UPDATES: HEALTHY LIVING

This  blog is irregularly updated   with the latest detailed pharmacological information on the ingredients of anti-aging preparations, the powder blend compositions, and mail-order/wholesale prices.

These are all detailed  on the page Product Details and Pricelists. but of course all the ingredients, as food supplements, can be ordered individually to US  or UK  or Japanese pharmacopoea standard anywhere from any reliable importer or manufacturer.

The prices listed are not updated weekly, they are a guide; and  dependent from day to day on imported costs which are mostly rising constantly .

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The public, as well as interested distributors/retailers, are invited to contact Healthspan Life!.

RESTRAINING UNNECESSARY RISING COSTS OF COMMON DRUG THERAPY AND CONFLICTS OF INTEREST:

The review published yesterday by Discovery Health  “Medicine expenditure up by 26% in private healthcare industry” based on the Mediscor Medicines Review resonates with this week’s editorial from JAMA on Resolving Unreported Conflicts of Interest. Apart from anticancer therapy (which affects relatively few patients but is very costly), by far the two top drug costs to the private  health system in RSA  are antihypertensive and hypolipidemic drugs.

But why are these two groups of drugs 1/6th of  local private medicines expenditure?

The reason is quite plainly vested interests- between prescribers, drug developers and retailers, for  well-known reasons:
1.  Modern western medicine  rarely attempts to address the pathogenesis  of disease – it takes too much effort by prescribers and patients to try to change diet and  lifestyle. And  the only “modern” drug that addresses the main causes of the common degenerative diseases – overweight, (pre) diabetes type 2, lipidemia, atheroma, thrombosis,  hypertension, cancer, arthritis, dementia – is the antioxidant, insulin-sensitising, energising,  nitric-oxide-promoter, antilipidemic, antithrombogenic, antihypertensive, anti-infertility, anti-PCOS,  appetite-and-weight-suppressive,  anticancer, and diabetes-preventing   plant-derived metformin. This is the only prescription drug  ever – with zero serious persisting adverse effects in appropriate dose -    that has been  shown (including in the only 20year randomized controlled trial ever) to actually reduce all  major morbidity and all-cause mortality by over one-third.

2. Only new ie under-patent drugs are $billion dollar –a-year rainchecks in a $trillion dollar industry where only disease pays (not prevention- which keeps patients out of hospitals & specialist centres  and off new drug) .

So the Disease Industry has correctly pinpointed overweight and hypertension as the two leading risk factors to bombard consumers with new drugs;

but  has created the  gigantic marketing ploy  that these common lifestyle-diet problems  need designer drugs: that
average mild to moderate hypertension must be treated by combinations of angiotensin-and adrenergic, and calcium-blockers – which  do not reduce all-cause morbidity and mortality.;
and  even average lipid levels  by statins and now even the futile  ezetimibe –which do not reduce all-cause morbidity and mortality;
and overweight-obesity  by patented drugs like Orlistat and Rimonabant –which do not reduce all-cause morbidity and mortality  ,
and type 2 diabetes by new sulphonylureas, glitazones and even more toxic and expensive injectables  like gliptins- –which do not reduce all-cause morbidity and mortality .

But  simple analysis of the hundreds of better-quality  published studies and trials (not those ghost-written in glossy journals  for drug companies to promote their products) shows that:

For average mild-to-moderate hypertension, no modern drugs (with many serious  adverse effects)   surpass for benefit  the triple and zero-side-effect  combination of lowdose reserpine plus lowdose coamiloretic- in RSA costing retail about R45 per 4 months ie about $2/month;

For average-risk overweight adults with or without lipidemia and diabetes, nothing surpasses the global benefits- major reduction in all-cause mortality and mortality- of  metformin started in low dose eg 250mg/day and increased  slowly to tolerance.
Obviously primary prevention  for everyone includes a few grams a day of the essentials that  deplete at all ages with longevity, the degrading food chain,  pollution and stress – the natural ~50  replacement supplements of  vitamins and minerals and the human biologicals EPA+DHA, CoQ10, arginince, carnitine, n-acetyl cysteine, alphalipoic acid, taurine, carnosine, MSM, chondroglucosamine, lutein, bioflavinoid,  choline, inositol, 5HTP, GABA, melatonin, plus key plant supplements eg ginkgo, milk thistle, galega, gymnema, coleus etc;

all of which can be simply taken as a powder blend in water twice a day with a teasp of cod liver oil or a fish oil capsule;
at a global retail cost of as little as R100/$12 a month ( plus  in older people, appropriate physiological  human sex hormones).

So while there is some- but relatively little-  competition between generics, the major saving in both cost, risks and prevention is between therapeutic equivalents eg lowdose coamilozide+reserpine, metformin, and other safe effective  supplements – which are all that are needed for prevention and most treatment of all the major degenerative diseases of aging including osteoporosis  (which agents  Industry and their funded lobbyists- researchers, academics, regulators  try persistently to denigrate if not actively suppress)-  vs other newer- and heavily marketed  classes of antihypertensives, appetite ,  lipidemia and osteoarthritis-osteoporosis  suppressants.

This issue of promoting evidence-based best  therapeutic equivalents is indeed blowing against the wind, the tsunami of $billion dollar adspend by Big Business to promote their designer labels. But all countries- while  run by ruthless politician big business looking after their own interests – do pay some lip service to restraining the normative  monopolistic and price-fixing racketeering that screws the man in the street- both in gross overpricing, and in massive tax evasion by big business, and in rigging of elections and tenders .

Our own Medical Schemes Council is in the process of open consultations about the revised necessary and approved drug lists for all diseases in the medical schemes industry. Hence urgent vigorous debate is urgently required – in all countries- before vested interests further strangle citizens’ choice of and access to both cheap old drugs to eg reverse the dropping of reserpine by bureaucrats in UK, Europe and state clinics here, and reverse the rising tide of suppression of the best prevention and treatment there is- the base of all modern medicines – minerals, vitamins and the numerous proven safe human and plant biologicals.

The trend by the FDA and EU and Big Business in RSA must be reversed, before they (in the interests of their own pockets filled with paybacks by Big Pharma) put all supplements totally on prescription by health professionals- the very people whose livelihood (including their shares in Big Pharma, med schemes and hospitals) depends on new quick-fix designer drugs which cure and prevent no chronic degenerative disease ie on avoiding effective doses and combinations of proven supplements.

As it is, the medical schemes in RSA are now compelled to pay for the services of witchdoctors (who admittedly probably kill far fewer people than do modern prescriptions and surgery for non-urgent conditions) yet these schemes- while insuring for profit people who persist in suicidal and homicidal smoking and alcohol and sexual behaviour-  flatly refuse to pay for the best prevention  there is – the supplements mentioned- because  they are neither promoted by Big Pharma nor on prescription.

Numerous references are available under many keywords on this website below.

ndb

DANGEROUS MEDIA MISREPORTING ON SWINE FLU:

The media are the main cause of panic. An unsourced report being broadcast in South Africa – on the internet and our local radio- is that “According to the World Health Organisation (WHO), at least 429 people have died around the world from swine flu, which has infected 94 512 people in 136 countries”.

This is dangerous nonsense. What an authoritative report today says is  “by Monday, the total number of cases worldwide reached 94,512 — with 429 deaths — according to the World Health Organization (WHO)”.

Its all about simple English, between four-letter words:  with versus from or of…

All authoritative reports indicate that the great majority of deaths are occurring in patients with serious chronic underlying disease – who commonly die anyway, often of trivial infections . Very few swine flu deaths have been in healthy young people ie attributable to swine flu virus iteslf. It has been clear for months that the swine flu is in general as highly contagious as the long-circulating other flu strains, but if anything milder; with probably millions affected- mostly untested, unreported since it is so mild.

So it is not surprising that where it is tested for, it is commonly found – eg in sick people with serious heart, lung or other immune-suppressing illness.

For unclear reasons – about which conspiracy theorists can speculate given the $trillion benefits to the disease and vaccine and antiviral industry of panic – no consolidatd report of autopsies of patients who have died with swine flu has yet been published, to establish in how many the flu was apparently the cause of death.

Until now, all authoritative reports are that vey few previously healthy people have been confirmed to have died of or from the swine flu- despite the fact that sudden death (ie from often unexpected heart attack, heart arrhythmia or stroke) is the commonest mode of sudden death – especially in the unfit ie smokers, the overweight, asthmatics, cardiacs, cancer etc…

AMERICAN GERIATRIC SOCIETY PROMOTES OPIOIDS AHEAD OF NONSTEROIDAL ANTIINFLAMMATORIES FOR PAIN..

n a landmark 1990 judgment (Ferrell 1995) , the court ruled that carers have a duty to provide pain relief even if opioids are necessary, where pain contributes materially to functional impairment and decreased quality of life.

Now the American Geriatric Society has reinforced that  (Ferrell 2009) , but warned against use of NSAIDs because of their risks, as this column argued last week starting rather with paracetamol acetaminophen +- opioid as backup.

ndb

AVOIDING ANTIDIABETIC DRUGS APART FROM METFORMIN FOR AS LONG AS POSSIBLE

A new review last week from Quebec Universities of insulin use in 69674 elderly diabetics is both limited in application, and instructive. We regularly see older patients who were started on insulin when they were first diagnosed diabetic because they were acutely ill, but who mostly should have been weaned off insulin fairly soon onto metformin etc, since even insulin is associated with higher mortality let alone complications. The topic is thoroughly discussed recently.

Since hypertensive and glycation damage is a common consequence of even the prediabetic metabolic syndrome, a  crucial issue is what we see in practice, that for the treatment of hypertension,  the triple combination of low-dose thiazide diuretic eg HCT 12.5mg combined with amiloride  1.25mg as eg amiloretic /coamilozide and with lowdose reserpine (rather than betablocker) has no risk of aggravating or causing diabetes. It is unsurpassed for the gentle normalization of most  mild to moderate hypertension- especially when combined in the overweight with metformin to tolerance  so as to virtually abolish the future risk of developing diabetes. This combination brings no serious  problems, unlike the betablockers or the now-heavily punted but troublesome  calcium channel and angiotensin blockers.

It is encouraging  to see confirmed that in these elderly Quebecois (even with only 71% on metformin; 29% on sulphonylurea  monotherapy – which like cortisone doubled the risk of needing insulin; 25% on thiazide and 30% on betablocker therapy, and 5740 on 16 or more drugs) –   the incidence of becoming dependent on insulin is only 1% a year over the 7years of this study – possibly less since

1. we have no idea how many of these patients were coached enough on avoiding sugars and reducing both cooked fats, salt, alcohol and fructose, and

2. it is  better to start early especially antidiabetic antioxidant antilipidemic antiatheroma  balanced minerals, vitamins B C D E K, and biologicals (including the likes of fish oil, metformin/galega, coQ10,  arginine, carnitine; appropriate parenteral balanced human HRT (estrogen, testosterone, progesterone) , and  relevant other herbs). All these combined (in just  two  blends) can in a first-world population  largely avoid both need for cortisone and  insulin therapy,  fattening, diabetes, vascular / renal disease, dementia, osteoporosis, blindness, and cancer ;

3 taking metformin to tolerance (which is bizarrely uncommon practice) is far better  before if necessary adding sulphonylureas/ glitazones/ insulin which promote fattening and other problems,  with little net benefit..

4. starting on  metformin preventatively ie  well before diabetes presents  can reduce the incidence of new diabetes, pancreatic burnout and cancer  by up to 80%.

Yet preventative metformin- with zero serious adverse effects  and halving of mortality in appropriate use- is still  irrationally vociferously  objected to. Is this  because of the Disease Industry’s driving force, to avoid prevention at all cost since only disease pays: effective prevention with natural supplements  like metformin and appropriate parenteral HRT would deplete surgeries and hospitals of serious chronic degenerative illnesses.

The BARI study showed clearly that by the time vascular disease presents in diabetics, surgery has no better outcome than medical therapy. All four major diabetes prevention programs (in China then USA then India then Greece) confirmed the major benefit (even against cancer) of adding metformin early if the patient cannot implement permanent effective diet and exercise.

So why are “Authorities” still not mandating  preventative metformin in the resistant overweight at all ages? Why are those who should know better still  attacking  preventative physicians for practicing evidence-based medicine ie using appropriate metformin in a life-threatening situation- progressive or persistent overweight ie BMI above 25kg/sqm?

One hopes that this Quebec analysis pushes authorities to enforce that metformin built up slowly from eg 250mg/d  to tolerance -ideally with blood level control-  is the only firstline chronic drug   therapy of type 2 diabetes, even where the new patient has also to be temporarily stabilized with  insulin.

ndb

editorial: COMPLEMENTARY, HOMEOPATHIC MEDICINE APPROVED IN SWITZERLAND

editorial comment on `HOMEOPATHIC BASICS (June ’09)   Dr. Ron Beare ND., DHomMed, South Africa below:

On May 17, 2009, in a unique referendum “ the people of Switzerland voted by a two-thirds majority  to force Parliament to pass  a constitutional amendment that supports the use of complementary medicine (CAM), incorporating admission of doctors of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and Traditional Chinese Medicine (TCM) into obligatory health insurance; integration of complementary medicine into teaching and research; and safeguarding of proven remedies.”

This vote by the  notoriously conservative rightwing Swiss  is a stunning precedent for enforcement of the peoples’ sensible rights and wishes irrespective of the machinations of  politicians and Big Business, the inconvenient truth of  oligarchy disaster capitalism especially when it manipulates organized religion as extremist  “right wings” do everywhere from Islam to Baptist America to C of E Britain to Rome to  India, China, Japan and without exception in Africa. Especially in South Africa where the AK47-brandishing State President Rev Jacob Zuma- a habitual serial adulterer  (never mind polygamist) supported by acolytes swearing to kill for him – announces that he will rule until the Christ comes….

Phytotherapy, anthroposophical and TCM deal with foodstuffs, natural plant remedies- the origin and foundation of modern drugs. But what of homeopathy?

In 2005 the University of Berne published a major meta-analysis comparing homeopathy with allopathy (Hahneman’s reference term for conventional modern medicine)  in comparable chronic conditions including respiratory-allergy, musculoskeletal, neurological and gastrointestinal. They concluded that “Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. Discounting these biases, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions.”

But “110 homoeopathy trials and 110 matched conventional-medicine trials were analysed. 21 homoeopathy trials (19%) and nine (8%) conventional-medicine trials were of higher quality. When the analysis was restricted to large trials of higher quality, the odds ratio was 0·88 (95% CI 0·65–1·19) for homoeopathy (eight trials) and 0·58 (0·39–0·85) for conventional medicine (six trials).”  This outcome statistically favours alopathic medicines and not homeopathy. .

But such analysis does not address the risk:benefit ie the adverse effects of allopathic drugs; it did note the small number of large trials of high quality.  So what this study largely raises is the power of placebo, belief ie autosuggestion and spontaneous resolution in both homeopathy and alopathy, and the fallacies of randomized controled trials and metanalyses.

It also highlights the paradox that while western medicine aims, claimsto be science-based, for daily minor consultations in the better-off  it is largely in daily practice  the art of  temporizing medicine, symptom-based palliation while the underlying stressor, be it emotional or infection, subsides spontaneously. And apart from trauma, or infection, or the small percent of adults with the most common deadly genetic diseases  eg Huntingdon’s chorea or haemophilia which can only be palliated,  for chronic common  diseases of aging there are no modern drugs which address the rckbasic degenerative pathogenesis.

Metformin the 85year old extract of the age-old medicinal galega officinalis is the only prescription “drug” which does so, in the appropriate dose and patient a true panacea since (like fish oil)  it addresses virtually every pathogenetic mechanism of obesity- lipidemia- diabetes, hypertension- heart-vascular-renal, retinopathy, dementia and hypoimmunity. Quality cannabis the Forbidden Medicine is similarly a powerful multidisease therapy, while vastly safer as a recreational dependency than heavily marketed tobacco smoking, gratuitous sex, alcohol and sugar products-the four horsemen of the apocalypse-  after human bloodlust- mass starvation, violence,  murder and warfare the greatest killers of all ..

But  homeopathy is like religion: ineffable, unprovable. As  the great Dane Søren Kierkegard the founder of modern psychology and  fierce critic of the Church wrote almost two centuries ago,  personal religion (as opposed to tribal membership) can only be by a leap of faith, a suspension of reason. The theologian Karen Armstrong, the scientist Steven Jay Gould, the London philosophers AC Greyling and John Gray, and many top novelists – George Elliott,   Hermann Wouk, Margaret Attwood and John Fowles – have written perceptive books dissecting  true religion- which is at worst a harmless fulfilling moral code – and caring calling-  for many, except when (like religion and medicine through the ages) abused for political domination and greed in the pursuit of power by the ruthless. Homeopathic physicians surely  cannot be thus accused, unlike the Disease Industry and Big Pharma ..  Homeopathy did not, like mainstream medicine in Hahneman’s time, incarcerate and even neuter  like animals the feeble and the  sad with the bad irrespective.

It is commonly said that one in three admissions to USA hospitals, and thousands of premature deaths there  each year, are iatrogenic, contributed to by modern medicines and rash surgery. Except in nondiagnosis of serious treatable illness which progresses by neglect, this cannot happen with homeopathy.

But if these beliefs and organized practices- homeopathy, reflexology, craniosacral medicine, faith healing, personal (not dictated) religion, nutritional supplements in moderation by experience –   are harmless, are they better or worse than most modern marketed chronic drugs, which mostly prove for common chronic conditions eventually  to be inferior to old and proven remedies, if they do not collapse or fall into neglect within years of their launch from adverse effects or disillusion. Examples are non-steroidal anti-inflammatory analgesics including coxibs (compare to the enduring paracetamol, and analgesic herbs); bisphosphonates (compare to appropriate ancient anabolic supplements including enduring appropriate HRT), or statins and glitazones (compare to ancient metformin and other natural antioxidants); or the troublesome angiotensin blockers for common hypertension (compare to gold standard old  low dose reserpine plus low dose coamilozide) .

In that context of inquiry one can read this exposition by a naturo-/homeopathic physician with well over 50 years of practice experience on the observations and teachings of Hahnemann, a profoundly observant and ethical medical practitioner, linguist and scientist for his times. . . he was certainly the first and most famous medical doctor of modern times. Although Edward Jenner was four years his senior and William Harvey two centuries earlier, they made their mark each in only one field, whereas Hahnemann applied his mind to all disease – both chronic, infectious, poisoning and the humane care of the insane. He was eerily prophetic of our modern Disease Industry- sell at any cost: “he  claimed that the medicine of his time did as much harm as good: ‘My sense of duty would not easily allow me to treat the unknown pathological state of my suffering brethren with these unknown medicines. The thought of becoming in this way a murderer or malefactor towards the life of my fellow human beings was most terrible to me’ .” If only the FDA and it’s devotees would follow this principle before applying relatively untested new drugs where well-proven old have long existed.

It is not inconceivable that molecular biology may yet, paradoxically,  explain by quantum mechanics a theoretical basis for homeopathy, setting it aside from pseudoscience and quackery, since modern critical reviews still leave room for doubt. .

ndb

`HOMEOPATHIC BASICS (June  ’09)   Dr. Ron Beare ND., DHomMed, South Africa.

“It is amazing to think that Dr. Samuel Hahnemann MD  (1755-1843), a German physician and the Founder of homeopathy, http://en.wikipedia.org/wiki/Samuel_Hahnemann lived at a time when medicine recognized bloodletting and purging, mixtures made from vipers, opium, mercury; and other physically degrading poisons.

He was always mindful of the teachings of that other genius Hippocrates, Father of herbal medicine.

Hippocrates, the Father of Natural/Herbal Medicine, died about 400 years before the Christian era.

It is he whose Hippocratic Oath defines the Code of medical ethics even to-day.

Hippocrates denied the then superstitious causes of disease.

He stated in lectures and books that feelings and thought came from the brain, not the heart or liver (as it was thought for centuries before and after Hippocrates).

He was the first dr. to describe epilepsy and pneumonia.

He also said that physicians should do no harm.

Because health is our greatest blessing, we must always improve our lifestyles, by walking, diet and hygiene.

Some 2000 years after Hippocrates’ entreaties about Natures’ healing without perpetrating invasive harm;  Dr. Samuel Hahnemann (1755-1843) established a vibrant energy type of medicine, based on the totality of each patient’s individual symptoms.

“The Removal of the Totality of Symptoms means the Removal of the Cause” (Kent, “Lectures on Homeopathic Philosophy”).

FOR MILDER PAIN, WHY USE NSAIDS OTHER THAN PARACETAMOL -ACETAMINOPHEN?

It is 4 months since this column last addressed nonsteroidal anti-inflammatory drugs NSAIDs.

A new study (from USA, UK and Canada – Ray 2009) of NSAIDs  claims that in those with ischemic heart disease, the popular NSAIDS -diclofenac, ibuprofen or rofecoxib(Vioxx) – increased serious heart disease/ death by about 50-67% compared to nonusers; whereas naproxen over some 111000 patient years of use gives no significant risk or benefit.

A new study from Denmark (Fosbol 2009) this year looked at a million healthy individuals with no hospital admissions or selected therapy. Compared to no NSAID use, ibruprofen and naproxen gave no added risk of death/ myocardial infarction; diclofenac gave 67% increased risks, and the two coxibs (rofecoxib Vioxx; celecoxib Celebrex)  increased risk 100%.

So we are led to believe that naproxen or ibuprofen is the NSAID  mild-to-moderate analgesic  of choice. Naturally the American Colleges and academia – who represent the Disease Industry, not patients- recommend yet other potentially toxic drugs- like  the magical proton pump inhibitors- to counteract the adverse NSAIDS..

But is this just a myopic view beloved of big pharma, to promote their snake oils.?

Another new study from Denmark (Gislason 2009) of 110 000 patients after admission for heart failure in the 12 years 1994-2005, showed that 57% died; 9000 (8%) were rehospitalized with acute heart attack  and 40 000 (38%) were rehospitalized with heart failure. Thus heart failure in a well-nourished population has a poor prognosis. In 36 000 who had used NSAIDs compared to non-users, risk of death was doubled on  diclofenac; increased~67% on  (rofe-or cele)coxibs; and was  significantly increased 22-31% by all other NSAIDs including naproxen and ibruprofen.

It is common cause after 20 years that injected diclofenac is the only NSAID that can unpredictably cause sudden death. So it’s administration risks culpable homicide when it is totally unwarranted. No cases of sudden death from any oral NSAID   including aspirin appear on Medline, apart perhaps from the risk of hyperacute asthma (Asamoto 1999).

But what of gastrointestinal bleeding  risks of NSAIDS? a 2007 study in Japan (Yajima) scoped all orthopaedic patients who took NSAIDs for more than 4 wks: oral diclofenac increased risk of erosive gastric lesions sixfold. A new review from Seattle (Schlansky 2009) refers to Helicobacter synergism in all NSAID use.

WHAT IS THE NEED FOR NSAIDS? The Wikipedia entry on NSAIDs  sums it up: it has almost four times as much text on the numerous  adverse effects of NSAIDs as on their uses- in fact the  article does not discuss the advantages of NSAIDS as analgesics; in fact it states plainly  that alone  just  “their gastrointestinal effects  are estimated to result in 103,000 hospitalizations and 16,500 deaths per year in the United States”.

All designer drugs are dangerous in overdose. Without overdose, paracetamol has no risk – and the Wikipedia entry thereon is balanced and highly favourable even for infants. We know well that paracetamol- a fatal liver toxin in overdose- should not be marketed without a built-in simple liver (and antineuritic) protective of  eg (carbo-or N-acetyl-)cysteine, alphalipoic acid and vitamin BCo.  But the Disease – Big Pharma Industry is not interested in prevention- Only Disease Pays. And Regulators, lobbyists and legislators  protect their source of work and income- the Drug Industry.

Fish oil (EPA+DHA) is probably  the most beneficial NSAID supplement we have (- perhaps ahead of other front-runners like vitamins C, D, magnesium and CoQ10-) halving all sudden deaths, and reducing by at least a third all major chronic degenerative diseases from CVD to diabetes, arthritis, learning, depression, behaviour disorders. Industry wont pay for head-on comparative trials. But the trial evidence suggests that fish oil and oral EDTA have better risk-benefit than aspirin and other antiplatelet agents, NSAIDs and warfarin.

We know that for moderate trauma and small – medium (even knee) joint pain/  contusions, self-massage with any natural NSAID like arnica or wintergreen is all that is needed, combined if necessary orally with up to 3 to 4gm paracetamol /day +- if needed a little codeine.   Prior 2002 found no significant difference in pain relief between paracetamol and naproxen in tension headache.

For more serious pain,  short of strong opioids, there is in fact no overall trial evidence that weak opioids or NSAIDs are better than eg hypnotherapy, or acupuncture,  or judicious paracetamol; to which latter if necessary a little codeine can be added as step-up analgesia. The latter  agents have none of the deadly risk of NSAIDs. Amadio 1984 showed that of Peripherally Acting Analgesics: ” paracetamol at up to 4 g per day compares favorably in analgesic potency to aspirin and other NSAIDs, and  should be considered the treatment of choice for mild-to-moderate pain”.  Skovlund 1991 showed no significant difference between naproxen and paracetamol in postpartum uterine spasms.

Six RCTs – five in mostly European peoples and one in Hong Kong- found paracetamol equal to diclofenac (Voltaren) – March 1994 in arthritis; Brevik 1999 and Kubitzek 2003 in dental surgery; Hoogewijs 2000 and Woo 2006 after trauma; and Munishankar 2008 after Caesarian section.  In a Cochrane analysis 2003, Towheed showed that in the one placebo-controlled RCT in osteoarthritis, paracetamol was clearly superior to placebo with a similar safety profile. And the general principle of therapy applies, that if required, combination of analgesics from different groups is better than single drug therapy. But given the many potentially fatal risks of the NSAIDs – compared to paracetamol, opioids and if indicated  aspirin -  there is no compelling reason to add NSAIDs  for pain.

We know that it is negligent to initially sentence people with  spontaneous mild-moderate head/neck/backache or tendonitis at the shoulder, elbow, knee etc to bedrest, NSAIDS, opioids or referral for xrays, scans or surgery. 95% will settle rapidly with reassurance, posture instruction and simple topicals and paracetamol analgesia. Otherwise most pain will disappear with firm reassurance with brief simple laying on of hands eg massage and traction with gentle rotational manipulation and instruction in auto-reinforcement -  pressure point eg earlobe pressure, or acupuncture, or hypnosis. And most of the remainder resolve quickly with  simple targeted injection with a little local anaesthetic plus depot steroid.

And we know that with judicious use, topical corticosteroid injection – never mind judicious brief systemic steroid (corticosteroid, calciferol, testosterone) has little or no risk and far greater target and multisystemic benefit than NSAIDs; and for chronic conditions, like fish oil at least address the underlying pathogenic mechanisms/causes- whereas NSAIDs and paracetamol ignore these.

Is drug-speeded resolution of inflammation essential and beneficial except for the drug vendor? A careful RCT by Bradley ea from Indiana University in 1992 observed that “joint tenderness and swelling, presumptive evidence of synovitis, may not be a priori indications for use of an antiinflammatory drug, or predict greater responsiveness to treatment with an antiinflammatory drug than to a pure analgesic, in symptomatic treatment of patients with knee osteoarthritis”.

So why are synthetic  NSAIDs and especially the Coxibs  still used? Why do academics and Regulators still allow, promote  them for  routine use, other than to profit Big Pharma, and cause perhaps a quarter million deaths a year globally?

UPDATED: A FLU FALSE ALARM? WHAT IS KILLING MEXICANS IN THE CURRENT FLU OUTBREAK?

7 June 2009: after about 3 months since the first cases were reported (in USA), the death rate has settled down to well below 0.025% outside Mexico (about 2% there) , despite the mild swine flu having spread globally to probably millions of people briefly affected.

In virtually all deaths (149 so far associated)  there were apparently serious  underlying chronic health problems, so it remains unclear whether this virus is ever fatal in previously well people. .

UPDATE 3 June  2009: since the original report of the current epidemic of this “swine” flu, some 136 deaths  associated with it’s presence ( in well over 21000 cases world wide)  have now been ”confirmed”  from North America (none from other continents) – 104 in Mexicans, 27 Americans, 3 Canadians and one Chilean and 1Costa Rican- but scant details of these deaths have so far been published.

UPDATE 28 MAY 2009: since the original report of the current epidemic of this “swine” flu, some 108 deaths  associated with it’s presence ( in well over 15 000 cases world wide)  have now been ”confirmed”  from North America (none from other continents) – 90 in Mexicans, 15 Americans, 2 Canadians and one Costa Rican- but scant details of these deaths have so far been published.

UPDATE 27 MAY 2009: since the original report of the current epidemic of this “swine” flu  in this column a month ago , it appears that this virus has likely spread far more widely than is being tested (at enormous  profit for American industry?) and reported on.  It seems if anything  milder than average seasonal flu.

So the published statistics surely become increasingly meaningless?

Some 100deaths  associated with it’s presence ( in well over 13 000 cases world wide)  have now been ”confirmed”  from North America (none from other continents) – 84 in Mexicans, 13 Americans, 2 Canadians and one Costa Rican- but scant details of these deaths have so far been published. The great majority of deaths  have apparently been in people with documented major underlying disease eg diabetes, lung or heart diseases.  So it is unclear what role the virus- if any- has played in these deaths, whether the virus was  contributory or incidental.

Similarly, while the virus has been reported sensitive to and widely treated with Tamiflu,  no randomized controlled trial in these flu cases has apparently been done, so there is no information as to whether using antivirals makes the slightest difference or contributes to morbidity.  It is the age-old dilemma of modern prescription antibiotics  and vaccines- when is the right time if ever to use them ?..

Only randomized controlled double blind trials will tell.

UPDATE: Despite the current epidemic of this “swine” flu so far mild in North America (even in Mexico) and then western Europe,  only 61  deaths   in Mexicans-(out of >2400 confirmed cases there  so far – ie 0.25%),  and a handful  in neighbours-  Americans  Canadians  and a Costa Rican- have  by 14th  May been associated with proven American hybrid H1N1   swine flu.  (Another ~100 deaths in N America  are suspect, await reporting of both hybrid virus test results, autopsy  and antecedent pathology).

Contrary to skeptical  US  physicians , the current American swine influenza A  flu H1N1  concern is anything but a hoax – although  deaths attributable to swine flu  have  been confirmed only in some two dozen Mexicans.

It is common cause that influenza A kills hundreds of thousands of the frail elderly and children worldwide each year.

Is the new hybrid America-Mexican  “swine” H1N1 flu virus  epidemic virulent at all?

What are Mexican and USA  Public Health officials doing to clarify this?

No autopsy results have yet been reported to confirm whether and how  overwhelming Mexican hybrid swine flu has actually directly caused a single death. . . The  death rate in Mexico attributed directly  to swine flu is  currently apparently unknown. But  if it is the American swine virus causing death, below 8 deaths might  have been expected in non-Mexicans . But so far there have been no very ill cases or suspicious deaths attributed to swine virus  except in Mexicans..

It is striking  that after a month, there are still no reports anywhere to indicate whether deaths in these Mexicans  with the hybrid American flu virus had any clear cause of death attributable to the virus eg virus meningitis, virus pneumonitis, virus carditis, virus hepatitis, virus gastroenteritis, etc.

So there is still slim proof yet that this hybrid (human-swine-avian) H1N1 virus is virulent,  has actually itself killed anyone (as  opposed to them dying of other causes eg malnutrition, exposure, intoxications, bacterial or other virus  infection, cancer, diabetes, heart disease, cancer etc, although also carrying the hybrid virus). Most of us in eg South Africa carry TB, but it mostly harms only those with  eg malnutrition/poor crowded housing/ diabetes  or HIV.

With billions  dying prematurely each year of poverty, poor obstetric and child care, plagues, and human malevolence  like war and genocide, motor accidents, homicide, cholera, AIDs,  smoking, alcoholism and other lethal street drugs,  what is the fuss all about? Is it just another misguided   false alarm or, worse, a hoax?

Or is the frenzy over swine flu  a deliberate opportunistic conspiracy beloved of dramatists  and the media, shock tactics  to distract from the world Depression and irreversible climate change caused by willful  global  governmental- Big-Business  disaster capitalism? Is it mostly opportunism to  earn $billions for the global Disease Industry mafia and their lobbyists in academia, the media and academia  by generating panic flu product buying over the rest of 2009, and divert a few $million in aid to  poor countries?

Stranger human conspiracies have happened the past two  centuries ie in our /grandparents’  lifetime, – like the recent  two world wars started by Europeans, the holocausts perpetrated by power-mad “enlightened”  humans against blacks (USA, Africa), the poor/ intellectually impaired (America),  jews & gypsies (Europe), armenians, greeks,  hindus,  kurds and muslims(eg the Balkans), arabs  (by Europeans),  Poles & Russians (Stalin), Chinese (the Opium wars), against pregnant  women and infants (the American stilbestrol  and German-Japanese thalidomide scandals), against the now virtually extinct non-white natives of the Americas, Australia, New Zealand – and against the larger non-human  life forms of the forests, wilds and the oceans.

The latest persisting genocidal conspiracy  is the ongoing denial by Mother Church and governments of any form of birth control or equal rights  to billions of   defenseless women worldwide; and the ongoing tolerance  of barbaric primitive genital mutilation of millions of African female (including forced circumcision of male) children; and the gang-rape and execution of  millions of (mostly)  Muslim  women on grounds of adultery after they have been seduced/ raped or attempted to escape from forced slavery-  abusive “marriage”. .

Only time will tell.

ndb

UPDATED FIGHT FLU (influenza A or B) and all (eg Swine) infection PRECAUTIONS/ TREATMENT:

May 2009:   PRECAUTIONS against both ‘flu and colds: (see the updated swine flu alert):

CDC WARNING: “Special Considerations for Children: Aspirin or aspirin-containing products  should not be administered to any confirmed or suspected  influenza  case  aged 18 years old and younger due to the risk of Reye syndrome. For relief of fever, other anti-fever  medications are recommended “. These may be acetaminophen paracetamol or  herbal anti-inflammatory drugs.

UK: “Aside from their obligations under health  safety legislation, employers can help to minimise  spread of the virus and support good infection control practice by positively encouraging any employee who reports feeling unwell with influenza-like symptoms to stay at home until their symptoms resolve, by sending people home who develop influenza-like illness at work (avoiding public transport and wearing a face mask if possible) and by ensuring that stocks of surgical facemasks are available in the workplace for symptomatic staff to wear until they get home.– DoH Pandemic Flu Plan, November 2007″

Seasonal Influenza A  is a major risk for older people everywhere, it kills half a million people a year.

The American hybrid H1N1 swine flu is so far only a real risk (>1% mortality) in Mexico, or in people already critically ill with other problems eg malnutrition,  obesity diabetes, emphysema, heart/ kidney  failure, cancer,  etc (who are at high risk of any passing bugs).

During outbreaks of infection, or if you feel a cold/ flu coming on:

–DON’T overstress or overexert yourself.

–STAY AWAY from:   Public transport and busy clinics and offices; or returning overseas travelers –  if you must meet them or  share the car with them, they and you must wear a mask, have  no contact.

–REST at home if you feel feverish/a cold coming on, perhaps take a cold shower twice a day.

- if you have flu, or during outbreaks, wear a SURGICAL MASK in public transport, open clinics- for protection against airborne TB, flu and cold viruses. Don’t share masks with anyone. Discard mask if at all soiled. wash hands often.

BOOST YOUR IMMUNITY: – also against TB, HIV/AIDs and all common chronic diseases

1. DIET/LIFESTYLE: Eat, drink and exercise prudently and regularly, and get plenty of fluids (incl tea), rest and sleep, if needed with melatonin at night for poor sleep; avoid smoking,  sugars and undiluted fruit-juice and sweetened commercial drinks. Tighten diabetic/ overweight  control eg add metformin/galega to tolerance (ie short of nausea/ diarrhoea);      eliminate suspect allergens eg milk- and wheat(gluten) -products.

2. STEAM twice a day if you feel a cold coming on.

3. SNIFF a pinch of ENHANCED VITAMIN C* powder 3 x day (50/50 vitamin C + bioflavinoid – a fruit polyphenol).

4. Take ENHANCED VIT C* rapid stepwise dose increase from 1gm 1/4  tsp  a day  up to 2 tsp (~8gm)  2-6  x/day-less if diarrhoea. some people tolerate only <300mg/d, but most (especially if ill) tolerate up to >100gms a day spread over the 24hours; as infection settles, so does the tolerance drop back toward perhaps <4gms a day.

+ FOR-INFECTION BLEND*.

+ FOR-LUNGS BLEND* if chesty/sinus or smoker, or prone to bronchitis/cough/asthma.

+ SUTHERLANDIA and/or Aloe

+ a good MULTINUTRIENT  for balance incl plenty of garlic; and vitamin D3 and betacarotene each up to 10 000iu and zinc up to 30mg/day. . . plus fish oil plus CoQ10.

5. For prevention consider  a homeopathic ‘Flu VACCINE unless allergic -altho’  it is a nonspecific immune booster. There is as yet no specific H1N1 vaccine. BUT the big question is whether to risk the current mercury/ aluminium-based commercial vaccines ,  or the safe but highly dilute  homeopathic version.  Injections in particular may have powerful placebo effect.

6. Consider nonspecific GAMMAGLOBULIN injection- but it is now very costly because of extra screening for eg hepatitis, HIV – and also not totally without risks. Hyperimmune serum from someone who has recovered from  the current  ie American swine flu  is better, as we know from experience   with eg  rabies, tetanus, Congo fevers- but there are still far too few cases of American flu.

7. If you are on drugs likely to aggravate lung problems or infections – consider with your healthcare provider to reduce or stop  them urgently eg swop problem antihypertensive drugs (betablockers and angiotensin- blockers-ACEI, ARBs) to safer old drugs. Reduce or stop anti-inflammatories NSAIDS or  bisphosphonates eg Fosamax – take the >dozen natural supplements that are always better and far safer against fractures and frailty.  Avoid unnecessary antibiotics as these create, dont help, risks. Cortisone dose can sometimes be modified to reduce risk.

8. What about the ANTIVIRALS  Tamiflu and Relenza? read the problems about them  and decide for yourself whether it is worth the risks and considerable cost… Bloomberg.com today  says “The human form of H1N1 that’s currently circulating is resistant to Roche’s Tamiflu (not GSK’s Relenza)” Last week’s  USA report says “widespread oseltamivir Tamiflu resistance was detected among circulating influenza A (H1N1) viruses in USA; but  all influenza viruses tested this season (ie 2008)  have been susceptible to zanamivir Relenza ” .  Last year “there was 100% H1Ni resistance to Tamiflu in RSA”;  and  “strains resistant to Relenza have been reported”.

” Relenza is a safe and effective treatment for influenza, BUT  needs to be given early after the first symptoms appear -  Six to 12 hours is ideal. Usually the time taken to get a prescription renders it  ineffective. The poor oral bioavailability of Relenza zanamivir  limits dosing to inhalation”.

“An FDA  Public Health Advisory warns  of respiratory problems following inhalation of Relenza by patients with underlying asthma or chronic obstructive pulmonary disease. “

Such lung patients in particular need their cortisone pump, and theophylin, and NAcetyl-or-carbo-cysteine +/or guaifenesin, and extra magnesium, vit C, nicotinamide vit B3,  pantothenate vit B5, vit D3 ideally 6000 to 10 000iu/day, and   probiotic.

So the best seems to be to withhold commercial antivirals   until flu strikes, then hit it immediately hard with eg Relenza plus  amantidine/rimantidine.

For prevention combine all the natural supplements and precautions listed above – ESPECIALLY in areas like Southern Africa where major endemic poverty – malnutrition -obesity diabetes,  drug abuse (incl alcohol and cigarette/ cannabis smoking etc), TB, AIDS and cholera abound.

No American swine flu cases have yet been reported in Africa or mainland Asia or India; but with pandemic TB, AIDS, cholera, malaria etc, and winter biting hard this week to herald the usual bad flu season in the Southern hemisphere, it will be harder to distinguish acute flu from other potential infections.

Take this list and go ask you local health care provider  if you have been exposed to and suspect bad flu, as well as your  specialist if you are seeing one – who should all  know more about simple effective local remedies-  but above all, take the simple preventative nonprescription  steps above. .. .

ndb

WARNING: INSULIN THERAPY TRIPLES MORTALITY IN TYPE 2 DIABETICS WITH NORMAL-to-RAISED C PEPTIDE

A report today from Hong Kong finds that   “insulin-treated type 2 diabetics with high C peptide are at a significantly higher risk of cardiovascular events (hazard ratio [HR] 2.85, p = 0.049) and death (HR 3.43, p = 0.043)”.

Thus insulin should be added only in uncontrolled type 2 diabetics with low C peptide.

Those with normal to high C peptide levels apparently have good insulin output, thus insulin resistance.

The corollary is that, rather than insulin and insulin secretagogues/ mimetics, these patients  simply need better diet and oral  insulin sensitizers.

Yet we continue to see patients  gaining weight and getting sicker  on insulin (and sulphonylureas and glitazones) , instead of them being guided to better diet ( fat-free cooking, sugar-free, low in fruit juice, salt, cornstarch)  and natural  supplementary   insulin sensitizers to tolerance (ie galega/metformin, the dozen minerals and vitamins, at least 10 human biologicals, fish oil and a choice of a thousand herbs.

UPDATE AMERICAN HYBRID SWINE ‘FLU (H1N1) SPREAD:

In future see updates at  http://healthspanlife.wordpress.com/2009/05/03/a-false-flu-alarm-what-is-killing-mexicans-in-the-current-flu-outbreak/

Update 26 May 06h00 GMT: The world tally for LABORATORY-CONFIRMED H1N1 American (swine/ Mexican) flu  infections in 52 countries is as follows: 12 570cases:

The AMERICAS: 17 countries: USA6764  Mexico4541; Canada921;  Panama 76;  Chile 82; Costa Rica 28; Peru 27;  Colombia 13; Ecuador 24,  Brazil 9, El Salvador 6;  Guatamala4;   Cuba 4,   Argentine 19; Paraguay 1; Nicaragua 1; Honduras 1;  DEATHS 98.

EUROPE  21 countries: Spain 136; Portugal 1; UK137; Ireland 1  ,  Belgium 7, Netherlands 3, France 19,  Germany 17,  Italy 19   Austria 1,  Switzerland 1,   Greece 1; Turkey 2;  Israel 8; Norway 4;  Finland 2; Sweden 3;  Denmark 1, Poland 2,   Russia 2; Iceland 1; Kuwait 18; UAE 1;

East/Asia: 12 countries: Japan350, China 20; Taiwan 5;  S Korea 23; Thailand 2;  Cambodia 1;  Malaysia 2; India 3;  New Zealand 9, Australia 31; Philippines 1;

All reported  98 associated deaths have been on the North American continent -  apparently still only 14 deaths in non-Mexicans;  ie Americans  11, Costa Rican 1 and Canadian 2- and all in apparently  previously vulnerable/  ill patients. There is still no clarity as to whether any of the associated 81 deaths in Mexicans occurred in previously healthy well and adequately housed and fed  patients

Update 25 May 06h00 GMT: The world tally for LABORATORY-CONFIRMED H1N1 American (swine/ Mexican) flu  infections in 50 countries is as follows: 12 570cases:

The AMERICAS: 17 countries: USA6552  Mexico4174; Canada805;  Panama 76;  Chile 74; Costa Rica 28; Peru 25;  Colombia 12; Ecuador 12,  Brazil 9, El Salvador 6;  Guatamala4;   Cuba 4,   Argentine 5; Paraguay 1; Nicaragua 1; Honduras 1;  DEATHS 93.

EUROPE  21 countries: Spain 133; Portugal 1; UK133; Ireland 1  ,  Belgium 7, Netherlands 3, France 16,  Germany 17,  Italy 19   Austria 1,  Switzerland 1,   Greece 1; Turkey 2;  Israel 8; Norway 4;  Finland 2; Sweden 3;  Denmark 1, Poland 2,   Russia 2; Iceland 1; Kuwait 18; UAE 1;

East/Asia: 12 countries: Japan345, China 16; Taiwan 5;  S Korea 22; Thailand 2;  Cambodia 1;  Malaysia 2; India 3;  New Zealand 9, Australia 18; Philippines 1;

All reported  93 associated deaths have been on the North American continent -  apparently still only 12 deaths in non-Mexicans;  ie Americans  10, Costa Rican 1 and Canadian 1- and all in apparently  previously vulnerable/  ill patients. There is still no clarity as to whether any of the associated 81 deaths in Mexicans occurred in previously healthy well and adequately housed and fed  patients

Update 24 May 19h00 GMT: The world tally for LABORATORY-CONFIRMED H1N1 American (swine/ Mexican) flu  infections in 49 countries is as follows: 12 545cases:

The AMERICAS: 17 countries: USA6552  Mexico4174; Canada805;  Panama 76;  Chile 55; Costa Rica 28; Peru 21;  Colombia 12; Ecuador 10,  Brazil 9, El Salvador 6;  Guatamala4;   Cuba 4,   Argentine 1 ; Paraguay 1; Nicaragua 1; Honduras 1;  DEATHS 92.

EUROPE  21 countries: Spain 126; Portugal 1; UK133; Ireland 1  ,  Belgium 7, Netherlands 3, France 16,  Germany 17,  Italy 14;   Austria 1,  Switzerland 1,   Greece 1; Turkey 2;  Israel 7; Norway 4;  Finland 2; Sweden 3;  Denmark 1, Poland 2,   Russia 1; Iceland 1; Kuwait 18;

East/Asia: 12 countries: Japan342, China 16; Taiwan 5;  S Korea 21; Thailand 2;  Cambodia 1;  Malaysia 2; India 3;  New Zealand 9, Australia 17; Philippines 1;

All reported  92 associated deaths have been on the North American continent -  apparently still only 11 deaths in non-Mexicans;  ie Americans  9, Costa Rican 1 and Canadian 1- and all in apparently  previously vulnerable/  ill patients. There is still no clarity as to whether any of the associated 81 deaths in Mexicans occurred in previously healthy well and adequately housed and fed  patients.

Update 23 May 05h00 GMT: The world tally for LABORATORY-CONFIRMED H1N1 American (swine/ Mexican) flu  infections -in 47  countries  is as follows: 12 457 cases:

The AMERICAS: 17 countries: USA6552  Mexico4174; Canada805;  Panama73;  Chile 44; Colombia 12; Ecuador 8, Peru 17; Costa Rica 26;  Brazil 9, El Salvador 6;  Guatamala*4;   Cuba 4,   Argentine 1 ; Paraguay 1; Nicaragua 1; Honduras 1;

EUROPE  20 countries: Spain 126; Portugal 1; UK120; Ireland 1  ,  Belgium 7, Netherlands 3, France 16,  Germany 17,  Italy 14;   Austria 1,  Switzerland 1,   Greece 1; Turkey 2;  Israel 7; Norway 4;  Finland 2; Sweden 3;  Denmark 1, Poland 2,   Russia 1;

East/Asia: 10 countries: Japan321, China 11; Taiwan 5;  S Korea 5; Thailand 2;  Malaysia 2; India 3; New Zealand 9, Australia 14; Philippines 1;

All reported  92 associated deaths have been on the North American continent* -  apparently still only 11 deaths in non-Mexicans;  ie Americans  9, Costa Rican 1 and Canadian 1- and all in apparently  previously vulnerable/  ill patients. There is still no clarity as to whether any of the associated 81 deaths in Mexicans occurred in previously healthy well  patients.

Update 22 May 19h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 46 countries – 11 163 cases:

The AMERICAS: 17 countries: USA*6552  Mexico*4008; Canada*719;  Panama*73;  Colombia 12*; Ecuador 8, Peru 16; Costa Rica* 26;  Brazil* 9, El Salvador* 7;  Guatamala* 3;   Cuba 4,   Chile 29*; Argentine* 1 ; Paraguay 1; Nicaragua 1; Honduras 1;

EUROPE  20 countries: Spain** 118; Portugal 1**; UK**117; Ireland 1 ** ,  Belgium 5**, Netherlands** 3, France** 16,  Germany**  17,  Italy** 14;   Austria 1**,  Switzerland 1**,   Greece 1**; Turkey 2;  Israel* 7; Norway** 4;  Finland 2**; Sweden 3**;  Denmark 1**, Poland 2**,   Russia 1;

East/Asia: 10 countries: Japan***317, China 11; Taiwan 5;  S Korea*** 4; Thailand 2***;  Malaysia 2; India 3; New Zealand*** 9, Australia 13***; Philippines 1;

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 90, apparently still only 11 deaths in non-Mexicans  ie Americans  9, Costa Rican 1 and Canadian 1- and all in apparently  previously vulnerable/  ill patients. There is still no clarity as to whether any of the associated 79 deaths in Mexicans occurred in previously healthy well  patients.

Update 21 May 05.30 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 44 countries – 11  167 cases:

The AMERICAS: 16 countries: USA*5764  Mexico*3892; Canada*719;  Panama*69;  Colombia 12*; Ecuador 8, Peru 2; Costa Rica* 20;  Brazil* 8, El Salvador* 6;  Guatamala* 3;   Cuba 4,   Chile 25*; Argentine* 1 ; Paraguay 1; Nicaragua 1;

EUROPE  19 countries: Spain** 111; Portugal 1**; UK**112; Ireland 1 ** ,  Belgium 5**, Netherlands** 3, France** 16,  Germany**  14,  Italy** 9;   Norway** 4;  Finland 2**; Sweden 3**;  Denmark 1**, Poland 2**,  Austria 1**,  Switzerland 1**,   Greece 1**; Turkey 2;  Israel* 7;

East/Asia: Japan*** 292, China 8; Taiwan 3;  S Korea*** 4; Thailand 2***;  Malaysia 2; India 3; New Zealand*** 9, and Australia 10***; Philipines 1;

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 87, apparently still only 11 deaths in non-Mexicans  ie Americans  9, Costa Rican 1 and Canadian 1- and all in apparently  chronically  ill patients. There is still no clarity as to whether any of the associated 76 deaths in Mexicans occurred in previously healthy well  patients. More demographic details are awaited, but the CDC today notes that obesity is obviously a major risk factor- as usual.

Update 20 May 07h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 42 countries – 10 390 cases:

The AMERICAS: 14 countries: USA*5469  Mexico*3734; Canada*516;  Panama*59;  Colombia 12*; Ecuador 1, Peru 2; Costa Rica* 9;  Brazil* 8, El Salvador* 4;  Guatamala* 3;   Cuba 3,   Chile 11*; Argentine* 1 ;

EUROPE  18 countries: Spain** 107; Portugal 1**; UK**107; Ireland 1 ** ,  Belgium 5**, Netherlands** 3, France** 16,  Germany**  14,  Italy** 9;   Norway** 3; Finland 2**; Sweden 3**;  Denmark 1**, Poland 2**,  Austria 1**,  Switzerland 1**,   Greece 1**; Turkey 2;  Israel* 7;

East/Asia: Japan*** 262, China 7; Taiwan 1;  S Korea*** 4; Thailand 2***;  Malaysia 2; India 3; New Zealand*** 9, and Australia 5***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 82, apparently still only 9deaths in non-Mexicans  ie Americanos  7, Costa Rican 1 and Canadian 1- and all in  chronically  ill patients. There is still no clarity as to whether any of the associated 75 deaths in Mexicans occurred in previously healthy well  patients. More demographic details are awaited, but the CDC today notes that obesity is obviously a major risk factor- as usual.

Update 19 May 17h30 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 41 countries – 10 232 cases:

The AMERICAS: 14 countries: USA*5469  Mexico*3648; Canada*516;  Panama*59;  Colombia 11*; Ecuador 1, Peru 2; Costa Rica* 9;  Brazil* 8, El Salvador* 4;  Guatamala* 3;   Cuba 3,   Chile 10*; Argentine* 1 ;

EUROPE  18 countries: Spain** 103; Portugal 1**; UK**102; Ireland 1 ** ,  Belgium 5**, Netherlands** 3, France** 14,  Germany**  14,  Italy** 9;   Norway** 2; Finland 2**; Sweden 3**;  Denmark 1**, Poland 2**,  Austria 1**,  Switzerland 1**,   Greece 1**; Turkey 2;  Israel* 7;

East/Asia: Japan*** 191, China 7;  S Korea*** 4; Thailand 2***;  Malaysia 2; India 1; New Zealand*** 9, and Australia 1***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 80, apparently still only 7 deaths in non-Mexicans  ie Americanos  5, Costa Rican 1 and Canadian 1- and all in  chronically  ill patients. There is still no clarity as to whether any of the associated 73 deaths in Mexicans occurred in previously healthy well  patients.

Update 18 May 15h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 40 countries – 8862 cases:

The AMERICAS: 14 countries: USA*4714;  Mexico*3103; Canada*516;  Panama*55;  Colombia 11*; Ecuador 1, Peru 1; Costa Rica* 9;  Brazil* 8, El Salvador* 4;  Guatamala* 3;   Cuba 3,   Chile 2*; Argentine* 1 ;

EUROPE  18 countries: Spain** 103; Portugal 1**; UK**101; Ireland 1 ** ,  Belgium 5**, Netherlands** 3, France** 14,  Germany**  14,  Italy** 9;   Norway** 2; Finland 2**; Sweden 3**;  Denmark 1**, Poland 2**,  Austria 1**,  Switzerland 1**,   Turkey 2;  Israel* 7;

East/Asia: Japan*** 135, China 6;  S Korea*** 3; Thailand 2***;  Malaysia 2; India 1;      New Zealand*** 9, and Australia 1***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 76 , apparently still only 7 deaths in non-Mexicans  ie Americanos  5, Costa Rican 1 and Canadian 1- and all in  chronically  ill patients. There is still no clarity as to whether any of the associated 69 deaths in Mexicans occurred in previously healthy well  patients.

Update 17 May 19h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 40 countries – 8817 cases:

The AMERICAS: 13 countries: USA* 4714;  Mexico*3102; Canada* 516;  Panama* 54; Colombia 11*; Ecuador 1, Peru 1; Costa Rica* 9;  Brazil* 8, El Salvador* 4;  Guatamala* 3;   Cuba 3,   Argentine* 1 ;

EUROPE  18 countries: Spain** 103; Portugal 1**; UK**101; Ireland 1 ** ,  Belgium 5**, Netherlands** 3, France** 14,  Germany**  14,  Italy** 9;   Norway** 2; Finland 2**; Sweden 3**;  Denmark 1**, Poland 2**,  Austria 1**,  Switzerland 1**,   Turkey 2;  Israel* 7;

East/Asia:  8Japan*** 93, China 7;  S Korea*** 3; Thailand 2***;  Malaysia 2; India 1;    New Zealand*** 9, and Australia 1***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 75 , apparently still only 6 deaths in non-Mexicans  ie Americanos  4, Costa Rican 1 and Canadian 1- and all in  chronically  ill patients. There is still no clarity as to whether any of the associated 69 deaths in Mexicans occurred in previously healthy well  patients.

Update 16 May 07h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 34 countries – 8485cases:  USA* 4714;  Mexico* 2895; Canada* 518; Spain** 103;  UK** 85; Panama* 43; France** 14, Germany**  14, New Zealand*** 9, Italy** 9;  Costa Rica* 8;  Brazil* 8, Israel* 7,   Colombia 11*;  Japan*** 4, Belgium 4**,  China 4***; El Salvador* 4; Guatamala* 3;  Netherlands** 3,  Cuba 3, S Korea*** 3; Thailand 2***;  Norway** 2; Finland 2**; Sweden 2**;   Poland 2**, Malaysia 2, and one  each Ecuador, Peru; Argentine*;   Ireland**,  Austria**, Denmark**,  Switzerland**,  Portugal**;  and Australia***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 73 , apparently still only 6 deaths in non-Mexicans  ie Americanos  4, Costa Rican 1 and Canadian 1- and all in  chronically  ill patients. There is still no clarity as to whether any of the associated 67 deaths in Mexicans occurred in previously healthy well  patients.

Update 15 May 06h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 34 countries – 7737cases:  USA* 4298;  Mexico* 2656; Canada* 449; Spain** 100;  UK** 78; Panama* 39; France** 14, Germany**  12,  Italy** 9;  Costa Rica* 8;  Brazil* 8, Israel* 7,  New Zealand*** 7, Colombia 10*;  Japan*** 4,  China 4***; El Salvador* 4; Guatamala* 3;  Netherlands** 3,  S Korea*** 3; Thailand 2***;  Norway** 2; Finland 2**; Sweden 2**;   Belgium 2**, and one  each Cuba*; Argentine*;   Ireland**,  Austria**, Denmark**,  Switzerland**,   Poland**, Portugal**;  and Australia***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 70 , apparently still only 5 deaths in non-Mexicans  ie Americanos  3, Costa Ricna 1 and Canadian 1- and all in  chronically  ill patients. There is still no clarity as to whether any of the associated 65 deaths in Mexicans occurred in previously healthy well  patients.

Update 14 May 21h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 34 countries – 7673cases:  USA* 4298;  Mexico* 2656; Canada* 389; Spain** 100;  UK** 78; Panama* 39; France** 14, Germany**  12,  Italy** 9;  Costa Rica* 8;  Brazil* 8, Israel* 7,  New Zealand*** 7, Colombia 7*;  Japan*** 4,  China 4***; El Salvador* 4; Guatamala* 3;  Netherlands** 3,  S Korea*** 3; Thailand 2***;  Norway** 2; Finland 2**; Sweden 2**;   Belgium 2**, and one  each Cuba*; Argentine*;   Ireland**,  Austria**, Denmark**,  Switzerland**,   Poland**, Portugal**;  and Australia***.

All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 69 , apparently still only 4 deaths in non-Mexicans  ie in USA, Costa Rica  and Canada- and all in previously very ill patients. There is still no clarity as to whether any of the associated 65 deaths in Mexicans occurred in previously healthy well young patients.

Update 13 May 20h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 33 countries – 6483cases, plus ??  suspected  cases;  USA* 3370;  Mexico* 2446; Canada* 358; Spain** 100;  UK** 71; Panama* 29; France** 13, Germany**  12,  Italy** 9;  Costa Rica* 8;  Brazil* 8, Israel* 7,  New Zealand*** 9, Colombia 7*;  Japan*** 4,  China 4***; El Salvador* 4; Guatamala* 3;  Netherlands** 3,  S Korea*** 3; Thailand 2***;  Norway** 2; Finland 2**; Sweden 2**; Argentine  2*;  and one  each Ireland**,  Austria**, Belgium**, Denmark**, Switzerland**,   Poland**, Portugal**; Australia***;  Cuba*.

Update 12 May 20h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 33 countries – 6042cases, plus ??  suspected  cases;  USA* 3139;  Mexico* 2282; Canada* 330; Spain** 98;  UK**  68; Panama* 18; France** 13, Germany**  12,  Italy** 9;  Costa Rica* 8;  Brazil* 8, Israel* 7,  New Zealand*** 7,  Japan*** 4,   Netherlands** 3,  El Salvador* 4; Guatamala* 3;  Colombia 6*; S Korea*** 3; Thailand 2***;  Norway** 2; Sweden 2**; China 2***; and one  each Ireland**,  Austria**, Denmark**, Switzerland**,  Finland 2**; Poland**, Portugal**; Argentine  2*; Australia***;  Cuba*.  All reported associated deaths so far have been on the North American continent* – the total deaths now amount to 63 , apparently still only 4 deaths in non-Mexicans  ie in USA, Costa Rica  and Canada.

update 11 May 14h00 GMT: the rate of new cases seems to be dropping everywhere, altho laboratories are catching up with the backlog to reveal the extent of those outbreaks in the minority of  regions which could afford or bothered with  testing. Only 4% of confirmed cases have been reported outside the Americas-  and of the 221 cases elsewhere , 202  have been in the 13 European coastal ie Atlantic-Baltic-Mediterranean  countries.

The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 30 countries (up from 19 a week ago) – 5351 cases, plus >1500  suspected  cases;  USA* 2733 plus another 433 suspected;  Mexico* 2062; Canada* 284; Spain** 95; UK**  65; France** 13, Germany**  11,  Italy** 9; Costa Rica* 8; Brazil* 8, Israel* 7,  New Zealand*** 7,  Japan*** 4, S Korea*** 3; Netherlands** 4, Guatamala* 3;  El Salvador* 4;   Panama* 15; Colombia 3*; Norway** 2; Sweden 2**; and one  each Ireland**  Austria ** Denmark**, Switzerland**,  Poland**, Portugal**; Argentine *   Australia***; China ***  and  Hong Kong***.  All reported associated deaths so far have been on the North American continent.

ie proven swine flu cases:  5021 in the Americas*; 204 in Europe-Israel**; and 17  in the West Pacific arc***. The relative population size in millions of the  USA : Mexico: Canada  is 309 to 109 to 36; so it is to be expected that the total number of Americans infected (let  alone dying)  will be 3 times higher than of  Mexicans let alone 15 times higher than of Canadians. But the deaths outside Mexico attributable to swine flu are simply not happening. Hence the growing feeling that the deaths in Mexicans are due to another bug so far eluding detection eg strep pneumonia- which would not be detected unless different specimen are cultured. .

61  deaths (57 in Mexicans) have now been reported in patients with confirmed swine flu, but only 28 have so far been  clearly and solely attributed to the virus (not other causes) -  all in Mexicans (another 100 deaths suspect); (plus another 33 deaths  with swine flu virus  but not proven attributable eg   in  very high risk patients  – all Mexicans, plus 2  Americans, a Canadian and a Costa Rican) .   The attributable death rate in (near) Mexicans  relative to all proven cases there is thus ~2.8%, but none  directly related elsewhere away from the Mexican border

update 10 May 15h00 GMT: The  tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections is as follows ( confirmed cases reported by all countries):  world- 30 countries (up from 19 a week ago) – 4571 cases, plus >1500  suspected  cases;  USA* 2432 plus another 433 suspected;  Mexico* 1626 (plus  >533 suspected cases); Canada* 280; Spain** 95; UK**  48; France** 12, Germany**  11,  Italy** 9; Costa Rica* 8; Israel* 7,  New Zealand*** 7, Brazil* 6, Japan*** 4, S Korea*** 3; Netherlands** 3, Guatamala* 3;  El Salvador* 2;   Panama* 2;  Norway** 2; and one  each Ireland**  Austria ** Denmark**, Switzerland**,  Poland**, Portugal**, Sweden**; Argentine * Colombia*;  Australia*** and  Hong Kong***. All reported deaths so far have been on the North American continent.

ie proven swine flu cases:  4364 in the Americas*; 194 in Europe-Israel**; and 16  in the West Pacific arc***. The relative population size in millions of the  USA : Mexico: Canada  is 309 to 109 to 36; so it is to be expected that the total number of Americans infected (let  alone dying)  will be 3 times higher than of  Mexicans let alone 15 times higher than of Canadians. But the deaths outside Mexico attributable to swine flu are simply not happening. Hence the growing feeling that the deaths in Mexicans are due to another bug so far eluding detection eg strep pneumonia- which would not be detected unless different specimen are cultured. .

Although 53 deaths have now been reported in patients with confirmed swine flu, only 28 have been attributed to the virus (not other causes) -  all in Mexicans (another 100 deaths suspect); (plus another 25 deaths  with swine flu virus  but not proven attributable eg   in  very high risk patients   in 21 Mexicans, in  2  Americans, a Canadian and a Costa Rican .   The attributable death rate in (near) Mexicans  relative to all suspected  cases there is thus ~1.2%, but none  directly related elsewhere away from the Mexican border.

update 9 May 15h00 GMT tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections as follows ( confirmed cases reported by all countries):  world- 29 countries- 4040 cases , plus >1500  suspected  cases;  USA 2224 plus another 412 suspected;  Mexico 1364 (plus  >533 suspected cases); Canada 242; Spain 93; UK  39; France 12, Germany  11,  Italy 8; Israel 7,  New Zealand 7, Brazil 6, Netherlands  3, Japan 3, S Korea 3;  El Salvador 2;   one  each Ireland  Austria  Denmark, Switzerland,  Poland, Portugal, Sweden; Argentine  Colombia, Costa Rica;  Guatamala;  Panama; Australia and  Hong Kong.

ie proven swine flu cases:  3843 in the Americas; 180 in Europe-Israel; and 15  in the West Pacific. The relative population size in millions of the  USA : Mexico: Canada  is 309 to 109 to 36; so it is to be expected that the total number of Americans infected (let  alone dying)  will be 3 times higher than of  Mexicans let alone 15 times higher than of Canadians. But the deaths outside Mexico attributable to swine flu are simply not happening. Hence the growing feeling that the deaths in Mexicans are due to another bug so far eluding detection eg strep pneumonia- which would not be detected unless different specimen are cultured. .

Only 28  deaths attributed to   proven Mexican  flu have been confirmed – all in Mexicans (another 100 deaths suspect); (plus another 20 deaths  suspect but not proven attributable eg  one  each in  a very high risk woman each in an American woman (cause of death not disclosed)  and  Canada (died from asthma).   The attributable death rate in (near) Mexicans  relative to all suspected  cases there is thus ~1.5%, but none  directly related elsewhere away from the Mexican border.

The above stats do not mean that the outbreak has not occurred everywhere. It may simply be that cases (and deaths) are indistinguishable from other infections in vast areas like Africa, Arabia, Russia, China, and are not being monitored and tested for reporting in >70% of the world’s people & countries. .

update 8 May 19h00 GM tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections as follows ( confirmed cases reported by all countries):  world- 26 countries- 3446 cases , plus >3300  suspected  cases; Mexico 1364 (plus  >1700 suspected cases); USA 2224 ;  Canada 242; Spain  93; UK  40; Germany  11, France 12,Israel 7,  New Zealand 7, Italy 8;  Brazil 6,Netherlands  3,  S Korea 3;  El Salvador 2;   one  each  Argentine 1, Colombia, Costa Rica;  Guatamala;   Ireland  Austria   Denmark, Switzerland,  Poland, Portugal, Sweden; and  Hong Kong.

ie proven swine flu cases:  3255 in the Americas; 174 in Europe-Israel; and 9 in the West Pacific. The relative population size in millions of the  USA : Mexico: Canada  is 309 to 109 to 36; so it is to be expected that the total number of Americans infected (let  alone dying)  will be 3 times higher than of  Mexicans let alone 15 times higher than of Canadians. But the deaths outside Mexico are simply not happening – and even in Mexico, the fatality rate among those swine flu positive is s0 far only 0.4%

48  deaths associated with  proven Mexican  flu have been reported – 46 in Mexicans (another 100 deaths suspect); ( one in  a very high risk American woman Texan  living on the Mexican  border severely obese, already pneumonic after recent childbirth; and one in a very high risk elderly Canadian woman in Canada;).  The death rate in (near) Mexicans  relative to all suspected  cases is thus ~1.5%, but none  directly related elsewhere away from the Mexican border. The impression grows that the new hybrid strain is in fact less virulent than the seasonal flu viruses long circulating around the world; and that in Mexico and elsewhere, as in 1918 , deaths are either where this new mild virus has become the final tipping straw, or else death is in fact due not to the incidental swine flu virus but to a co-infecting bug – eg the strep pneumonia (which killed most in the ‘18  H1N1 epidemic) or one of the prevalent virulent influenza A  N2- or N3- or N5-H.. viruses.

Update 6 May 20h00 GMT: tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections as follows (no longer reporting WHO figures as up to yesterday, but confirmed cases reported by all countries):  world- 23  countries- 2267 cases , plus >4100 suspected  cases; Mexico 1112 (plus  >2955 suspected cases); USA  831 ;  Canada 165; Spain  81; UK  32; Germany  9, France 7,New Zealand 5, Italy 5; Israel 4, El Salvador 2;  S Korea2;   one  each  Colombia, Costa Rica;  Hong Kong; Netherlands  Ireland  Austria   Denmark, Switzerland,  Poland, Portugal, Sweden, Guatamala..

ie confirmed cases: the Americas  1726 ie 92.6% ;  W Europe+ Israel 134;  west  Pacific  6; Africa O; mainland EurAsia O.

Update 5 May 21h00 GMT: tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections as follows:  world- 21 countries-  1478 cases , and 833  suspected probable cases; Mexico 806 (out of >2950 suspected cases); USA  405 ;  Canada 140; Spain  57; UK  28; Germany  9, New Zealand 6, Italy 5; Israel 4, France 4, El Salvador 2;  S Korea2;   one  each  Colombia, Costa Rica;  Hong Kong; Netherlands  Ireland  Austria   Denmark, Switzerland, Portugal.

ie confirmed cases: the Americas  1355 ie 90% ;  W Europe+ Israel 113;  west  Pacific  6; Africa O; mainland EurAsia O.

27 deaths associated with  proven Mexican  flu have been reported – only   in Mexicans (another 101 deaths suspect). 5 were 13yrs or younger, 4 over 60yr. The death rate in Mexicans relative to all suspected  cases is thus about 1%.

Update 4 May 17h00 GMT: tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections as follows:  world- 21 countries-  1103cases out of >4600  suspected probable cases; Mexico 590 (out of >2500 suspected cases; USA  293 ;  Canada 101; Spain  54; UK  27; Germany  8, New Zealand 6, Israel 4, , El Salvador 2; France 4,  Italy 4;   one  each  Colombia, Costa Rica; S Korea, Hong Kong; Netherlands  Ireland  Austria   Denmark, Switzerland, Portugal.

ie confirmed cases: the Americas  949; W Europe+ Israel 103;  west  Pacific  6; Africa O; mainland Asia O.

26 deaths associated with  proven Mexican  flu have been reported – only   in Mexicans (another 101 deaths suspect). 5 were 13yrs or younger, 4 over 60yrs.

update 3 May 16h00 GMT:  Mexico, USA, Canada, UK   and Spain have extra cases confirmed, and  3 new confirmed related deaths in Mexico- the last in  midweek- but no new countries have confirmed cases since yesterday.  Now another 11 suspicious  cases have reportedly died in Mexico since yesterday.  But no evidence of confirmation has been disclosed.   SO THERE IS NO PANDEMIC, and no spreading epidemic- only North America is heavily involved.  So the only slight possibility of this mild flu epidemic outside the Americas is in Western Europe.

People die everyday – the majority suddenly- of both common and bizarre  causes.  It is hair-raising that after a month, there are still no reports anywhere to indicate whether deaths in cases with the hybrid American flu virus had any clear cause of death attributable to the virus eg virus meningitis, virus pneumonitis, virus carditis, virus hepatitis,  etc. So there is no proof yet that this H1N1 virus has actually killed anyone (as  opposed to them dying of malnutrition, exposure, bacterial or other viral  infection, cancer, diabetes, heart disease etc, although also carrying the new hybrid H1N1 virus). Is the analogy AIDS? where the cause of death is often secondary infections.

tally for LABORATORY-CONFIRMED American (swine/ Mexican)  flu infections as follows: world- 19 countries-  909 cases out of >4120  suspected probable cases; Mexico 506 (out of >2500 suspected cases; USA  233 (and another 514 probable?) ; Canada 85; Spain  44; UK  18 (and another 9 probable?), Germany  8, New Zealand 4, Israel 4, Costa Rica 2, France 2 (and another 7 probable?),  Italy 2;   one  each  Colombia, S Korea, Hong Kong; Netherlands  Ireland  Austria   Denmark, Switzerland.

ie confirmed cases: N America  826; W Europe+ Israel 83;  west  Pacific  6; Africa O; mainland Asia O.

20 deaths associated with  proven Mexican  flu have been reported – only   in Mexicans (another 101 deaths suspect). 4 were 13yrs or younger, 4 over 60yrs. No autopsy results yet confirm whether overwhelming Mexican flu has actually caused a single death. . . The associated death rate in Mexico is   still only 4% of confirmed cases – which means that by now – if it is the American swine virus causing death- around  18 deaths could have been expected in non-Mexicans. But so far there have been no very ill cases or suspicious deaths  except in Mexicans . . is this just a false alarm, or a profiteering conspiracy?

update 2 May 17h00 GMT:   THERE IS NO GLOBAL EPIDEMIC NOR THREATENED PANDEMIC. Despite a gross  of  recent flu cases being screened in Australia, not one has so far been positive for the hybrid virus there. And very few cases of person-to-person transmission have been reported outside Mexico. Outside Mexico, the cases have been milder than the seasonal flu that kills tens of thousands of elderly folk every year.

SEE THE UPDATED PRECAUTIONS/TREATMENT.

tally for confirmed American (swine/ Mexican)  flu infections are as follows:  world- 17 countries-  714 cases (up from 265 in  3 days- out of >4700  suspected probable cases); Mexico 443; USA in 3days doubled from 64 to 162; UK  15, Canada-13 to 55, Spain 4 now 15; Germany  6, New Zealand-4, Israel-3, Costa Rica-2, France 2,  one  each Netherlands  Ireland  Austria   S Korea  Denmark, Hong Kong, Switzerland.       Africa O.

(”Confirmed” is where the specific virus has been isolated.)

25 other countries have suspect cases.

17 Deaths associated with  swine flu have been reported only   in Mexicans – but no autopsy results yet reported to confirm whether swine flu has actually caused a single death. . .

This recalls the experience in the 1918 H1N1 Spanish flu  epidemic that deaths were due to superinfection with strep pneumonia- which is easily treated with antibiotics, although antibiotic resistance may now be high in countries  where antibiotics are freely available and overused.

There have been no more deaths or serious cases related to this American hybrid flu virus reported- but more tests are awaited to see if the deaths in Mexicans could be related to eg a different H1N1 virus, or to strep pneumonia that speculatively accounted for most of the  1918 flu epidemic deaths.

update 1st May GMT 17hoo: the identifying name of this virus is a problem: the first case  was in USA, not Mexico. But the brunt, and all deaths, have been in Mexicans. The virus is a mix of human, bird and swine genetic material- but this hybrid  hasn’t been found in swine yet. There have been lots of type A H1N1 viruses – and worse- around the past century.

so the handle of American  hybrid  flu is the most appropriate.

The reference labs are swamped with backlog of  samples from suspect cases, so the number of confirmed cases and countries will rise- but the number of new suspects seems to be leveling off- with no new serious cases reported from Mexico, and still none serious  anywhere else in the world. There is no sign of a pandemic.

But the news bulletins say nothing about the 2500 cholera deaths in 40 000 cases in Zimbabwe..

Apart from probable cases, the  tally for confirmed swine flu infections are as follows:  world- 17 countries-  533 cases(up from 265 in  2days- out of >4400  suspected probable cases); Mexico 312; USA in 48hrs doubled from 64 to 141; Canada-13 to 35, Spain 4 now 13; UK  11, Germany  4, New Zealand-4, Costa Rica-2, Israel-2,  one  each Netherlands  Ireland  Austria   S Korea  Denmark, Hong Kong, Switzerland, China    ..  South Africa O.

13 confirmed  Mexican  deaths reported  related  to the swine virus – but without autopsies, not  proven that they were due to the swine flu. Other nationals no deaths.

Except in Mexicans, nothing more than average flu symptoms have been reported in confirmed  or probable cases.  So the mystery remains: why have only Mexicans died with this virus?   Deaths  cannot be  from the swine virus alone if no-one but  Mexicans have died from it.

And until autopsy details are released from Mexico confirming that the “confirmed cases” died from overwhelming swine flu, there is no confirmation that this swine flu outbreak is even virulent.

But already the outbreak has become a multibillion dollar windfall for USA between antiviral, vaccine and screening kits.. and a costly disaster for airlines due to the media hype. So far there is no indication to start mass-producing vaccine that will only be available months hence, when the new virus is likely to have greatly changed it’s genetics by then.

Since the outbreak did not start in Mexico but in USA, and is a hybrid avian+ swine+human virus, the least confusing is to stick with the name swine flu- there are worse earlier H1N1 viruses around the world.

update 30 April 17h00 GMT: at midday GMT there  were apparently 108 confirmed swine flu cases reported in the USA- up from 64 +- 36hrs before.

update 30 April 07h00 GMT “The UN’s World Health Organization (WHO) has raised the alert over swine influenza to level five – one short of a pandemic. A phase five alert means human-to-human transmission in at least two countries.”  Only 8 of of the   168 confirmed cases of swine flu have died in Mexico.

Independent on line an hour ago says two  suspect cases have been reported  locally, in Gauteng and West Cape. But so far there has not been a single case of serious illness in  let alone danger for a  non-Mexican in or coming out of Mexico, nor in  anyone who has been in contact with travelers from Mexico. So there is no justification  for the media hysteria, nor for the risky costly American antiviral drugs. All suspect cases so far (other than in Mexicans)  have been average mild flu – and very few cases have been confirmed with the virus even  in Mexico. Many cases of our regular flu this season have been worse than confirmed swine flu cases in non-Mexicans .

So there is nowhere near a pandemic on the horizon- just a lucrative scare for media, for Disease Agencies like the CDC and WHO, American Authorities and the Disease Industry- laboratories and (American) Drug and vaccine and H1N1 screening kit  companies, and pharmacists!.

update 29 April 21.30 GMT: 10 US states have now reported 121  suspect swine virus cases including 1 death in Texas, a visiting toddler from Mexico. Total 2917 suspect cases worldwide .  120 deaths  in Mexicans (few have yet been confirmed as due to swine H1N1)  with 168 cases confirmed swine H1N1 cases out of >2700 suspected cases. . The WHO tally for confirmed infections are as follows: US-64, Canada-13, Britain-5, Spain-4, Germany-3, New Zealand-3, Costa Rica-2, Israel-2, and Austria-1.. none yet in RSA or Australia or Asia or Africa.

update 29  April 07h34 GMT so far good  news-  just on 2000 cases reported from Mexico- but no further deaths there, and no serious cases anywhere else in the world. They are looking frantically for an alternative reason for the deaths – 152 so far reported ,  but few as yet confirmed swine virus -  in Mexicans.

updated 28 April 2009 15h20 GMT. The USA and then WHO  today declared Swine flu  a level 4 health emergency, a pandemic.  See the up-to-the minute report .. it has spread around the world in 2 months.

But so far – unlike in previous flu epidemics-  there are no reports of serious illness eg pneumonia, encephalitis, carditis,  collapse or deaths outside Mexico, not even on the latest Australian or CDC websites.

Why is this swine H1N1 virus affecting especially those between the ages of ~20 – 50yrs?

50years  from 2009= 1959. So the last related outbreak must have been before that time- to give us oldies immune memory protection: perhaps we acquired some  genetic  immune resistance from our parents who survived the 1918 ( also H1N1 swine virus ) flu pandemic (my father was a warden in that epidemic- which killed one of his 11 siblings; his parents, and my grandmother’s parents, had survived the perilous journey out of Russia in the early 1880s, likely after surviving  the great flu epidemic of 1857-9).

But this doesn’t explain why the current outbreak also spares those under 20years.

But we peak in the mid-20s, that’s when all systems start aging.. . and in first-world communities, most are attending group educational institutes if not living carefree for most of those youth years, possibly enhancing group immunity, and before the real stresses of work and kids and smoking and alcohol  hit us…

However, it is  futile to speculate on the affected agebracket since virtually all cases originate in Mexico, where diet, ecology  and lifestyle must be radically different from the other countries whose citizens have been affected.

Why are deaths occurring only in Mexicans? especially when no trace of swine flu has been detected on the piggeries there?

is it Hispanic genes making them more susceptible?

is it an as-yet unidentified bug that is unmasked by/ coincidental to the mild flu contagion that tourists are carrying out?

is it a local acute or chronic toxin that the Mexicans have been exposed to that makes them more vulnerable to this swine flu?

The fact that in Mexico it is mainly the 25-45yr olds who have been affected points especially to workplace exposure? what is the smoking, drug usage, diet, vocational and gender spread of the victims? The first confirmed case of swine flu occurred in California days before the first reported case in Mexico.

Shades of Jose Samargo’s brilliant 1995 novel Blindness, in which an unidentified contagion in an unnamed country inflicts white blindness on almost everyone – and no-one is ever referred to by name.  Shades of New World and Olde World  peoples 500 years ago who were decimated when previously unknown infections scythed through them, brought in by immune humans or eg rodents. Shades of the carnage of AIDS in subSaharan Africa but no-where else, about which conspiracy theories circulate.

PRECAUTIONS against both ‘flu and colds: see the list.

No swine flu cases have yet been reported from  Africa; but with pandemic TB, AIDS, cholera etc, and winter biting hard this month to herald the usual bad flu season, it will be harder to distinguish acute swine flu from other potential  flu/ common cold infections.

Take this list and go ask you local infectious disease specialist, as well as your health care provider-  but above all, take the simple preventative nonprescription  steps listed .. .

So far the most deaths have been reported in  Mexicans ( apparently <2% of those infected - compared to the global estimated deathrate of  2.5% in 1918)  – and only 11  (so far) in visitors with flu returning home  from Mexico ie 0.3%. So this may turn out to be another profitable false alarm for USA Big Pharma to mass-sell antivirals and imminent specific vaccines- as apparently happened after the SARS scare a few years ago, which fortunately  never became the predicted  fatal global  pandemic..

help-line ph +0027836299160.

Healthspan Life!*

ndb