Daniel in The Lion's Den

938: Swine Flu V – Latest Developments: The Umrah, Israel, and Africa / New Deadly Pathogens: West Nile virus, Lyme disease, Legionnaires disease, the cyclospora parasite…

H1N1 Swine-Flu kept many Moslem pilgrims at home‏

IRIN-News 26^th August 2009

Far fewer Moslems than normal undertook the lesser pilgrimage known as Umrah because of co-ordinated efforts by health ministers in the Gulf and beyond to control the spread of H1N1 Swine-Flu, about 30% less than normal levels, and a variety of precautions were in place. The WHO expressed concern that there might be a second wave of the virus because of the approaching cooler season.

The resort-city of Eilat in Israel reported the first known death of a man from H1N1 Swine-Flu in July. According to officials, Israel had more than 1,500 documented cases – known.

Swine-Flu was expected to increase with the end of the public-school holidays on 20^th July as all respiratory infections go down during school holidays and go up again when schools begin, because children were reservoirs for viruses.

Pandemic H1N1 Swine-Flu 2009 in Africa:

As at 16^th November 2009, 29 countries have officially reported 15,072 laboratory confirmed cases of pandemic H1N1 Swine-Flu 2009 and 103 deaths. The breakdown of confirmed cases and deaths by country is given in the table below. Kindly note that the following are known countries and reported cases only. There could be others… Cases / Deaths

Algeria 78-0 / Angola 13-0 / Botswana 23-0 / Burundi 11-0 / Cameroon 4-0 / Cape Verde 62-0 / Congo 8-0 / Cote d'Ivoire 3-0 / Democratic Republic of Congo13-0 / Ethiopia 6-0 / Gabon 1-0 / Ghana 18-0 / Kenya 417-0 / Lesotho 54-0 / Madagascar 169-0 / Malawi 4-0 / Mauritius 69-8 / Mozambique 101-2 / Namibia 71-1 / Nigeria 1-0 / Rwanda 374-0 / Sao Tome & Principe 41-0 / Seychelles 33-0 / South Africa 12,619-91 / Swaziland 2-0 / Tanzania 561-1 / Uganda 224-0 / Zambia 80-0 / Zimbabwe 12-0 Total: 15,072-103

Gleaned from various sources…

The West Nile virus is a member of the family-Flaviviridae, part of the Japanese encephalitis antigenic complex of viruses; it is found in both tropical and temperate regions. It mainly infects birds, but is known to infect humans, horses, dogs, cats, bats, chipmunks, skunks, squirrels, and domestic rabbits. The main route of human infection is through mosquito bites.

Lyme disease, or borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu lato is the main cause of Lyme disease in the US, whereas Borrelia afzelii and Borrelia garinii cause most European cases. The disease is named after the village of Lyme, Connecticut, where a number of cases were identified in 1975; it is the most common tick-borne disease in the Northern Hemisphere. Although it was realised in 1978 that Lyme disease was tick-borne, the cause of the disease remained a mystery until 1982, when Borrelia burgdorferi was identified. It is transmitted to humans by the bite of infected ticks belonging to a few species of the genus-Ixodes.

Legionellosis is an infectious disease caused by gram negative, aerobic bacteria belonging to the genus-Legionella. Over 90% of legionellosis cases are caused by Legionella pneumophila, a ubiquitous aquatic organism that thrives in temperatures between 25 and 45 ° C, with an optimum around 35 ° C. Legionellosis takes two distinct forms: Legionnaires' disease, also known as Legion Fever (archaic), is the more severe form of the infection and produces pneumonia. Pontiac fever is caused by the same bacterium, but produces a milder respiratory illness without pneumonia which resembles acute influenza.

Legionnaires' disease got its name when an outbreak of pneumonia occurred among people attending a convention of the American Legion in Philadelphia in July 1976. The causative agent was identified in January1977 as a previously unknown bacterium.

An estimated 8,000 to 18,000 people get legionellosis in the USA each year. Some people can be infected with the Legionella bacterium and have only mild symptoms or no illness at all.

Outbreaks of Legionnaires' disease receive significant media attention. However, the disease usually occurs as single, isolated cases not associated with any recognised outbreak. When outbreaks do occur, they are usually in the summer and early autumn, though cases may occur at any time of year. The fatality rate of Legionnaires' disease has ranged from 5% to 30% during various outbreaks.

Cyclospora is a parasite that is composed of one cell. It is too small to be seen without a microscope. Its full name is Cyclospora cayetanensis. Outbreaks of illness in the USA causing infectious watery diarrhea, nausea, and vomiting have been found to be related to Cyclospora.

The Cyclospora parasite is transmitted to persons who contact objects contaminated with infected stool. Reports of outbreaks of Cyclospora infections in 1977 were preliminarily associated with the consumption of fresh fruits such as strawberries and raspberries.

In the past, people who travelled in developing countries were more likely to get cyclospora infections. These days, the infection is found worldwide

937: Swine Flu V – Latest Developments: The Middle-East, Asia, Europe, Western Pacific, the Americas / New Deadly Pathogens: Marburg, monkey-pox, BSE: mad-cow disease

IRIN-News 18^th November 2009

According to the 14^th November WHO up-date, more people have died from H1N1 Swine-Flu in Iran than in any of the 22 countries in the Eastern Mediterranean Region. With 33 deaths to date, Iran made up about 17% of the 188 total known and recorded deaths in the region since May 2009. Saudi Arabia had 28 deaths, with Oman 25. Syria had the highest rate by far of deaths, with 9.5% of all cases being fatalities; followed by Yemen 2.5%, Afghanistan 1.7%, and Iran 1.5%

Kuwait had the highest number of cases with 23% of all 28,751 known and recorded cases in the region, followed by Saudi Arabia; Oman; and Egypt. Kuwait also had the highest number of cases per capita with 2.46 cases per 1,000 in the population, followed by Oman with 1.12 cases per 1,000 and Bahrain with 1.10 cases per 1,000.

Since the WHO last regional H1N1 Swine-Flu update on 7^th November, Egypt had the highest number of new cases, 850, followed by Iraq 561, Iran 515, and Oman 500. Somalia reported its first two cases in the beginning of November – only known and recorded cases.

By 8^th November, the WHO had reported over 503,536 global cases of H1N1 Swine-Flu with at least 6,260 deaths. However, it noted that because countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number

The WHO segmented the world into six regions: Africa, the least affected region, had 2.9% of the global total of H1N1 Swine-Flu cases; the Eastern Mediterranean Region 5.1%; Southeast Asia 8.8%; Europe 15.5%; Western Pacific 29.8%, and the Americas 37.9%.

Pandemic H1N1 in the Eastern Mediterranean Region 14^th November Cases / Deaths

Afghanistan 779 14 / Bahrain 793-6 / Egypt 2,494-7 / Islamic Republic of Iran 2,153-33 / Iraq 1,835-9 / Jordan 2,380-4 / Kuwait 6,640-17 / Lebanon 761-2 / Libyan Arab Jamahiriya 21-0 / Morocco 824-0 / Oman 3,829-25 / Pakistan 6-1 / Palestine 901-1 Qatar 23-1 / Saudi Arabia 4,119-28 / Sudan 21-0 / Syrian Arab Republic 230-22 / Tunisia 141-0 / United Arab Emirates 79-0 / Yemen 711-18…Total: 28,751-188 – known countries and recorded cases only

Gleaned from various sources…

Reports in green (checked and edited) / highlights in red / extra highlights and comments in brown / dangerous in orange / highly dangerous in pink / good and true in blue / and my comments in black. Kindly note that whenever Orange and Pink indicate Horse-shit and Horse-fart respectively, you will be told…

The Marburg virus is the common name for the genus Marburg-virus, which contains one species: the Lake Victoria Marburg-virus. The virus causes Marburg Haemorrhagic Fever or Marburg Virus Disease. It originated in Central and East Africa, and infects both human and non-human primates. The Marburg Virus is in the same taxonomic family as Ebola, and both are identical structurally although they elicit different antibodies.

Taxonomy: the science of classifying plants, animals, and microorganisms into increasingly broader categories based on shared genetic features.

Monkey-pox is an exotic, rare infectious disease caused by the monkey-pox virus. The disease was first identified in 1958 in laboratory monkeys – thus providing it with its name – but in its natural state it seems to infect rodents more than primates. The disease is most prevalent in Central and West Africa, but an outbreak occurred in the United States in 2003.

Human monkey-pox is a zoonotic viral disease – passed from animals to humans – that occurs primarily in remote villages of Central and West Africa in proximity to tropical rainforests where there is more frequent contact with infected animals; monkey-pox is usually transmitted to humans from rodents, pets, and primates through contact with the animal's blood or through bites. Monkey-pox can be difficult to distinguish clinically from small-pox, to which it is closely related, and chicken-pox, to which it is not. Blood-tests of animals in Africa later found that other types of animals probably had monkey-pox. Scientists also recovered the virus that causes monkey-pox from an African squirrel which might be the common host for the disease. Rats, mice, and rabbits can get monkey-pox, too. Monkey-pox was reported in humans for the first time in 1970.

BSE, or Bovine Spongiform Encephalopathy, commonly known as mad-cow disease, MCD, is a fatal, neurodegenerative disease in cattle that causes a spongy degeneration in the brain and spinal cord. BSE is a relatively new disease of cattle. It was first recognised and defined in the United Kingdom in November 1986. Over the next few years, the epidemic grew considerably and affected all parts of the country, but to different degrees. It reached its peak in 1992. It has a 4-year incubation period, usually affecting adult cattle at a peak age onset of four to five years – all breeds and genders being equally susceptible. In the UK, the country worst affected, more than 179,000 cattle were infected and 4.4 million slaughtered during the eradication programme.

Most scientists believe that the disease may be transmitted to humans who eat the brains or spinal-cords of infected cattle-carcasses. It is known as a new variant of Creutzfeldt-Jakob disease in humans, and by October 2009, it had killed 165 people in Britain, and 44 elsewhere, with the number expected to rise because of the long incubation period of the disease. Between 460,000 and 482,000 BSE-infected animals had entered the human food-chain before controls on high-risk offal were introduced in 1989.

A British inquiry concluded that the BSE epidemic was caused by cattle, who are normally herbivores, being fed the remains of other cattle in the form of meat and bone meal (MBM), which caused the infectious agent to spread. The origin of the disease itself remains unknown. The infectious virus is distinctive for the high temperatures at which it remains viable; this contributed to the spread of the disease in Britain, which had reduced the temperatures used during its rendering process. Another contributory factor was the feeding of infected protein supplements to very young calves.

Creutzfeldt–Jakob Disease, sometimes incorrectly referred to as mad-cow disease, is a rare degenerative neurological disorder, or brain disease, that is incurable and invariably fatal. It is the most common among the types of transmissible spongiform encephalopathy found in humans. It affects about one in every one million people per year worldwide; in the USA, there are about 200 cases a year. It usually appears in later life and runs a rapid course. Typically, onset of symptoms occurs at about age 60, and about 90% of patients die within 1 year. In the early stages of the disease, patients may have failing memory, behavioral changes, lack of co-ordination and visual disturbances. As the illness progresses, mental deterioration becomes more pronounced and involuntary movements, blindness, weakness of extremities, and coma may occur.

For SARS: severe respiratory syndrome, read: 932

936: Swine Flu V – Latest Developments / New Deadly Pathogens: The Hanta virus / Evolution in Motion

WHO confirms first cases of H1N1 – Swine-Flu‏ – IRIN-News 2009

On 11^th June 2009, the WHO signalled that a pandemic of 2009-H1N1 Swine-Flu was under way. On 9^th November, the WHO issued a statement saying Somalia was the last country in the Eastern Mediterranean region to report confirmed cases of H1N1 Swine-Flu.

16^th November 2009: The WHO (Horse-shit) reported that the first cases of pandemic H1N1-2009 Swine-Flu had been confirmed in Somalia.

2009-H1N1 Swine-Flu was first detected among humans in Mexico and the USA, from where it spread around the world in a matter of days – in much the same way as regular seasonal flu.

WHO official supports H1N1 emergency measures‏ – IRIN-News 3^rd November 2009

A UN-WHO official backed the Afghan government's health emergency declaration which involved a three-week closure of all schools and universities in Afghanistan as a means of preventing the spread of H1N1 Swine-Flu, calling it an appropriate and timely measure to curb its spread. According to the Ministry of Education, there are over 9 million children and students at schools, colleges, and universities in the country; all of which would be required to stay at home from 2^nd to 23^rd November. Afghanistan had reported over 320 H1N1 Swine-Flu cases with two deaths as at 3^rd November.

Officials urge calm at schools amid Swine-Flu hysteria – The Daily Star October 2009

Alarm spread among Lebanese over fears of a large-scale swine-flu outbreak in schools after the country’s first A-H1N1 death, a 30-year-old woman who had been 8 months pregnant, but officials said there was no need to panic. People panicked extensively, and most focused on schools, although the risk of catching the virus anywhere else was just as high…

Five more cases of Swine-Flu in Lebanon – The Daily Star 10^th June 2009

Lebanon's Health Ministry announced that five people had been diagnosed with the deadly A-H1N1 virus, or Swine-Flu, bringing the total number of confirmed infections in the country to eight known or reported cases, and that all the diagnosed cases had been isolated and treated.

Dear readers and fellow-Apes. A brief detour is absolutely necessary for you to understand the seriousness of the situation; so kindly bear with me…Gleaned from various sources…

The WHO is currently monitoring not fewer than 40 infectious and highly dangerous diseases that have been around for only a few decades: the hanta-virus, Marburg, monkey-pox, BSE or mad-cow disease, SARS: severe respiratory syndrome, Lyme disease, the West Nile virus, Legionnaires disease, encephalitis, thalasaemia, the cyclospora parasite…

Hanta-viruses belong to the Bunyaviridae family of viruses which is divided into 5 genera: Orthobunyavirus, Nairovirus, Phlebovirus, Tospovirus, and Hantavirus. Like all members of the B-family, hanta-viruses have genomes comprised of three negative-sense single-stranded RNA-segments, and are therefore classified as negative-sense RNA-viruses. Viruses in the genus Hanta-virus are unique in that they are transmitted by aerosolized rodent excreta or bites, whereas all other genera in the Bunyaviridae family are arthropod-borne viruses.

Aerosolized: converted into a fine spray or small particles

Arthropods: invertebrate animals that have jointed limbs, segmented bodies, and exoskeletons made of chitin: insects (mosquitoes), arachnids, centipedes, crustaceans. Phylum: Arthropoda

The name, Hanta-virus, was derived from the Hantan River, where the Hantan virus, the etiologic agent – cause or origin – of Korean hemorrhagic fever was first isolated. The disease caused by the Hantan virus is called hemorrhagic fever with renal syndrome or HFRS, a term that is accepted by the WHO. It was formerly called Korean hemorrhagic fever – a term that is no longer in use.

The hanta-viruses constitute a relatively newly discovered genus of viruses; the disease entity HFRS was first recognized by a Korean doctor who worked for the West during the Korean War in the early 1950s. In 1993, a newly-recognised species of hanta-virus was found to be behind the Hanta-virus cardiopulmonary syndrome, HCPS, also called HPS, caused by the Sin Nombre virus, Spanish for nameless virus, in New Mexico and other Four-Corner states. In addition to the Hanta-virus and the Sin Nombre virus, several other hanta-viruses have been implicated as etiologic agents for either HFRS or HCPS.

Regions especially affected by HFRS include China, the Korean Peninsula, Russia (Hanta, Puumala, and Seoul viruses), and northern and western Europe (Puumala and Dobrava viruses). Regions with the highest incidences of HCPS include Patagonian Argentina, Chile, Brazil, the US, Canada, and Panama, where a milder form of disease that spares the heart has been recognised. The two agents of HCPS in South America are the Andes virus – also called Oran, Castelo de Sonhos, Lechiguanas, Juquitiba, Araraquara, and Bermejo viruses, among many other synonyms – which is the only hanta-virus that has shown an interpersonal form of transmission, and the Laguna Negra virus, a close relative of the Rio Mamore virus. In the US, minor cases of HCPS include the New York virus, the Bayou virus, and possibly the Black Creek Canal virus.

As at July 2007, six states had reported 30 or more cases of Hanta-virus since 1993 – New Mexico 69, Colorado 49, Arizona 46, California 43, Texas 33, and Washington 31. Other states that reported a significant number of cases include Montana 25, Idaho 19, and Utah 24. Compared to other states, Oregon has a notably lower overall rate relative to population – with only 7 cases.

Hanta-virus pulmonary syndrome or HPS is a deadly disease transmitted by infected rodents through urine, droppings, or saliva. Humans can contract the disease when they breathe in aerosolized virus. HPS was first recognised in 1993 and has since been identified throughout the USA. Although rare, HPS is potentially deadly. Rodent-control in and around the home remains the primary strategy for preventing hanta-virus infection.

935: Swine Flu IV – New Deadly Pathogens Sprouting: The Ebola virus / The Nipah virus / The Hendra virus

Gleaned from various sources…

Ebola is a viral-genus that causes the Ebola haemorrhagic fever – EHF. There are four recognised speci es within the Ebola-virus genus, which have a number of specific strains.The Zaire-virus is the type-species, which is also the first discovered and the most lethal. Electron-micrographs show long filaments, characteristic of the Filoviridae viral family.

Google-Wikipedia

Filoviridae: the family of viruses belonging to the order Mononegavirales. Filoviruses are single-stranded negative-sense RNA-viruses that target primates. There are two genera: the Ebola and Marburg viruses. These viruses cause viral haemorrhagic fevers, characterized by bleeding and coagulation abnormalities, often leading to death. The name is derived from the Latin word: filum, alluding to the thread-like form of virus particles that appear in electron microscope images

The Mononegavirales are an order of viruses comprising species that have a non-segmented, negative sense RNA-genome. The order includes four families:

Bornaviridae: Borna disease virus; Rhabdoviridae: Rabies virus; Filoviridae: Ebola-Marburg virus; and Paramyxoviridae: Newcastle-disease virus and measles virus

Primates: humans, gorillas, chimpanzees, bonobos, rare black arboreal chimpanzees, native to West Africa, south of the Congo River, orangutans, and monkeys, as well as the somewhat less familiar lemurs, lorises, galagos, pottos, sifakas, indris, aye-ayes, and tarsiers, but humans, however, place themselves and their close relatives, chimpanzees, gorillas, and orangutans in the family-Hominidae or hominids, also known as great apes

The virus interferes with the endothelial cells lining the interior surface of blood vessels and coagulation. As the blood vessel walls become damaged and the platelets are unable to coagulate, patients succumb to hypovolemic shock. Ebola is transmitted through bodily fluids. Skin and conjunctiva exposure may also lead to transmission, but to a lesser extent. Ebola first emerged in 1976 in Zaire. It, however, remained largely obscure until 1989, with a widely publicized outbreak in Reston, Virginia, USA.

Centre for Disease Control Special Pathogens Branch: Ebola haemorrhagic fever is a severe, often-fatal disease in humans and non-human primates that has appeared sporadically since its initial recognition in 1976.

The disease is caused by infection with the Ebola virus, named after a river in the Democratic Republic of the Congo formerly Zaire in Africa, where it was first recognised. It is one of two members of a family of RNA-viruses called Filoviridae. There are five identified subtypes of the Ebola virus. Four of the five have caused disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The 5^th, Ebola-Reston, has caused disease in non-human primates, but not in humans.

The Nipah virus is an emerging zoonotic virus – a virus transmitted from animals to jumans. In infected people, the virus causes severe illness characterized by inflammation of the brain – encephalitis – or respiratory diseases, and also causes severe diseases in animals such as pigs, resulting in significant economic losses for farmers. It is closely related to the Hendra virus; both are members of the genus Henipavirus, a new class of virus in the Paramyxoviridae family. Although the Nipah virus has caused only a few outbreaks, it infects a wide range of animals and causes severe illness that result in death in people, making it a public health concern. It was first discovered in 1999 during an outbreak among pig-farmers in Malaysia. Since then, there have been 12 outbreaks, all in South Asia. During the initial outbreaks in Malaysia and Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via respiratory droplets, contact with throat or nasal secretions from the pigs, or contact with tissues of sick pigs. In the Bangladesh and India outbreaks, consumption of fruits or fruit-products: raw date-palm juice contaminated with urine or saliva from infected fruit-bats was the most likely source.

During the later outbreaks in Bangladesh and India, the virus spread directly from human-to-human through close contact with secretions and excretions. In Siliguri, India, transmission of the virus was reported within a health-care setting, where 75% of cases occurred among hospital staff or visitors. The virus causes a severe illness characterized by inflammation of the brain – encephalitis – or respiratory diseases; it can be transmitted from animals to humans and directly from humans to humans. In Bangladesh, half the reported cases between 2001 and 2008 were due to human-to-human transmission. It can cause severe diseases in domestic animals such as pigs. There is no treatment or vaccine available for either people or animals; fruit-bats of the family-Pteropodidae are the natural hosts of the Nipah virus.

The Nipah virus – a member of the family-Paramyxoviridae – is related but not identical to the Hendra virus. It was initially isolated in 1999 upon examination of samples from an outbreak of encephalitis and respiratory illness among adult men in Malaysia and Singapore. Its name originated from Sungai Nipah, a village on the Malaysian Peninsula where pig-farmers became ill with encephalitis.

The Hendra virus, formerly called equine morbillivirus, is a member of the Paramyxoviridae family. It was first isolated in 1994 from specimens obtained during an outbreak of respiratory and neurologic disease in horses and humans in Hendra, a suburb of Brisbane, Australia. The natural reservoir for the Hendra virus is thought to be flying-foxes, bats of the genus-Pteropus, found in Australia. Although still under investigation, preliminary data suggest that bats of the genus-Pteropus are also the reservoirs for the Nipah virus in Malaysia.

The Hendra virus caused diseases in horses in Australia, and the human infections there were due to direct exposure to the body fluids, tissues, and excretions from infected horses. The Nipah virus caused relatively mild diseases in pigs in Malaysia and Singapore. It was transmitted to humans, cats, and dogs through close contact with infected pigs – Well, mild yesterday, wild today; or mild today, wild tomorrow…Etc, and so forth and so on

934: Swine Flu III – New Deadly Pathogens: HIV-AIDS / Dengue haemorrhagic fever / Lassa fever

New deadly pathogens sprouting, old ones re-emerging, more virulent, resistant, and resilient; it’s Evolution in Motion…

Dear readers and fellow-Apes. A brief detour is absolutely necessary for you to understand the seriousness of the situation, so kindly bear with me…Gleaned from various sources…

An associate-professor of medicine in the section on infectious diseases at the Wake-Forest University School of Medicine in Winston-Salem, North Carolina, stated that their concern was that the swine-flu virus was going to be with us, all over the world, for quite a while, and that it could change – evolve – and become more virulent, more resistant, and more resilient, with a highly increased secondary-transmission rate.

Also, the spread of swine-flu isn’t the only disease-problem that health officials all over the world are concerned with. Let us consider the scope of the threats, look at some of the underlying causes, see how the situations have developed, and imagine where things could go from here, and how worse they could become…

The WHO is currently monitoring not fewer than 40 infectious and highly dangerous diseases that have been around for only a few decades: HIV/AIDS, Ebola, dengue haemorrhagic fever, Lassa fever, Nipah, Hendra, the hanta-virus, Marburg, monkey-pox, BSE or mad-cow disease, SARS: severe respiratory syndrome, the West Nile virus, Lyme disease, Legionnaires disease, encephalitis, thalasaemia, the cyclospora parasite…

HIV/AIDS will be the subject of another series of reports…revised and coming out soon…

Dengue haemorrhagic fever – DHF – is a severe, potentially deadly infection spread by certain species of mosquitoes: Aedes aegypti. Four different dengue-viruses are known to cause DHF, which occurs when a person catches a different type of dengue-virus after being infected by a different one previously. Prior immunity to a different dengue-virus type plays an important role in this severe disease. Worldwide, more than 100 million cases of dengue-fever occur every year. Not a few of these develop into DHF. Most infections in the USA are brought in from other countries by a traveller who has returned to the USA. Risk-factors for DHF include having antibodies to the dengue-virus from prior infections, being younger than 12, a female, or a Caucasian.

YEMEN: Dengue cases on the rise in Taiz city‏ – IRIN-News October 2009

SANAA: According to health officials, hundreds of people in Taiz City, 250km south of the Yemeni capital, had dengue-fever and local hospitals were admitting new cases daily. The National Malaria Control Programme (NMCP) in Taiz told IRIN-News that since the new outbreak in September, at least 350 cases had been confirmed and a further 1,000 cases were suspected. The NMCP said that the number of infections had increased due to the widespread use of uncovered water tanks, particularly in the city's slums, and swamps and open sewers contributed much to the reproduction of the vector, known as the Aedes aegypti mosquito that transmits the fever. A professor at the Taiz University Faculty of Medicine added that many cases went undiagnosed or misdiagnosed and were not properly treated as most of those infected did not go to hospital for screening; and that the number of dengue-infected cases could be many times more than those registered by the NMCP, as symptoms could be difficult to detect.

The SUDAN: Rains, poor roads hamper mystery disease response‏ – IRIN-News October 2009

JUBA: According to officials, efforts to identify a haemorrhagic-disease that had killed four people in a remote corner of Southern Sudan were thwarted by bad roads made impassable by heavy rainfall. The deaths took place in Kitkit, a military outpost in Western Bahr al-Ghazal state. The state's director-general of health had written to Southern Sudan's health-ministry in Juba in September to report the deaths, and that six soldiers had complained of nose-bleeds and vomiting blood.

Lassa fever is an acute haemorrhagic fever first described in 1969 in the town of Lassa, in Borno State, Nigeria, located in the Yedseram River valley at the southern end of Lake Chad. Clinical cases of the disease had been known for over a decade earlier but not connected with this viral pathogen. The disease is endemic in West African countries, and causes 300-500,000 cases annually with approximately 5,000 deaths. Outbreaks of the disease have been observed in Nigeria, Liberia, Sierra Leone, Guinea, and the Central African Republic, but it is believed that human infections also exist in the Democratic Republic of the Congo, Mali, and Senegal. Its primary animal host is the Natal Multi-mammate Mouse (Mastomys natalensis), an animal indigenous to most of Sub-Saharan Africa. Although the rodents are also a source of protein for peoples of these areas, the virus is probably transmitted by the contact with the faeces and urine of animals accessing grain-stores in residences. Lassa fever is known to be endemic in Guinea, Liberia, Sierra Leone, and parts of Nigeria, but probably exists in other West African countries as well.

Msn-Encarta-Dictionary

Mammate: the milk-secreting organ of female mammals – a woman's breast or a cow's udder. It includes the mammary gland and associated exterior structures such as the nipple or teat.

Endemic: describes a disease that occurs and spreads within a particular country or area

933: Swine-Flu Again II – When it began / pandemic looming / countries affected / lull before the storm

Gleaned from various sources…

Reports in green / highlights in red / extra highlights and comments in brown / dangerous in orange / highly dangerous in pink / good and true in blue / and my comments in black. Kindly note that whenever Orange and Pink indicate Horse-shit and Horse-fart respectively, you will be told…Before you begin, kindly read the previous Swine-Flu Postings: 793 / 794 / 795 / 796 / 797 / 798

April 2009: The first swine-flu cases were detected in Mexico and the USA and health officials around the world went on high alert. Protective measures were taken and surveillance systems were put in place, and pharmaceutical companies (Horse-shits) stepped up production of anti-viral drugs – rubbing their palms together at the prospect of highly increased sales. In cities where swine-flu cases had been confirmed, schools were closed, large public gatherings like sports events and concerts were cancelled, and malls, restaurants and other public places were empty – reminiscent of the SARS and Avian-flu outbreaks in 2003…see: 932

Aided by modern transportation, the virus spread rapidly and on 11^th June, with more than 125,000 confirmed cases and 140 deaths in 73 countries – kindly note that the figures could be twice or more as much – the WHO finally declared the virus a pandemic – a global outbreak – or warned that a global swine-flu pandemic was imminent – the first time in 41 years – as more nations confirmed cases of the deadly disease that had spread around the world in a matter of days.

Although most of the affected were not thought to be in serious danger, the flu's spread from Mexico and the USA to every corner of the globe deepened fears that modern air-travel could spread disease faster than anything in history. Nations from Asia to Europe to the Americas announced new confirmed and suspected cases of the flu, believed to be a new strain of virus that had combined existing varieties of bird, swine, and common human influenza.

On 11^th June 2009, the WHO declared an H1N1-swine-flu pandemic, and raised the warning level to phase-6 on a 1-6 scale, marking the first global pandemic since the 1968 Hong Kong flu, which meant that the threat of a pandemic was imminent, that time was short for nations to put emergency plans into action, and that all countries should activate their pandemic-preparedness plans immediately, and the biggest question at the time was how severe the pandemic might be.

Officials in Mexico, the epicentre of the outbreak, said that 8 people had died but 91 infected people were healthy – Horse-fart! How could they be infected and healthy at the same time? Also, those were the known or reported cases only. They said the suspected death-toll from the disease was 84, about half the previous number – Horse-fart again! If anything, the number had increased by twice at least. Some experts suggested that the virus grew weaker as it spread. The only confirmed swine-flu death outside Mexico was a Mexican toddler – a young child who is just beginning to walk – in the USA. President Barack Obama ruled out closing the border between the two countries as part of the measures to fight the spread of the disease. He said it would be closing the barn-door after the horses have escaped (Horse-fart), more like closing the gates after the enemy has entered the fort, because they already had cases, and that it was a cause for deep concern but not panic.

Mexico shut down several public venues – including popular tourist-sites as well as all bars, restaurants, and gyms in the capital – while major cruise-lines and tour-operators also stopped trips to the country. The government said the ultimate cost to Mexico from the swine-flu crisis could be up to 0.5% of the Gross-Domestic-Product – as much as $70 billion. In addition to the airline and travel sectors, which had already been suffering from the global economic down-turn, pig-farmers in many places were hit hard by the swine-flu crisis.

Since the outbreak, swine-flu quickly made its way around the world, and nations stepped up checks at airports and distributed flu-medicines to try to halt the spread of the disease.

In New Zealand, officials said the number of confirmed or probable cases was 13, all but one of whom were from a high school group that had recently visited Mexico, and that the number of suspected cases was 104 – More Horse-fart! New Zealand's deputy-director of public health said that the symptoms were around the mild end of the spectrum of influenza.

Switzerland became the fifth European country to confirm the virus, with one case in a man who had recently returned from Mexico – Poor Mexico. It had to take all the blame and like it, too. There were also cases in Austria, Britain, Germany, and Spain – all had recently returned from Mexico!? And in South America, Peru reported its first case – someone who had recently returned from Mexico!?

After Israel had announced more suspected cases, neighbouring Egypt ordered the immediate slaughter of all pigs in the country – What a sorry-worry world! Tens of thousands of children died – and are still dying – from starvation every day while thousands of pigs (from swine-flu), cows (from mad-cow disease, and chickens (from avian-flu) were slaughtered.

Many countries banned imports of North American pork, leaving US pig-farmers reeling even though the disease cannot be caught from eating the meat (this is Horse-shit) – an ill-thought-of thought that led US authorities to stop calling it swine-flu.

The Centers for Disease Control said they were calling it the 2009 H1N1 flu. Well, call it what you like and whatever you will; swine-flu is a disease from swine

What the final outcome would be remained to be seen. With the arrival of summer in the northern hemisphere, and warm temperatures that flu-viruses do not like, the spread slowed down considerably. But that could be the lull before the storm. What would happen in the autumn and winter when the traditional flu-seasons began was something else altogether. Flu viruses usually go away in the summer but return in the autumn and, especially, winter…with a vengeance.

The H1N1 virus or swine-flu virus is a sub-type of flu-virus A, and the most common cause of flu in humans. Some strains of H1N1 are endemic in humans and cause a small fraction of all flu-like illness and all seasonal flu. H1N1 caused some percentage in all human-flu infections from 2004-2005. Other strains of H1N1 are endemic in pigs, swine-flu, and in birds, avian-flu.

In June 2009, the WHO declared that a new flu-strain of swine-origin, H1N1, was responsible for the 2009 flu pandemic which the money-mad-moron-monkey-media calls swine flu.

The 1977 to 1978 Russian-flu epidemic was caused by A/USSR/90/77-H1N1. It infected mostly children and young adults because a similar strain had been prevalent from 1947 to 1957, causing most adults to have substantial immunity. It was included in the 1978/79 flu-vaccine.

In the recent 2009 flu-pandemic, the virus isolated from patients in the USA was found to be made up of genetic elements from four different flu-viruses: North American swine-flu, North American avian-flu, human-flu, and Asian and European swine-flu viruses – a mongrel-mix of genetic sequences. The new strain appeared to be the result of a re-assortment of human-flu and swine-flu viruses, in all four different strains of sub-type H1N1.

A worldwide update by the WHO on 11^th October 2009 stated that 74 countries had officially reported over 399,234 laboratory-confirmed cases of the H1N1 swine-flu-pandemic, including 4,735 deaths – Remember; reported cases only. The WHO (Horse-shit) is no different from all the other con-dupe-scam-syndicates. It checks where it wants, examines whom it wants, and declares what is suitable enough for it to continue to survive and thrive

President Barack Obama officially declared H1N1, or swine-flu, a national emergency on 25^th October 2009. A study conducted in co-ordination with the University of Michigan’s Health Service is scheduled for publication in the December 2009 American Journal of Radiology, warning that H1N1-flu can cause pulmonary embolism – a condition in which an artery is blocked by an embolus, usually a blood clot, formed at one place in the circulation and then lodging in another – surmised as a leading cause of death in the pandemic. The study suggests physician evaluation via contrast enhanced CT-scans for the presence of pulmonary emboli when caring for patients diagnosed with respiratory complications from a severe case of H1N1 or swine-flu.

932: Swine Flu Again I – It’s not over yet. In fact, it’s just about to begin – In the beginning was…

Gleaned from: Google and Medscape Today

I’m afraid I must begin with…

SARS, Severe Acute Respiratory Syndrome is a respiratory disease in humans which is caused by the SARS corona-virus SARS-CoV.There has been one near pandemic to date, between the months of November 2002 and July 2003, with 8,096 known infected cases and 774 deaths – a case-fatality rate of 9.6% known or reported cases only – worldwide being listed in the WHO's 21^st April 2004 concluding report.Within a matter of weeks in early 2003, SARS had spread from Guangdong province of China to rapidly infect individuals in some 37 countries around the world. Mortality by age group as of 8^th May 2003 was below 1% for people aged 24 or younger, 6% for those 25 to 44, 15% in those 45 to 64 and more than 50% for those over 65.In comparison, the case-fatality rate for known and reported cases of influenza is usually around 0.6% primarily among the elderly, but can rise to as high as 33% in locally severe epidemics of new strains. The mortality rate of the primary viral pneumonia form is about 70%.

As at May 2006^[update], disregarding a laboratory induced infection case in 2004, the spread of SARS had been fully contained, with the last infected human case seen in June 2003 – That was Horse-shit! However, SARS has not been eradicated, unlike smallpox, as it is still present in its natural host-reservoirs, animal populations, and there is a strong potentiality that it could return into the human population in the future.

Early in 2003, the global infection control community faced a great challenge, sudden SARS. The rapid spread of SARS, its capacity to infect health-care workers, and its many unknown features in the early days of the outbreak meant that health care workers were unsure of the most effective methods of infection control to prevent disease transmission. Those conditions made designing appropriate, effective and standard infection control responses difficult. Innovation was necessary. SARS-related infection control practices observed in three affected countries during the height of the 2003 outbreak were risk assessment, patient segregation, strategies to provide easy access to clinical areas, health-care worker protection, and efforts to promote public confidence. Many of those strategies could be considered for use in the post-2003 SARS era, especially in preparation for an influenza or Avian-flu pandemic…and…

April 2009

A medical source reported that a Chinese woman had died from what might have been SARS, while travelling on a train from the Far-East Russian city of Blagoveshchensk to Moscow.

The train was stopped at the Zuyevka station in central Russia's Kirov Region, and 51 Chinese passengers and two Russian train stewards were sent to a local hospital and quarantined as the cause of the death of the young woman had not yet been established and that all necessary measures had been taken to prevent the spread of possible infection.

NB: A return of SARS after all those years seemed highly unlikely. By forbidding the sale and consumption of civet cats in south China restaurants, the Chinese stopped the 2003 outbreak. Perhaps the unfortunate young woman and her family, who were traveling with her – and who were quarantined – had enjoyed an illicit meal of civet cat before getting on the train.

931: Mosquitoes and Malaria XXI – Quinine: Pregnancy-Complications / Interactions with other Diseases / Derivatives and Non-Medical Usage

Malaria – prevention is better than cure, and cure is better than endure, because the treatments and the drugs are most of the time very bitter, painful, and as dangerous as the disease itself since they often cause very serious side-effects and complications…

Quinine and pregnancy:

In very high doses (higher than those used to treat malaria) during the first trimester of pregnancy, quinine could act as an abortifacient, and/or cause birth defects, especially deafness. In the USA, quinine is classed as a Category X teratogen by the Food and Drug Administration, because it can cause birth defects if taken by a woman during pregnancy. In the UK, the recommendation is that pregnancy is not a contra-indication to quinine therapy for falciparum malaria, which contradicts the US recommendation; although it should be used with caution; the reason for this is that the risks to the pregnancy are small and theoretical, as opposed to the very real risk of death from falciparum malaria.

Abortifacient: describes a drug or device that causes abortion

Teratogen: Greek teratos: monster, and genes: born substance or agent in the external environment that can induce deformities in a fetus or baby in its mother’s womb

Quinine and interactions with other diseases:

Quinine can cause hemolysis – the destruction of red blood-cells and the release of the hemoglobin they contain – but again this risk is small and the physician should not hesitate to use quinine when there is no alternative. Quinine can also cause drug-induced Idiopathic thrombocytopenic purpura – the condition of having a low platelet count – thrombocytopenia – of no known cause – idiopathic. As most causes appear to be related to antibodies against platelets, it is also known as immune thrombocytopenic purpura. Although most cases are asymptomatic – not showing or producing indications of a disease or other medical condition – very low platelet counts can lead to a bleeding diathesis and purpura: Latin purpura, purple; is the appearance of red or purple discolorations on the skin, caused by bleeding underneath the skin. Small spots are called petechiae and large spots are called ecchymoses. This is also common with typhus fever and can be present with meningitis caused by meningococcal meningitis or septicaemia.

Typhus: an infectious disease that causes fever, severe headaches, a rash, and often delirium. It is spread by ticks and fleas carried by rodents and canidae – members of the dog family:

Meningitis: a serious, sometimes fatal, illness in which a viral or bacterial infection inflames the meninges, causing symptoms such as severe headaches, vomiting, stiff neck, and high fever

Meninges: the three membranes that surround and protect the brain and the spinal cord, called the dura mater, the arachnoid mater, and the pia mater

Quinine can cause abnormal heart rhythms and should be avoided if possible in patients with atrial fibrillation, conduction defects, or heart-block. Quinine must not be used in patients with hemoglobinuria, the presence of hemoglobin in the urine that has been freed from red blood cells, myasthenia gravis, an autoimmune disease involving extreme weakness of some muscles, caused by the blocking of the receptors for acetylcholine, the neurotransmitter that causes muscular contraction, or optic neuritis, inflammation of a nerve, accompanied by pain, loss of reflexes, and muscle shrinkage, because it worsens these conditions.

Quinine Derivatives or Non-medical uses of quinine:

Tonic-water; in normal-light and UV; Quinine is a flavour component of tonic-water, bitter lemon, and vermouth. According to tradition, the bitter taste of anti-malarial quinine-tonic led British colonials in India to mix it with gin, thus creating the gin-and-tonic cocktail, which is still popular today in many parts of the world

In some areas in the USA, non-medical use of quinine is regulated by the FDA and, in Germany, quinine is limited to between 83-85 parts per million 83-85 mg/kg, which is 0.5% to 0.25% the concentration used in therapeutic tonic

In France, quinine is an ingredient of an apéritif known as Quinquina

Because of its relatively constant and well-known fluorescence quantum yield, quinine is also used in photochemistry as a common fluorescence standard

Quinine and quinidine are used as the chiral moiety for the ligands used in Sharpless asymmetric dihydroxylation – this is highly technical and complicated. Look up words, if you are interested…or curious

Quinine is often added to street-drugs, cocaine or ketamine, in order to cut the product and make more profit

In Canada, quinine is an ingredient in the carbonated chinotto beverage called Brio

In the UK, the Scottish Company, A.G. Barr's, uses quinine as an ingredient in the carbonated and caffeinated beverage called Irn-Bru

In England, Australia, and New Zealand, quinine is an ingredient in Schweppes and other Indian Tonic-waters, at a concentration of 0.5%

In Uruguay and Argentina, quinine is an ingredient of a Pepsico Inc. Tonic-water drink named Paso de los Toros

In South Africa, quinine is an ingredient of a Clifton Instant-Drink named Chikree that is produced by Tiger Food Brands. Etc, and so forth

930: Mosquitoes and Malaria XX – Quinine: Side-Effects / Conditions and Diseases it could cause

Although highly effective, Quinine is not recommended for prevention – prophylaxis – because of its side-effects and poor tolerance. When used for prophylaxis, the dosage for quinine sulfate is 300–324mg, once daily, beginning one week prior to, and during, travel and continuing for four weeks after returning.

Side effects / Conditons and Diseases:

Therapeutic doses for quinine usually cause cinchonism and, in rare cases, it may even cause death – usually by pulmonary edema. The development of mild cinchonism is not a reason for stopping or interrupting quinine therapy since the risk of death by malaria is higher and the patient should be reassured. Blood-glucose levels and electrolyte concentrations must be monitored when quinine is given by injection; the patient should also be under cardiac monitoring when the first quinine injection is given – and these are precautions that are unavailable in developing countries where malaria is most malicious.

Cinchonism or quinism is a pathological condition in humans caused by an overdose of quinine or its natural source, cinchona bark. Symptoms of mild cinchonism, which may occur from standard therapeutic doses of quinine, include flushed and sweaty skin, ringing of the ears or tinnitus, blurred vision, impaired hearing, confusion, reversible high-frequency hearing loss, headache, abdominal pain, rashes, lichenoid, photosensitivity, vertigo, dizziness, dysphoria, nausea, vomiting, and diarrhea

Pulmonary: relating to or affecting the lungs

Edema: a buildup of excess serous fluid between tissue cells

Serous: relating to, resembling, or producing serum – Look up the meanings of any words that draw your attention and/or interest – Msn-Encarta

Large doses of quinine may lead to severe symptoms of cinchonism: skin rashes, deafness (reversible), somnolence, diminished visual acuity or blindness, anaphylactic shock, and disturbances in cardiac rhythm and death from cardio-toxicity. Quinine overdose can also result in a rare form of hypersensitivity reaction termed black-water fever that results in massive hemolysis, hemoglobinemia, hemoglobinuria, and renal failure. Patients treated with quinine may also suffer from hypoglycemia – the medical condition of having an unusually low level of sugar in the blood – especially when administered intravenously, and hypotension – low blood pressure.

Most symptoms of cinchonism – except in severe cases – are reversible and disappear once the quinine dosage or treatment is withdrawn or ended.

It is much less common when quinine is given by mouth, but oral quinine is not well tolerated – quinine is exceedingly bitter and many patients will vomit after ingesting quinine tablets – other drugs such as Fansidar: sulfadoxine; sulfonamide antibiotic, with pyrimethamine, or Malarone: proguanil with atovaquone, are often used when oral therapy is required. Blood-glucose, electrolyte, and cardiac monitoring are not necessary when quinine is given orally.

Fansidar is an anti-malarial agent, each tablet contains 500mg sulfadoxine and 25mg pyrimethamine…also cornstarch, gelatin, lactose, magnesium stearate, and talc.

Fatalities associated with the administration of Fansidar have occurred due to severe reactions to the drug, including Stevens-Johnson syndrome and Toxic Epidermal Necrolysis. Prophylactic treatments must be stopped at the first appearance of skin-rash, or if a significant reduction in the count of any formed blood-elements is noticed, or upon the occurrence of active bacterial or fungal infections.

Stevens–Johnson syndrome is a life-threatening condition affecting the skin in which cell-death causes the epidermis to separate from the dermis. The syndrome is thought to be a hypersensitivity complex affecting the skin and the mucous membranes. Although the majority of cases are idiopathic, diseases or disorders that have no known cause, the main class of known causes is medications, followed by infections and (rarely) cancers.

Toxic Epidermal Necrolysis, also known as Lyell's syndrome, is a life-threatening dermatological condition that is frequently induced by a reaction to medications.It is characterized by the detachment of the top layer of skin (the epidermis) from the lower layers of the skin (the dermis) all over the body.

Alan Lyell (1917-2007) was a Scottish dermatologist who described Lyell's syndrome.

There is broad agreement in medical literature that TEN can be considered a more severe form of S-J syndrome, and debate whether it falls on a spectrum of disease that includes erythema multiforme, a skin condition of unknown etiology, the branch of medicine that investigates the causes and origins of diseases – possibly mediated by deposition of immune complex in the superficial microvasculature of the skin and oral mucous membrane that usually follows an antecedent infection or drug exposure. It is a common disorder, with peak incidence in the second and third decades of life.

Quinine can cause paralysis if accidentally injected into a nerve. It is extremely toxic in overdose and the advice of a poison-specialist should be sought immediately.

Some studies have related the use of quinine to hearing impairment, which can cause some high-frequency loss, but it has not been conclusively established whether such impairment is temporary or permanent – i.e. reversible, or irreversible.

929: Mosquitoes and Malaria XIX – Quinine: Origin / History / Synthesis / Derivatives / Dosage

Gleaned from various sources…quoted as and when…

Quinine was first brought to Europe by Jesuits and it was used to cure King Louis XIV. The drug inhibits hemozoin bio-crystallization in the plasmodium and facilitates aggregations of cytotoxic hemes. Toxic-free hemes then accumulate in the parasites, leading to their death.

Msn-Encarta

Cytotoxic: describes a drug that prevents cell division or a type of cell in the immune system that destroys other cells

Heme: the deep red, non-protein portion of hemoglobin that contains iron

Quinine was derived from the original Quechua, Inca word for the cinchona tree bark: Quina or Quina-Quina, which roughly means bark of bark. Prior to 1820, the bark was first dried, ground to a fine powder, and then mixed into a liquid, usually wine, which was then drunk.

Large scale use of quinine as a prophylactic began around 1850, although it had been used in un-extracted form by Europeans since at least the early 1600s. Quinine was first used to treat malaria in Rome in 1631. During the 1600s, malaria was endemic to the swamps and marshes surrounding the city of Rome. Over time, malaria was responsible for the deaths of several Popes, many Cardinals, and countless common citizens of Rome. Most of the priests trained in Rome had seen malaria victims and were familiar with the shivering brought on by the cold phase of the disease. In addition to its anti-malarial properties, quinine is an effective muscle relaxant, long used by the Quechua Indians of Peru to halt the shivering in cold temperatures.

A Jesuit apothecary observed the Quechua Indians using the quinine-containing bark of the cinchona tree for that purpose. While its effect in treating malaria and malaria-induced shivering was entirely unrelated to its effect in controlling shivering from cold, it was still the correct medicine for malaria. At the first opportunity, he sent a small quantity to Rome to test in treating malaria. In the years that followed, cinchona bark became one of the most valuable commodities shipped from Peru to Europe.

Msn-Encarta

Apothecary: a historical name for a medical person who formulates, prepares, and dispenses materia medica to physicians, surgeons and patients; and also offers general medical advice and a range of services – a position now served by a pharmacist and performed solely by other specialist practitioners

Quinine also played a significant role in the colonization of Africa by Europeans. As the dawn of modern pharmacology, Quinine was the prime reason why Africa ceased to be known as the white man's grave. It was quinine's efficacy that gave colonists fresh hope and opportunities to swarm into the Gold Coast, now Ghana, Nigeria, and other parts of West Africa.

Synthetic quinine; main article: quinine total synthesis

The Cinchona tree remains the only practical source of quinine. However, under wartime pressure, research towards synthetic-quinine production was undertaken. A formal chemical synthesis was accomplished in 1944 by American chemists R.B. Woodward and W.E. Doering. Since then, several more efficient quinine total syntheses have been achieved, but none of them can compete in effective and economic terms with the isolation of the alkaloid from natural sources.

Quinine is a basic amine – any organic derivative of ammonia formed by the replacement of hydrogen with one or more alkyl (alkaloid) groups – and is therefore always presented as a salt. Various preparations that exist include hydrochloride, dihydrochloride, sulfate, bisulfate and gluconate. This makes quinine dosage very complicated, because each of the salts has a different weight.

The following amounts of each form are equal: Quinine base 100mg = Quinine hydrochloride 122mg; Quinine dihydrochloride 122mg = Quinine sulfate 121mg = Quinine bisulfate 169mg = Quinine gluconate 160mg.

All quinine salts may be given orally or intravenously; quinine gluconate may also be given intramuscularly or rectally. The main problem with the rectal route is that the dose can be expelled before it is completely absorbed, but this can be rectified by giving half-a-dose again.

The intra-venous dose of quinine is 8mg of quinine base every eight hours; the intra-muscular dose is 12.8mg of quinine base twice daily; the par PR dose is 20mg/kg of quinine base twice daily. Treatment should be maintained for seven days.

The preparations available in the UK are quinine sulfate 200mg or 300mg tablets and quinine hydrochloride 300mg/ml for injection. Quinine is not licensed for IM or PR use in the UK. The adult dose in the UK is 600mg of quinine dihydrochloride IV or 600mg of quinine sulfate orally every eight hours.

In the US, quinine sulfate is available as 324mg tablets under the brand name Qualaquin; the adult dose is two tablets every eight hours. There are no licensed inject-able preparations of quinine in the US. Quinidine is used instead.

Daniel in The Lion's Den

938: Swine Flu V – Latest Developments: The Umrah, Israel, and Africa / New Deadly Pathogens: West Nile virus, Lyme disease, Legionnaires disease, the cyclospora parasite…

937: Swine Flu V – Latest Developments: The Middle-East, Asia, Europe, Western Pacific, the Americas / New Deadly Pathogens: Marburg, monkey-pox, BSE: mad-cow disease

IRIN-News 18th November 2009

Since the WHO last regional H1N1 Swine-Flu update on 7th November, Egypt had the highest number of new cases, 850, followed by Iraq 561, Iran 515, and Oman 500. Somalia reported its first two cases in the beginning of November – only known and recorded cases.

By 8th November, the WHO had reported over 503,536 global cases of H1N1 Swine-Flu with at least 6,260 deaths. However, it noted that because countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number

The WHO segmented the world into six regions: Africa, the least affected region, had 2.9% of the global total of H1N1 Swine-Flu cases; the Eastern Mediterranean Region 5.1%; Southeast Asia 8.8%; Europe 15.5%; Western Pacific 29.8%, and the Americas 37.9%.

Gleaned from various sources…

936: Swine Flu V – Latest Developments / New Deadly Pathogens: The Hanta virus / Evolution in Motion

WHO confirms first cases of H1N1 – Swine-Flu‏ – IRIN-News 2009

On 11th June 2009, the WHO signalled that a pandemic of 2009-H1N1 Swine-Flu was under way. On 9th November, the WHO issued a statement saying Somalia was the last country in the Eastern Mediterranean region to report confirmed cases of H1N1 Swine-Flu.

16th November 2009: The WHO (Horse-shit) reported that the first cases of pandemic H1N1-2009 Swine-Flu had been confirmed in Somalia.

2009-H1N1 Swine-Flu was first detected among humans in Mexico and the USA, from where it spread around the world in a matter of days – in much the same way as regular seasonal flu.

WHO official supports H1N1 emergency measures‏ – IRIN-News 3rd November 2009

Officials urge calm at schools amid Swine-Flu hysteria – The Daily Star October 2009

Five more cases of Swine-Flu in Lebanon – The Daily Star 10th June 2009

Lebanon's Health Ministry announced that five people had been diagnosed with the deadly A-H1N1 virus, or Swine-Flu, bringing the total number of confirmed infections in the country to eight known or reported cases, and that all the diagnosed cases had been isolated and treated.

Dear readers and fellow-Apes. A brief detour is absolutely necessary for you to understand the seriousness of the situation; so kindly bear with me…Gleaned from various sources…

935: Swine Flu IV – New Deadly Pathogens Sprouting: The Ebola virus / The Nipah virus / The Hendra virus

Gleaned from various sources…

934: Swine Flu III – New Deadly Pathogens: HIV-AIDS / Dengue haemorrhagic fever / Lassa fever

Dear readers and fellow-Apes. A brief detour is absolutely necessary for you to understand the seriousness of the situation, so kindly bear with me…Gleaned from various sources…

933: Swine-Flu Again II – When it began / pandemic looming / countries affected / lull before the storm

Gleaned from various sources…

932: Swine Flu Again I – It’s not over yet. In fact, it’s just about to begin – In the beginning was…

April 2009

931: Mosquitoes and Malaria XXI – Quinine: Pregnancy-Complications / Interactions with other Diseases / Derivatives and Non-Medical Usage

Quinine and pregnancy:

Teratogen: Greek teratos: monster, and genes: born substance or agent in the external environment that can induce deformities in a fetus or baby in its mother’s womb

Quinine and interactions with other diseases:

Quinine Derivatives or Non-medical uses of quinine:

930: Mosquitoes and Malaria XX – Quinine: Side-Effects / Conditions and Diseases it could cause

Side effects / Conditons and Diseases:

929: Mosquitoes and Malaria XIX – Quinine: Origin / History / Synthesis / Derivatives / Dosage

Synthetic quinine; main article: quinine total synthesis

IRIN-News 18^th November 2009

Since the WHO last regional H1N1 Swine-Flu update on 7^th November, Egypt had the highest number of new cases, 850, followed by Iraq 561, Iran 515, and Oman 500. Somalia reported its first two cases in the beginning of November – only known and recorded cases.

By 8^th November, the WHO had reported over 503,536 global cases of H1N1 Swine-Flu with at least 6,260 deaths. However, it noted that because countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number

On 11^th June 2009, the WHO signalled that a pandemic of 2009-H1N1 Swine-Flu was under way. On 9^th November, the WHO issued a statement saying Somalia was the last country in the Eastern Mediterranean region to report confirmed cases of H1N1 Swine-Flu.

16^th November 2009: The WHO (Horse-shit) reported that the first cases of pandemic H1N1-2009 Swine-Flu had been confirmed in Somalia.

WHO official supports H1N1 emergency measures‏ – IRIN-News 3^rd November 2009

Five more cases of Swine-Flu in Lebanon – The Daily Star 10^th June 2009