Talk:2009 swine flu pandemic

Article's name discussion

1st renaming

from '2009 Mexico and U.S. swine influenza outbreak' to '2009 H1N1 influenza outbreak'

Extended content

This article's name will be outdated the moment a case is reported in a third country. I suggest that once the strain is given a name by the CDC, that name be integrated into this article's title. Resurr Section (talk) 10:07, 25 April 2009 (UTC) What about : "2009 H1N1 flu outbreak" ? Yug 12:03, 25 April 2009 (UTC) —Preceding unsigned comment added by 78.231.120.5 (talk) Agreed. --Artman40 (talk) 13:21, 25 April 2009 (UTC) Double agreed. Jolly Ω Janner 13:22, 25 April 2009 (UTC) Agreed even more. Alphabet55 (talk) 14:47, 25 April 2009 (UTC) The current name, 2009 Mexico and U.S. swine influenza outbreak, violates Wikipedia's WP:NOR no original research. 1) This is because I haven't seen a single reliable source that call it this. 2) The introductory paragraph starts with "The", not "A" This means that it is a proper name, violating 1) 3) It's also inaccurate because there is reference in the news for it to be Mexican but not U.S. (even though there are 8 U.S. deaths). The solution is: 1) Temporarily, to remove "The" 2) Follow the original suggestion to use the CDC name when it is coined. User F203 (talk) 15:02, 25 April 2009 (UTC) just a correction... there are 8 US infections and 0 US deaths as of yet. --68.209.2.187 (talk) 15:41, 25 April 2009 (UTC)

2nd renaming talks

Proposal: from '2009 H1N1 influenza outbreak' to '2009 swine flu outbreak'

• favoring '2009 H1N1 influenza outbreak' : user Yug argue that this name is accurate, while '2009 swine flu outbreak' de facto refer to a pork-to-pork flu, and that an encyclopedia (such wikipedia) should not copy such misleading name.
• favoring '2009 swine flu outbreak' : user Nosimplehiway argue that all media (CNN, NPR, CBC, BBC, New York Times) using the name 'swine flu', as well as the WHO & CDC, wikipedia should use the same name.

Further opinions are need to get a concensus. Yug (talk) 18:04, 26 April 2009 (UTC)

Extended content

Most media outlets seem to simply be calling it "Swine Flu", so maybe "2009 Swine Flu Outbreak" would work best. Casual users will more likely be searching by that less technical name, and not likely H1N1. Nosimplehiway (talk) 19:39, 25 April 2009 (UTC) So, most media are misleading when using 'swine flu'. According to my own opinion, we are not yet pork. Yug (talk) 20:43, 25 April 2009 (UTC) One century ago, a British Sir would have happily add “by your grand mother, or by your grand father, you look more like to be apes ” Yug (talk) 20:47, 25 April 2009 (UTC) This is not just in my own opinion. In addition to major media outlets (CNN, MSNBC, CBC, NPR and BBC), it is being referred to as "Swine Flu" by the CDC, HealthCanada and by the Mexican Health Secretary. (Well, in Spanish it is Gripe Porcina, and for French Canadians, it is being translated as Grippe Porcine.) If we list this page under some other name, it will be less accessible to those seeking info on this disease.Nosimplehiway (talk) 21:14, 25 April 2009 (UTC) http://portal.salud.gob.mx/contenidos/noticias/influenza/conferencia_prensa_preguntas240409.html http://www.cdc.gov/swineflu/investigation.htm http://www.hc-sc.gc.ca/index-eng.php http://www.hc-sc.gc.ca/index-fra.php I understand your point, and yes: most media use 'swine flu', I agree. My opinion is that an encyclopedia, wikipedia, should no copy misleading names. In the previous big human flu, the names are : 1918 flu - Asian Flu - Hong Kong Flu - Fujian flu . While non-human flu have name such as : Canine influenza - Equine influenza Avian influenza - Swine influenza, specifically occuring as animal-to-animal transmission. The recent years so called Avian Flu was still an occuring as animal-to-animal transmission. But here, we are now, especially in this wiki article, talking about human-to-human transmission, and no more of the former Swine flu. So, in my opinion, a new name will soon appear. And the misleading 'swine flu' name should be avoid on an encyclopedia, such wikipedia. Yug (talk) 22:32, 25 April 2009 (UTC) For whatever reason you may not personally like that it is called Swine Flu, but it is. Every media outlet and government agency I can find is calling it that. That is it's name. I have found "swine flu" used as the primary name on MSNBC, CNN, NPR, the CBC, the BBC, the New York Times, the Times of London, Reuters, the AP, the Australian Broadcasting Corp. and the LA Times. Add to that the government agencies I cited above (CDC, Mexican Sec. of Health and HealthCanada). Oh, and add to that the World Health Organisation which calls it swine influenza or swine flu in the bodies of articles, though it should be noted they are using the designate "swine influenza A(H1N1)" more formally. If you have a problem with the common language term "swine flu" take it up with those sources. Nosimplehiway (talk) 23:12, 25 April 2009 (UTC) Name discussion is interesting in what it reveals about wikipedia and the level of reliability, NPOV etc. Just by glancing at the diff language versions this can be seen. Deutsch thinks its not even noteworthy - so article deleted (with apparently no voting on that), Portuguese says north america, spanish swine fever and i have also seen diff strain names. It would be good to agree on a common authority, as WHO seems to be the overall arbiter (not individual nations) re pandemic status, perhaps the title should reflect the WHO terminology and thus Influenza and not flu should be used in the title, as woudl be the case in a scientific journal, this is not the simple English version of wikipedia after all. —Preceding unsigned comment added by 212.246.66.223 (talk) 13:19, 26 April 2009 (UTC)

looking at the offical UN name for it "swine influenza A(H1N1)" ( see www.who.int/mediacentre/news/statements/2009/h1n1_20090425/en/index.html ) is interesting, when there is time probably good to have disambiguation/redirect pages that catch the more technically accurate search terms but for now suggest that this is quickly becoming the primary "swine flu" article, in the interests of providing quick access to people looking to know whats going on it would be helpful if people who type swine flu into the search box come here - then when time permits add the rest of the appropriate additions such as disambiguation to 1918 swine flu etc - one vote for "swine flu" as article title with disambiguation etc to follow [ note that this is not a technical position but more based on what is the public usage and meaning - technically its not really swine flu etc...]

—Preceding unsigned comment added by 209.17.145.179 (talk) 19:20, 26 April 2009 (UTC) 

Edit conflicts

It seems like Wikipedia does pretty well merging edits, even if the diff from "Show changes" shows reverts. —Centrx→talk • 16:33, 25 April 2009 (UTC)

NY towns

[1] Let's leave the names in for now, please. They are so few (thankfully so far) that they are notable enough for a one-off mention, if the California counties are. rootology (C)(T) 16:50, 25 April 2009 (UTC)

Anything other than a general mention of these cases should be left out because they are identified speculatively by a single non-medical source, whereas the California counties are identified definitely as the same H1N1 by all medical authorities involved.

It is probable that one or both of the schools mentioned by the Daily News do not have the H1N1 swine flu. School outbreaks of various diseases happen all the time. A cursory search ([2]) reveals numerous major high-school flu outbreaks for many years.

Specifically, the virus at the Chappaqua high school was identified by the Westchester Health Department in this article specifically as norovirus, not influenza.

—Centrx→talk • 17:26, 25 April 2009 (UTC)

This article suggests the Amityville case may have been influenza A, though still not necessarily this new H1N1 swine strain. —Centrx→talk • 17:27, 25 April 2009 (UTC)

However, this later article identifies the illness as a common form of influenza, not an unsubtypeable form that would have been sent to the CDC for special identification. —Centrx→talk • 17:34, 25 April 2009 (UTC)

Useful flu-specific forum

The Swine Influenza Outbreak Forum at FluTrackers.com is a useful news aggregator, and also has some expert discussion that may be interesting.

FluTrackers is a very good link. Anyone object to listing this in the article under Outside Links?Nosimplehiway (talk) 21:24, 25 April 2009 (UTC)

Done. I also added links under that section to the appropriate CDC and WHO pages. —Centrx→talk • 22:12, 25 April 2009 (UTC)

Also interesting are these comments at the BBC, which are reviewed and selected by the BBC but may be unreliable. —Centrx→talk • 18:06, 25 April 2009 (UTC)

Smithfield Foods

Keep an eye on this;

• http://www.grist.org/article/2009-04-25-swine-flu-smithfield/
• http://www.jornada.unam.mx/2009/04/06/index.php?section=estados&article=030n1est

You know how it goes-- this will start to spread fast from news sources, if even 0.1% true. rootology (C)(T) 18:43, 25 April 2009 (UTC)

Timeline breakdown found

See here. If anyone has access to local news sources that tie into the listed events and details, this article can be significantly expanded. It goes all the way back to March 30th. rootology (C)(T) 18:48, 25 April 2009 (UTC)

Nice. Maybe we can get together a list of sources like this, that are outside the Times's and the CDC's of the world. —Centrx→talk • 19:00, 25 April 2009 (UTC)

Beginning this article

"There was a 2009 Mexico and U.S. flu outbreak of a new swine flu strain of Influenza A virus subtype H1N1.[1]"

This is the first sentence. It is strangely worded, not to mention when you dumb it down slightly, it is basically saying "There was a flu outbreak of a new flu strain of influenza". Too many flu's, and wrong tense since it's a current event. —Preceding unsigned comment added by 70.53.46.85 (talk) 19:06, 25 April 2009 (UTC)

I have fixed it up. For information on how you can edit, visit Wikipedia:Introduction. —Centrx→talk • 19:20, 25 April 2009 (UTC)

Kansas

I heard there were two cases in Kansas. Can anyone find a reference? 24.144.116.147 (talk) 20:27, 25 April 2009 (UTC)

[3] rootology (C)(T) 21:20, 25 April 2009 (UTC)

Suspected cases

This article says that there are cases of this outbreak in Massachusetts and Minnesota, but don't approximate any type of figures. Should I wait to insert them into the table until a number is provided? — Σxplicit 22:51, 25 April 2009 (UTC)

Yes. --Una Smith (talk) 23:01, 25 April 2009 (UTC)

There is another (3rd?) suspected case in Canada, per the media.[4] I would not mention it in the article, because now that this strain is on the "radar", in some places any influenza-like illness will be counted as a possible case involving this virus. --Una Smith (talk) 01:10, 26 April 2009 (UTC)

Deaths from possible cases

If we get a citation for the figure of 14 deaths from confirmed cases, will that then be subtracted from the 68 deaths from possible cases? Someone will have to keep an eye on making sure the numbers match up properly. --π! 22:56, 25 April 2009 (UTC)

Yes. --Una Smith (talk) 23:01, 25 April 2009 (UTC)

I've changed it back to the way it was before, except renaming "Deaths from possible cases" to "Deaths from all cases". That column was apparently added as a "placeholder"--with empty and so incorrect values. Someone tried to correct it by adding values close to correct, and so it was all botched. —Centrx→talk • 23:05, 25 April 2009 (UTC)

Since 44 of the deaths are still being investigated, we may have to lower that number eventually. --π! 23:13, 25 April 2009 (UTC)

Quite possibly, though if Mexico is following its standard MO and informal reports are correct, such as BBC comments by the Mexico City doctor and another resident, the number will be higher. —Centrx→talk • 23:34, 25 April 2009 (UTC)

unusually virulent

None of the confirmed cases in the US were "unusually virulent"; either the phrase needs to be removed from this article, or it needs to be qualified with a source that establishes the virus in Mexico is in fact "unusually virulent". --Una Smith (talk) 23:00, 25 April 2009 (UTC)

This may be supposed to be in reference to the fact that this severe swine flu spread by human-to-human transmission, not the usual direct contact with animals. —Centrx→talk • 23:21, 25 April 2009 (UTC)

Virulence is the ability of a pathogen to cause disease (morbidity) or death (mortality). This new strain is notably low in its virulence, at least in California: there, out of the 50 cases that triggered investigation due to severity, 0 were this new strain. --Una Smith (talk) 23:55, 25 April 2009 (UTC)

There is too little data to draw conclusions about properties of the virus. It responds well to antiviral treatment. The fact that out of seven cases, none of them got deathly ill, doesn't say much. --π! 23:59, 25 April 2009 (UTC)

The low virulence is demonstrated by the fact that although the new strain is circulating in California, none of the severe cases of influenza-like illness were due to the new strain. Anyway, low and high are relative; how about we just remove any subjective descriptions of the new strain, at least for the time being? --Una Smith (talk) 00:55, 26 April 2009 (UTC)

What I'm not seeing is the evidence that it is "circulating" in California. --π! 01:16, 26 April 2009 (UTC)

Circulating is a tangent; do we need to discuss it? The difference in apparent virulence between the US cases and the central Mexico cases may be not in this new influenza virus, but in the secondary infection that causes the pneumonia that is the immediate cause of the deaths there. --Una Smith (talk) 01:24, 26 April 2009 (UTC)

Is there really a difference in apparent virulence? Given numbers reported here recently on the news, 1600 cases in Mexico, of which 68 were fatal, vs. 8 cases in the US, split between California and Texas, how many deaths would we expect given the death rate in Mexico? Running the numbers, we'd expect 0.34 deaths, which is exactly what we have, rounded to the nearest integer (you can't have a fractional number of deaths). Victor Engel (talk) 15:39, 26 April 2009 (UTC)

Wow, that's a lot of colons. I'm not trying to be argumentative, I'm just thinking through the epidemiology of this. The two things that we know is that 7 people were infected in California, and that nobody else demonstrating severe flu symptoms has proven to have H1N1. We cannot make any conclusions based on this. The seven probably had been to Mexico, heard about the outbreak, ran to the doctor as soon as they started to show symptoms, and have been on antivirals ever sense. You're assuming that other people have been infected and simply don't have severe symptoms, but we don't have evidence anyone else has even been exposed. --π! 01:49, 26 April 2009 (UTC)

We all are thinking it through... None of the confirmed US cases had severe symptoms (eg, pneumonia); all were self-limiting. So far, it appears only one confirmed US case was even hospitalized,[5] and most (all the rest?) of the cases required no medical treatment at all. That's one approach to the question. The other approach is to consider what is know from surveillance of severe cases. The US has a large influenza surveillance program that preferentially checks the virus type in severe cases of ILI. In the US, so far no severe case of influenza due to this strain has been detected. See 2008-2009 Influenza Season Week 15 ending April 18, 2009 --Una Smith (talk) 05:04, 26 April 2009 (UTC)

Re "we don't have evidence anyone else has even been exposed": the fact that all but 2 of the confirmed cases in the US are unlinked is strong evidence that this strain already has spread, undetected, among other people in the US. Re "The seven probably had been to Mexico, heard about the outbreak, ran to the doctor as soon as they started to show symptoms, and have been on antivirals ever sense." No, all 7 were detected by the influenza surveillance program, from samples collected days or weeks prior to the first public report. Also, the official reports about most of the confirmed cases state that the symptoms are mild and required no medical treatment. --Una Smith (talk) 05:15, 26 April 2009 (UTC)

Myriad government denials as "responses"

Are we really going to add an entry for every single country in the world that denies any flu exists in their country, which will probably be every single country in the world that does not have any suspected cases? —Centrx→talk • 23:18, 25 April 2009 (UTC)

I have deleted Denmark and Ireland, whose only response is the non-notable and ubiquitous statement that "we don't have it; we monitor developments and take all reasonable steps; wash your hands". Kept Peru because "maximum air and sea alert" sounds big and military, but it is possible Peru should be deleted too as it seems that phrase may just mean the same ordinary precautions every country takes. —Centrx→talk • 23:26, 25 April 2009 (UTC)

I believe the countries listed are appropriate as having a significant level of involvement, connection or action regarding the virus. I am positive we are not going to include every country, nor would I support such an endeavor. Cordovao (talk) 23:29, 25 April 2009 (UTC)

I do agree the entry on Peru is debatable in whether we should have it, but I personally think the governor's actions are quite notable in the current climate (emphasize on current, could be not notable later). Oh, and I agree with the removal of Denmark and Ireland. Cordovao (talk) 23:33, 25 April 2009 (UTC)

For those interested, the Australian response can be found at this ABC report. The current Argentina section seems similar — does anyone else think it should be removed? --Zigger «º» 08:12, 26 April 2009 (UTC)

Removed the Argentina section, as they were just following the global WHO advice. Ref was http://www.reuters.com/article/marketsNews/idUSN2648252220090426 . --Zigger «º» 08:41, 26 April 2009 (UTC)

Madagascar 1

Any references to Madagascar should be considered highly suspect, and should probably be removed immediately absent solid citations.

For those unfamiliar, there is a popular flash game called Pandemic II, the object of which is to create a virus which kills off the entire world population. It is a nearly impossible game to win because at the slightest hint of ill health anywhere in the world, the President of Madagascar orders all ports into the country closed, thus preventing infection of his populace.

It has become a prevalent internet meme, and references to it have already been removed from this article at least twice. Wine Guy Talk 23:50, 25 April 2009 (UTC)

Perhaps semi protect is necessary on account of this? --Saddhiyama (talk) 12:16, 26 April 2009 (UTC)

While I agree that all Madagascar information should not be considered good faith, we should try to keep the rest of the page as easy to update as possible. For now, the vandalism is relatively contained and I don't think the whole page should suffer as a result. Ijwofawx (talk) 12:54, 26 April 2009 (UTC)

Review please, if this RS for this article - I think it is

Look past the "blog", please, as blogs are not inherently "unreliable", as detailed from many sources at Wikipedia:Blogs as sources. The site in question was posted by me above here, and is:

• biosurveillance.typepad.com, written by the named individual, James M. Wilson V, MD.

He's a certified expert on the subject, a scientist in the field, and has testified before both the US Congress and US Senate. More info on him. He's also the CTO and Chief Scientist of Veratect, a corporation that specializes in tracking this very sort of influenza outbreak. He's about as expert as anyone can possibly be on the subject. From his biography on his site (how does this guy not have his own article at James M. Wilson V??):

He was the Principal Investigator of Project Argus, Chief of the Argus Research Operations Center, and Division Head of Integrated Biodefense at the Imaging Science and Information Systems Center, Georgetown University. He was a founding member of the Biosurveillance Indication and Warning Analysis Community (BIWAC), which included CDC’s Global Disease Detection team; USDA’s Centers for Epidemiology and Animal Health (CEAH); DHS’ National Biosurveillance Integration Center; the Armed Forces Medical Intelligence Center; other Intelligence Community organizations; the Defense Threat Reduction Agency; and the US Strategic Command Center for Combating Weapons of Mass Destruction. He was a member of the Department of Homeland Security National Biosurveillance Integration System (NBIS) Concept Design Review team and the first Chief of Analytic Operations at the National Biosurveillance Integration Center (NBIC). Dr. Wilson has served as a Special Assistant to the Director for Weapons of Mass Destruction at the US Army Medical Research and Materiel Command Telemedicine and Advanced Technology Research Center (USAMRMC-TATRC), Ft. Detrick, Maryland; Visiting Scientist at NASA-Goddard Space Flight Center; consultant to NOAA’s National Environmental Satellite, Data, and Information Service (NESDIS); and research team member of the World Health Organization Tai Forest Project on Ebola Hemorrhagic Fever.

Any objections to using this specific blog post written by Dr. Wilson as a source here, besides invalid/inaccurate claims that we can't use blogs as a source? rootology (C)(T) 00:47, 26 April 2009 (UTC)

He is a reliable source. Care does need to be taken in describing the information he conveys. For example, if "Residents claimed that three pediatric cases, all under two years of age, died from the outbreak", that probably does not belong in an encyclopedia. Much such information is in this source. Though the reporter is reliable, he is conveying potentially uncorroborated sources with the appropriate tentativeness. —Centrx→talk • 00:53, 26 April 2009 (UTC)

Is the blog really by this person? One reason blogs are not reliable sources is that identity claims are not reliable. --Una Smith (talk) 01:08, 26 April 2009 (UTC)

Given that the same username of Jim Wilson matches his Gmail (iceaxe5) contact info on the site and his personal twitter which also links back to his company's site, a link to the iceaxe handle here, and a host of links from Googling around, it's pretty obviously Dr. Wilson between all the clues laying around, plus the actual writing and analysis on the site--if it's not, which is highly unlikely--it's an impersonator of the absolute highest degree that has apparently matching levels of technical expertise in these sciences. I did shoot him an email earlier, though, but haven't heard back. I can only imagine he's a bit busy today, given that this is the kind of thing people like him and the CDC folks have been waiting for their whole careers, to deal with. rootology (C)(T) 01:22, 26 April 2009 (UTC)

I just got an email back from Dr. Wilson, and yeah, it's him all right, I'm sure of it. Given all of this, while it's technically possible to jump through more hoops, like asking for an email from the corporate address, or who knows what else, I think it would be overkill. Centrx, you want to dive into it for dissecting what he has on that great post? I'm about to get short on time. rootology (C)(T) 01:47, 26 April 2009 (UTC)

Okay, this satisfies my reservations about the source. --Una Smith (talk) 17:53, 26 April 2009 (UTC)

Outbreak vs. Epidemic

I'm not suggesting we change the title of the page, I'm just curious — what would be the criteria to start calling this a "flu epidemic" as opposed to a "flu outbreak"? --π! 01:24, 26 April 2009 (UTC)

This already qualifies as an epidemic AFAIK. GTNz (talk) 01:25, 26 April 2009 (UTC)

Probably once we all agree it meets the technical definition. What about global pandemic? Same idea. rootology (C)(T) 01:26, 26 April 2009 (UTC)

Yeah, that's what I was thinking. I hereby declare this to be the place to discuss the classification, once it becomes an issue. --π! 01:51, 26 April 2009 (UTC)

My amateur view is that the comparative epidemic label would be too ambiguous here as to the specificity(?) of the disease. Currently, it's too small for an "influenza epidemic", large enough for a "swine flu epidemic", but unique as a new strain. --Zigger «º» 10:31, 26 April 2009 (UTC)

Mexican Doctor: Deaths far greater then reported?

Obviously they can not be confirmed, but should this be mentioned in the article?

http://news.bbc.co.uk/2/hi/talking_point/8018428.stm --Vessol (talk) 01:43, 26 April 2009 (UTC)

I added it. If anyone feels that it does not meet WP:RS, please feel free to remove it. JCDenton2052 (talk) 03:35, 26 April 2009 (UTC)

I'll remove this. It's misleading in regard to the vaccine (presumably for other types of flu) and the status of the deaths (lab-confirmed vs suspected). --Zigger «º» 03:58, 26 April 2009 (UTC)

I cited the BBC article, which is an interesting source, but quoting one reader comment here goes too far. The BBC "Have your say" format does not stake the network's credibility on the veracity of each individual comment printed. However, we can assume that these comments taken as a whole are not altogether unrepresentative of the feeling of the Mexican readership. Mike Serfas (talk) 04:59, 26 April 2009 (UTC)

Believe it or not, I think I know where this came from. I'm pretty sure it's a copy/paste from 4chan's /x/ board, where all they really talk about is how the controversial issue of the moment is either a government conspiracy, a zombie apocalypse, or both. They've demonstrated a distinct tendency to incite panic just to get cheap laughs, so I wouldn't trust anything they say. Belgium EO (talk) 19:04, 26 April 2009 (UTC)

3 confirmed in Texas

I guess it is official now that there are 3 infected in Texas?? [6]--Vrysxy ¡Californication! 02:46, 26 April 2009 (UTC)

'Cases of this strain of influenza by country or state.' box

It would be nice if there was a 'last updated' note for this. 72.200.101.17 (talk) 03:32, 26 April 2009 (UTC)

Protect this page

I think that this page should be protected, as it's a matter of public health concern. False info could cause panic, etc. Thomasmallen (talk) 05:37, 26 April 2009 (UTC)

Page protection won't ensure that only accurate information appears on the page, but will ensure that several major contributors to the article no longer can contribute. They are using anon accounts, perhaps because they are on travel and using insecure computers so do not wish to risk exposing their password to hackers. Better would be for more editors to watchlist the page and examine diffs. --Una Smith (talk) 05:43, 26 April 2009 (UTC)

Agree, there are a few major contributors on the page using anon accounts here. Naughtyzzz (talk) 05:55, 26 April 2009 (UTC)

Precautionary treatments

What I'd like to put in the article more than anything else is information about medical precautionary treatments that might help the flu, but it is essential to avoid speculation and stick to good sources. Still, I'd be grateful if the myriad editors working on this article watch for interesting reports:

• Pneumococcal conjugate vaccine and Pneumococcal polysaccharide vaccine - recommendations for these vaccinations have left many adults unvaccinated, but with the flu reported to have killed young adults in Mexico largely by pneumonia, will that change?

• The 2008 seasonal flu vaccine - the CDC has said that it is "unlikely" to be effective. We should be seeing more solid data about this as this outbreak continues.

• Nutrition and supplements - while these issues tend to raise controversy, there continue to be reports that nutritional deficiency contributes to the risk of illness.[7] This issue may be quite important to the world's poor.

New technology would also be nice, but our time to wrestle with the virus or the bureaucracy may have run out. Mike Serfas (talk) 05:54, 26 April 2009 (UTC)

I did come across an article [8] earlier today which says that Baxter International has begun working on a vaccine. I considered adding this to the article, perhaps under the WHO response heading, but decided against it until more information becomes available.

If anyone thinks this should go in now, feel free to add it. Wine Guy Talk 06:34, 26 April 2009 (UTC)

United States section

Main article: 2009 H1N1 flu outbreak in the United States

Officials in the United States said that eight people were infected with swine flu in California and Texas and all have recovered.

In Kansas, two cases have been confirmed: a couple resident in Dickinson County. The husband traveled to Mexico in mid April for a professional conference and became ill after he returned home. The wife became ill later. They were not hospitalized and state health officials describe their illnesses as mild.

In New York, eight children in one school in New York City are believed to be infected after a school trip to Mexico. The New York case has been confirmed as Influenza A Virus, which meets the Centers for Disease Control and Prevention (or CDC) definition of a probable case of swine flu. Tests are still underway to determine if this flu virus is the new strain of H1N1.

Comments on United States section

The United States section seems a bit short. The above text might help improve it. QuackGuru (talk) 07:00, 26 April 2009 (UTC)

10 cases confirmed in New Zealand

10 cases have been confirmed here according to Television news, unfortunately theres no internet content to reference yet --119.224.40.127 (talk) 08:31, 26 April 2009 (UTC)

Citation has been found and added. Please note, that while these are now probable cases, they are not yet confirmed. Wine Guy Talk 08:40, 26 April 2009 (UTC)

If a health official says it's likely, that means it's probably 99% likely. This is critical information and people interested in this subject are going to want to appreciate the international scope of this flu.--24.87.88.162 (talk) 09:13, 26 April 2009 (UTC)

No, 99% would have a description such as "almost certainly". For the criticality and scope a link to the 1918 flu pandemic should be sufficient. If 5% of the world population dies, 10 students will matter little. People especially in NZ may well be interested, but wikipedia is not a news service. Let's focus on referenced facts for now rather than trying to spin an interesting lead. --Zigger «º» 09:40, 26 April 2009 (UTC)

A health official saying it is likely means (1) influenza-like illness (ILI) and (2) some reason other than timing to link the ILI to this outbreak. --Una Smith (talk) 13:21, 26 April 2009 (UTC)

Obama's visit

From Bloomberg:

The first case was seen in Mexico on April 13. The outbreak coincided with the President Barack Obama’s trip to Mexico City on April 16. Obama was received at Mexico’s anthropology museum in Mexico City by Felipe Solis, a distinguished archeologist who died the following day from symptoms similar to flu, Reforma newspaper reported. The newspaper didn’t confirm if Solis had swine flu or not.

JCDenton2052 (talk) 09:52, 26 April 2009 (UTC)

See http://www.nytimes.com/2009/04/26/world/americas/26mexico.html?em -- it currently seems to be a "non-story". --Zigger «º» 10:15, 26 April 2009 (UTC)

Wikipedia says he died of a heart attack.

http://en.wikipedia.org/wiki/Felipe_Solis —Preceding unsigned comment added by 212.246.66.223 (talk) 12:45, 26 April 2009 (UTC)

I heard from a news source that it was pneumonia, not swine flu. 192.12.88.7 (talk) 13:46, 26 April 2009 (UTC)

Many of the deaths in Mexico seem to occur due to pneumonia resulting from a secondary/co infection. We do of course need reliable sources saying he died from swine flu and given that sadly the number of deaths is quite high, we'd need a good reason to mention this one specific person (he met Obama is not a good reason) Nil Einne (talk) 17:30, 26 April 2009 (UTC)

Madagascar 2

(or over 9000?) :)

Someone just edited that Madagascar had it's posrts closed. I'm 100% sure it's someone from 4chan. --190.225.9.100 (talk) 10:49, 26 April 2009 (UTC)

I just saw it on the news, legit —Preceding unsigned comment added by 83.101.47.117 (talk) 12:10, 26 April 2009 (UTC)

Source? http://knowyourmeme.com/memes/president-madagascar---shut-down-everything --80.162.43.158 (talk) 13:08, 26 April 2009 (UTC)

Please see the discussion above under the exact same heading. Any addition of the Madagascar meme should be considered vandalism. As it seems to be very persistent I am on the verge of calling a semi protect of the article on account of this. --Saddhiyama (talk) 13:12, 26 April 2009 (UTC)

Are we sure this is a meme rather than legitimate news? 192.12.88.7 (talk) 13:42, 26 April 2009 (UTC)

Oh, I guess it's a meme after all. But what if it actually happens at some point? 192.12.88.7 (talk) 13:44, 26 April 2009 (UTC)

Well thats easy to spot as there should be a reliable source cited to prove it. --Saddhiyama (talk) 13:51, 26 April 2009 (UTC)

So far, I have not seen any reports of Madagascar actually doing anything. 192.12.88.7 (talk) 13:57, 26 April 2009 (UTC)

Requested semi-protection, regretfully. --Zigger «º» 14:22, 26 April 2009 (UTC)

For the best, in my opinion, Zigger. Thank you for requesting. Cordovao (talk) 15:06, 26 April 2009 (UTC)

France

Rumour mill says those cases turned out not to be swine flu afterall, but haven't seen a RS for that yet. 92.7.31.210 (talk) 11:51, 26 April 2009 (UTC)

I've removed the section. News Limited's Daily Telegraph is not exactly famous for breaking French news, and openly shows the story's source as the vague "correspondents in Paris". --Zigger «º» 14:05, 26 April 2009 (UTC)

I added the France section again (earlier) with a better source. --Zigger «º» 18:22, 26 April 2009 (UTC)

Just one case now : http://www.lefigaro.fr/flash-actu/2009/04/26/01011-20090426FILWWW00189-grippe-porcine-plus-qu-un-cas-en-france.php (french source) —Preceding unsigned comment added by 77.201.220.231 (talk) 20:41, 26 April 2009 (UTC)

Writing style

Folks, please read Wikipedia:Recentism and try to write in an encyclopedic style with an eye on the future. Most of the article needs to be rewritten right now. It might be a good idea to look at other articles on outbreaks and learn from those. Viriditas (talk) 11:58, 26 April 2009 (UTC)

Some of us have already read that wide-ranging essay, as well as historical articles on similar topics, but it may be more immediately helpful if you could make some specific suggestions or criticisms here. They will be welcomed. --Zigger «º»

In popular culture

I added an "in popular culture" section, and added a song that has been written about the disease, it appeared in Mexico's two biggest newspapers, reforma, and excelsior, and was properly cited, however, someone removed it since it adds nothing to the article. Anyone agree with keeping it? Agrupación Cariño wrote a song called Cumbia de la influenza.

IMHO, it really depends on how influential the song or the artist are in popular culture. Has this song charted in Mexico, either in CD sales or downloads (like how Don McLean's hit song American Pie references the death of Buddy Holly and company)? Has it become a semi-theme song for the event, used by news outlets and popular radio stations (like how Laura Branigan's song Gloria became associated with Hurr. Gloria)? Has the flu been featured on a major fictional television show or movie (like the Titanic being portrayed in a movie)? Some guy somewhere writing a song and it being mentioned in a newspaper or two hardly qualifies as a mass, pop culture phenomenon. Keep on eye on it, though. If it charts well, or is by a major artist, then I would support it's inclusion. Nosimplehiway (talk) 15:30, 26 April 2009 (UTC)

Admin is harming the world, needs to be unlocked

This article is deadly serious. Minutes ago an administrator placed a lock on it preventing some people from writing. This needs to end.

If there is vandalism, then a special policy could be enacted for this article (due to the seriousness of the subject): any vandalism and no warnings, but immediate blocking.

Nohars (talk) 14:24, 26 April 2009 (UTC)

The protection was needed to keep uncited and incorrect information out of the article.--Jojhutton (talk) 14:26, 26 April 2009 (UTC)

I agree with Jojhutton. For the sake of seriousness then a lock might be needed, as it seems a lot of juveniles insist on adding false information to the article. --Saddhiyama (talk) 14:29, 26 April 2009 (UTC)

In my experience of such articles, particularly 7 July 2005 London bombings, non registered editors are invaluable in the early stages of development. While a target for vandals this article has the potential to draw in new editors and for them to supply up to date information. There is also significant input from other editors, more than enough to cope with any vandalism. I would appreciate if other admins could review this protection as I feel it unnecessary. |→ Spaully^₪† 15:20, 26 April 2009 (GMT)

This article is moving so quickly already. Lot of bad info out there and potential vandals - and this is so serious. Keep the block on - not difficult to get one anyway. Dinkytown 15:38, 26 April 2009 (UTC)

Why are other admins required to review? The issue for me was that joke and data vandalism edits and corrections were impeding editing for all editors, and for readers the article was often in a vandalised state. The semi-protection is temporary, and I expect it will be lifted a few hours early anyway due to high interest in the topic. Swine influenza had already been semi-protected for 24h. --Zigger «º» 16:01, 26 April 2009 (UTC)

The semi-protection is fine, for this. rootology (C)(T) 15:45, 26 April 2009 (UTC)

Fair enough, consensus seems to support it. I suggested other admins had a look as I imagine they generally have more experience on block decisions than most users. Thanks, |→ Spaully^₪† 17:44, 26 April 2009 (GMT)

It has become difficult to submit an edit here due to edit conflict notices, and vandalism worsens the problem. Edit summaries tend to be missed or omitted under these circumstances. (I really wish Wikipedia offered a way for people to annotate edits after getting past the edit conflict checkpoint) People close to the action may log in to Wikipedia for the first time and submit interesting content, but even so it is only likely to run into "original research" policies or other obstacles. I hope that these people will find their way to the Talk page and submit information here, where experienced editors can try to pursue it and find solid sources, but they may not be aware that semi-protection only applies to the main article page.

Wikipedia does have a process called "WP:article probation" if necessary, but hopefully things won't come to that. Mike Serfas (talk) 19:06, 26 April 2009 (UTC)

as an anonymous contributor support the protection approach for now, this is a serious developing situation that needs accuracy and authoritative sourcing, feel like the people who are editing are doing a good job - once the immediacy fades then can remove protection —Preceding unsigned comment added by 209.17.145.179 (talk) 19:40, 26 April 2009 (UTC)

vandalism and irish government response

i'm a total n00b, so i'm probably doing this wrong, but i came here earlier to add the Irish government's response to this situation. Official statement here:

http://www.hse.ie/eng/News/National_Tab/swineflu.shortcut.html

and now i can't edit this article, so can someone else put this in please?

i noticed alot of vandalism on this page. much of it seemed to be based on the popular online computer game 'pandemic 2'. this is a very serious article and needs to be protected. not the time or place for jokes.

thank you by plasticshark —Preceding unsigned comment added by PlasticShark (talk • contribs) 14:48, 26 April 2009 (UTC)

Thanks for the info, but similar government statements have already been removed from the article for other countries, as they lack both notability and uniqueness. --Zigger «º» 16:07, 26 April 2009 (UTC)

Artificially Made?

“This strain of swine influenza that’s been cultured in a laboratory" is a quote from the video below. I think that this might be something fairly importanted to note. Would this serve any use in the article?

Source: http://www.theglobeandmail.com/servlet/story/RTGAM.20090424.wvswine_flu0424/VideoStory/International/?pid=RTGAM.20090424.wswine0424 (At roughly 35 seconds in) —Preceding unsigned comment added by Empusa22 (talk • contribs) 14:52, 26 April 2009 (UTC)

Thank you for pointing this video out, but he isn't arguing that the H1N1 virus we are seeing in Mexico and elsewhere is artificial, just that similar strains have been cultured in a laboratory. Cordovao (talk) 15:30, 26 April 2009 (UTC)

2009_H1N1_flu_outbreak_in_the_United_States but no Mexico

There should be a Mexico page. Ikip (talk) 16:13, 26 April 2009 (UTC)

I guess main article could contain it all as Mexico was source of the outbreak. Other countries shall be divided into differente sections then.--Fluence (talk) 16:58, 26 April 2009 (UTC)

Possible cases in scotland

Hi, i'm not very good at this wikipedia thing, but i just spotted this and thought somebody might like to put some info on wiki about it: http://news.bbc.co.uk/1/hi/scotland/glasgow_and_west/8019544.stm —Preceding unsigned comment added by Lummo (talk • contribs) 16:24, 26 April 2009 (UTC)

Added. Thanks! rootology (C)(T) 16:28, 26 April 2009 (UTC)

Added to the United Kingdom section. --Zigger «º» 16:37, 26 April 2009 (UTC)

Table ordering and placement guidelines for this article

I suggest we enforce this way:

1. The table should be at the top right of the page. It's the clearest summary of 'everything' and sums it up in one fell swoop.
2. First sort by deaths. Next, by possible cases, then confirmed.
3. Secondly sort by confirmed cases, if no deaths in that nation.
4. Third, sort by possible cases.

It's basically trended that way, but we should all drive for that goal. rootology (C)(T) 16:18, 26 April 2009 (UTC)

Confirmed cases section

This section is going to get outdated every hour practically. Since H1N1 is showing up in multiple nations so fast in the past 24 hours, it's going to spread even faster for this by the nature of how these things work, and we're going to have this section on prose eternally lagging behind. I'd be strongly against moving the table down there--the table should be front and center on the article in the lead. What to do with this section, though? rootology (C)(T) 16:37, 26 April 2009 (UTC)

I'd suggest a short summary for each country in which cases are confirmed. Malinaccier (talk) 17:46, 26 April 2009 (UTC)

Actually nevermind. I propose we take out the section entirely in favor of keeping the table. Malinaccier (talk) 17:50, 26 April 2009 (UTC)

I would use this section to make a clear distinction between local outbreaks (eg, California, Texas, New York) and sporadic cases linked to recent travel to outbreak areas. Eg, the couple in Kansas: he returned from a trip to Mexico, got sick, his wife got sick, both recovered; so far, the virus has not spread to any of their contacts so there is no local outbreak. --Una Smith (talk) 17:49, 26 April 2009 (UTC)

Possible case in Brazil

Globo News TV published this: http://video.globo.com/Videos/Player/Noticias/0,,GIM1014235-7823-INFECTOLOGISTA+CONFIRMA+SUSPEITA+DE+GRIPE+SUINA+NO+BRASIL,00.html (portuguese).
Infectologist confirms possible case of swine influenza in Brazil. Added to portuguese wiki. Marcosrom (talk) 17:05, 26 April 2009 (UTC)

It seems it's a mexican tourist, under observation at the Emilio Ribas Institute of Infectology, in the city of São Paulo. But has not been issued a confirmation from any kind of official sources, so let's wait for this. 189.121.177.112 (talk) 19:49, 26 April 2009 (UTC)

Okay, we now have official news of a possible first AND second case of the flu http://br.noticias.yahoo.com/s/26042009/25/manchetes-hospital-sp-examina-suspeita-gripe.html http://www1.folha.uol.com.br/folha/cotidiano/ult95u556523.shtml

We should add brazil now. 189.121.177.112 (talk) 19:49, 26 April 2009 (UTC)

G1 Portal: http://g1.globo.com/Noticias/Brasil/0,,MUL1098946-5598,00.html (portuguese). Marcosrom (talk) 19:50, 26 April 2009 (UTC)

So, will any "established user" edit the article? I tried to find news in english about this, but had no luck. Maybe that is not a problem, since there are tons of links to spanish language news reports as source in the article.189.121.177.112 (talk) 20:39, 26 April 2009 (UTC)

Mexico (83 now dead)

Sky News reports that 83 people have now died [9]. "Mexican City Mayor Marcelo Ebrard said two more people have died of the virus, taking the death toll to 83." magnius (talk) 17:44, 26 April 2009 (UTC)

AP saying 5 died overnight giving 86 dead.[10][11]

No cite for UK cases

The page says there are confirmed UK cases of swine flu but there is no cite and I cant find anything on news websites. —Preceding unsigned comment added by 78.149.187.75 (talk) 18:00, 26 April 2009 (UTC)

I removed this, they are definately not confirmed at this time. Pontificalibus (talk) 18:04, 26 April 2009 (UTC)

More cases in Colombia

The article says there are 5 possible cases of swine flu. But in this morning, the goverment confirm there are now 11. Source: [12] April 26, 2009.--SaitoK (talk) 18:07, 26 April 2009 (UTC)

Influenza-like illness

I have made Influenza-like illness (ILI) into an article, rather than a redirect to Influenza (which still does not explain ILI. --Una Smith (talk) 18:07, 26 April 2009 (UTC)

Thank you for your edits! :) Malinaccier (talk) 18:09, 26 April 2009 (UTC)

add link to 2009 Swine Flu H1N1 Outbreak and Migration Map

http://maps.live.com/?v=2&encType=1&cid=F4ACB81BC72A2139!112 has a map tracking the migration paths of infections

Pandemic index

I added a link and a graphic here to show what the generally accepted pandemic scale seems to be. We're not there yet. rootology (C)(T) 18:14, 26 April 2009 (UTC)

Time to archive this talk page?

What do you guys think, it is getting long, I say we archive it now... More opinions would be helpful... ZStoler (talk) 18:15, 26 April 2009 (UTC)

I'll add automation for it. rootology (C)(T) 18:18, 26 April 2009 (UTC)

Dead Space

Can we do something about the dead space at the top?--24.87.88.162 (talk) 18:17, 26 April 2009 (UTC)

More Possible UK cases

Just found this link http://news.bbc.co.uk/1/hi/england/northamptonshire/8019536.stm family quarantined in their own home and issued with vaccine. —Preceding unsigned comment added by 86.15.88.86 (talk) 18:20, 26 April 2009 (UTC)

Merge proposal

(moved from Talk:2009 H1N1 flu outbreak in the United States) Really, why is this not part of the main article? Nja²⁴⁷ 18:18, 26 April 2009 (UTC)

Because it's already too big to merge back into it. It's only a matter of time until there is enough content to fork Mexico off as well. I'm surprised no editors with Spanish skills haven't done so already. rootology (C)(T) 18:24, 26 April 2009 (UTC)

This is a worldwide issue, not specific to the US at all. What they do on Spanish Wikipedia is up to them, but this is English Wikipedia and there seems to be very little convincing reasoning that the US needs its own special article separate from the main one at this point in time. Nja²⁴⁷ 18:28, 26 April 2009 (UTC)

Yes its a global matter, but we still do our articles the way we do. The existence of this article has zero impact on the existence of the main one linked off the main page. Our way of doing things is always to constantly fork and split content to sub articles when the content gets too big for the parent article. That's what happened here. It makes no sense to put this back in. The main page has a general overview/up to date info, and the sub-articles go here. Should there be no Mexico page either, you are saying now? rootology (C)(T) 18:34, 26 April 2009 (UTC)

Disagreeing is fine, but saying things like 'our way of doing things' and making assertions of statement which I did not say is quite poor behaviour, and I hope you take a breath and calm down a little bit please before addressing others in such a manner. Nja²⁴⁷ 19:19, 26 April 2009 (UTC)

I've cleaned up/expanded the sub-article quite a bit, for what it's worth. –Juliancolton | ^Talk 19:36, 26 April 2009 (UTC)

I disagree that the articles should be merged, as it would impossible to do so without violating WP:UNDUE. –Juliancolton | ^Talk 18:44, 26 April 2009 (UTC)

Athough the pandenic is international, different countries respond in their ways and means. I believe that an article on the flue outbreak in the USA is granted given its length and amount of sources. BatteryIncluded (talk) 18:46, 26 April 2009 (UTC)

I agree. I find some of the arguments here that say it's 'to big to merge' to be lacking. The US article is hardly that large, and the info could easily be fit into this article. Creating a specific article about one country on a global crisis, one that has only about 20 confirmed cases, is clearly pandering to a certain point of view, that being that a lot of editors here are American. I don't think 'it's to big' is a clear reason for keeping a POV article up. The only way you could remedy this with keeping the US article up is be making individual article fore Mexico and maybe Canada, seeing as they have confirmed cases. Mexico, in fact, as way more confirmed cases then the either two and the only country to have deaths caused by the illness. Lemniwinks (talk) 20:45, 26 April 2009 (UTC)

Confirmed cases in Canada

Sky News and BBC News (TV) saying there are now 6 confirmed cases in Canada —Preceding unsigned comment added by 78.149.187.75 (talk) 18:40, 26 April 2009 (UTC)

as of Sunday, April 26, 2009 | 2:02 PM ET [expect ongoing changes in total] cbc reports at www.cbc.ca/canada/story/2009/04/26/mexico-swine-flu.html 4 cases of swine flu confirmed in Nova Scotia, 2 in B.C. - putting this in as part of record of changes in total —Preceding unsigned comment added by 209.17.145.179 (talk) 18:59, 26 April 2009 (UTC)

CBC newsworld on television has reported that the 4 cases in Nova Scotia were students who did not travel to Mexico themselves. There were 11 students who returned sick from Mexico earlier this month, but the 4 confirmed cases were not members of the trip to Mexico, indicating human to human transmission has occurred in Canada. —Preceding unsigned comment added by 137.186.84.71 (talk) 19:08, 26 April 2009 (UTC)

Information on the six confirmed cases in Canada is in the article. If you are not seeing it, please refresh the page in your browser.

Also, I have removed the expand template, as relevant information from cited sources has been included. What more expansion is needed? Wine Guy Talk 19:15, 26 April 2009 (UTC)

New vaccine Development

My house mate is a molecular biologist with decades of research experience, although he does not study influenza. He says biomed science is much more advanced now than in 1918, so if cost is not an issue, a new vaccine can be developed very quickly (we are saved!) by growing the virus in pigs or goats or by expressing the antigen in bacteria even. I'm not saying: "quote him" (hearsay of original research), but perhaps Wikipedia should say something more insightful then that "a new vaccine takes months to develop and deliver". Do a literature search and quote it, don't just dismiss experts because they aren't willing to contribute to Wikipedia themselves (they are busy or hate Wikipedia because of its false equality). Cheers (Anon, who will not be participating in this discussion further).

Relevant reviewed research references are certainly welcome, and would be preferred to news articles! The time estimate came from Dr. Anne Schuchat, interim Deputy Director for Science and Public Health Program at the CDC. --Zigger «º» 19:13, 26 April 2009 (UTC)

7th possible case in Spain

Sanidad aragonesa detecta un caso sospechoso de gripe porcina en Teruel (Spanish).--87.218.20.244 (talk) 18:52, 26 April 2009 (UTC)

unusually mongrelised mix ? extraterrestrial ?

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

I have question about statement:

• 'be made up of genetic elements from four different flu viruses — North American swine influenza, North American avian influenza, human influenza A virus subtype H1N1, and swine influenza virus typically found in Asia and Europe - "an unusually mongrelised mix of genetic sequences" '.

What this meant? I want to ask questions: Maybe it is came from extraterrestrial? —Preceding unsigned comment added by B767-500 (talk • contribs) 19:27, 26 April 2009 (UTC)

We prefer to use the talk page only to dicuss improvements rather than the article rather the subject itself, I hate to be rude but that's the rules unfortunately. extraterrestrial seems highly unlikely, unless its like some mad science fiction where aliens are putting the virus on the earth to wipe out a significiant amount of human population to make invasion easier, lol. 82.23.106.229 (talk) 19:32, 26 April 2009 (UTC)

Think you're looking for this. ;) rootology (C)(T) 19:33, 26 April 2009 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

WHO Pandemic Influenza Phases

I thought the CDC's graphic of pandemic severity a bit alarmist inasmuch we're remaining at WHO's Phase 3. (Thus we're not at Sustained Human to Human Transmission, which is Phase 4; Phases 5/6 would denote a global influenza pandemic.) Although I've added to the text of the article, it needs a WHO or, more likely given the licensing issues, a WHO-like graphic or scale. These bureaucratic criteria are of some importance!

http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

If some bright spark can licitly add WHO's actual graphic to the article, all the better!

http://www.who.int/about/licensing/en/index.html

kencf0618 (talk) 19:39, 26 April 2009 (UTC)

Two Possible Cases in Brazil

Now we have more sources:
http://br.noticias.yahoo.com/s/26042009/25/manchetes-hospital-sp-examina-suspeita-gripe.html
http://www1.folha.uol.com.br/folha/cotidiano/ult95u556523.shtml
http://g1.globo.com/Noticias/Brasil/0,,MUL1098946-5598,00.html (all in portuguese)

We should add Brazil to the list and map. Marcosrom (talk) 20:38, 26 April 2009 (UTC)