H1N1: Swine Flu virus mutation in Netherlands endangers patients

Dutch authorities said that a patient infected by a mutant strain of the swine flu virus had died, but added that primarily, the virus was not the cause of death, simply a contributing factor.

Tamiflu Resistant
Harald Wychgel, spokesman for the Dutch Institute for Health and the Environment, told AFP that there had been a "mutation or minor change in the virus to make it resistant to Tamiflu," used in the treatment for influenza. He neglected to say that this also makes it resistant to the current vaccine being provided to members of the Dutch and European public.

FUD
The use of Tamiflu as a 'treatment' is, in itself controversial and many consultants believe it has little real effect. The real benefit comes to the pharmaceutical companies that are distributing it widely using FUD selling techniques. (FUD: Fear, Uncertainty and Doubt) It is helping them ride the storm of economic crisis also sweeping across Europe.

The male patient died on Sunday in the northern city of Groningen. The news of this was witheld until now. "He died not because the virus was resistant but because he was seriously ill and caught the Mexican (swine) flu," Wychgel said.

"We have carried out tests on the patient's associates to see if the mutation had spread but we found no such indications", he said.

Mutated virus spreading
The spread of Tamiflu resistant H1N1 (Influenza A) Swine Flu (Mexican flu) continues and reports said that two more patients in the Netherlands had shown resistance to Tamiflu and therefore the new vaccine.

The death in Groningen is the fifth fatal case of mutated A(H1N1) flu officially reported in Europe, after two in France and two in Norway but many more cases exist worldwide.

The World Health Organisation said last month that mutations had been observed in Brazil, China, Japan, Mexico, where the swine flu pandemic began, Ukraine, and the United States, as early as April. Italy also reported a non-fatal case on Monday.

"The mutations appear to occur sporadically and spontaneously. To date, no links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread," a WHO statement said on November 20.

The WHO also underlined that there was no evidence of more infections or more deaths as a result, while the mutated virus detected up to that point remained sensitive to antiviral drugs used to treat severe flu, oseltamivir (Tamiflu) and zanamivir (Relenza). Unfortunately this is not the case.

Scientists are less complacent and more knowledgable. They know and fear that mutations in flu viruses will continue because that is the nature of viruses, to change and survive. The appearance of a new and potentially virulent strain could cause a more deadly pandemic flu.

The virus scientists reiterated a call for close monitoring of all new variants of H1N1, no matter how 'safe' they appear to be at first. This is no time for rhetoric!

The WHO's role?
The WHO have been trying to downplay the existance of a vaccine resistant variant but has finally come out and admitted it. They also cannot deny that they have lost control of the situation, if they ever had it to begin with.

People are dying from a strain of influenza that they have no vaccine for. Their only role at present is to sit on their comfortable chairs enjoying their comfortable executive life, whilst keeping an accurate count of the mounting deaths, telling everyone that things are not that bad and waiting for the storm to pass.

The Money Trail
Meanwhile, the campaign to vaccinate the entire population of the world with a hastily prepared, poorly tested and potentially damaging vaccine, continues unabated.

After all, there is much at stake; stockpiles of vaccine to be paid for by public funds, process plants churning out millions of doses, sales targets to be met, expenses to be paid, celebratory lobbying events to be organised and incentives to be paid to co-operative government officials; all funded from the meagre profit margins of the pharmaceutical companies, allegedly.

Is Innovation a Healthcare Solution?

While we don't yet have holographic physicians to consult, healthcare is moving online, encouraged by an international coalition of medical and technology companies.

Medical devices from weighing scales to asthma inhalers could soon carry the technology to connect directly to the web, shuttling data between doctors and their patients.

For practical reasons, health workers are often unable to talk to home-based patients with chronic conditions on a daily basis but they could keep in contact online. Medical records automatically updated whenever the patient measures their own blood pressure, checks their weight, or takes their medication. Such technology could help medical workers ensure remote patients are healthy, and detect any problems at an early stage before they become serious.

The move beyond traditional telehealth, remote contact with a patient through phone calls or video conferencing, is being encouraged by the Continua Health Alliance, a non-profit open industry group. The alliance boasts some powerful players in both the technology and medical arenas, including IBM, Intel, Google, Kaiser Permanente and the UK's National Health Service.

We're moving into a 'Web 2.0'-style healthcare model. The medical provider doesn't have to be logged in at the same time as the patient to see the data.

Remote control

The technology for a "Health 2.0" model already exists, but the standards needed to guarantee its smooth running have been lacking, until now. In February, Continua announced guidelines aimed to ensure the interoperability of new medical gadgets. Continua-certified devices will use USB or Bluetooth, and data transmitted between devices will use an IEEE standard in the same way that Wi-Fi networks do.

At the beginning of the year US firm Nonin unveiled the world's first Continua-certified product, a USB handheld pulse oximeter for blood oxygen monitoring.

More devices have followed: in May, international technology development firm Cambridge Consultants announced a wireless inhaler built around the company's Continua-compatible Vena platform.

The device receives a wireless signal and alerts the user when a dose should be inhaled. Once it has sensed the medication being issued, the gadget transmits a confirmation signal back to a central server, and the patient's health record is automatically updated.

'Ecosystem approach'

"To be honest the technology is the easy bit," says Paul Jones, chief technology officer for the National Health Service. "It's all very well having a clever weighing device in your room that notices your weight has increased and you're at risk of diabetes but if that alert doesn't reach the right people the whole system falls apart."

The UK Department of Health has begun trials involving thousands of patients to test whether patients and medics could benefit from the Health 2.0 system, although it's too early yet to draw any conclusions.

Parker is confident that tests of this nature will show the power of the Continua model, because the Continua Alliance already links professional healthcare workers with technology providers. "It's a whole ecosystem approach," he says, which provides technology companies with feedback from healthcare experts to improve their products.

FaceBook for health?

Health 2.0 might involve more than patient-medic interactions. The social networking sites that have emerged in recent years could have their healthcare counterparts, says Paul Williamson of Cambridge Consultants, which is based in the UK.

"We made some concept websites that go with our inhaler to show how you could use the data to benefit the patient," he says. The sites receive signals from medical devices and award points for every compliant dose of medicine. Friends with similar conditions could then informally compete against each other to improve compliance.

Watch a video of Cambridge Consultants' inhaler and concept social network site in action (YouTube)

In research, it's been found that the biggest motivation to take care of your health is co-workers and family. If we can tie compliance to social situations we can create the right environment for people to help themselves.

Sharing society

Parker acknowledges that some may find talk of merging health records and social networks unsettling given the privacy concerns dogging existing services like Facebook. Indeed, any talk of moving medical records online is met with unease, when Continua Alliance member Google launched the Google Health service last year, privacy and security issues were raised. Data security will always remain a high priority.

Thankfully attitudes are changing. With online services like Twitter, people are sharing more personal information than ever before, and some web users may have few qualms about sharing personal data. There's been a sociological shift from not sharing any information to sharing everything, your location and what you're doing every hour of the day.

Jones stresses that patients won't be forced to use the new technology, even in the publicly funded NHS. Those in the UK that do opt for an online service can expect their data to be stored in NHS-run systems rather than Google Health or similar private-sector databases.

"It's about understanding that there's a trade-off," says Parker. A patient might decide that the benefits from using the latest technology to interact with medics, and their peers, outweigh the potential privacy cost – or they might not. "I think a lot of people are now looking at this and deciding it's worth it."