My comments in red....

If it turns out that SIV causes a mild illness (and it may well) we shouldn't be worried at all. But there is so much uncertainty about how it's going to play out. Initially, there were very worrisome similarities to the 1918 flu. As the days go on, it looks less like that flu, but we just don't know yet.

Here's what CDC says: I really think that's all good advice. I'm not planning to do anything different than that, unless people start dying all over the place. Then things will change.

I guess I really wouldn't be any more worried than with the regular flu. I'd approach it the same way; wash hands frequently and stay away from hacking, sneezing, coughing people. I don't think masks are necessary at this point.

Having the flu will protect you from having it again, as long as the strain is the same. Over time, the virus undergoes gradual changes, called antigenic drift. The more drift, the more differences in the proteins, the less your body "remembers" it. As the virus changes, your body has less protection, but some protection is better than nothing and it may mean less severe illness.

In addition to what others have said, there are only a handful of places that can do confirmatory testing, and a limited number of people who know how to do it. Naturally they're overwhelmed.

That's a good question and I don't know the answer. I'm not sure this has ever really been explained.

Usually asymptomatic carriers don't shed much virus, as they're not sneezing, coughing and blowing their noses which are the best ways to spread virus. And I doubt if asymptomatic >51 year olds are going to act much differently than asymptomatic <51 year olds. IOW, if I had to share a glass with an asymptomatic person, I'd rather they were older than younger.

I don't know of any numbers yet, but it's a virtual certainty that it's underreported. The question is to what degree. It's a critical question, because that's how we come up with case fatality rates, attack rates, etc. which help determine how virulent the disease is.

I'm not going to have much time today, but I want to make one quick point about this email... This comment is really inaccurate. We may be at Phase 6, but we've been there before, we'll be there again, and every time there is a pandemic we're in uncharted territory, because they are all different! Technically, yeah, we've never been at Phase 6, because those definitions are new. I don't know when WHO first came up with this paradigm, but it came out of pandemic preparedness planning after H5N1. We've had pandemics in our lifetime (mine, anyway :)). They just didn't have the name of a phase attached to them.

That was based on a letter to the editor of Emerging Infectious Disease. It really wasn't "research" at all, just conjecture. It's an interesting idea, and should be explored further, but there really isn't any evidence for it at this point.

As someone mentioned, the other swine flu thread is long, and I know the board has had problems when threads get too big. I know there were some questions I wanted to respond to, but now I can't find the original posts. Maybe we should continue the thread here. I apologize to anyone whose questions weren't answered; please repost. Old Thread

Have you tried looking him up here? http://www.peoplefinders.com/ http://www.whitepages.com/ If he has any bills in his name, he might show up.

Yes, and there's a post about that very issue at Effect Measure:

As they continue to sequence the genome, they're understanding it better. The first reports were human+pig+avian. That's apparently changed, and now seems to be a reassortant of just 2 pig strains.

That's not accurate. It's a reassortant of two pig strains. There does not appear to be any avian or human components.

*Phew* Low path avian influenza shouldn't be a big problem.

That's a very good question, and I don't know the answer. That was the case in the 1918 flu, and I'm not sure anyone understands why. The 1918 flu actually had a W shape, with elevated rates in the very young, 15-45, and the elderly. There were valleys between those ages. The older valley is well understood, but the younger one, to my knowledge, has never been explained well.

This is old (April 23) but it's going to take me a few minutes to find it. Not only are most (I've heard all, but can't find it right now) deaths in that age group, the very young/old don't even seem to be catching it, or at least aren't getting diagnosed with it. I'll try to find a more recent source.

Well, crap.

It is a respiratory virus, but it doesn't really care how it gets in your oropharynx- droplets through sneezing and coughing work, but so does touching (or eating, of course) a contaminated object then touching your nose/mouth. Flu viruses can survive up to 48 hours on inanimate objects. But the squash probably left Mexico a lot longer than 48 hours ago. Just wash it real well and wash your hands. Washing and cooking would both get rid of any virus that happened to be lurking.

I sure hope you mean swine flu. Avian flu right now would be a little... inconvenient.

One other thing I wanted to mention... If my guesses are right, once things really take off here, (as they almost certainly will, now) we will begin to see US deaths, and in that same age group. Although the case fatality ratio (cfr) may be similar to that of the seasonal flu, the death rate in the 20-50 range will be proportionally much higher than in the seasonal flu. So while I am somewhat reassured, it's not all rosy news. And I could be 100% wrong.

I'm not sure but I'll try to find out.

Viral load refers to how much virus there is floating around in your body. It's true that for most viruses, the higher the exposure the sicker you are likely to get. I'm not sure why viral load would be higher in Mexico though. Again, it's not really the number of deaths in Mexico that is so worrisome, it's the pattern of deaths almost exclusively in young people. If the reason people are dying in Mexico were due to health care, or nutrition, or a cofactor, or some other unknown risk factor, it should be killing older and younger people as well. And it isn't. Here's what I think is happening. First of all, I think infection has probably been going on for quite some time in Mexico. There are numerous reports of people near that pig farm who were sick in February, and probably earlier. Infection is probably widespread and vastly underestimated, many magnitudes higher than what is known. Official reports are something like 1600 cases; I'm betting it's in the 100s of thousands. If there are 150,000 infections, 150 deaths is just about the same case fatality ratio as you would find with seasonal flu. So that is very reassuring. If that had happened in the US, our surveillance system would have picked it up. Mexico doesn't do the kind of surveillance we do here. But it still doesn't address why only younger people are dying. When you see an abrupt age cutoff in mortality it is very likely to have to do with immunologic memory. In an earlier post, I mentioned that each time we have a new pandemic, it replaces the subtype that had been circulating previously. (There is one exception; I'll explain soon.) When H1N1 showed up in 1917-1918, it replaced the H2 virus that had been circulating since 1890. H1N1 then circulated (going through many gradual changes, but all the while remaining an H1) until 1957, when a new H2 suddenly appeared. This circulated until 1968, when H3 appeared and H2 disappeared. In 1977, an H1 virus, very similar to the pre-1957 virus, suddenly appeared. That is the exception- it did NOT replace the H3 that showed up in 1968, but both H1 and H3 have been co-circulating ever since. (H1 has changed quite a bit since then and doesn't much resemble the pre-1977 or pre-1957 virus anymore.) Anyway, if this current swine H1 is similar to the pre-1957 H1, people born before 1957 might have enough immunity to protect themselves from getting extremely ill. That's exactly what was seen in 1918; those born prior to 1890 had immunologic "memory". As an aside, many people believe that the virus that emerged in 1977 was a laboratory accident or deliberately released, because it was almost identical to the pre-1957 virus. That almost certainly could not have happened naturally. (I hope you don't mind that I'm writing this under your post. I'm too tired to go back and look which post I should put this under.)