Tue 18 Nov 2003
USA - Widespread Rash of Increased Influenza Activity
Today there were twenty-six areas (zip codes) with newly identified influenza activity across the United States and three areas with increased activity. Only one area dropped off the active list.

Here is a gif animation that shows US flu activity for the 10-20 November timeframe. Note the swath of new influenza activity on 18 Nov. [Revised 22 Nov.]

The author stated on 14 November (see updated forecast above), "Further solar CMEs which impact Earth during this flu season should not trigger any substantial new influenza outbreaks." That statement may [or may not] be correct. The three day delay between the most recent CME [on 15 Nov] to reach Earth and the widespread influenza activity barrage [on 18 Nov] seems a little short for a cause and effect relation. [Revised 22 Nov.]

Another matter which does come to mind, however, is the possibility that the CME may have driven more than the normal amount of comet dust (from the first of two Leonid meteor showers this year) into Earth's atmosphere. (According to a Space Weather News e-mail dated 18 Nov, "The 2003 Leonid meteor shower began on Nov 13th with a mild flurry of meteors over the Pacific Ocean." The second shower is due on Nov. 19th.) The extra dust particles could serve as condensation centers for water droplets, which could have then led to the unusual North-South band of precipitation that raced from West to East across the United States. The cause of the high winds associated with this weather system needs more investigation. It may have been related to a jet stream being pushed closer to the Earth's surface.

The five-day time delay between the 13 Nov Leonid meteor shower and the 18 Nov influenza blast seems sufficient to perhaps reconsider the author's 7 Sep disclaimer "... barring any unforeseen Earth-comet tail encounter, there should be no new exobiological visitors (viral or bacterial) dropping in on the Earth during the northern hemisphere's normal flu season." The comet dust, in this case, may have even begun dropping in earlier than 13 Nov.

. . .

Wed 19 Nov 2003
USA - Influenza A Virus, Vaccine Composition
The influenza vaccine now being given was not developed to protect against a strain of the virus [A/Fujian/411/2002(H3N2)] that has surfaced in this country this fall, but the government is optimistic that this year's vaccine will stave off outbreaks, a top federal official said on Mon 17 Nov 2003. The reason is that animal studies suggest that the strain of virus [A/Panama/2007/99] included in the vaccine is close enough to the new one that the vaccine will still protect, said Dr. Julie L. Gerberding, the Director of the Centers for Disease Control and Prevention (CDC) in Atlanta.

Still, she warned, that the United States could face a severe epidemic this year, given that the influenza season began unusually early and has hit Texas and Colorado particularly hard. ... The influenza vaccine includes three strains of influenza virus, but was not designed to protect against a new one that has appeared in a number of countries over the last year. . . .

The World Health Organization committee that makes the recommendations for the influenza vaccine knew about the Fujian strain in Feb 2003, said Dr. Klaus Stoehr, an influenza expert at the organization. But Dr. Stoehr said in a recent interview that the committee decided not to include the Fujian strain [in the Northern Hemisphere vaccine] because [there was not sufficient time to modify for inclusion in the current vaccine.]

Source: ProMED Digest - Wed 19 Nov 2003 - Vol. 2003: No. 445

Sat 22 Nov 2003
China (Beijing) - Pediatric Diarrhea, rotavirus suspected
Beijing Star Daily (via Healthoo.com) Thu 13 Nov 2003 [edited]
A new virus still has not been discovered from among the cases of pediatric diarrhea in Beijing municipality. Yesterday the media said that since the onset of winter, this city has seen a gradual increase in pediatric diarrhea, and there were specialists who said that the cause of this pediatric diarrhea is suspected to be a new virus. This reporter went to confirm this information from the Beijing's Children's Hospital, and received a denial [that a new virus is involved] in response. . . .

Yesterday's headline that: "Children's Hospital Receiving 10000 Pediatric Diarrhea Cases Daily, New Virus Suspected" has aroused the attention of not a few children and parents. . . . But this reporter learned from the Hospital that for seasonal reasons, every year during this period there is always an increase in diarrhea patients treated at the hospital . . . Looking at current conditions, the primary cause of diarrhea among pediatric patients is rotavirus, not that a new virus has emerged.

Fri 21 Nov 2003
China: Reassessment of Gastroenteritis Outbreak in Guangzhou
On 12 Nov 2003, an outbreak of gastroenteritis was reported by ProMED-mail in Guangzhou, China, and subsequently archived as "Viral gastroenteritis update 2003 (24) 20031112.2801".

This report suggested that the etiologic agent was a virus and that the symptoms of fever, vomiting and diarrhea were characteristic of a viral gastroenteritis. A subsequent report suggested that the incident was probably the result of staphylococcal food poisoning. [On 16 Nov, the ProMED Digest moderator, Vol. 2003: No. 444, stated that the staphylococcal food poisoning diagnosis must be suspect and viral gastroenteritis more likely if fever was really present.]

Source: ProMED Digest - Wed 22 Nov 2003 - Vol. 2003: No. 449

Wed 26 Nov 2003
USA Influenza, Colorado
See MSNBC's online report Flu kills 4 children in Colorado. Larimer county, mentioned in the MSNBC article, located some 60 miles NNW of Denver, has been in a Watch status on FluWatch.com since 8 Nov.

Sat 29 Nov 2003
China (Guangdong Province) - Undiagnosed Gastroenteritis at Dongguan University of Technology
Between Thur 20 Nov 2003 to Fri 21 Nov 2003, a number of students at the Songshan lake Campus of Dongguan University of Technology developed vomiting, diarrhea, fever, and other symptoms. . . . According to an unidentified student, some 30-40 students were affected. There were also students who became ill but did not go to the clinic or hospital for treatment. . . . An administrator says that 10 students went to the hospital for treatment [the evening of 18 or 19 Nov], [the next day] another 11 students were added, but symptoms were relatively light. [More than 1600 students are at the school.] The administrator also said that although some students suffered ill temper and other feelings, these were caused by psychological influences. . . . [Campus food and drinking water are being analyzed by health authorities.]
Source: ProMED Digest - Saturday, November 29, 2003 - Vol. 2003: No. 456
From: Southern Metropolitan Daily, Sat 22 Nov 2003 (translated from Chinese. [edited]

Mon 01 Dec 2003, Paris
Flu Epidemic Hits France's Ailing Health Sector
More than half a million people in France, including many children, have contracted flu, gastroenteritis or bronchitis in recent weeks in a unusually early winter flu outbreak--and experts say the triple-epidemic has yet to recach its peak. - - - [Some hospitals are described as being in a "permanent state of crisis." . . . "Media coverage of crowded hopital waiting rooms and off-duty staff being recalled to cope with the influx may eveh have exacerbated the crisis by causing alarm and prompting more people to bypass local doctors and head straight to the hospital."]
Source: Reuters: Health News Mon 01 Dec 2003 08:15 AM ET [Edited.]

Sat 06 Dec 2003, Moscow
Undiagnosed Disease Outbreak Among Students at Moscow State University
According to the "Stolichnaya" newspaper, [a disease outbreak started] at the end of November in a number of student hostels simultaneously. According to preliminary data the cause of the outbreak is a severe form of pneumonia. . . [According to the Student Health Service Polyclinic] "This outbreak may be a severe form of flu with associated high temperature, where an affected person might die in 3 days."
Source: ProMED Digest - Sat 06 Dec 2003 - Vol. 2003: No. 459