A place for the latest news, information and discussion regarding disasters, terrorism, emerging infectious diseases, disaster response, mitigation and preparedness!
Yet another storm hit the country last week, the fourth for the month of October. The Philippines is among the more disaster-prone countries in the world. In 2006 alone, over 40 percent of the natural disasters in the globe occurred in Asia. For the Philippines, that translates to an annual average of 22 tropical cyclones—five of which are destructive—and high-intensity earthquakes every six years.
Over the years, our neighbors have adjusted their disaster mitigation measures. Indonesia, Singapore and Malaysia, for example, each have a single comprehensive law addressing calamities, which covers all phases of disaster management, from preparedness, mitigation, response to recovery.
These countries employ varying disaster-management structures and organizations. Singapore, Malaysia and Australia have their disaster-management agencies placed under a government department, such as the Ministry of Home Affairs in Singapore, the Federal Attorney General’s Department in Australia, and the Prime Minister’s Department in Malaysia. Others like China, Hong Kong, Japan, Korea and Vietnam have an inter-agency coordinating body. Indonesia, on the other hand, has a national authority on disaster management, the National Disaster Management Agency, which reports directly to the President.
In the Philippines, we have the National Disaster Coordinating Council (NDCC), created under Presidential Decree 1566 in 1978. It is the highest policymaking body for disasters in the country, and oversees the regional and municipal disaster coordinating councils.
The paradigm on natural-disaster management has shifted from providing response and recovery toward preparing for disasters, strategic planning and mitigation. As disaster-relief specialist Fred Cuny explains, emergency management is a continuous cycle, and necessarily includes adapting infrastructure, in line with disaster mitigation, as well as increasing public awareness on disaster preparedness and prevention.
Notably, India recently passed its Disaster Management Act of 2005, which decentralized emergency management under the supervision of the National Disaster Management Authority, the lead agency that formulates guidelines on disaster management and coordinates its implementation. Also, the Indian government has just formed the Emergency Management and Research Institute (EMRI). Funded through a public/private partnership, EMRI intends to improve how communities respond to emergencies. Its initial efforts include providing emergency-management training, creating a single emergency hotline, and establishing standards for emergency management.
Other Asian countries such as Japan, Malaysia, Indonesia, Vietnam and Korea have international or regional emergency-training centers. Korea has launched the largest disaster-management simulation training center. Indonesia, on the other hand, has established an international consortium of universities to build up an international-level capacity on disaster-risk management, and facilitate collaboration and pooling of resources of interested international institutes around the world.
In my home province Aurora, we are in the process of establishing the Aurora Disaster Management Training Center (ADMTC) with the help of the Philippine Atmospheric, Geophysical and Astronomical Services Administration and Japan’s Hyogo Prefecture. The latter, because of its experiences in responding to high-intensity earthquakes such as the Great Hanshin Awaji Earthquake, is in the best position to provide the training center professional expertise, technology and equipment.
Hopefully, the ADMTC will be the first of many Disaster Management Training Centers (DMTC) around the country, and operate as the model for capacity-building of local officials, policymakers, professionals and academic organizations in disaster-risk management.
Our lack of preparedness during the past typhoons has multiplied the losses we incurred. The best way to avoid a massive disaster is to be prepared. Establishing a DMTC in strategic locations will certainly help engage Filipinos in the continuous cycle of disaster mitigation, and prevent the typhoons Ondoy and Pepeng from having a sequel
“Heavy rain has caused havoc in north and east Scotland with homes flooded, roads closed and trains cancelled.
Dozens of elderly people had to be moved from their care home in the Aberdeenshire town of Huntly.
The centre of Stonehaven in Aberdeenshire was under water after rivers burst their banks.
And a man in his 60s died after his car was in collision with a lorry on the A90 Fraserburgh to Cortes road. Police said weather could have been a factor…..”
CNN, 11/2/09: “Eighteen people were rescued — but as many as 21 others were
missing — after a boat sank late Sunday in remote seas off
Australia’s Cocos Islands, according to Australian Customs and
Border Protection Service officials.”
CNN, 11/2/09: “At least 30 people are killed as a suicide bomber detonates
explosives outside a bank in the Pakistani city of Rawalpindi,
police report.”
Experts advise WHO on pandemic vaccine policies and strategies
Pandemic (H1N1) 2009 briefing note 14
30 OCTOBER 2009 | GENEVA — The Strategic Advisory Group of Experts (SAGE) on Immunization, which advises WHO on policies and strategies for vaccines and immunization, devoted a session of its 27–29 October meeting to pandemic influenza vaccines. The experts reviewed the current epidemiological situation of the pandemic worldwide and considered issues and options from a public health perspective.
Items on the agenda included the status of vaccine availability, results from clinical trials on vaccine immunogenicity, and early results from safety monitoring in countries where administration of the H1N1 pandemic vaccine is currently under way.
The experts also advised WHO on the number of doses of vaccine needed to confer protection, also in different age groups, the co-administration of seasonal and pandemic vaccines, and vaccines for use in pregnant women. Recommendations on the formulation of seasonal influenza vaccines for the southern hemisphere in 2010 were also provided.
Current situation
Globally, teenagers and young adults continue to account for the majority of cases, with rates of hospitalization highest in very young children. Between 1% to 10% of patients with clinical illness require hospitalization. Of hospitalized patients, from 10% to 25% require admission to an intensive care unit, and from 2% to 9% have a fatal outcome.
Overall, from 7% to 10% of all hospitalized patients are pregnant women in their second or third trimester of pregnancy. Pregnant women are ten times more likely to need care in an intensive care unit when compared with the general population.
Based on these and other current findings, the experts made a number of recommendations.
Single dose recommended
The experts noted that a variety of pandemic vaccines, including live attenuated and both adjuvanted and non-adjuvanted inactivated vaccines, have now been licensed for use by regulatory authorities. SAGE recommended the use of a single dose of vaccine in adults and adolescents, beginning at the age of 10 years, provided such use is consistent with indications from regulatory authorities.
Data on immunogenicity in children older than 6 months and younger than 10 years are limited and more studies are needed. Where national authorities have made children a priority for early vaccination, SAGE recommended that priority be given to the administration of one dose of vaccine to as many children as possible. SAGE further stressed the need for studies to determine dosage regimens effective in immunocompromised persons.
Co-administration of vaccines
Clinical trials investigating the co-administration of seasonal and pandemic vaccines are ongoing, but SAGE acknowledged the recommendation, from the US Centers for Disease Control and Prevention, that live attenuated seasonal and live attenuated pandemic vaccines should not be co-administered.
The experts recommended that seasonal and pandemic vaccines can be administered simultaneously, provided both vaccines are inactivated, or one is inactivated and the other is live attenuated. The experts found no evidence that co-administration of vaccines, as recommended, would increase the risk of adverse events.
Vaccine safety
The experts reviewed early results from the monitoring of people who have received pandemic vaccines and found no indication of unusual adverse reactions. Some adverse events following vaccination have been notified, but these are well within the range of those seen with seasonal vaccines, which have an excellent safety profile. Although early results are reassuring, monitoring for adverse events should continue.
Vaccines for pregnant women
Concerning vaccines for pregnant women, SAGE noted that studies in experimental animals using live attenuated vaccines and non-adjuvanted or adjuvanted inactivated vaccines found no evidence of direct or indirect harmful effects on fertility, pregnancy, development of the embryo or fetus, birthing, or post-natal development.
Based on these data and the substantially elevated risk for a severe outcome in pregnant women infected with the pandemic virus, SAGE recommended that any licensed vaccine can be used in pregnant women, provided no specific contraindication has been identified by the regulatory authority.
Vaccines for the southern hemisphere in 2010
SAGE also considered vaccines for use in the southern hemisphere during the 2010 winter season. Two options were assessed: a trivalent vaccine, effective against the H1N1 pandemic virus, the seasonal H3N2 virus, and influenza B viruses, and a bivalent seasonal vaccine, effective against H3N2 and influenza B viruses, which might need to be supplemented with a separate monovalent H1N1 pandemic vaccine.
The experts concluded that both options should remain available for vaccine formulations in the southern hemisphere, subject to national needs.
NIAID Scientists Propose New Explanation for Flu Virus Antigenic Drift
Influenza viruses evade infection-fighting antibodies by constantly changing the shape of their major surface protein. This shape-shifting, called antigenic drift, is why influenza vaccines — which are designed to elicit antibodies matched to each year’s circulating virus strains — must be reformulated annually. Now, researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have proposed a new explanation for the evolutionary forces that drive antigenic drift. The findings in mice, using a strain of seasonal influenza virus first isolated in 1934, also suggest that antigenic drift might be slowed by increasing the number of children vaccinated against influenza.
Scott Hensley, Ph.D., Jonathan W. Yewdell, M.D., Ph.D., and Jack R. Bennink, Ph.D., led the research team, whose findings appear in the current issue of Science.
“This research elegantly combines modern genetic techniques with decades-old approaches to give us new insights into the mechanisms of antigenic drift and how influenza viruses elude the immune system,” says NIAID Director Anthony S. Fauci, M.D.”
“No one is sure exactly how the antigenic drift of flu viruses happens in people,” says Dr. Yewdell. According to the prevailing theory, drift occurs as the virus is passed from person to person and is exposed to differing antibody attacks at each stop. With varying success, antibodies recognize one or more of the four antigenic regions in hemagglutinin, the major outer coat protein of the flu virus. Antibodies in person A, for example, may mount an attack in which antibodies focus on a single antigenic region. Mutant viruses that arise in person A can escape antibodies by replacing one critical amino acid in this antigen region. These mutant viruses survive, multiply and are passed to person B, where the process is repeated.
It is not possible to dissect the mechanism of antigenic drift in people directly, notes Dr. Yewdell. So he and his colleagues turned to a classic mouse model system developed in the mid-1950s at the University of Chicago, but used rarely since. The team infected mice with a strain of seasonal influenza virus that had circulated in Puerto Rico in 1934. Some mice were first vaccinated against this virus strain and developed antibodies against it, while others were unvaccinated.
After infecting the vaccinated and unvaccinated mice with the 1934 influenza strain, the scientists isolated virus from the lungs of both sets of mice and passed on these viruses to a new set of mice. They did this nine times. After the final passage, the researchers sequenced the gene encoding the virus hemagglutinin protein. Of course, says Dr. Yewdell, gene sequencing was not possible in the mid-1950s, when the nature of the gene was first elucidated, and until very recently, sequencing was expensive and time-consuming. “Now, with automated gene sequencers, sequencing of dozens of isolates is easily done overnight,” he says.
Sequencing revealed that the unvaccinated mice — which lacked vaccine-induced antibodies — had no mutated influenza viruses in their lungs. In contrast, the hemagglutinin gene in virus isolated from vaccinated mice had mutated in a way that increased the ability of the virus to adhere to the receptors it uses to enter lung cells. Essentially, says Dr. Yewdell, the virus can shield its hemagglutinin antigenic sites from antibody attack by binding more tightly to its receptor.
“The virus must strike the right balance, however,” Dr. Yewdell says. “Excessively sticky viruses may end up binding to cells lining the nose or throat or to blood cells and may not make it into lung cells. Also, newly formed viruses must detach from infected cells before they can spread to the next uninfected cell. Viruses that have mutated to be highly adherent to the lung cell receptors may have difficulty completing this critical step in the infection cycle.”
Next, the researchers infected a new set of unvaccinated mice with the high-affinity mutant virus strain that had emerged in the first series of experiments. In the absence of antibody pressure, the virus reverted to a low-affinity form and was once again able to easily infect cells and spread.
“We propose a model for antigenic drift in which high- and low-affinity influenza virus mutants alternate,” says Dr. Yewdell. In adults — who have been exposed to many strains of influenza in their lifetime and, correspondingly, have a wide range of antibody responses — the virus is pressured to increase its receptor affinity to escape antibody neutralization. When such high-affinity mutants are passed to people — such as children — who have not been exposed to many influenza strains or who have not been vaccinated against flu, receptor affinity decreases. People who have not been exposed to multiple influenza virus strains or who have never been vaccinated against influenza are said to be immunologically naïve.
“Our model predicts that decreasing the immunologically naïve population — by increasing the number of children vaccinated against influenza, for example — could slow the rate of antigenic drift and extend the duration of effectiveness of seasonal influenza vaccines,” he says.
Visit www.flu.gov for one-stop access to U.S. government information on avian and pandemic influenza. For more information, also see NIAID’s flu Web portal ( http://www3.niaid.nih.gov/topics/Flu/).
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.
The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.NIAID Scientists Propose New Explanation for Flu Virus Antigenic Drift
Influenza viruses evade infection-fighting antibodies by constantly changing the shape of their major surface protein. This shape-shifting, called antigenic drift, is why influenza vaccines — which are designed to elicit antibodies matched to each year’s circulating virus strains — must be reformulated annually. Now, researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have proposed a new explanation for the evolutionary forces that drive antigenic drift. The findings in mice, using a strain of seasonal influenza virus first isolated in 1934, also suggest that antigenic drift might be slowed by increasing the number of children vaccinated against influenza.
Scott Hensley, Ph.D., Jonathan W. Yewdell, M.D., Ph.D., and Jack R. Bennink, Ph.D., led the research team, whose findings appear in the current issue of Science.
“This research elegantly combines modern genetic techniques with decades-old approaches to give us new insights into the mechanisms of antigenic drift and how influenza viruses elude the immune system,” says NIAID Director Anthony S. Fauci, M.D.”
“No one is sure exactly how the antigenic drift of flu viruses happens in people,” says Dr. Yewdell. According to the prevailing theory, drift occurs as the virus is passed from person to person and is exposed to differing antibody attacks at each stop. With varying success, antibodies recognize one or more of the four antigenic regions in hemagglutinin, the major outer coat protein of the flu virus. Antibodies in person A, for example, may mount an attack in which antibodies focus on a single antigenic region. Mutant viruses that arise in person A can escape antibodies by replacing one critical amino acid in this antigen region. These mutant viruses survive, multiply and are passed to person B, where the process is repeated.
It is not possible to dissect the mechanism of antigenic drift in people directly, notes Dr. Yewdell. So he and his colleagues turned to a classic mouse model system developed in the mid-1950s at the University of Chicago, but used rarely since. The team infected mice with a strain of seasonal influenza virus that had circulated in Puerto Rico in 1934. Some mice were first vaccinated against this virus strain and developed antibodies against it, while others were unvaccinated.
After infecting the vaccinated and unvaccinated mice with the 1934 influenza strain, the scientists isolated virus from the lungs of both sets of mice and passed on these viruses to a new set of mice. They did this nine times. After the final passage, the researchers sequenced the gene encoding the virus hemagglutinin protein. Of course, says Dr. Yewdell, gene sequencing was not possible in the mid-1950s, when the nature of the gene was first elucidated, and until very recently, sequencing was expensive and time-consuming. “Now, with automated gene sequencers, sequencing of dozens of isolates is easily done overnight,” he says.
Sequencing revealed that the unvaccinated mice — which lacked vaccine-induced antibodies — had no mutated influenza viruses in their lungs. In contrast, the hemagglutinin gene in virus isolated from vaccinated mice had mutated in a way that increased the ability of the virus to adhere to the receptors it uses to enter lung cells. Essentially, says Dr. Yewdell, the virus can shield its hemagglutinin antigenic sites from antibody attack by binding more tightly to its receptor.
“The virus must strike the right balance, however,” Dr. Yewdell says. “Excessively sticky viruses may end up binding to cells lining the nose or throat or to blood cells and may not make it into lung cells. Also, newly formed viruses must detach from infected cells before they can spread to the next uninfected cell. Viruses that have mutated to be highly adherent to the lung cell receptors may have difficulty completing this critical step in the infection cycle.”
Next, the researchers infected a new set of unvaccinated mice with the high-affinity mutant virus strain that had emerged in the first series of experiments. In the absence of antibody pressure, the virus reverted to a low-affinity form and was once again able to easily infect cells and spread.
“We propose a model for antigenic drift in which high- and low-affinity influenza virus mutants alternate,” says Dr. Yewdell. In adults — who have been exposed to many strains of influenza in their lifetime and, correspondingly, have a wide range of antibody responses — the virus is pressured to increase its receptor affinity to escape antibody neutralization. When such high-affinity mutants are passed to people — such as children — who have not been exposed to many influenza strains or who have not been vaccinated against flu, receptor affinity decreases. People who have not been exposed to multiple influenza virus strains or who have never been vaccinated against influenza are said to be immunologically naïve.
“Our model predicts that decreasing the immunologically naïve population — by increasing the number of children vaccinated against influenza, for example — could slow the rate of antigenic drift and extend the duration of effectiveness of seasonal influenza vaccines,” he says.
Visit www.flu.gov for one-stop access to U.S. government information on avian and pandemic influenza. For more information, also see NIAID’s flu Web portal ( http://www3.niaid.nih.gov/topics/Flu/).
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.
The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
Typhoon Mirinae Strengthens, Heads for Vietnam Coast (Update1)
By Dave McCombs and Van Nguyen
Nov. 2 (Bloomberg) — Typhoon Mirinae unexpectedly strengthened from a tropical storm as it neared Vietnam’s central coast, where authorities had ordered evacuations.
The cyclone, which had been forecast to weaken to a tropical depression, is expected to make landfall in the next few hours, the U.S. Navy Joint Typhoon Warning Center said.
Sustained winds rose to as high as 120 kilometers (75 miles) per hour as of 4 p.m., Hanoi time, from 83 kph at 7 a.m., the center said. The typhoon’s eye was 416 kilometers northeast of Ho Chi Minh city as the storm moved west-southwest at 13 kph.
About 7,900 people, mostly children, women and elderly residents in Phu Yen, Khanh Hoa and Ninh Thuan provinces, where the storm may make landfall, were evacuated as of 9 p.m. yesterday local time, the committee said. More people will be evacuated today, according to the statement.
Typhoon Mirinae will bring heavy rains to the central coast and central highlands, Vietnam’s National Committee for Flood and Storm Control said today in a statement. Typhoon Ketsana last month left at least 163 dead and caused 14.3 trillion dong ($801 million) in damage, the committee said.
Local governments issued an alert for more than 18,100 boats with almost 104,000 crewmen aboard to take shelter or navigate out of Mirinae’s forecast path, the committee said.
Vietnam is the world’s second-biggest exporter of rice and biggest producer of the robusta coffee.
The main coffee-growing region, including Lam Dong and Dak Lak provinces, are in the southern part of the central highlands that may be affected by the tropical depression. The main rice production areas aren’t in the storm’s path.
SEOUL — North Korea has again pressed the United States for a decision about starting bilateral talks, with a diplomat warning Monday that the North was “ready to go our own way” with its nuclear weapons program.
“Now that we have shown the generosity of stating the position that we would be willing to talk to the United States and hold multilateral talks including the six-way talks, it is time for the United States to make a decision,” an unidentified spokesman for the North’s Foreign Ministry told its official news agency, K.C.N.A.
The comments came after Ri Gun, the ministry’s chief diplomat on U.S. affairs, held informal talks with American officials in the United States last week.
It remained unclear whether Mr. Ri offered enough of a commitment to nuclear inspections and resumption of six-nation nuclear disarmament talks to persuade Washington to agree to one-on-one talks.
Washington has said it would not meet North Korea in bilateral talks unless the North returned to the six-nation talks that also include South Korea, China, Japan and Russia. American officials also vowed to continue to enforce the sanctions imposed by the United Nations after North Korea’s second nuclear test in May.
On Monday, the North Korean spokesman said Pyongyang has reached a conclusion that “the direct parties, which are the North and the United States, must first sit down and find a rational solution.”
To achieve a nuclear-free Korean peninsula, he said, the United States and North Korea must first end their “hostile relationship,” which in the past has meant negotiating a non-aggression treaty and starting nuclear arms-reduction talks with the United States and other regional powers.
After months of raising tensions with its nuclear and missile tests, North Korea last month gave a vaguely worded promise that it would return to the six-party talks, but only if it saw progress in establishing bilateral talks with Washington
Pakistani policemen secure the site after a sucide bomb blast in Rawalpindi on Monday.
STORY HIGHLIGHTS
Islamabad, Pakistan (CNN) — A suicide bomber detonated explosives Monday outside a bank in Rawalpindi where people had lined up to pick up their monthly checks, police said.
The blast, in the Cannt area of the city, killed at least 35 people and wounded more than 65 others, said Aslam Tareen Ishtiaq Shah, a police official.
Rawalpindi, about 18 miles (30 kilometers) from the capital city of Islamabad, is a closely guarded city that is home to the country’s military headquarters.
The Cannt area is short for cantonment, so called because of its proximity to the military offices. It is home to several travel agencies and mid-range hotels.
The bomber rode up to the front of the National Bank in a motorcycle or a bicycle, said Rawalpindi Police Chief Rao Muhammad Iqbal.The impact of the bomb was so intense that residents a block away said they thought the blast took place where they were.
The explosion blew out windows in the three-story building and blackened its walls. Rescue workers in surgical masks picked through the rubble looking for survivors.
Iqbal Nisouwana, a driver, who rushed to the scene to help tend to the wounded said he saw five men in uniform among the wounded.
In recent weeks, Pakistan has been relentlessly rocked by a wave of attacks as Islamic militants retaliate against a military offensive to rout insurgents operating along the Pakistan-Afghan border.
On October 10, militants held dozens of hostages for some 22 hours inside the army headquarters in Rawalpindi. Eleven military personnel, three civilians, and nine militants were killed in the siege.
On October 20, back-to-back explosions took place at Islamabad’s International Islamic University. At least six people died in the attack. Twenty-nine others were wounded.
And on October 28, a massive car bomb tore through the heart of a bustling marketplace in Peshawar, killing at least 100 people and injuring at least 200 others.
The attack on the capital of the North West Frontier Province was the deadliest terrorist attack on Pakistan since the October 2007 attack on a homecoming rally for former Prime Minister Benazir Bhutto. More than 135 people were killed in the suicide bombing in Karachi. Bhutto escaped harm, but she was assassinated two months later
Swine Flu Etiquette: Should families self quarantine?
7:00 amOctober 28, 2009, by Theresa Walsh Giarrusso
We all know I’m a germaphobe, but I am wondering about some choices moms are making after they know one of their children has the Swine Flu. Here are a few examples to consider for our discussion:
1. A child is officially diagnosed with the Swine Flu. The mom, her husband and the child’s sibling all show up at a very optional social event two days later. My feeling is they put other people at risk showing up when one of their children had full on Swine Flu.
The mother’s argument was that she was trying to keep the second child away from the first so he wouldn’t catch it, but a few minutes earlier she had said the doctor said they were most contagious before they felt sick. So her son had already been exposed under that theory.
2. Another mom reported that after her eldest was diagnosed with the Swine Flu she still sent her daughter to school the next day. One day later, that daughter had the Swine Flu. The mom and the baby ended up catching it too. The husband has yet to come down with it. Who knows how many classmates also picked it up!
My assumption is that sibs and probably mothers are going to catch it if one child has it, and I would argue that if at all possible (for at least for 24 to 48 hours after a diagnosis) kids and parents should try to stay away from other people to help prevent the Swine Flu from spreading.
I know in some cases parents cannot miss work. And I’m not saying a well child should be kept out of school for a week or anything that extreme. I just think I would be inclined to keep the “well” child out at least for a day to see what develops. And at the very least skip optional activities for the whole family.
3. A mom who runs a daycare center says they do allow sibs of Swine Flu patients to come to school. They’re not so worried about sibs spreading it as they are parents giving the actual patient Motrin and sending that child on to school because they can’t miss work.
So those are some examples with Swine Flu to think about. But let’s also look at it the context of other illnesses:
Last year my baby has the Rotavirus. She was sick for a week. We had planned to have a Valentine’s Party that weekend at a jumpy place with a bunch of friends. Obviously I wouldn’t have gone and wouldn’t have brought the baby, but the same mom from my first example was very adamant that she didn’t want to be around any members of my family at all! We ended up canceling the party instead of having friends worry about their kids catching something from us. (None of the other kids came down with it.)
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