Swine flu fears ebb as cases decline

Swine flu has fallen off the public radar as reported cases dropped for the fourth consecutive week in Delaware.

Health experts say the incidence of novel H1N1 influenza has dropped significantly and that there is little or no reason to anticipate an epidemic.

A peak of 603 influenza-like illnesses were reported during the week of Oct. 18. The most recent data, from the week of Nov. 15, listed only 110 reports. Those reports come from throughout the state.

Swine flu cases also have dropped in local acute-care hospitals, universities, federally qualified health centers, long-term care facilities and prisons.

Because of the drop, health officials with Delaware's Division of Public Health are considering downgrading the swine flu activity level, currently listed here as "widespread." As the cases of swine flu decline nationwide, other states have already made that kind of downgrade. Seasonal flu cases in Delaware have been rare.

"At this point, we're continuing to see [swine flu] at different locations in the state but we will be reassessing as to whether we should temporarily change our designation," said Dr. Karyl Rattay, director of the public health division. "But we don't know what to expect from one week to the next."

Downgrading the activity level shouldn't change the message of prevention, Rattay said. People must continue to cover their mouths with the crook of their arm when they cough; wash their hands frequently with soap or alcohol-based hand rub and avoid close contact with sick people.

There's no telling whether the swine flu virus may peak again, however.

"There's clearly some unpredictability here with this virus," Rattay said. "But if we get another resurgence of H1N1, which we probably will see at some point, it may very well not be as intense."

Rattay said that vaccinations here may be one reason why the illness reports have dropped. The public health division has shipped out about 167,800 doses of swine flu vaccine this season.

The decline in public interest got a dramatic illustration Wednesday. As swine flu fears and cases mounted during late summer, the Muslim Professionals of Delaware decided to schedule a seminar on the virus to educate the public about various worries and misconceptions about swine flu.

The event, held Wednesday night, was originally scheduled for what was expected to be a period of high interest, when both the swine and seasonal influenzas would be spreading rapidly.

But when the meeting began, a reporter was the only member of the public in attendance.

To Semab Chaudhry, one of the planners, the dearth of attendees showed how interest in the swine flu has faded.

"At the time we scheduled this, it made sense because we thought the swine flu would be peaking in the winter," he said. "But people haven't seen a big breakout in their communities and therefore they don't think this is a priority anymore. ... I guess it's good news from a community health perspective."

Fewer questions

Local pulmonologist Ghazala Farooqui gave a Swine Flu 101 primer.

She said that the number of questions about the virus from patients at her practice tailed off a month ago.

"In October, everyone was so anxious about the virus, but now things are getting better," she said.

As illness reports have subsided, so have the number of patients entering the emergency department at Alfred I. duPont Hospital for Children.

Spurred by swine flu fears, a record number of patients sought help at the Rockland hospital's emergency department more than once this fall.

But in recent days, that volume has fallen back to near normal.

Parents who in October would have whisked their child to the emergency department after the first sign of the flu have now realized that they don't need such care when the flu symptoms are mild.

A mild version of the swine flu may have run its course in many people in Delaware, said Dr. Magdy Attia, associate director of the emergency department.

"And also, a fair number of kids have been vaccinated already," he added.

Scientist steps down during e-mail probe. Hacked messages about global warming caused controversy

A scientist who is one of the central figures in the uproar over pirated e-mails from the University of East Anglia's Climate Research Unit announced Tuesday that he is stepping down as the unit's director while the university investigates the incident.

Climate skeptics have seized on several e-mails from Phil Jones to other researchers as evidence that prominent scientists have sought to silence their voices in the debate over global warming. Jones's e-mail account was apparently hacked and his e-mails were posted online last month.

"What is most important is that CRU continues its world leading research with as little interruption and diversion as possible," Jones said in a statement. "After a good deal of consideration I have decided that the best way to achieve this is by stepping aside from the Director's role during the course of the independent review and am grateful to the University for agreeing to this. The Review process will have my full support."

Several of Jones's e-mails to colleagues have sparked controversy, including his comment that he had used "a trick" to "hide the decline" in a chart showing global temperatures, and his request to "delete any emails" regarding a specific topic. Another e-mail suggested that he and other respected scientists boycott an academic journal called Climate Research because it had agreed to publish a paper they viewed as flawed.

"I will be emailing the journal to tell them I'm having nothing more to do with it until they rid themselves of this troublesome editor," he wrote to other researchers.

Jones denied repeated requests for interviews by The Washington Post, but he issued a statement last month saying his words had been taken out of context, a position echoed by other academics on the e-mail chain, including Michael E. Mann, director of the Earth System Science Center at Pennsylvania State University. Jones denied deleting any e-mails, and said he meant to imply the way he arranged the temperature chart was "a clever thing to do" rather than an effort to distort the science.

Trevor Davies, pro vice chancellor for research at East Anglia, in Norwich, England, said the inquiry will examine whether the university responded properly to Freedom of Information Act inquiries, the status of its data security and "any other relevant issues." He added that nothing in the pirated e-mails suggested that the unit's work was "not the highest-quality of scientific investigation and interpretation."

Marc Morano, who edits the climate skeptic blog ClimateDepot.com, welcomed the news in an e-mail: "This is a positive development in the battle against politicized science. Jones was at the epicenter of the UN's efforts to hype man-made climate fears. His stepping down is a victory for science."

Melanie Fitzpatrick, a climate scientist at the Union of Concerned Scientists, an advocacy group, said opponents of action on climate change are using the hacked e-mails "to spread disinformation."

Citing flu, Sebelius orders review of public-health defenses

WASHINGTON - A top Obama administration official, citing problems with the swine flu vaccination campaign and other problems in preparedness, announced plans yesterday for a major review of the federal government's policies for developing public-health defenses.

Health and Human Services Secretary Kathleen Sebelius said she had ordered the review in part because the swine flu vaccine shortage had highlighted the nation's dependence on antiquated technology.

"We'll look for the fastest ways to move to new technologies that will let us quickly produce countermeasures that are more dependable and more robust," Sebelius said in prepared remarks to the American Medical Association's Third National Congress on Health System Readiness, which is being held in Washington. "Not just for flu and not just for infectious diseases, but for all the public-health threats we face today."

The review will be led by Nicole Lurie, the assistant secretary for preparedness and response, and will be complete by "early next year," Sebelius said.

"We face a wider range of public-health threats than ever before," Sebelius said. "It could be anthrax delivered in an envelope. It could be a dirty bomb set off in a subway car."

The nation's ability to respond to such threats depends not only on having enough hospital beds, emergency rooms, doctors, and equipment such as masks and ventilators, but also on state-of-the-art diagnostic tests, medications, and vaccines, she said.

But these countermeasures "can often take years to discover, develop, manufacture, and distribute," she said. "Like a lot of countries, we've often failed to make the kind of long-term investments in countermeasures we need to stay safe."

Sebelius defended the government's response to H1N1, noting that the virus was identified quickly, diagnostic tests were produced and distributed rapidly, and the vaccine program was launched as soon as possible. At least 69 million doses of vaccine are now available. But the vaccine was produced much more slowly than officials hoped and predicted. The lag is a clear example of the shortcomings of today's technologies, she said.

Progress had been made, she said. A new vaccine factory that can make flu vaccine using cells instead of eggs opened last week in Holly Springs, N.C., after Novartis received more than $400 million in federal funding.

Pfizer Buys Rights To Protalix Drug for As Much as $115 Million

Pfizer (PFE: 18.6524, 0.4624, 2.54%) unveiled a deal worth up to $115 million Tuesday to acquire the rights to Protalix’s (PLX: 9.04, -0.79, -8.04%) Gaucher’s drug.

The drug giant agreed to make an upfront payment of $60 million for the drug, which is called taliglucerase alfa. The companies said Pfizer will receive exclusive worldwide licensing rights for the commercialization of the drug, but that Protalix will keep exclusive commercialization rights in Israel.

Pfizer also said it could make up to $55 million in additional milestone payments for the drug.

Gaucher’s disease is an inherited condition that causes an enzyme deficiency that often results in spleen and liver enlargement, anemia, excessive bleeding and bruising and bone disease.

“We are excited about this collaboration, which represents a significant step towards bringing, for the first time, a plant-based enzyme replacement treatment option to patients affected by Gaucher’s disease,” Protalix CEO David Aviezer said in a statement.

Protalix said it is preparing to complete a rolling new drug application with the U.S. Food and Drug Administration. The FDA has given the drug orphan drug and fast track status, which allows for an expedited review of drugs that treat rare conditions or diseases.

The companies said they will split future revenues and expenses for the development and commercialization of taliglucerase alfa on a 60%/40% basis.

The news wasn’t received well by Protalix’s shareholders as the company’s stock tumbled to $8.69 in the premarkets after closing at $9.86 on Monday. Pfizer’s stock inched higher to $18.30 after closing at $18.17 on Monday.

“By joining our advances in biologics manufacturing and protein development with Pfizer’s global strengths in patient services and reimbursement we expect to help make taliglucerase alfa an important and cost-effective treatment choice for Gaucher’s patients throughout the world,” said Aviezer.

Are you ready for the dog and cat flu?

Just in case you weren't panicking enough over the swine flu, it turns out that the virus that causes it, H1N1, can make dogs, cats and ferrets sick, too.

H1N1 got its nickname, the swine flu, due to its origin in pigs, but it's really a genetic mashup of human, swine and bird viruses. Because it can cause serious illness and even death in susceptible humans, particularly infants and pregnant women, veterinarians greeted the recent news that it could affect family pets with alarm.

The first cases in pets were reported in ferrets, which are notoriously prone to influenza viruses. But when the American Veterinary Medical Association (AVMA) reported last month that a sick cat in Iowa had the disease, epidemiologists and virologists took notice. It was the first time a cat had become ill from an influenza virus.

Since then, two more sick cats, one of whom died, tested positive for H1N1, and Chinese officials announced Saturday that they had isolated the virus in two sick dogs.

Dr. Tony Johnson, a clinical assistant professor at the Purdue University School of Veterinary Medicine, said that it doesn't look like our pets are a risk to us.

In fact, we're a risk to them -- every cat that's been diagnosed with H1N1 lived with a human who had a respiratory illness shortly before the cat became sick.

"So far there is no evidence that this virus can be passed from cats to humans," Johnson said. "Sometimes a virus can make a host sick, but not reproduce and become infectious in that host."

That appears to be the case with the H1N1-positive dogs in China as well. The Chinese Ministry of Agriculture reported that the virus found in the dogs, whose breeds and ages were not given, was 99 percent identical to the human swine flu, suggesting that they contracted it from people.

"Only when the virus mutates within dogs will it be a new threat to humans," Feng Zijian of the Chinese Center for Disease Control and Prevention told China Daily.

Johnson acknowledged that feline to human transmission of the virus can't be ruled out, but he asked cat owners not to over-react. "The humans who gave the virus to their cats recovered, and so will most cats," he said. "Common sense and a cool head are better than flipping out and putting your cat out with the garbage."

There may be many more undiagnosed cases of H1N1 in pets, because it's rarely tested for and has symptoms similar to other canine and feline diseases, which are usually mild.

The AVMA describes those symptoms as "lethargy, loss of appetite, fever, runny nose and/or eyes, sneezing, coughing or changes in breathing (including difficulty breathing)." But as with humans, some dogs and cats with respiratory infections will go on to develop pneumonia, and some of them will die.

With doomsday scenarios about mutant pathogens making headlines around the globe, a certain amount of over-reaction isn't a surprise.

It doesn't help that one of the viruses that can be transmitted between humans and dogs and cats is a pretty terrifying one: rabies. But rabies in domesticated animals is very rare in the United States, and most pets are vaccinated against the disease.

A handful of other diseases and parasites can affect humans, dogs and cats, like fleas, intestinal worms and skin diseases like ringworm.

But until five years ago, no influenza virus had ever been known to cause illness in a dog or cat, which is somewhat surprising given that influenza viruses typically originate in farm animals and wildlife, and dogs and cats have always lived closely with humans and their livestock.

The H1N1 outbreak isn't the first time an influenza virus has adapted to be able to cause illness in a dog, however.

That occurred in 2004, when an equine influenza virus, H3N8, was identified as the cause of a deadly outbreak of respiratory disease in racing greyhounds in Florida.

Canine influenza

Woody, a flat-coated retriever, is a healthy adult dog today, but when he was just a puppy in Texas, he came down with what his breeder thought was "kennel cough," the dog version of a cold.

But what Woody had was something no one thought to look for, a brand new virus that posed a serious risk to very young, very old and immune-compromised dogs.

"He spent the next month at the vet school at Texas A&M, fighting for his life," said his owner, Gina Spadafori, who lives in Sacramento. "He survived, but he was weak and spent many weeks recuperating after that."

The bug that almost killed Woody was a viral changeling dubbed H3N8. Originally thought only to affect horses, it had adapted itself to be able to cause disease in another species, the dog.

Once researchers started looking for H3N8, they found dogs carrying the virus in 30 states (including California) and the District of Columbia, a wide distribution suggesting it had been spreading without detection for quite some time.

The virus, now dubbed "canine influenza virus" or CIV, probably went undiscovered for so long because its symptoms in most dogs mimic the usually-mild kennel cough, officially known as "canine respiratory disease complex."

"Canine influenza virus is generally a mild disease, with typical symptoms of cough, some lethargy, fever and perhaps nasal discharge," said Dr. Melissa Kennedy, a clinical virologist at the University of Tennessee Veterinary Teaching College and an infectious disease and immunology consultant for the Veterinary Information Network.

But for some dogs, like Woody, that risk is much greater. "As with the human influenza, there is a risk for secondary bacterial infections which can be serious," Kennedy said. "This risk is highest among puppies and elderly dogs, where immunity may not be as good as in healthy adult animals."

Researchers at Iowa State University estimate around 80 percent of infected dogs become ill, and even the 20 percent who don't can still infect other dogs. Around 10 percent of sick dogs develop pneumonia, and somewhere between 1 and 5 percent die.

Although a vaccine for CIV came on the market in May, it's far from perfect. It can protect the dog from getting sick, but sometimes it only makes symptoms less severe or shortens the period of time that the dog is sick, as well as the length of time he's infectious.

Unfortunately, it doesn't prevent infection with CIV, which means vaccinated dogs can carry the disease home to other dogs even if they're not showing any symptoms themselves.

Kennedy said she does not consider the new canine influenza vaccine a "core" vaccine that should be given to every dog, but rather a tool that might be helpful in shelters, kennels or other environments where dogs are housed in close quarters and high numbers.

"Dogs that board or frequently co-mingle with other dogs could also be at risk," she added. So owners of dogs who go to dog parks, training classes, doggie daycare centers, dog shows or other places where dogs gather should discuss the vaccine with their veterinarians.

Dog owners concerned about CIV or H1N1 should keep an eye out for their early symptoms, such as a cough or nasal discharge. A dog with a fever of more than 104 degrees, lethargy, a green nasal discharge or difficulty breathing is at high risk of developing dangerous complications and needs immediate veterinary attention.

The AVMA is actively tracking instances of H1N1 in animals and posting updates on its Web site. The organization also provides comprehensive information on canine influenza, as well as the new CIV vaccine.

Climategate: Follow the Money

Last year, ExxonMobil donated $7 million to a grab-bag of public policy institutes, including the Aspen Institute, the Asia Society and Transparency International. It also gave a combined $125,000 to the Heritage Institute and the National Center for Policy Analysis, two conservative think tanks that have offered dissenting views on what until recently was called—without irony—the climate change "consensus."

To read some of the press accounts of these gifts—amounting to about 0.0027% of Exxon's 2008 profits of $45 billion—you might think you'd hit upon the scandal of the age. But thanks to what now goes by the name of climategate, it turns out the real scandal lies elsewhere.

Climategate, as readers of these pages know, concerns some of the world's leading climate scientists working in tandem to block freedom of information requests, blackball dissenting scientists, manipulate the peer-review process, and obscure, destroy or massage inconvenient temperature data—facts that were laid bare by last week's disclosure of thousands of emails from the University of East Anglia's Climate Research Unit, or CRU.

But the deeper question is why the scientists behaved this way to begin with, especially since the science behind man-made global warming is said to be firmly settled. To answer the question, it helps to turn the alarmists' follow-the-money methods right back at them.

Consider the case of Phil Jones, the director of the CRU and the man at the heart of climategate. According to one of the documents hacked from his center, between 2000 and 2006 Mr. Jones was the recipient (or co-recipient) of some $19 million worth of research grants, a sixfold increase over what he'd been awarded in the 1990s.

Why did the money pour in so quickly? Because the climate alarm kept ringing so loudly: The louder the alarm, the greater the sums. And who better to ring it than people like Mr. Jones, one of its likeliest beneficiaries?

Thus, the European Commission's most recent appropriation for climate research comes to nearly $3 billion, and that's not counting funds from the EU's member governments. In the U.S., the House intends to spend $1.3 billion on NASA's climate efforts, $400 million on NOAA's, and another $300 million for the National Science Foundation. The states also have a piece of the action, with California—apparently not feeling bankrupt enough—devoting $600 million to their own climate initiative. In Australia, alarmists have their own Department of Climate Change at their funding disposal.

And all this is only a fraction of the $94 billion that HSBC Bank estimates has been spent globally this year on what it calls "green stimulus"—largely ethanol and other alternative energy schemes—of the kind from which Al Gore and his partners at Kleiner Perkins hope to profit handsomely.

Supply, as we know, creates its own demand. So for every additional billion in government-funded grants (or the tens of millions supplied by foundations like the Pew Charitable Trusts), universities, research institutes, advocacy groups and their various spin-offs and dependents have emerged from the woodwork to receive them.

Today these groups form a kind of ecosystem of their own. They include not just old standbys like the Sierra Club or Greenpeace, but also Ozone Action, Clean Air Cool Planet, Americans for Equitable Climate Change Solutions, the Alternative Energy Resources Association, the California Climate Action Registry and so on and on. All of them have been on the receiving end of climate change-related funding, so all of them must believe in the reality (and catastrophic imminence) of global warming just as a priest must believe in the existence of God.

None of these outfits are per se corrupt, in the sense that the monies they get are spent on something other than their intended purposes. But they depend on an inherently corrupting premise, namely that the hypothesis on which their livelihood depends has in fact been proved. Absent that proof, everything they represent—including the thousands of jobs they provide—vanishes. This is what's known as a vested interest, and vested interests are an enemy of sound science.

Which brings us back to the climategate scientists, the keepers of the keys to the global warming cathedral. In one of the more telling disclosures from last week, a computer programmer writes of the CRU's temperature database: "I am very sorry to report that the rest of the databases seems to be in nearly as poor a state as Australia was. . . . Aarrggghhh! There truly is no end in sight. . . . We can have a proper result, but only by including a load of garbage!"

This is not the sound of settled science, but of a cracking empirical foundation. And however many billion-dollar edifices may be built on it, sooner or later it is bound to crumble.

Obama Issues Order for More Troops in Afghanistan

WASHINGTON — President Obama issued orders to send about 30,000 additional American troops to Afghanistan as he prepared to address the nation Tuesday night to explain what may be one of the most defining decisions of his presidency.

Mr. Obama conveyed his decision to military leaders late Sunday afternoon during a meeting in the Oval Office and then spent Monday phoning foreign counterparts, including the leaders of Britain, France and Russia.

Robert Gibbs, the White House press secretary, declined to say how many additional troops would be deployed, but senior administration officials previously have said that about 30,000 will go in coming months, bringing the total American force to about 100,000.

On top of previous reinforcements already sent this year, the troop buildup will nearly triple the American military presence in Afghanistan that Mr. Obama inherited when he took office and represents a high-stakes gamble by a new commander in chief that he can turn around an eight-year-old war that his own generals fear is getting away from the United States.

The speech he plans to deliver at the United States Military Academy at West Point at 8 p.m. will be the first test of his ability to rally an American public that according to polls has grown sour on the war, as well as his fellow Democrats in Congress who have expressed deep skepticism about a deeper involvement in Afghanistan.

Mr. Gibbs told reporters at the White House that Mr. Obama would discuss in the speech how he intended to pay for the plan — a major concern of his Democratic base — and would make clear that he had a time frame for winding down the American involvement in the war.

“This is not an open-ended commitment,” Mr. Gibbs said.

Mr. Obama and President Hamid Karzai of Afghanistan spoke for more than an hour Tuesday morning in a video conference, The Associated Press reported, quoting a statement issued by Mr. Karzai’s spokesman.

The administration was sending its special representative for Afghanistan and Pakistan, Richard C. Holbrooke, to Brussels on Tuesday to begin briefing NATO and European allies about the policy.

He will be joined at NATO headquarters there on Friday by Secretary of State Hillary Rodham Clinton and Gen. Stanley A. McChrystal, who will brief NATO foreign ministers in his capacity as the senior allied commander.

Before leaving for West Point on Tuesday, Mr. Obama will meet with more than two dozen Congressional leaders at the White House to discuss his plan. Mr. Obama spent much of Monday calling allied leaders.

He spoke for 40 minutes with President Nicolas Sarkozy of France, who signaled that France was not in a position to commit more troops. There are currently 3,750 French soldiers and 150 police officers in Afghanistan.

“He said France would stay at current troop levels for as long as it takes to stabilize Afghanistan,” said an official briefed on the exchange, who spoke on the condition of anonymity to describe a private diplomatic exchange.

Instead of troops, Mr. Sarkozy told Mr. Obama that France was putting its focus on a conference in London sponsored by Germany and Britain to rally support for Afghanistan, officials in Washington and France said.

The French defense minister, Hervé Morin, publicly confirmed the French position on Monday, saying, “There is no question for now of raising numbers.”

Prime Minister Gordon Brown of Britain said Monday that Britain would send 500 additional troops to Afghanistan in early December, raising the number of British troops there to 10,000.

The announcement was closely coordinated between the governments in London and Washington, the two largest troop providers in the 43-nation coalition fighting in Afghanistan. Mr. Brown spoke to Mr. Obama by video link after his announcement in the House of Commons.

Mr. Obama also called President Dmitri A. Medvedev of Russia and Prime Minister Manmohan Singh of India, and he met at the White House with Prime Minister Kevin Rudd of Australia.

Administration officials said that Mr. Obama in his speech would lower American ambitions for the rate of training Afghan soldiers and the national police, a position that could put him at odds with some senior lawmakers.

They have been pressing to expand and accelerate the training, to speed the day when Afghan forces could assume more security duties and American troops could begin to withdraw.

In his strategic assessment, General McChrystal called for increasing the Afghan Army and the national police force by a combined 400,000 people.

But after originally embracing this approach, administration officials had second thoughts, fearing that pursuing this goal would just churn out thousands of substandard recruits. An administration official said the focus now would be on producing somewhat fewer but better trained troops, as quickly as possible. The shift was reported Monday by The Wall Street Journal.

Under the new plan, newly trained Afghan security forces will work with American or other allied forces at every level. General McChrystal recommended this requirement in his assessment to increase the quality of the Afghan force and “accelerate their ownership of Afghanistan’s security.”

A senior Defense Department official, speaking on the condition of anonymity to describe a plan that had not been formally announced, said Monday that the first additional troops would be thousands of Marines sent to opium-rich Helmand Province, a Taliban stronghold in the south of Afghanistan. The Marines will begin to arrive in the region in January, the official said, and will be followed by a steady flow of tens of thousands..

Most of the additional forces in the south will go to Kandahar Province, the Taliban heartland, where the United States is stretched thin and has very few troops in the province’s largest city, also called Kandahar. The Taliban are currently in control of large parts of the province and are contesting control of the city.

The Defense Department official said that the additional United States troops would be used to try to secure the city and then the region.

“With more forces we should be able to lock down the security in Kandahar and the surrounding areas of Kandahar,” the official said.

The official said that after the president’s speech, which will begin at 5:30 a.m. Wednesday in Afghanistan, General McChrystal would brief his commanders and then embark on a daylong fly-around to visit NATO military installations in the country — Kandahar in the south, Mazar-i-Sharif in the north, Bagram Air Base in the east and Herat in the west.