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Pastimes : SARS - what next? -- Ignore unavailable to you. Want to Upgrade?

To: Icebrg who wrote (614)	6/28/2003 9:15:19 PM
From: Henry Niman	Respond to of 1070

I'm not sure how temperature related it is. When its flu season I think that the virus is present in warmer and colder areas. Here is a chart for the entire US for influenza. I'm sure that WHO could look at it an declare the US "influenza free", but few would predict that there would be no flu or milder flu in the next 12 months. The CDC doesn't even publish reports between May 10 and Oct 5 cdc.gov Check out the flu graph for 2002/2003 (and there ir a flu vaccine) cdc.gov

To: Icebrg who wrote (614)	6/28/2003 10:21:24 PM
From: Henry Niman	Respond to of 1070

>>one would suspect that the spread of the virus in that location should not be so much affected by seasonal factors, as they don't appear to have much of a variation in their weather. << The link for influenza in the US not only had a chart of cases (which had a sharp peak in February), but it also had a map of US cases for the week ending May 10. There was a slight difference between northern and southern states, but by May the flu season was pretty much over. States as far north as ME or OR had no cases, while states as far south as FL or AZ still had sporadic cases. The only two states that had regional levels were NY and MA, but several adjacent states (PA, NY, CT) had no cases. Based on the types of influenza detected, the CDC is recommending that the vaccine for next year include all three major subtypes. I didn't see any indication that the US had "defeated" influenza or any hints that it had been put "box in the box", even though the graph for 2003 looked remarkably like the graph for SARS cases in 2003.

To: Icebrg who wrote (614)	6/29/2003 4:24:42 AM
From: Henry Niman	Respond to of 1070

Here is the worldwide data for influenza who.int

To: Icebrg who wrote (614)	7/5/2003 5:31:22 PM
From: Henry Niman	Read Replies (1) \| Respond to of 1070

>> have some problems understanding the seasonal factor<< Here are a few comments on co-infections with coronaviruses, which may be a significant issue in the Fall or Winter: cmbi.bjmu.edu.cn "Co- or Sequential Infections The other factor that is important in terms of SARS is this question of whether there are concurrent or sequential respiratory viral infections, and whether these exacerbate the SARS coronavirus infections. What I want to show here is a precedent for that in animals, a recent study conducted by a master's DVM student in my lab, Dr. Hayes. In this study, he infected pigs with a porcine arterivirus which in the Nidovirales order, which is the same order as the coronaviruses are in. He gave them this PRRS virus first, and then PRCV after five days. What he found in this study was a longer shedding of PRCV after the dual infections, and the fecal shedding of PRCV was more common after the dual infections. We don't understand the reason for that at this time, but we can speculate on several hypotheses. He also found—also the group in Belgium, Van Reuth and Pensaert, found—that there was prolonged fever, respiratory disease, and reduced weight gain after these dual infections. This shows a normal pig lung tissue; this is what the tissue looks like after PRCV infection, and this is after the dual infection. I want to point out there is a lot of infiltration here of monocytes in the lung. They are some of the major lesions that are seen, as well as some inflammation in the lungs. The other study I think is quite pertinent with what we're seeing happening the world today is the study from Van Reuth and Pensaert in Belgium that showed if they gave PRCV first and then they infected pigs with swine influenza two days later, they had severely enhanced respiratory disease compared to either virus alone. Often it's hard to reproduce some of these respiratory viral infections in an animal model, so this has relevance because recently avian influenza outbreaks have been diagnosed in the Netherlands, so I think we can imagine what might happen if both of these viruses co-infected people together. Other factors have been defined from animal studies. These, again, were mixed infections, dual infections with PRCV, or with PRRS, or with PRCV followed by bacterial LPS in five days. These animals were found to develop more severe respiratory disease after LPS exposure and enhanced fever, compared to pigs inoculated with each agent alone. Again, this may have relevance to SARS cases if there are secondary bacterial infections. "