Friday, May 1

I apologize for not posting lately, but have been busy with work assignments. Since the S&P closed over 875 today for the first time, I will provide some analysis later this weekend. In the meantime, I would like to take some time to discuss the H1N1 flu virus, which has been making news lately. There is a good possibility a national emergency in the coming week, which would have a big impact of the stock market.

Marcus Gitterle, MD: (Director of Longevity Research) is an Emergency Room Physician in New Braunfels, Texas. He sent out an email to some patients, close friends, and family a couple of days ago, which was intended only to help them understand the seriousness of this epidemic. One of the recipients went public with the email; and since then, he has been forced to backtrack somewhat on his comments to KSAT in San Antonio as the email indited the media for not providing adequate public awareness of the seriousness of the pandemic.

His comments are revealing. His original email message is as follows:

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Subject: Flu Update from Dr. Gitterle

After I returned from a public health meeting yesterday with community leaders and school officials in Comal County and Hays County, Heather suggested I send an update to my patients in the area, because what we are hearing privately from the CDC and Health Department is different from what you are hearing in the media. Some of you know some of this, but I will just list what facts I know.

- The virus is infectious for about 2 days prior to symptom onset

- Virus spreads more than 7 days after symptom onset (possibly as long as 9 days) (this is more unusual than ordinary flu)

- Since it is such a novel (new) virus, there is no "herd immunity," so the "attack rate" is very high. This is the percentage of people who come down with a virus if exposed. Almost everyone who is exposed to this virus will become infected, though not all will be symptomatic. That is much higher than seasonal flu, which averages 10-15%. The "clinical attack rate" estimation from CDC and WHO may be around 40-50%. This is the number of people who show symptoms. This is a huge number. It is hard to convey the seriousness of this to those outside of the medical fields.

- The virulence (deadliness) of this virus is as bad here as in Mexico, and there are folks on ventilators here in the US, right now. This has not been in the media, but a 23 month old in Houston is fighting for his life, and a pregnant woman just south of San Antonio is fighting for her life. In Mexico, these folks might have died already, but here in the US, folks are getting Tamiflu or Relenza quickly, and we have ready access to ventilators. What this means is that within a couple of weeks, regional hospitals will likely become overwhelmed.

- Some of the kids with positive cases in Comal County have had more than 70 contacts before diagnosis as a minimum figure. - There are 10-25 times more actual cases (not "possible" cases -

- ACTUAL), than what is being reported in the media. The way they fudge on reporting this is that it takes 3 days to get the confirmatory nod from the CDC on a given viral culture, but based on epidemiological grounds, we know that there are more than 10 cases for each "confirmed" case right now.

- During the night, we crossed the threshold for the definition of a WHO, Phase 6 global pandemic. This has not happened in any of our lifetimes so far. We are in uncharted territory.

- They are advising President Obama to declare an emergency sometime in the next 72-96 hours. This may not happen, but if it doesn't, I will be surprised. When this happens, all public gathering will be cancelled for 10 days minimum.

- I suggest all of us avoid public gatherings. Outdoor activities are not as likely to lead to infection. It is contained areas and close contact that are the biggest risk.

- I suggest all of us avoid public gatherings. Outdoor activities are not as likely to lead to infection. It is contained areas and close contact that are the biggest risk.

- Tamiflu is running out. There is a national stockpile, but it will have to be carefully managed for law enforcement and first responders as it is not enough to treat the likely number of infections when this is full-blown. I don't think there is a big supply of Relenza, but I do not know those numbers. If I had to choose, I would take Relenza, as I think it gets more drug to the affected tissue than Tamiflu.

- You should avoid going to the ER if you think you have been exposed or are symptomatic. ER's south of here are becoming overwhelmed today-- and I mean that -- already. It is coming in waves, but the waves are getting bigger.

- It appears that this flu produces a distinctive "hoarseness" in many victims. The symptoms, in general, match other flu's; namely, sore throat, body aches, headache, cough, and fever. What is not too common in regular flu cycles is vomiting and diarrhea which seems to be associated with this, further dehydrating victims. Some have all these symptoms, while others may have only one or two.

- N-Acetyl-Cysteine -- a nutritional supplement available at the health food store or Wimberley Pharmacy, has been shown to prevent or lessen the severity of influenza. I suggest 1200mg, twice a day for adults, and 600mg twice a day in kids over 12. It would be hard to get kids under 12 to take it, but you could try opening the capsules and putting it on yogurt. For 40 pounds and up, 300-600 mg twice a day, for less than 40 pounds, half that.

- Oscillococinum, a homeopathic remedy, has been vindicated as quite effective in a large clinical trial in Europe, with an H1N1 variant. You can buy this at Hill Country Natural Foods, or the Wimberley Pharmacy. If any of my patients become ill, or suspect infection, call the office, do not come without calling and DO NOT go to the ER. If one member in a family is identified all would be given the Tamiflu or Relenza (that is normal course of action) if there is enough distributed to fill prescriptions.

Public health stated that one family member identified or suspected to have contracted the flu it will require the whole family to be ‘quarantined’ in their own home until enough time has passed for the remaining household to have contracted it or be considered infection free ( 7 to 10 days per person).

As another suggestion, if any member of the family is on routine medication- fill those prescriptions now. Have plenty fluids, Motrin, soups, etc available and make contingency plans in case your family is affected.

Dr. Marcus Gitterle

New Braunfels, TX

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The 1918 Spanish Flu that killed 20 to 40 million worldwide was also the H1N1 version, but with an additional amino acid. The 1918 Spanish Flu also started out in the spring and was at first considered a mild virus throughout that spring. It died out in the northern hemisphere when summer came but sustained itself in the southern hemisphere as it is now starting to do in New Zealand, Australia and in Asia.

It was not until the fall of 1918 when everything broke loose in the northern hemisphere as people considered the virus mild and continued on to work and rapidly spread the infection.

Considering we are already at the end of the flu season and warmer weather has started, we are getting a massive spread of this virus; so this tells you how virulent this virus is. This suggests the next couple of winters will bring very high rates of infection and overwhelm the healthcare system. Watch Dr. Henry Niman of Recombinomics discussing"Swine" flu. His projections are disturbing, to say the least. He is a world-known doctor specializing in infectious diseases like SARS, flu, etc.

Remember, 9 out of 10 people will only get mild to moderate symptoms from this flu. According to Dr. Niman (who says he is not wrong and WHO essentially agrees with his analysis), Mexico is the prime proving grounds for this virus as it started in February and had a chance to take root.

To put things into prospective, based on the Mexico flu's virulence, if you see 1/3 of the population of the US get the virus as in 1918 - - say 100 million people - - expect to see 90% with mild to moderate symptoms, with 10% getting pneumonia, and an overall 3% mortality rate from pnemonia like in 1918 and now Mexico (actually, Mexico's mortality rate is thought higher). With a a 3% mortality rate, you could see 3 million US deaths. With modern medical technology, maybe this will fall to 1.5 million, which assumes we don't run out of medical supplies and our medical system is not overwhelmed.

So, don't consider virus to be a flash in the pan just yet. It is virulent and will likely be back next fall. Hopefully, we will have a vaccination available by this fall.

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From the Survivalblog.com

The Mexican Flu and You

In the past 24 hours I've received dozens of e-mails from SurvivalBlog readers about the emerging Mexican Flu. Some news stories have included cryptic comments from heath officials, implying that the mechanism of infection makes this particular virus "very difficult to contain." This leads me to conclude that those infected have a long latency period during which they are infectious, yet, they do not display frank symptoms. This does not bode well for any hopes of containing the spread of the virus.

Then we hear a CDC official stating: "The swine flu virus contains four different gene segments representing both North American swine and avian influenza, human flu and a Eurasian swine flu." That strikes we as something very peculiar.

The disease is respiratory, and has one strong similarity to the 1918 Spanish Flu: "The majority were young adults between 25 and 45 years old," said one official under the condition of anonymity. Since, young and healthy people with strong immune systems are the most likely to succumb, this might indicate that the biggest killer is a cytokene storm--a collapse caused by the human immune system's over-reaction to a pathogen.

I strongly recommend that everyone reading this take the time to re-read my background article on flu self-quarantine and other precautions: Protecting Your Family From an Influenza Pandemic. The details that I give there are quite important. Pay special attention to my discussion of the shortage of hospital ventilators. If anyone in your family is immunosuppressed, consider yourselves on alert. Make your final preparations to hunker down, immediately.

In the next few days, there is a good chance of wholesale panic, including some well-publicized "runs" --probably first for hand sanitizer and face masks, and soon after for bottled water and groceries. Plan on it.

UPDATE: The BBC News web page Mexico flu: Your experiences has some updates posted from individuals in Mexico City.

To summarize, here are some key quotes from a recent article:

"This outbreak is particularly worrisome because deaths have happened in at least four different regions of Mexico, and because the victims have not been vulnerable infants and elderly."The most notorious flu pandemic, thought to have killed at least 40 million people worldwide in 1918-19, also first struck otherwise healthy young adults."..."But it may be too late to contain the outbreak, given how widespread the known cases are. If the confirmed deaths are the first signs of a pandemic, then cases are probably incubating around the world by now, said Dr. Michael Osterholm, a pandemic flu expert at the University of Minnesota."No vaccine specifically protects against swine flu, and it is unclear how much protection current human flu vaccines might offer."

Current statistics show a less than 10% lethality rate, but of course the first wave of flu victims are getting access to the best medical care available. If the contagion spreads, sheer numbers will quickly overwhelm hospital facilities--particularly the number of mechanical ventilators available. So the lethality rate may rise, even if there is not a viral mutation.

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The BBC News web page Mexico flu: Your experiences has some updates posted from individuals in Mexico City. This article is worth reading.