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Swine Flu Mutates Into New Diseases and into Political Issues

November 30th 2009

Europe Topics - Yuliya Timoshenko
Yuliya Timoshenko

Reports in Europe and elsewhere are rife of a mutation of the H1N1 “swine flu" virus that apparently first appeared in Ukraine and has now popped up in numerous other countries. As of November 28, two fatal cases of the mutated virus emerged in France, following two deaths caused by the virus identified in Norway on November 20. According to the World Health Organization, the same virus has been identified in patients in other countries including Brazil, China, Japan, Mexico, and the United States.

So far, in France, 76 deaths have been recorded for H1N1. Worldwide, deaths blamed on the epidemic rose by 1,000 during the week of November 21-28. But in the Ukraine, the total figure surpassed 300 in early November 2009, with as many as 16 deaths caused in one day.

The mutated virus appears to be able to penetrate further into the passages of victim’s lungs, thus making it more dangerous. However, there is yet no evidence to show that it can be spread between people. As long as there is no proven “person-to-person” contagion, the relative risk posed by the mutation is low, experts insist.

It is obvious that the mutated flu causes special complications, as demonstrated by the deaths caused in Norway and France. Viruses typically mutate within their victims, thereby reproducing. It has been suggested that the fact that this mutation has been identified in at least 6 different countries merely shows that it is one of the possible mutations that can emerge.

However, H1N1 deaths may increase as its mutations combine. The permutations are many. Some mutations are vaccine- and antiviral-resistant, while another causes lung hemorrhaging. Each mutation is causing different effects in victims, and even combining to attack individuals in some cases. In the UK, a laboratory reported that the current H1N1 vaccine would probably not be effective against the variant of the swine flu virus that caused a panic in Ukraine. This variant, in which the virus uses D225G as a receptor binding domain, causes bleeding in the lungs. Another H1N1 mutation results in the resistance to treatment with antiviral medication. The mutation that results in acute lung damage has been called a "low reactor" to the vaccine, meaning that the vaccine will not provide an immune response for that strain of virus adequate to prevent infection.

Lung hemorrhaging caused by a swine flu mutation has been reported from China and Norway to France and the Ukraine. Thus far in the United States, there have been unconfirmed reports of fatalities in patients with hemorrhaged lungs. Worldwide, a strain of the H1N1 bug resistant to Tamiflu, a principal anti-viral medication, has been found with high incidence in Wales and North Carolina. One such case has been found in France. About 80 million doses of vaccine have been distributed worldwide and about 65 million people have been vaccinated so far, according to the World Health Organization (WHO).

News of the H1N1 flu, aside from any mutations, has captured headlines and blogs over the planet as international organizations such as WHO, and national governments struggle to respond. Near panic has gripped Ukraine where millions rushed to buy doses of Tamiflu and other anti-viral medications as well as surgical masks to avoid contagion. Schools and all universities there have been closed and nine regions of the country were put under quarantine. Bolstered by alarmist media reports in Ukraine, there was much talk in the media and on the street about deliberate infection by pharmaceutical companies or the government as conspiracy theories became rife. For example, some argued that flights of helicopters and fixed-wing aircraft had been seen spraying the populace with clouds of unknown substances feared to be the virus itself. Reports also emerged that the lungs of the mutated virus’ victims had turned black as coal while the death toll rose. Hospitals are being converted into emergency treatment centers, having been caught off guard by the deaths of 400 people in just three weeks.

In the Ukraine, the virus became political. Reports of the flu, and the government response, comes in the midst of a presidential election that pits as opponents the incumbent President Victor Yushchenko, incumbent and former ally Prime Minister Yulia Tymoshenko, against a Russian-backed rival. Tymoshenko, who has been blamed for a faltering economy and pandering to Russia, has capitalized on (or even fostered) the panic in Ukraine for political gain, according to some observers. Political observers also noted the competing appearances by the two politicians at hospitals and the bedsides of sufferers. Tymoshenko and two her ministers personally and ceremoniously received a Tamiflu air shipment in the middle of the night in early November, and she has given assurances that her government has the situation well in hand. Some polling data suggests that this apparent concern has not availed the natural gas tycoon: one poll has her trailing a rival by nearly 2 to 1. Tymoshenko has also banned all mass gatherings and political rallies -- after she had already had hers.

Although the World Health Organization concluded that "the numbers of severe cases do not appear to be excessive when compared to the experience of other countries," pharmacies ran out of surgical masks and medicines whiles panicked Ukrainians dangerously hoarded supplies as Tymoshenko sprang into action and dominated media reports. This is opportune for Tymoshenko, who had been thought to be losing the race to Russia’s candidate Viktor Yanuovich—a man many Ukrainians believe may have been linked to an assassination attempt on Yushchenko. As Ukrainian GDP contracted by over 15 percent in the third quarter of 2009 and Tymoshenko continued to bicker with Yushchenko, her approval ratings plummeted from a high of 47 percent in the spring of 2005 to just 14 percent in October—an improvement from summer 2009. Tymoshenko’s prospects are now much brighter, given that at least the first wave of contagion has been stemmed before the January 2010 election. Medical experts expect the flu season to peak again in January and February. A Tymoshenko spokesman has disavowed any suggestions that the president made political capital out of a medical crisis but has managed to bolster a faltering medical system and prepared it for further flu contagion.

Flu season or not, the outcome of the January 2010 Ukrainian election is critical to both Russia and the West. Both Tymoshenko and Yushchenko favor Ukraine’s admission to NATO and the EU. Before becoming Prime Minister in a second term that began in 2008, Tymoshenko stated in a Foreign Affairs essay of the need for a buffer between Russia and the West while offering Ukraine into the bargain. Yushchenko is married to a woman who had been a US citizen and a Reagan-era official in the State Department. He enjoyed good relations with President George W. Bush and set a course for Ukraine that has been at odds with his Russian neighbor.

On November 27, the Ukrainian parliament failed to over-ride Yushchenko’s veto of a $125 million package of aid in the flu epidemic. He said he supports putting additional funds toward fighting the flu, but was against the way the government wanted to finance the increase, arguing that the proposed law could also lead to the devaluation of the national currency. Prime Minister Yulia Tymoshenko criticized Yushchenko and said he bears full responsibility for flu casualties in Ukraine.

Russia has also had its share of flu deaths and reaction to infection. At least ten universities in western Russia have been closed due to the flu. The State Pedagogical University in the city of Lipetsk said it is canceling classes because about one in four of the university's students are sick with flu-like symptoms, even though they are not known if they have swine flu, or a variant of H1N1. The closure is expected to last until December 2.

But the Mideast has actually been hit the hardest. According to the latest World Health Organization estimates, influenza H1N1 has more victims in Iran than in the other 22 countries of the WHO’s Eastern Mediterranean Region. With 33 deaths so far, Iran registers 17 percent of the total 188 deaths in the region since May 2009. Saudi Arabia has recorded 28 deaths, Oman 25 and Syria 22 and also had the highest rate of fatalities in comparison to the cases with 9.5 percent of them being fatal. Yemen follows with a rate of 2.5 percent, Afghanistan with 1.7 percent, and Iran with 1.5 percent. Kuwait has registered the highest number of cases with 6,640 (23 percent of all the 28.751 in the region), followed by Saudi Arabia with 4,119; Oman with 3,829; and Egypt with 2,494. Kuwait also has the highest number of cases per head with 2.46 over a thousand, followed by Oman with 1.12 cases (over a thousand), and Bahrain with 1.10 cases (over a thousand).

In Saudi Arabia, authorities were prepared for the annual Hajj pilgrimage, imposing tight security and anti-flu initiatives. Saudi authorities deployed some 20,000 medical staff and more than 100,000 security personnel as more than 2.5 million Muslim faithful prepared to descend upon the holy cities of Mecca and Medina. Three persons, including an elderly Pakistani, are confirmed victims of the flu. Besides the flu epizootic, the Saudis must contend with tensions between Sunni and Shia Muslims, which in the past caused hundreds of deaths and injuries. In recent weeks, the Saudi government called on Iran not to politicize Hajj after Iran’s Supreme Leader Ali Khamenei called for “demonstrations against the United States and Israel.”

Local health authorities are on high alert; so far, 20 pilgrims have shown signs of the flu. Four of these died, having had prior health problems like pulmonary infection and cancer. Another four remain in care, and 12 were dismissed from hospital. Over the past few weeks, Riyadh has urged other governments to restrict the pilgrimage to healthy adults between 18 and 65. Additional doctors have been deployed, more hospital beds provided, and some 1.5 million units of Tamiflu stockpiled. Additionally, six 24-hour health clinics are available within the Grand Mosque at Mecca.

The Health Ministry of Israel had registered 51 swine flu deaths as of early November. A two-year-old child from Nazareth died following a swine flu shot; she had had several illnesses and recently received a pacemaker. Another 41 people complained of side effects of the flu jab. The standard for inoculation holds that children under the age of three are not good candidates for the flu vaccine.

In the conflictive Democratic Republic of Congo, an unknown epidemic has caused three deaths and affected more than 100 people. The epidemic broke out in Londela Kayes, in southwest DRC some 300 miles from Brazzaville. Symptoms include diarrhea, strong fever and vomiting. Health authorities on the scene have concluded that they are confronting a flu virus even while they have yet to receive samples. The A/H1N1 has been found in Brazzaville and Pointe Noire and was presumably spread from there. The DRC reported its first case in October at a Brazzaville school.

Cutting Edge senior correspondent Martin Barillas is editor of Spero Forum.


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