Bad guts

Returned home from the Arsenal game on Sunday by way of a crappy bar in Peterborough (Bogarts has been closed due to allowing underage drinking). Met with some locals and decided it's about time I got to know the denizens of this city. And they were horrible. I tried to like them but the group I met were insincere, obnoxious and spoiling for a fight. And that was just the girls. Pugnacious and vituperative. They also liked to appropriate personal belongings. It was like being back at school and running in to the bullies. This is what happened to them. Their moment of triumphant success was in the playground and they want to prolong it.

I have a stomach ache - irritable bowel I guess you'd say. Took the time off work just as the swineflu thing was appearing. I have done loads of work on preparednes for bird flu and it all applies. I feel like I ought to be there in order to busybody around with bird flu but in fact as an advisor I am only one or two steps ahead of them and in my absence they have taken all the right decisions. Maybe I'm not really needed although I suspect it would reassure them to know I'd had some involvement.

One aspect of the Mexican outbreak that hasn't really been revealed is the age and prior state of health of the fatalities. Flu is survivable with prompt medical care, as is secondary pneumonia. But in an overcrowded smoggy place like Mexico City would flu have a higher rate of attrition than in San Diego? I suspect so, especially amongst the elderly, the poor and neonatals. We should still have only a watching brief rather than a reactionary response at this stage I think. At the moment the WHO are discussing changing the alert status to 5. That would be to say that the virus has reached pandemic potential status and would trigger antiviral production. If they do that we could have just as many fatalities from seasonal flu amongst those who would normaly be vaccinated in the approaching season. They will be elderly and infirm and children. Big decision. Most of the recent typed patients with swine flu in the US and Canada and now the UK have pretty mild symptoms. Testing positive for A(H1N1) doesn't mean you are going to die. The important thing is to quarantine those who test positive (for one thing to prevent further mutation possibilities interacting in a host with another virus).

It's safe to eat pork as well.

It emerges now through the WHO press conference that Mexican victims were apparently healthy young adults and that the similar virus was cropping up in different locations. This doesn't explain why they have a large number of fatalities in Mexico and none abroad. But it does bear the hallmarks of early stage pandemic in that, like 1918, it isn't just attritional amongst those who would not have a high probability of surviving an acute febrile infection. I think the next trigger point will be a fatality in another country.