FluPortal.org

[Lord Jim / cc (usable on your site) / Flickr]

Two recent H1N1 briefings, although not directed specifically at journalists, contain helpful information that might be useful to you in your reporting.

First: Last week, the World Health Organization released a briefing note about H1N1 in animals. It’s significance is its stress on the need for ongoing monitoring, since animals — like humans — might well be hosts for viral mutations or recombinations. The worry here: if the current H1N1 virus mutates, it could become more pathogenic.

Concern has traditionally focused on swine, which are susceptible to infections from human and avian influenza viruses as well as swine influenza viruses. As influenza viruses have eight neatly segmented genes, swine could theoretically operate as a viral “mixing vessel” for the exchange of genetic material when an animal is co-infected with different viruses. Such an event could lead to changes in the genetic makeup of the H1N1 virus or result in a novel influenza virus of unknown public health significance. [...]

Another concern is the continuing presence of the highly pathogenic H5N1 avian influenza virus in poultry in several countries, where the virus is endemic. While no one can predict how the H5N1 virus might behave under the pressures of a pandemic, all data to date have been reassuring.

Second: This week, FDA commissioner Dr. Nancy Hamburg sent a letter to U.S. health-care providers. Its goal: to give them information about the H1N1 vaccine that they can pass on to patients — to increase their confidence in the vaccine. The information includes a succinct history of the manufacturing process. It begins like this:

First, scientists at laboratories in the United States and elsewhere modified the 2009 H1N1 virus into a version suitable to be used as the “seed” for the development of vaccines. The process that was followed is similar in every respect to that which is employed every year for the preparation of seasonal influenza vaccines, as slightly different strains appear regularly each year.

It goes on to explain each step through licensing and clinical trials.

On this Veterans Day, U.S. troops in Afghanistan are fighting swine flu as well as the Taliban. They’re living and working in close quarters in Afghan communities that are highly susceptible to widespread H1N1 — susceptible because the local health-care system is extremely fragile and because no WHO vaccine donations have yet arrived. The first Afghan flu death was reported on October 28th, and as of two days ago, eleven citizens had died. The Afghan government has declared a state of emergency, closing schools and universities for three weeks.

How are US soldiers and Marines in Afghanistan being protected? The U.S. Department of Defense is now receiving its first vaccines and figuring out how to distribute the supply. The vaccine will be mandatory for military personnel, and deployed troops will be among the first to receive it.

Here’s a one-minute video (embeddable) reporting on the DoD’s vaccine distribution:

[DoD]

Back here in the US, boot camp for new Army recruits now includes a flu-prevention regimen involving Army-green bottles of hand sanitizer, alcohol wipes, and sleeve coughing:

“We use this over and over, everyday,” said Spec. Arielle Schiltz, 20, of Detroit, Mich., showing how the small vial of hand gel she was issued fits in a shoulder pocket. “You just rub it in. After the latrine, before eating, after eating. It could be 15 to 20 times a day.”

(You can see the bottles in this embeddable six-minute video created earlier this fall by the Army Training and Doctring Command. The video is aimed at military personnel and stresses prevention techniques.)

If you’re interested in reporting on H1N1 and military personnel from your city or region, you could start at the DoD Military Health System’s influenza page, where you can find, among other things, the transcript of yesterday’s H1N1 webhall (an online Q&A). The National Guard also has its own H1N1 page.

In an earlier post, we mentioned that FluPortal is using the social bookmarking service Delicious.com to collect H1N1 coverage and flu-related stories from public broadcasters and other media outlets. For stations wanting to know more about Delicious, we have produced a guide to using social bookmarking in your H1N1 coverage. Delicious can assist your staff in collaborative research and reporting around H1N1. It also can be a great way to identify and share local flu resources with your audience. And for stations looking to offer an RSS feed of your H1N1 stories — you can use Delicious to build one. Take a look at the guide and see if social bookmarking can be a useful addition to your online coverage.

If your station is currently using Delicious (or you’re a power user and have some additional tips), let us know in the comments of this post. We can add your suggestions to the FluPortal guide to Delicious.

Remember Flu.gov’s flu-shot locator? And Josh’s post about mapping local H1N1 vaccine clinics? Well Google may have come up with the best option yet: its own flu-shot locator.

Try it. It’s very easy to use. When I punched in PRX‘s location — Harvard Square in Cambridge, MA — this is what came up:

The red syringe icons indicate seasonal-flu shots; the blue indicate H1N1 shots. In addition to the addresses and phone numbers for each clinic in the left-hand sidebar, there’s also a helpful reminder to contact the clinic you pick before heading out — to check on its supply of vaccine. It also suggests that the MA public-health department may have additional clinic listings.

Google isn’t making the individualized maps embeddable — so you might still prefer to create your own vaccine-clinic map for your H1N1 web page. [See update below.]

[Update 13 November 2009: We just learned that Google collaborated with Flu.gov on the finder and that you CAN embed a widget on your website! You get to choose a small or large version. Just copy and paste the code; it can be on your site in seconds. Here's what the small one looks like:]

This is Part III of an occasional series on creative-commons photos you can use for H1N1 stories or web pages. (Part I here and Part II here.) These are pictures you can use for free — with attribution (full explanation here).

Today: swine-flu street art from around the world.

Stefan Kloo (aka “Lord Jim”), originally from Germany and now living in Los Angeles, takes lots of photos of street art. He captured this pig in LA back in May.

[Lord Jim / cc (usable on your site) / Flickr]

Guilherme Tavares also found a masked pig on the streets last spring — presumably in his town of Pelotas, Brazil.

[gui.tavares / cc (usable on your site) / Flickr]

Around the same time in Adelaide, Jes (aka mugley) documented an Australian version.

[mugley / cc (usable on your site) / Flickr]

Mayu ;P from Tokyo, Japan, also an avid street-art photographer, shot these protest posters in San Francisco earlier this autumn.

[Mayu ;P / cc (usable on your site) / Flickr]

Please let us know whether these posts offering photos are useful to you (or not). You can leave a comment or send us an email via our contact form.

[sea turtle / cc (usable on your site) / Flickr]

The Johns Hopkins University Applied Physics Laboratory, like many organizations and businesses, big or small, has a pandemic plan. Mary Lasky is in charge of that plan. She says her job means “being sure that business can continue” in any emergency — whether it’s a fire or an earthquake, or, at the moment, H1N1.

The Lab’s full pandemic plan is roughly 100 pages long, but the cleverest part is its one-page summary, which presents the most important elements for, Lasky explained, “different phases of a pandemic — e.g., verifying the critical work that cannot be disrupted, when to institute social distancing and work-at-home, actions to be taken if elements of the infrastructure are not available.” The one-page pandemic plan, Lasky told me, “is what seemed to get everyone’s attention” when she presented the idea at an international swine-flu summit in August. 

In addition to her work at the Applied Physics Lab, Lasky helps businesses and organizations in Howard County, Maryland, prepare for pandemic (and other) emergencies. (Click here to see examples of one-page pandemic plans she developed for the county.) This kind of local planning is happening across the country — in your neighborhood, too.

If you’re interested in reporting on it and would like to research the topic, try the relevant CDC page, Flu.gov page, Flu.gov FAQ, or Occupational Safety and Health Administration page. (Many of these resources might be directly useful to your station’s audience, too.) Harvard’s Nieman Foundation offers additional resources and specific story ideas here.

You might also be curious to learn more about SAFER — an NPR-NFCB project to help stations stay on the air during emergencies.

Leave a comment to suggest other places to find continuity planning information.

[Update 11 November 2009: Here are two interesting relevant articles -- one on the possibility of sick workers clogging up the web by working from home; and the other on pending legislation to mandate emergency paid sick leave.]

Health and Human Services just released a new embeddable video on the development, safety, and ongoing monitoring of the H1N1 vaccine:

[Flu.gov / YouTube]

You can find the video and other information about the safety of the H1N1 vaccine here at Flu.gov. (And for additional helpful info, check out this post and this one.)

[Update 5 November 2009: HHS also just released a report detailing "how federal vaccine safety monitoring is being improved to quickly track potential health problems following immunization."]

If you find yourself, in reporting on the H1N1 vaccine, needing to explain “community immunity,” the National Institute of Allergy and Infectious Diseases offers a clear graphic that says it all. Community (or herd) immunity occurs when enough people have been vaccinated to contain the spread of an infectious disease — often protecting even those who haven’t been vaccinated.

The graphic isn’t embeddable, but here’s what it looks like. (You can — as we did — easily grab a screenshot since it comes from a government site and is therefore in the public domain.)

[NIAID]

The image might also be useful for your H1N1 web page.

[samantha celera / cc (usable on your site) / Flickr]

The Atlantic Monthly recently published an article questioning the effectiveness of flu vaccines. Not the effectiveness (or safety) of vaccines in general; specifically the ability of flu vaccines to prevent flu deaths.

It examines the work of dissident flu experts who believe the government focus on vaccines and antivirals is like the New Orleans levees: flawed and hugely ineffective.

The numbers in flu-vaccine studies, these experts say, just don’t add up.

[S]tudy after study has found that people who get a flu shot in the fall are about half as likely to die that winter—from any cause—as people who do not. [...] Yet in the view of several vaccine skeptics, this claim is suspicious on its face. Influenza causes only a small minority of all deaths in the U.S., even among senior citizens, and even after adding in the deaths to which flu might have contributed indirectly. When researchers from the National Institute of Allergy and Infectious Diseases included all deaths from illnesses that flu aggravates, like lung disease or chronic heart failure, they found that flu accounts for, at most, 10 percent of winter deaths among the elderly. So how could flu vaccine possibly reduce total deaths by half?”

One flu researcher, Lisa Jackson, examined the idea that “people who get vaccinated are simply healthier than those who don’t, and thus less liable to die over the short term.” Data from 72,000 people over 65 suggest it might be true. So true, in fact, that it could explain “the entire benefit that other researchers were attributing to flu vaccine.”

The article also cites some historical data that raise questions about the effectiveness of the flu vaccine.

In 2004, for example, vaccine production fell behind, causing a 40 percent drop in immunization rates. Yet mortality did not rise. In addition, vaccine “mismatches” occurred in 1968 and 1997: in both years, the vaccine that had been produced in the summer protected against one set of viruses, but come winter, a different set was circulating. In effect, nobody was vaccinated. Yet death rates from all causes, including flu and the various illnesses it can exacerbate, did not budge.

The article concludes that “by being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.” It’s a provocative piece that seems to ask valid questions. It does, however, appear to consider “effectiveness” rather narrowly: it focuses on prevention of flu-induced deaths. Aren’t prevention of flu complications or prevention of flu, period, also important aspects of vaccine effectiveness? Could this — or any of the charges in the article — inspire some additional reporting?

[Update 10 November 2009: Check out this blog post by NPR's Joanne Silberner -- it takes up some shortcomings of the article but also contains some confusing elements of its own.]

Screenshot from the new iPhone app

Harvard Medical School may have one-upped the CDC’s mobile-phone H1N1 offerings. It recently released an H1N1 iPhone app. For just $1.99, you can download the application and have access to a wealth of H1N1 information and prevention tips to help you protect your family. For $4.00 more, business can purchase an additional component aimed at helping to minimize H1N1′s effect in the workplace.

I spoke with Dr. Anthony Komaroff, a professor of medicine at Harvard Medical School, and editor-in-chief of Harvard Medical Publications — the group behind the iPhone app. “For the last few years, Harvard Medical School has been considering publishing health information for the general public on mobile platforms. The swine flu pandemic was a good fit because it is a focused event, and an intensely important public health topic.”

Once downloaded, users of the app can watch informational videos, determine if specific symptoms indicate a possible H1N1 infection, and whether they should seek immediate medical care. Users can also find the status of the pandemic flu in their community with local data pulled from Health Map. Health Map (which has partnered with Flu.gov) collects its information from a variety of sources, including official public health agency findings, third party scientific monitoring, media reports, and community contributions.

Dr. Komaroff points to the enormous potential that mobile platforms offer to public health efforts. “Fifteen years ago, we never would have imagined having a pocket-sized device that can quickly find you an answer to a health question at almost any time and place.” The hope is that access to reliable and accurate H1N1 information on your mobile device will lessen the influence of misinformation about the H1N1 pandemic.

The HMSMobile Swine Flu Center iPhone app is available in the iTunes store.