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News Reports for January 17, 2013

by: NewsDiary

Sat Jan 12, 2013 at 14:05:30 PM EST

Reminder: Please do not post whole articles, just snippets and links, and do not post articles from the Las Vegas Review-Journal. Thanks!

• Poultry exports to Indonesia remain in limbo (Link)

• British Columbia: Masks mandated at Fraser Health Authority facilities to stop flu (Link)
• Ontario: Flu season has hospital ERs scrambling across GTA (Link)

• Gujarat: Two die of swine flu at Rajkot hospital (Link)

• Israeli boy dies of swine flu, first since 2010 (Link)

• Liow: Two trainees at Intan centre down with H1N1 (Link)

Bird flu confirmed in four poultry farms in Kaski (Link)

• MAGFOR Reinforces AI Surveillance (Link)

• Two Palestinians infected with H1N1 virus die  (Link)

United States
• Bad Flu Season Overshadows Other Winter Miseries (Link)
• Chicken soup, extra tissues: Hotels' take on flu epidemic (Link)
• IN: Indiana hospitals restrict visits to limit flu spread (Link)

• Large study confirms flu vaccine safe in pregnancy (Link)
• Regulators approve new insect-based flu vaccine (Link)
• Rapidly Produced Flu Vaccine Wins F.D.A. Approval (Link)
• How Far Off Is a Better Flu Shot? (Link)

• Five Social Media Tools to Fight the Flu (Link)
• Ask Well: Do I Need a Flu Shot if I've Had the Flu? (Link)
• Just One Workout Can Double Your Flu-Fighting Chances (Link)

• Recombinomics: Pennsylvania Flu Deaths Jump to 40 (Link)
• Recombinomics: US Week 2 Pneumonia & Influenza Death Rate Spikes to 8.3% (Link)
• Recombinomics: 9 Pediatric Flu Deaths Cited in CDC Week 2 FluView (Link)

• H (Link)

NewsDiary :: News Reports for January 17, 2013

News for January 16, 2013 is here.

Thanks to all of the newshounds!
Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:
WHO A(H1N1) Site
WHO H5N1 human case totals, last updated December 17, 2012
Charts and Graphs on H5N1 from WHO
Google Flu Trends
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki

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Palenstine: Two Palestinians infected with H1N1 virus die
Two Palestinians infected with H1N1 virus (Snip) died Wednesday in the West Bank (Snip).

(Snip) the two Palestinians are aged over 70 years old.

Death toll due to H1N1 infection in the West Bank has climbed to 17, while more than 566 people were infected with the virus (Snip).

Ramlawi said most of the deceased patients died because their bodies were weak and lacked immunity against viruses, adding that most of those who were infected with the virus received proper treatment from hospitals. http://www.china.org.cn/world/...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


Israel: Israeli boy dies of swine flu, first since 2010
The (Snip) toddler had suffered chronic illnesses, but showed no apparent symptoms of this disease prior to death; two women currently hospitalized in serious condition.

A 3-year-old boy (Snip) died Monday of swine flu (Snip). http://www.haaretz.com/news/na...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


Malaysia: Liow - Two trainees at Intan centre down with H1N1
KUALA LUMPUR: Two administrative and diplomatic officer (PTD) trainees were found to be infected with the H1N1 virus at the Intan training facility in Ipoh. (Snip) they have been isolated and their progress monitored.

"We found that out of the 109 trainees at the centre, 52 were suffering from mild cough and fever but they do not have H1N1. "There is no outbreak, it is just within this particular group and I ensure that action was taken so that no outbreak occurs," (Snip)


"H1N1 is always in the country. Please wash your hands and if you have cough or fever, don't mix with others and wear a mask," he said.

He added that Malaysians planning to travel to cold countries should get vaccinated as the weather could make them vulnerable to diseases. http://thestar.com.my/news/sto...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


US: Indiana hospitals restrict visits to limit flu spread
INDIANAPOLIS - Hospitals across Indiana are tightening visitor restrictions in hopes of preventing the spread of flu, which has claimed the lives of 27 people in the state this season.

Indianapolis health officials have asked area hospitals to implement a policy developed in 2009 during the H1N1 pandemic.

It prohibits people with flu-like illnesses from visiting hospital patients. Additionally, visits are restricted to immediate family, partners and significant others. All visitors under 18 must make special arrangements to see a patient.

Hospitals in Munster and Evansville are adopting similar policies during the outbreak, according to local news reports. Continued: http://www.journalgazette.net/...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


Pennsylvania Flu Deaths Jump to 40
Recombinomics Commentary

Eighteen (18) influenza-related deaths were reported last week, making 40 the total number of flu-related deaths reported season-to-date. A majority of reported deaths are among the elderly (persons >65 years of age). No pediatric (person <18 years) flu-related death has been reported this season.

The above comments and graph of hospitalized patients are from the week 2 flu report from Pennsylvania. The deaths in week 2 match the numbers in week 1 which brings the total number of deaths in the first two weeks of 2013 to 36, with three additional deaths reported in the final week of 2012.  This dramatic rise in deaths begins to reflect the virulence of the H3N2 circulating in Pennsylvania, and the large number of hospitalized cases in 2013 indicates the high death rate will continue.

(Snip)  Media reports have described a pediatric death in Lehigh Valley, which is likely to be lab confirmed, but is not included in the 40 deaths reported in the weekly reports.  The CDC has reported two H3N2 low reactors for the current season, characterized by T128A or L157S and both changes have been reported for Pennsylvania isolates (Snip)

(Snip) recent US isolates (Snip) show an frequency increase in the sub-clade with T128A, raising concerns that this sub-clade will become more common and lower the effectiveness of the H3N2 vaccine which was at 55% in early analysis.

See chart: http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


Nepal: Bird flu confirmed in four poultry farms in Kaski
POKHARA, Jan 16: The government has confirmed bird flu in four poultry farms in Kaski that had recently reported sudden chicken deaths. (Snip) lab tests of sample conducted in Pokhara, Kathmandu and the United Kingdom confirmed that the chicken had died of avian influenza.

"Our technicians culled 2,000 chickens and destroyed feed kept at the four farms to prevent the disease from spreading. They also sprayed chemicals in the affected farms," he added.

The directorate had deployed six teams of technicians in the affected areas.

Of the 35 samples collected from different poultry farms in Pokhara, tests confirmed bird flu in four samples. Continued: http://www.myrepublica.com/por...

**From Wikipedia: Pokhara Sub-Metropolitan City is the second largest city of Nepal with 264,991 inhabitants and is situated about 200 km west of the capital Kathmandu. It serves as the headquarters of Kaski District, Gandaki Zone and the Western Development Region. Map: http://maps.google.com/maps?hl...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


India: Two die of swine flu at Rajkot hospital (Gujarat)
Two women have died of swine flu at the Rajkot Civil Hospital over the last three days (Snip).

Meena Varaniya, a resident of Gandhigram area of Rajkot, died two days back at the hospital where she was admitted after being infected by the H1N1 virus (Snip). She died after four days of treatment.

Another woman, Radha Karsanbhai (19), a native of Chotila town in Surendranagar district, was admitted to the hospital on January 13 after suffering from high fever and cold. Radha was later found to be suffering from swine flu. She succumbed to the infection last night, sources added.

The district health department has, meanwhile, denied an outbreak of the deadly infection and said both the women caught infection when they had gone outside the district. Rajkot, Surendranagar, Vadodara, Jamnagar and Kutch had been listed by the health department as H1N1-afflicted districts earlier this month as authorities stepped up efforts to contain the virus' spread ahead of an expected onset of visitors from outside the state for various business and tourism events. Continued: http://www.indianexpress.com/n...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


Large study confirms flu vaccine safe in pregnancy
January 16, 2013

NEW YORK (AP) - A large study offers reassuring news for pregnant women: It's safe to get a flu shot.

The research found no evidence that the vaccine increases the risk of losing a fetus, and may prevent some deaths. Getting the flu while pregnant makes fetal death more likely, the Norwegian research showed.


The new study was led by the Norwegian Institute of Public Health. It tracked pregnancies in Norway in 2009 and 2010 during an international epidemic of a new swine flu strain.

Before 2009, pregnant women in Norway were not routinely advised to get flu shots. But during the pandemic, vaccinations against the new strain were recommended for those in their second or third trimester.

The study focused on more than 113,000 pregnancies. Of those, 492 ended in the death of the fetus. The researchers calculated that the risk of fetal death was nearly twice as high for women who weren't vaccinated as it was in vaccinated mothers.

U.S. flu vaccination rates for pregnant women grew in the wake of the 2009 swine flu pandemic, from less than 15 percent to about 50 percent. But health officials say those rates need to be higher to protect newborns as well. Infants can't be vaccinated until 6 months, but studies have shown they pick up some protection if their mothers got the annual shot, experts say.


United we stand: Divided we fall

Five Social Media Tools to Fight the Flu

Bernhard Warner on January 16, 2013  

The Centers for Disease Control and Prevention (CDC) officially declared this year's flu an epidemic last week, confirming what thousands of miserable patients may have already suspected. It's not that public health officials are clueless. The problem is that epidemiologists are almost always working off data that is a few weeks old. When a fast-moving flu bug is spreading, often mutating as it goes, cutting that lag time is critical to effectively fight influenza. The flu claims 250,000 to 500,000 lives per year and saps workplace productivity to the tune of $87 billion in the U.S. alone.

Increasingly, health officials are turning to computer coders to chase the flu in real time. Google Flu Trends (GOOG) became a star when it accurately reported the severity of the 2009 flu season nearly two weeks before the CDC. Its method of crunching data on regional flu-related search queries was hailed as a real breakthrough in early detection of contagious diseases.

The severity of the 2012-13 flu season may prove a further boon to epidemiologists and coders.[snip]

Here are five of the interesting tracking tools that Penttinen says he and his team are already using and/or following to speed up information flows in the flu fight. He laments that many of the tools don't work well in analyzing the non-English world. Still, he warns, public health agencies are following them-and you should, too.

NOTE: The article describes the purpose of each of the five sites below:

Google Flu Trends: http://www.google.org/flutrends/

DIZIE: http://born.nii.ac.jp/dizie/

MappyHealth: http://www.mappyhealth.com/

HealthMap: http://healthmap.org/en/

Flu Near You: https://flunearyou.org/

Videos available at the site:

Lothar Stitz: A Vaccine for Every Strain of the Flu

Severe Flu Season Driving Up Vaccine Demand

Fighting Off the Flu at the Office

What Is the Real Cost of the Flu for Families?

More Than 40 States Reporting Widespread Flu

How Does a Flu Outbreak Impact Business, Pharmas?

Is Paid Sick Leave Good for Business?

Can the Flu Virus Make the U.S. Economy Sick?

Canada: Masks mandated at Fraser Health Authority facilities to stop flu
Globe and Mail
Karen Baillie has been in the residential care business for 35 years, and she says this is a first for her.

Ms. Baillie, executive director of Laurel Place in Surrey, was referring to a rare, public-health edict requiring all visitors and staff at 125 long-term care facilities throughout the Fraser Health Authority to wear a mask, if they have not had a flu shot.

NICARAGUA: MAGFOR Reinforces AI Surveillance
16 January 2013

NICARAGUA - The Agriculture and Forestry Ministry has strengthened surveillance and launched a training program in light of the recent outbreak of avian influenza virus of the type H7N3, reported in the state of Aguascalientes in Mexico.

The announcement was made by Dr Marvin Rodriguez, director of animal health MAGFOR, who confirmed that Nicaragua is permanently on health alert to prevent entry of avian influenza and other diseases that could affect the bird population of the country.

Actions are run with the support of the country's poultry sector and the International Regional Organization for Agricultural Health, although the disease is not present in the country, said Dr Rodriguez.


United we stand: Divided we fall

[ Parent ]
Regulators approve new insect-based flu vaccine

By Jethro Mullen, CNN
updated 5:44 AM EST, Thu January 17, 2013

Lab developing long-lasting flu shot

Unlike other flu vaccines, Flublok doesn't rely on eggs or the influenza virus. [snip]Instead, it's made by growing a virus protein in insect cells. This allows for more rapid production in the event of a pandemic, the FDA says
The vaccine is available in limited supplies during the current flu season

Instead, Flublok's production involves programming insect cells grown in steel tanks to produce large amounts of a particular flu virus protein, known as hemagglutinin, according to Protein Sciences, the vaccine's manufacturer.
Most human antibodies that fight flu infection are directed against hemagglutinin, the FDA said.

This method allows for more rapid production, making more of the vaccine available more quickly in the event of a pandemic, the FDA said.

Flublok, which is different from other flu vaccines, because it isn't made using eggs or an influenza virus, is approved only for adults ages 18 - 49.

"This approval represents a technological advance in the manufacturing of an influenza vaccine," said Karen Midthun, director of the FDA's Center for Biologics Evaluation and Research. It has already been used in vaccines approved for other infectious diseases.


Flublok will be available in limited supply this winter and widely available during the next flu season, [snip]
And it proved 44.6% effective against all influenza strains in circulation, not just those that matched the strains included in the vaccine, according to the FDA.

Rapidly Produced Flu Vaccine Wins F.D.A. Approval

The vaccine, developed by a small company called Protein Sciences, is made with a process that does not require the virus to be grown in chicken eggs, as is now generally done. That means a vaccine could be ready weeks earlier in the event of a pandemic.

Manon Cox, the chief executive of Protein Sciences, said the company could have about 150,000 doses ready to distribute later this flu season. That is a relatively small amount, but it could be particularly helpful for people who do not get flu shots now because they are allergic to eggs.

Most flu vaccines are made by growing the virus in chicken eggs, then inactivating or killing it, a long process.

Flublok, by contrast, consists only of a protein - hemagglutinin - from the virus. The protein is made by putting the gene for hemagglutinin into a virus that infects insect cells. Those cells, from the fall armyworm, are grown in culture and churn out the protein. Neither eggs nor the live virus are used, though viral genetic information is needed.

[ Parent ]
Canada: Flu season has hospital ERs scrambling across GTA
Toronto Star
A nasty flu season combined with other seasonal viruses has swamped GTA emergency departments, with some seeing record numbers of patients.

Toronto Public Health alone said there had been 1,180 lab-confirmed influenza cases between September and Tuesday. It's more than triple the usual number by this time of year.

Bad Flu Season Overshadows Other Winter Miseries

Dr. Beth Zeeman says she can spot a case of influenza from 20 paces. It's not like a common cold.

"People think they've had the flu when they've had colds," Zeeman, an emergency room specialist at MetroWest Medical Center in Framingham, Mass., tells Shots. "People use the word 'flu' for everything. But having influenza is really a different thing. It hits you like a ton of bricks."


Dr. Andrew Pavia, an infectious disease specialist at the University of Utah, says flu has certain hallmarks. "A classic case of flu starts off suddenly with high fever, maybe shaking chills, severe muscle and body aches," he says. "It's not uncommon for people to say their hair hurts, they hurt so badly."


Chicken soup, extra tissues: Hotels' take on flu epidemic

Barbara Delollis8:40a.m. EST January 17, 2013

WASHINGTON D.C.- No traveler wants to catch the flu when they're on the road. So, as the deadly strain of influenza sweeps the USA, travelers and hoteliers alike have been taking extra precautions to stay healthy - or at least feel less miserable.


Travelers, meanwhile, view the flu epidemic as so threatening that many are changing their habits. Some simply aren't traveling this month, while others are skipping crowded elevators and avoiding gym equipment.

In a time of year when contact with germs could mean a week in bed, USA TODAY Road Warrior Richard Miller of Plano, Texas, says that something as simple as waiting in line in a hotel lobby poses risks. While checking into the Four Points by Sheraton hotel in Houston last week, Miller says a woman standing in front of him turned around and sneezed - all over his leg."No apology, even after I pointed out there were a couple of square inches on my other pant leg she might have missed," Miller says.

Susan Jacobsen of Washington D.C., says she brought a mini-bottle of Lysol disinfectant spray [snip] She used it to disinfect her hotel room.


Despite the vaccine, Ridderbusch remains so leery of catching the flu that she's ditched her traditional workout sessions in the hotel gym for exercising in her hotel room - far from germ-riddled equipment. She's avoiding other potential germ traps. [snip] "I try to avoid riding in the hotel elevator with anyone. I use the back of my hand for pressing elevator buttons,"


Proactive help. At the Omni Berkshire Place hotel, Labetti's encouraging employees to ask guests who don't appear to be feeling well if they can help. That could mean walking to a drugstore to buy a guest a specific medicine. "As a hotelier, the first thing out of your mouth is, 'What can we do for you?'," he says. "Do you need extra blankets? Do you need a humidifier? Whatever you need, we're going to take care of it. [snip]

Ask Well: Do I Need a Flu Shot if I've Had the Flu?


Brian Snyder/Reuters

First, how do you know you had the flu? There are more than 100 viruses that can cause "colds and flu" symptoms - though a bad flu is worse than most of them. Doctors often describe it as "high fever, aches and the feeling that you've been hit by a truck." The country is having an early flu season, plus a big wave of norovirus (sometimes called "stomach flu" or "winter vomiting flu"), plus its worst whooping cough outbreak in 50 years, plus the usual spate of winter colds. Unless a doctor took a nasal swab, you can't be sure that what you had was flu - and unless it was sent on to a top state laboratory or to the Centers for Disease Control and Prevention lab for sequencing (which is not routine), even your doctor wouldn't be able to say for sure exactly which flu virus it was.

Second, even if you had the flu, you presumably had only one strain, which you now have antibodies against. There are at least four strains circulating this year: H3N2, H1N1, and two different B strains. The flu shot contains vaccines against three of them (it only has one of the B's). By next year, some flu shots will have four vaccines. So a shot would still offer protection against flus you have not had. I suppose your chances of getting flu twice in one season aren't huge - but some people just get unlucky. And if you have any reason to particularly fear flu, like a depressed immune system, serious obesity or diabetes, or if you are pregnant, you should definitely talk to a medical professional about this.

How Far Off Is a Better Flu Shot?

Someday you may only have to get a flu shot every five years.

for National Geographic News
Published January 16, 2013

As you waited in line for your flu shot last weekend, you may have been wondering: Why must I go through this every year? The answer is that the influenza virus is a slippery character. Some viruses barely change at all over time. [snip] But influenza is "genetically plastic," said Schaffner. It mutates all the time, and it can combine with other flu strains to regularly make new variants.

Those kinds of changes happen so frequently that the body's immune system won't necessarily recognize this year's iteration of the flu as a dangerous threat-even if you suffered from or were vaccinated against last year's version.


"Is [the current vaccine] the answer for tomorrow? Yes, it's the best we have. Use it," said Michael Osterholm, lead author of the 2011 review and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"Is this the answer for the next few tomorrows?" he continues. "No. We need better flu vaccines."

And that need is acute. The World Health Organization puts the global death toll from seasonal flu at 250,000 to 500,000 per year, out of 3 million to 5 million severe cases. In the United States, an estimated 3,000 to 49,000 people die each year from the flu, according to the CDC.

[Much more]

Osterholm was the lead author of an October Center for Infectious Disease Research and Policy report that called for "game-changing" influenza vaccines.

The traditional flu vaccine includes pieces of the "head" of the hemagglutinin protein, which is found on the surface of the flu virus. When immune cells called B cells run into those bits of protein after vaccination, the cells learn to make antibodies against them. Later, if the actual flu virus comes along, these prepared B cells can mount a speedy response and prevent infection.

The problem is that this part of hemagglutinin mutates rapidly, and the older antibodies are of no use against the newer version of the virus.

Researchers and some biotech companies are now trying to target proteins in the influenza virus that don't vary from strain to strain and from year to year.

"If this piece of the virus is the same among all influenza viruses and doesn't change over time, maybe we can make a vaccine against it," said Gregory Poland, director of the Mayo Clinic's Vaccine Research Group.

The hope is that the approach yields a universal vaccine that protects against seasonal flu without annual shots. Such a vaccine could also keep the body poised to fend off a major new flu virus, like the 1918 strain that killed tens of millions of people and the 2009 pandemic of a strain of H1N1, aka swine flu.

As they seek that silver bullet, researchers are taking a variety of approaches.

[Note: the article continues to describe the attempts that are being made to develop a universal flu shot that may last five years and will cover all strains of flu.]

Oops! I meant to cut more text from the article.
The old hit "Post" instead of "Preview" got me again. There is much more to the article at the link above.

[ Parent ]
Just One Workout Can Double Your Flu-Fighting Chances

Ashley Feinberg
Considering how terrible this year's flu is, odds are good that you've already become a languid pile of festering contagions. And in case you've managed to evade the virus thus far, get thee a flu shot ASAP, obviously-but then go work out. It may just double your chances of staying plague-free.

Flu shots themselves are, at best, usually only about 70% effective, depending on how many antibodies it helps the body produce. It's common knowledge that those in good shape are better equipped to fight the flu, but even the elderly, who don't often respond well to inoculation, were able to improve their odds with increased exercise.

There's even good news for the exercise averse: all it takes is a single, 90-minute post-shot workout session to double your body's antibody response. And until then, trust no one. [The New York Times]

Poultry exports to Indonesia remain in limbo
Thursday, 17/01/2013

Australian poultry exports to Indonesia will not resume until at least 21 March, after Jakarta ban on imports after a strain of bird flu was detected on a New South Wales farm last November.

This is despite the farm, near Maitland in the Hunter Valley, being given the all-clear just days before Christmas.

Indonesia insists their import ban must extend for three months past the date that the all-clear was given, and then only after the World Organisation for Animal Health (OIE) is also notified.

Australian Chicken Meat Federation's executive director Dr Andreas Dubbs says Indonesia's action is different to the majority of nations importing Australian poultry.

"Many countries have reinstated the trade back in December or before and many countries only limited it to that farm or New South Wales so in the first instance so its a broad range and Indonesia is at one extreme of the spectrum in this instance."


United we stand: Divided we fall

US Week 2 Pneumonia & Influenza Death Rate Spikes to 8.3%
Recombinomics Commentary

Tomorrow's CDC week 2 FluView will show a Pneumonia and Influenza death rate of 8.3% well above the epidemic threshold of 7.3%. (Snip) in week 52 the rate approached the threshold of 7.1% when it increased to 7.0%.  In week 1 it crossed the 7.2% threshold when it rose to 7.3%.  Week 2 saw a full percent rise to 8.3 (Snip)

This rise was strongly suggested by Google Flu Trends which showed intense levels in most states and cities in the US, in contrast to the CDC telebriefing which noted some declines, especially in the southeast.  However, state weekly reports cited high numbers of fatalities, suggesting that the rate would soon spike higher to levels well above the epidemic (Snip).

Note: See chart: http://www.recombinomics.com/N...  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


9 Pediatric Flu Deaths Cited in CDC Week 2 FluView
Recombinomics Commentary

MA (1 ), NY (2 ), OH (1 ), MN (1 ), NE (1 ), TX (2 ), MI (1 )

The above list of 9 pediatric deaths will be cited in tomorrow's week 2 FluView.  These cases will increase the season total to 29.  As seen in the table below, the 9 cases in week 2 are the highest for this season and are higher than any week last season (Snip).  However, there are at least 8 more lab confirmed cases including 7 which have been reported in state repots.  Four of these seven are from Colorado, which reported two cases in week 50 and 2 more in their week 2 report.  The reasons for the delay in reporting these cases from Colorado, as well as the Indiana case that was reported in week 52, remains unclear.


FluView pediatric cases
Wk   #    Location
02    9    MA NY(2) OH MN NE TX(2) MI
01    2    KS TX
52    2    MI NY
51    8    AR FL ME MI(2) TX WA WI
50    2    NJ
49    1    TX
48    3    IN FL SC
46    1    TX
41    1    TN

Pediatric deaths not in FluView
02    4    OH+ CO(2) DE
01    2    PA* SC
52    1    IN
50    2    CO

*  = Lab confirmed but not in state updates
+ = Under investigation

(Note: See chart: http://www.recombinomics.com/N... )  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown


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