Pixies post with permission.

Let’s play “WHO do you trust”?

Less diplomatically: what’s not clear is whether CDC knows its arse from its elbow. It’s definitely not clear whether CDC would be honest with the American people, and with our military and DHS, should it detect a problem.

Additionally, in a best case scenario it’s not at all clear that CDC would do anything at all in a timely manner. And timeliness, if what we are talking about is highly contagious infectious diseases, is what counts.

Just when CDC knew of the emergence of the 2009 pH1N1 strain, and how honest they were about that, is something worthy of discussion. It may help illuminate what we can expect from CDC in terms of honesty, timeliness, and allegiance when evaluating other possible pandemic-capable virus outbreaks such as this new emerging situation with the H3′s in Iowa (not to mention something worse).

Remember, for some reason it was our DoD which found some of the initial novel H1N1 cases on April 2 in an American DoD family which had come back over the border from Mexico. It was the detection of the novel pandemic-capable H1N1 swine/avian/human strain by the U.S. Navy via a surveillance program it runs out of San Diego that helped force the situation into the light. From a CDC press conference held on April 23, 2009:

I’m not at all clear that had our Navy not become involved, that CDC would have copped to the fact that they knew a new pandemic-capable influenza strain had arisen. When the Navy got involved, CDC knew the hourglass had begun to run. A bit later, denials weren’t possible after Mexican authorities involved Canada in the situation (likely out of desperation).

Again, the CDC’s Anne Schuchat explaining things:

I’ll assume that “elsewhere” might logically mean “within Mexico, at the onset of this outbreak.” Yes, why indeed didn’t CDC know about an emerging virus in Mexico? With CDC’s much ballyhooed surveillance and relationship building for same with our friends and neighbors, it’s logical to ask why CDC appears to want the world to think it knew nothing of what was happening within Mexico as pH1N1 spread.

Without the involvement of our Navy and the public health lab in Ottawa, my hunch is that CDC would have sat on the relevant information interminably. And indeed that’s exactly what appears to have happened, up until the situation could not be denied, with a straight face at least, any longer.

When did CDC first learn of these novel, atypical, influenza cases? Well, at the April 23rd, 2009, press conference during which the the seven American novel flu cases (5 from CA, 2 from TX) were unveiled to our public and the media, CDC spokesperson Anne Schuchat stated that CDC had learned that some of these U.S. citizens had contracted the novel strain “quite a while ago,” as well as “in the more recent past couple of weeks,” so CDC had been aware of the situation, and that the strain had crossed into the U.S., for a some time:

Schuchat was pointedly unspecific. Nobody happened to ask just how long “quite a while ago” might have been.

We do know from the April 24th issue of the MMWR that the 9 yo girl in Imperial County, CA, become symptomatic and had been sampled on March 28. Her brother, who had been symptomatic earlier that week, apparently was not tested. The 10 yo boy in San Diego County, CA, had become symptomatic on March 30 and sought treatment (and was sampled) the same day. Why it took so long to reveal these cases (almost a month) is a mystery. But were these cases their first clue of the emergence of a new pandemic-capable strain? Likely not, and yet CDC remained silent.

Schuchat was asked a very relevant and very direct question at that same April 23 press conference by Donald McNeil of the New York Times. McNeil:

CDC’s Anne Schuchat’s answer at that April 23 press conference:

Really? Really?

She lied. On April 23, 2009, Anne Schuchat, representing the CDC, lied.

The day after that CDC press conference, it was again reported that Mexico had indeed been experiencing a wave of virulent flu and that the health authorities in Mexico had been well aware of it. From the Huffington Post, dated April 24, 2009:

Health Secretary Jose Angel Cordoba was not lying – he was telling the truth. 20 fatalities in Mexico had been confirmed by April 24.

The story of one of those victims, Adela Maria Gutierrez Cruz, a 39 year old Oaxacan woman who died April 13 in San Luis Potosi in Central Mexico of ARDS and atypical pneumonia, reached the Mexican and the North American press. Anne Suchat’s CDC was well aware of this fatal case.

Maria’s atypical flu strain (pH1N1) had already been sequenced in Ottawa and in Atlanta by the time of the April 23 press conference. The results from Ottawa had been reported to CDC by the Mexican authorities on April 16. The confirmation from CDC’s own test on Maria’s sample was reported by CDC to the Mexican authorities on the same day. CDC was well aware of Maria’s confirmation, every which way from Thursday, well ahead of that April 23 CDC press conference.

According to the Mexican media, Maria (39):

Maria (39) in Oaxaca, Mexico, was not the only fatal case of atypical influenza that CDC was very much aware of. Cases had been occurring in Mexico City since mid-March. (And Mexican authorities never asked CDC for help; CDC routine surveillance never picked it up? That’s doubtful).

On April 24, 2009, one day after the CDC’s Anne Suchat’s assertion to Donald McNeil of the NY Times that CDC had no confirmation of swine flu in Mexico, BBC reported:

Young adults had been dying in and around Mexico City (!) of a mysterious virulent influenza since mid-March and nobody had asked the CDC for help? CDC had offered no help, had tested no samples?

Really?

From an AP story, also dated April 24:

Again, these stories ran a day after Anne Schuchat of the CDC asserted to Donald McNeil of the NY Times that – “At this point, we do not have any confirmations of swine influenza in Mexico.” Somebody had confirmed approximately 20 deaths in Mexico were from the new swine flu.

So either CDC is entirely incompetent and thus should not be relied on to provide an early warning of potentially lethal pandemic-capable viruses OR CDC lied to the media and to the American people (as it now appears clearly to have done) in the Spring of 2009 and thus should not be relied upon to provide an early warning of potentially lethal pandemic-capable viruses the next time around.

(We hope those tasked with the defense of this country understand that very important point).

Anne Suchat prevaricated during that April 23, 2009, press conference even as she congratulated reporters, repeatedly, for asking “good questions.” The questions may have been good ones, but when the answers given to a reporter like Donald McNeil of the NY Times are untruths, what is happening is an information control session, rather than a sharing of data and fact.

Why in the world wouldn’t CDC know about a mysterious virulent ILI that was killing young adults in the capital city of our neighbors to the south? Isn’t it their business to know such things? Of course it is!

From a story in the Washington Post dated April 26, 2009, ironically entitled “U.S. Slow to Learn of Mexican Flu” (the CDC official version of the timeline put out for public consumption perhaps revealing more than a bit of “risk communications?):

From the same WaPo story, even allowing for the “official” timeline that CDC countenanced, it’s clear that whatever had been happening in Mexico had been happening for some time (since at least mid-March, possibly since January). Certainly CDC should have known about it, and when Anne Schuchat lied to Donald McNeil of the NY Times on April 23, we can be certain CDC and Dr. Schuchat knew much more than they claimed to know, which was nothing “about any confirmations of swine flu in Mexico.” Quite a lot had been going on south of our border for some weeks by the time CDC learned of Maria Adela Maria Gutierrez Cruz’s confirmation. Again, from the WaPo story:

So we’re supposed to believe that in spite of the fact that all this was going on in Mexico, with a very high awareness level amongst Mexican public health officials, CDC knew about none of it? Does CDC not have telephone service at it’s $1.5 billion dollar newly renovated campus? More from the same story:

Those investigators in Mexico never thought of asking their CDC friends for help? And nobody in Mexico, during what they thought was “an unusually severe outbreak of seasonal flu” chatted with anyone in Atlanta about all this? Nobody at CDC suggested that Mexico send any samples along to Atlanta?

Really? Really?

It’s a bending of the truth that’s beyond the laws of physics to think that CDC’s Anne Schuchat had the temerity to say, on April 23rd, that her agency knew “nothing about any pH1N1 confirmations in Mexico” because it sure looks like everybody else knew:

Ottawa informed Mexico on April 16. Mexico notified the PAHO on April 16 or 17. And we’re supposed to believe nobody told CDC? (Wait, it gets better..).

Now, let’s examine why Mexico ended up sending its samples to Canada. Or, let’s at least examine the CDC version of that story meant for public consumption. Again, from the WaPo story which no doubt made use of the well-scrubbed version of the timeline fed to it by health authorities on both sides of the border who by then were in search of damage control… It’s all so simple, you see:

The lady doth protest too much, methinks.

So CDC was aware that Maria Adela Maria Gutierrez Cruz’s samples and several other samples as well had proven positive because they had done the confirmation themselves on the 16th in Atlanta! And, CDC had been told that Ottawa had confirmed 15 other samples as well!

And yet, there was Anne Schuchat of the CDC stating to Donald McNeil of the NY Times on April 23, 2009, that: “At this point, we do not have any confirmations of swine influenza in Mexico.”

They had confirmations. Canada had been able to confirm within 6 hours of receiving the samples. CDC in Atlanta had been able to confirm within 4 hours of receiving the samples. Remember that, please, the next time this agency strings you along regarding how long it takes to make a confirmation. (In fact, we’re oddly waiting on confirmation of those Iowa H3′s right now, aren’t we?).

Not only did CDC have confirmation of swine flu in Mexico in spite of what Schuchat asserted, we know for certain they made the confirmation of pH1N1 in at least one particular fatal case (that of Adela María Gutiérrez (39) ) on April 16.

It’s funny, Acting CDC head Richard Besser, who had not been in attendance at that April 23 presser, admitted on the 24th that CDC indeed had gotten confirmation of several novel pandemic strain cases in Mexico. By that time the heat was on, the media smelled the illogic of the story as presented, and Besser had to admit to something or he and his agency would look incompetent or ridiculous or both. From a BBC story dated April 24:

And so it goes. None. One. Seven. Fourteen. Take with a very large grain of salt any information flowing from CDC. It’s become a political agency, its priorities not as they might appear. Indeed one wonders whether some officials there don’t believe that their official role and prime directive has become one of “information control” rather than “disease control.” One wonders who is giving those orders.

But back to why the Canadians got involved. My hunch is that we were not being terribly cooperative. We might have even been overtly stonewalling the Mexican authorities. They may have turned to Ottawa in utter frustration as things deteriorated around their country and young people continued to die. If Mexico had sent CDC samples, and the agency had stonewalled them (and we know CDC is very good at that) I can see how the Mexican authorities might have turned to Ottawa. Why all the stalling? Well, that might have been WHO’s idea. CDC is, after all, a WHO reference lab. If CDC had been finding anomalies in the atypical flu samples it had been sent as part of routine surveillance activities that go on all the time between the U.S. and Mexico, or because Mexico had fallen prey to a frightening flu-like virus that was killing its young and had asked CDC for help, it should have reported those findings back to Mexico. Maybe it did not. Maybe the CDC’s relationship with the WHO colored its actions. Again as Nancy Cox, head of CDC’s influenza division, explained:

Indeed, what Cox said makes sense. But what do we then do with the knowledge we obtain from our surveillance and testing?

If we’re doing routine surveillance in cooperation with Mexico, why would Mexico need to send atypical flu samples (from what were by mid-April obviously severe and fatal cases) to Canada? CDC wasn’t interested? Certainly CDC knew of the DoD atypical cases in the U.S. kids by April 2. But they had not made any contact with the Mexican public health authorities after that? They had no curiosity as to what was happening in Mexico? I don’t believe it.

Only when the light from Canada was shone on the problem was the problem in Mexico properly acknowledged. By that time, in spite of CDC’s “routine” surveillance, the novel pandemic strain was all over Mexico. It had caused dozens of deaths there already, and its crossing of the U.S. border (now carried by American families) had been confirmed by the U.S. Navy and CDC’s own EWIDS border surveillance programs weeks before that April 23 press conference.

CDC had confirmations from Mexico. In fact, due to the involvement of Ottawa (finally) CDC not only had confirmation of Adela María Gutiérrez’s case in hand by April 16, but everybody involved had had confirmation of 15 other Mexican cases as well:

All that information was conveyed to CDC on April 16th by Canadian and Mexican authorities (although it’s likely CDC was already quite aware of the entire ongoing situation, and its extent, from its own surveillance activities). CDC had, of course, been sent the same samples as well (as was routine). What was different, this time, was that Ottawa was involved. The lid of secrecy would have to come off, likely to the great relief of the Mexican health authorities. (Who, btw, have let it be known through repeated statements in the media that this sideshow will never happen again and that next time they’ll be ready).

So who, exactly, told CDC’s Anne Schuchat to lie on April 23 and assert that “at that point” CDC did “not have any confirmations of swine influenza in Mexico” when indeed CDC had knowledge of at least 15 confirmations (not including the 7 returning Americans)? Or should I ask instead, WHO?

It’s likely the officials at CDC knew far more about the situation in Mexico. Returning to the fairly well documented case of Adela Maria Gutierrez (39) who died on the 13th of April and who CDC confirmed on the 16th, the trail of her virus didn’t end there. A New York Daily News story dated May 1, 2009, tells a bit more about who Gutierrez might have infected, as well as when those infections were known. CDC likely watched it all happen live — I guess we are supposed to believe in some sort of state of suspended animation, curiously unable to move, even as things got completely out of hand. Where was CDC? More of the story:

All that was happening around just one of the many cases in Mexico and CDC had no idea what was going on, they had no scientific insight whatsoever? Really? No doubt similar scenarios had been playing out all over Mexico. At least 68 people had died by this time and many more were violently ill. Adela Maria Gutierrez’s case is simply one we happen to know something about. CDC had no doubt also heard the stories of the health care workers and Maria’s neighbors becoming infected. They knew about the other deaths at Dr. Aurelio Valdivieso General Hospital. They knew Adela Maria Gutierrez had been confirmed. And yet Anne Schuchat of CDC stood before the American people and denied she knew of any confirmed swine flu cases in Mexico.

But let’s be clear — it’s such a bold lie that it’s obvious that someone told Schuchat to do that. A CDC spokesperson, especially a career Rear Admiral, an Assistant Surgeon General of the USPHS and Director of the National Center for Immunization and Respiratory Diseases is not going to wing that on their own and make it up as they go. There were some very high-level machinations going on.

All of which makes me wonder – just when did CDC in its role as WHO reference lab begin to learn, via its routine surveillance, that a novel strain had emerged in Mexico? And if they knew, why would they hide that information?

Baja, California, is where Americans go, whether they are Los Angeles celebrities or DoD families from San Diego, to take vacations.

In late January of 2009, Goju began to post stories here at PFI of what officials were terming a Rickettsia outbreak on the Baja peninsula. CDC had received samples from Mexico, as one would expect:

It’s been unclear whether or at what point H1N1 cases were mixed in with the Rickettsia cases, and whether CDC had picked them up during surveillance months before it admitted to having confirmations:

Baja, California, Mexico seems to get a lot of support from some great labs:

A story the very well connected science reporter Maggie Fox filed for Reuters notes that health officials may have known of this problematic virus since January:

By February 9th, you might recall, Panasonic had (so oddly) put out that worldwide recall of staff due to worries about an emerging pandemic.

We still do not have the entire truth about what happened as the 2009 H1N1 pandemic emerged, but there sure is some stinky cheese in Atlanta surrounding the subject.

Regardless, from their track record of obvious and rank obfuscation during the onset of the pH1N1 pandemic, it seems that CDC may value political allegiances and spin far more than it cares for our public’s health, at least where matters of pandemic-capable strains, WHO loyalty, and cross-border issues of One World/One Health are concerned. In other words, if one is seeking to protect and defend the United States from potentially lethal biological pathogens, do not rely on the CDC. Do not expect them to be honest or transparent when speaking into a microphone in Atlanta.

So anyway, getting back to the topic at hand, how long does it take them to fully characterize an atypical influenza virus sample over at CDC again? Four hours, right? Ok, so what’s the status of those Iowa H3 strains?

Maybe we should just send the samples to Ottawa.

Dr. Ken Holtorf  Would not Give Flu Vaccine to his children.

http://www.youtube.com/watch?v=E1z7KSEnyxw&feature=related