 deaths). They will invariably be among the most severely ill influenza patients (i.e., deaths, ICU patients).

This is a hard diagnosis to make, and the most telling symptom may be hemoptysis
(bloody sputum, frothy bloody cough), although not all cases will have it.

• Acute onset of rather more severe respiratory infection (dyspnea‐‐ difficulty
breathing‐‐ is common)

• Hemoptysis is often seen on initial presentation (~70% of cases)

• CXR and physical exam will suggest alveolar infiltrates (radiographic opacities)

• Diagnosis is usually made by BAL (brochoalveolar lavage) and pathology testing
(increasingly more hemorrhagic fluid/secretions from sequential BAL

Email sent by the Regional Liaison Officer, Region IV, H1N1 Response Surveillance and
Epidemiology Team, Centers for Disease Control and Prevention

Questions concerning possible cases or this email may be directed to Medical Epidemiologist Zach Moore, MD, at the North Carolina Division of Public health at zach.moore@dhhs.nc.gov.

Here is the way I see it. By this email, that says the CDC (thus the WHO, and govts of the world) KNOW something is going on, they knew it was going to go on ahead of time too!

Now, that leads us to the fact - They have been Lying - when they have said "nothing has changed" in the past with the Swine flu and even currently and the ONLY thing they have to say is "Don't worry about it, just take your Swine Flu Shot"!

It seems, in my opinion the trail of lies keeps getting deeper and the fact the CDC, WHO and governments know the H1N1 is nothing but a bad case of the flu - but they Know much worst is and has been going on, Yet, they do NOT Inform the Public. They do Not change their stance on the vaccine that was made specifically for the Swine flu. Yet, that is Not the big problem nor will be in the near future around the world, from what I have gathered with the way this seems to be spreading.

This email is PROOF That something VERY BAD is Happening - no matter how the WHO wants to hide it!

Now - my question to countries and governments - WHY Hide this? I thought your job as Elected Officials were to Look out for What is Best of the Citizens of your Country - If so - Please start informing your citizens What is REALLY Going On! Start doing the JOB you were elected to - Start Protecting your Citizens by Giving them the TRUTH!

The Evidence is MOUNTING that People have been LIED to by the CDC, WHO, Governments of the World!

Donetsk - Third Death from Pneumonia 11/12/ 6:45

In the Donetsk region - the third death from pneumonia

Article:


In the Donetsk region of bilateral pneumonia dead woman - the third person for epidemiological period (October 30, 2009).

Як повідомили УНІАН в Донецькій обласній санітарно-епідеміологічній станції, померла мешканка міста Горловка, 1969 року народження. As UNIAN reported in the Donetsk regional sanitary-epidemiological station, died a resident of Gorlovka, born in 1969.

За інформацією ОблСЕС, у Донецькій області за минулу добу було зареєстровано 5007 звернень за меддопомогою хворих на респіраторні інфекції і грип. According OblSES in the Donetsk region over the past day was recorded 5007 downloads for meddopomohoyu patients with respiratory infections and influenza. Загальна кількість хворих на грип і ГРВІ з початку епідемії (з 30.10.09 р.) становить 62486 випадків, зокрема дітей – 24452, госпіталізовано всього 2815 хворих. The total number of patients with influenza and ARI from the beginning of the epidemic (from 30.10.09 City) is 62486 cases, including children - 24,452, all hospitalized patients in 2815. Померло 3 дорослих, секційний матеріал направлено для розшифровки діагнозу в Центральну СЕС м. Києва. Died 3 adults sectional material sent for decoding the diagnosis of the SES Central Kyiv. За словами епідеміологів, всі троє померли від двосторонньої пневмонії.. According to epidemiologists, all three died of bilateral pneumonia ..

За даними експрес-діагностики, в етіології захворювань переважають збудники грипу типу А. According to the rapid diagnosis, the etiology of diseases such as influenza agents dominate A.

Як повідомляв УНІАН, раніше за епідеміологічний період в Слов`янському районі померла 22-річна жінка і в місті Донецьк - чоловік, 1942 року народження. As UNIAN reported earlier in the epidemic period of Slavic area dead 22-year-old woman in Donetsk - man, born in 1942.

10 листопада на прес-конференції головний державний санітарний лікар Донецька Валерій КОВАЛЬОВ уточнив, що чоловік, який помер від двосторонньої пневмонії, не був заражений вірусною інфекцією, в патологоанатомічному висновку йому було поставлено діагноз – «ларінготрахеобронхіт під запитанням, геморрагічна пневмонія під запитанням». November 10 at the press conference, Chief Medical Officer Donetsk KOVALOVA Valery said that a man who died of bilateral pneumonia, was not infected infection in pathoanatomical conclusion he was diagnosed - larinhotraheobronhit under question, hemorrahichna pneumonia in question.

Suspect H1N1 Death In Romania near Ukraine Border 11/10/09 2:47 pm est

Suspect H1N1 Death in Romania Near Ukraine Border

Article:

Recombinomics Commentary 15:05
November 10, 2009

A man of 47 years of common Botosani Spear died Tuesday morning at home or, and authorities are considering alternative that they were sick of swine flu, informs Agerpres.Cops have limited access area and male family members are not allowed to leave the house. Prefect Botosani, Cristian Roman, president of the County Committee for Emergency, says that this case is treated, for now, as "suspicious death", the expected results necropsiei to be taken are appropriate.Ministry of Health was informed about this case. Doctors have taken samples to be sent to the Institute for Infectious Diseases "Matei Bals".

Oana Grigore, communications director for Health, said they did not confirm any cases of death by influenza A/H1N1 virus, adding that if the patient died in Botosani it is a man of 47 years, smoking, obesity , which was not seen by any doctor.

The above translation described a suspect swine flu death in northern Romania near the southern border of Ukraine (see map). This report follows a similar report from Belarus regarding a doctor who died in southern Belarus, near the northern border of Ukraine.

However, it is not clear if these recent reports reflect spillage of the H1N1 in Ukraine, or simply represents deaths identified through enhanced surveillance. Ukraine has now reported over 1 million influenza/ARI cases, including 174 deaths. The cause of these alarming numbers has been said to be later treatment, but the magnitude of the outbreak raises concerns that there have been genetic changes leading to enhanced transmission and increase lethality from hemorrhagic pneumonia.

The recent description of 90 hemorrhagic pneumonia cases has left little doubt that these deaths were due to H1N1 due to lab confirmation on a sub-set and an age distribution which matches H1N1 outbreaks worldwide.

The genetic changes can be addressed through sequence analysis, but the sequences and/or a description of the sequences has been delayed.

Release of sequences is overdue.

You notice they are saying the results are way over due from the deaths in the Ukraine. Those results were suppose to have been released last week (around the 4th) - they have not been released yet.

Those in Ukraine Government - Seem to Question Accuracy of Numbers of Sick! 11/09/09 8:02am

This is a very interesting Release from the Ukraine Government, if translated as stated, it seems to imply those in the Ukraine Government are even questioning the accuracy of those who are sick in the Ukraine. Notice they DO NOT SAY SWINE FLU - THEY USE PNEUMONIA as the cause of deaths! Are they having to change what it is, because it all involves the lungs? But are they now they simply using the word pneumonia - compared to pneumonic plague?

Link to article:

http://translate.googleusercontent.com/translate_c?hl=nl&sl=uk&tl=en&u=http://www.moz.gov.ua/ua/main/press/%3FdocID%3D14026&rurl=translate.google.com&usg=ALkJrhizNeR2fzmyA8ZnTvZz6RJEQZbobA


From Article:

The Minister of Health of Ukraine Vasily Knyazevich held telephone conference, during which communication with health departments in the field, representatives of operational staff, local authorities considered the problem of the spread of a flu epidemic, the question of the regions of medicines and medical products, solutions to human problems and quality of care.

Участь в нараді також взяли перший заступник міністра охорони здоров'я України Василь Лазоришинець, заступник міністра Володимир Юрченко, академік АМН України Георгій Розенфельд, голови управлінь та департаментів МОЗ України, керівники вищих медичних закладів України. Participation in a meeting also attended the First Deputy Minister of Health of Ukraine Vasyl Lazoryshynets, Deputy Minister Vladimir Yurchenko, Ukraine Academy of Medical Sciences George Rosenfeld, head offices and departments of Health of Ukraine, heads of higher medical institutions of Ukraine.

На початку засідання В. Лазоришинець надав оперативну інформацію щодо захворюваності по різних регіонах України та відзначив, що статистика захворювань на пневмонію, на жаль, свідчить про її зростання у 2009 р. At the meeting V. Lazoryshynets provided current information on diseases in different regions of Ukraine and noted that statistics on the disease pneumonia, unfortunately, shows its growth in 2009

Так, якщо в 2008 р кількість хворих за 9 місяців становила 176 тис 172 випадки, то за цей же період 2009 р. кількість хворих на пневмонію зросла до 183 тис. 828. Thus, if in 2008 the number of patients at 9 months was 176 thousand 172 cases, with the same period in 2009 the number of patients with pneumonia has risen to 183 thousand 828.

Особливо збільшилась кількість хворих у жовтні та кількість її важких форм, що викликає стурбованість серед лікарів. Especially the number of patients in October and the number of severe, causing concern among doctors. Окрему увагу приділено стану здоров'я вагітних, адже на пневмонію захворіло понад 700 жінок. Special attention is paid to health of pregnant women, ill with pneumonia because of more than 700 women. Станом на 6 листопада 2009 р. 7 вагітних перебували на апараті штучної вентиляції легенів, 9 вагітних - померло від важких форм пневмонії. As of November 6, 2009 7 pregnant women were on artificial ventilation, 9 pregnant - died from severe pneumonia.

Учасникам селекторної наради нагадали, що в Україні працює місія ВООЗ, яка надає консультативну допомогу фахівцям профільного міністерства та практикуючим лікарям. Conference call participants recalled that Ukraine is the mission of WHO, which provides advice to the experts of relevant ministries and practicing doctors. Як зазначила директор Департаменту розвитку медичної допомоги Мирослава Жданова, після спільної роботи з міжнародними експертами були вдосконалені та внесені зміни до протоколів надання медичної допомоги хворим. As the director of the Department of Healthcare Miroslav Zhdanova, after collaboration with international experts have been improved and changes to the protocols of care for patients. Зокрема, уточнені показання до госпіталізації, більш детально виписані шляхи надання допомоги хворим в стаціонарах. In particular, clarified the indications for hospitalization, written in more detail how the sick in hospitals. Таким чином, Міністерством охорони здоров'я України внесе відповідні зміни в деякі накази, інші регламентуючі документи, що допоможе практикуючим лікарям в подальшій роботі. Thus, the Ministry of Health of Ukraine will make the appropriate changes in some orders, and other regulatory documents that will help doctors to practice in the future.

Міністр охорони здоров'я Василь Князевич звернувся до регіонів з зауваженням про несвоєчасність подання статистичної інформації та з вимогою ретельно перевіряти достовірність поданих даних. Health Minister Vasily Knyazevich appealed to the regions with the observation of the untimely submission of statistical information and to request scrutinize the accuracy of submitted data. На сьогодні профільне міністерство опинилося у ролі заручника недобросовісної роботи управлінь охорони здоров'я в окремих областях, адже найбільший шквал критики стосується саме подання статистики щодо кількості захворювань в регіонах. Today, line ministries found themselves in the role of hostage unfair health care departments in certain areas, because the biggest storm of criticism applies to the submission of statistics on the number of diseases in the regions.

Крім того, під час спілкування в режимі реального часу В. Князевич заслухав інформацію регіонів щодо стану лабораторних досліджень на місцях, забезпечення регіонів апаратами ШВЛ, препаратом "Таміфлю" та ін. In addition, during the communication in real time AV Knyazevich heard information about the status of regional laboratory in the field, the regions of artificial pulmonary ventilation apparatus, the drug "Tamiflu", and others. медикаментами, перевірок органами прокуратури медичних закладів, тощо. medicines, inspections prosecutors medical facilities, etc.. Він запропонував медикам західних регіонів, які першими прийняли на себе удар розповсюдження вірусу грипу, поділитись досвідом з центральним та східним областям України, які готуються до можливих спалахів грипу та ГРВІ. He suggested that doctors western regions, which first took a shot at the spread of influenza virus, to share experiences from Central and Eastern regions of Ukraine, who are preparing for possible outbreaks of influenza and ARI.

Прес-служба МОЗ України Press Service of the Ministry of Health of Ukraine

Recombinomics says what is killing those In the Ukraine - Also in Killing in Other Countries 11/9/09 7:24am est

Recombinomics says the hemorrhagic pneumonia killing those In Ukraine - Also in Other Countries

Recombinomics says this hemorrhagic pneumonia (not H1N1 - in other words - lungs bleeding) is linked to other countries - notice they say "patients who developed a cytokine storm" - that is exactly what people have been warning about, of what will occur with the Swine Flu Vaccine! They are again asking for results of exactly what it is killing people, but no results are being forthcoming.

From Article: (again this is a medical article - can be hard to understand with all the genes and medical terms used)

1918 RBD Polymorphsm in Ukraine H1N1?
Recombinomics Commentary 04:22
November 9, 2009

The recent explosion of H1N1 cases in Ukraine (see map) has focused attention on sequences linked to the outbreak, especially those in the lungs of patients who developed a cytokine storm. This hemorrhagic pneumonia has been described previously in other fatal swine flu infections, but that rapid increase in reported deaths in Ukraine has raised concerns that the virus is transmitting more efficiently, or is replicating at higher levels in lung tissue.

These changes are frequently linked to changes in the receptor binding domain (RBD) in the HA protein. Changes in this domain can affect affinity for receptors and also modify tissue tropism. The recent expansion of seasonal H3N2 with M2 S31N was linked to two changes in or near the receptor binding domain, S193F and D225N.

Recent isolates from Sao Paulo, Brazil, collected from necropsy tissue from fatal cases had two changes at position 225. Two of the isolates, A/Sao Paulo/53845/2009 and A/Sao Paulo/53838/2009) had D225N (see list), the same change seen in seasonal H3N2. Interestingly, the swine H1N1 is a triple reassortant with flu genes from swine, humans, and birds. The human gene is PB1 and it was acquired in swine infected with a human H3N2. The initial isolates had three human genes, the H3 and N2 as well as the PB1. Thus, the prior association of the human PB1 in isolates with human H3,may increase the advantage offered by D225N.

However, two other isolates from Sau Paulo, A/Sau Paulo/53225/2009 and A/Sau Paulo/53206/2009, collected from the lungs of fatal cases, had another change at position 225, D225G. This polymorphism is more widespread and recent isolates have been found in Japan, Italy, and China (see list ). Moreover this polymorphism has been found in two isolates from the 1918/1919 pandemic, A/New York/1/1918 and A/London/1/1919. Thus, in 1918 the H1N1 virus usually had a D at position 225, but some of the later isolates had D225G, which parallels the data from the 2009 swine H1N1 isolates.

These RBD changes in recent isolates from Sao Paulo, as well as the presence of D225G in sequences from 1918/1919 raise concerns that the swine H1N1 is adapting to its human host by acquisition of RBD polymorphisms.

The explosion of cases in Ukraine, and delays in the release of sequences from fatal cases in Ukraine is a cause for increasing concern. Recent accelerations of deaths have been widespread across the northern hemisphere, raising concerns that receptor binding domain changes described above, as well as a third polymorphism at position 225, D225E, (see list) are gaining traction as the swine H1N1 adapts to human hosts.

An update on the Mill Hill sequences and deposit of such sequences at a public database such as GISAID, where Mill Hill recently deposited sequences from Europe, would be useful.


I am not a doctor - but it seems to me, someone should question if those dying had recently had the Swine Flu vaccine. But I won't count on that actually happening.