UA biologist Michael Worobey and 10 other scientists from around the world have posted their research on swine flu on an Internet "wiki" site.

As it turns out, the recent strain of swine flu has made people sick for far longer than many scientists have thought.

By studying the genes of the virus, University of Arizona biologist Michael Worobey and 10 other scientists from around the world have traced the outbreak’s rather humble beginnings to September, months before the media began reporting on the outbreak in Mexico.

Though new to humans, this strain of swine flu evolved from a variety of influenza viruses already well-known to researchers, Worobey and his colleagues determined this week.

“We’ve kind of shown conclusively that these are pig viruses,” Worobey said Thursday.

The UA professor and other scientists – some from as far away as the United Kingdom and Hong Kong – have published their findings online on a “wiki,” a Web site on which users can post and edit information.

“It’s like being in the same office,” Worobey said. “You’re able to critique and learn from stuff really quickly.”

Typically, scientists might sit on this kind of information and publish it later in an academic journal, the biologist said of the online group’s swine flu research. Worobey and his band of virus hunters thought providing real-time information might help epidemiologists avert a potential catastrophe.

Health officials in Arizona have confirmed 130 cases of swine flu – 22 in Pima County.

Nationwide, the virus has infected nearly 900 people in 41 states, according to the U.S. Centers for Disease Control and Prevention.

Epidemiologists have diagnosed nearly 2,400 people in 24 countries with swine flu, the World Health Organization reported Thursday.

In the event of a pandemic, WHO officials warned that as many as 2 billion could contract the virus.

From his reading of the data, however, Worobey doubts this iteration of swine flu poses such a dire threat.

Worobey, who has taught at UA since 2003, has spent much of his time studying the HIV virus that can cause AIDS. In 2007, he published findings that showed the HIV virus in the U.S. as early as 1969 – more than a decade before scientists had thought.

Worobey draws a common conclusion from his HIV and flu studies: “Epidemics take a long time to build up from the first case.”

Worobey and his colleagues will continue tracking the swine flu, trying to predict how it might evolve in the coming months.

“Everything we’ve seen so far is that it’s evolving the same way as the seasonal flu,” Worobey said.

———

Read the report:

To check out the research conducted by Worobey and his colleagues, go to http://tree.bio.ed.ac.uk/groups/influenza/.

PHOENIX – Enrollment in Arizona’s Medicaid program is surging because of the recession, with costly implications for the already troubled state budget.

The Arizona Health Care Cost Containment System reports that enrollment grew by nearly 102,000 from April 2008 to April 2009, an increase of 11 percent. The increase in April alone was 21,000.

AHCCCS’ budget administrator, Jeffery Tegen, said in a memo distributed this week to Gov. Jan Brewer’s budget staff and the Legislature that the increase is due mostly to “the economic downturn and subsequent job losses.”

Tegen’s memo says the increase will add $253 million of spending to the next state budget, which will cover the fiscal year starting July 1. That budget already faces a projected $3 billion shortfall.

PHOENIX – University of Arizona medical school professor Yvette Roubideaux is the new director of the Indian Health Service.

The White House says the U.S. Senate unanimously confirmed Roubideaux’s nomination Wednesday night.

Roubideaux, a member of the Rosebud Sioux Tribe, was an assistant professor in the Department of Family & Community Medicine at UA’s College of Medicine when she was picked by President Obama to head the IHS.

The White House says she has conducted extensive research on American Indian health issues, with a focus on diabetes and Indian health policy.

The IHS provides health care to American Indians.

Pima County health officials Thursday confirmed 12 more cases of swine flu, bringing the county’s total to 22.

Statewide, the number of confirmed diagnoses is 130.

Details about the new cases have not been released, Pima County Health Department spokeswoman Patti Woodcock said in a statement. “It is, however, my understanding that all have recovered or are in the process of recovering.”

Sunday, the first six cases of swine flu in the county were announced. Two involved middle school students in Tucson and Marana, the other four cases were on the Tohono O’odham Nation. By Tuesday, the number of cases had risen to 10.

“Keep in mind, we expected additional cases,” Woodcock said Thursday. “This does not change our approach to this virus.”-

Health officials recommend that people experiencing flu-like symptoms stay home and call a doctor before heading to a clinic or emergency room.

In line with recommendations by federal, state and local officials not to close schools because of the flu, Tucson and Marana schools have remained open. However, Tohono O’odham and Nogales schools have been closed as a precaution.

Tucsonan due to complete last leg of 800-mile walk

Tucsonan Sirena Dufault, who has fibromyalgia, plans to complete an 800-mile hike of the Arizona Trail on Tuesday.

When she set out to hike the 800-mile Arizona Trail last spring, Sirena Dufault worried that she might not finish.

The daunting trail stretches from Utah to the U.S.-Mexico border.

Tucsonan Dufault’s concern stemmed from her decade-long battle with fibromyalgia, a little-understood chronic pain disorder.

“I was a little hesitant to publicize it because I didn’t know how far I could go,” Dufault said this week. “Now I can comfortably do a 15-mile day with a big pack, no problem.”

Tuesday – on national Fibromyalgia Awareness Day – the 35-year-old will make a final, eight-mile hike north of Oracle to complete the trail, trudging from the Tiger Mine Trail head to the American Flag Trail head.

Dufault kept an online journal throughout her trek, which she made mostly by herself in one- to five-day trips. Tuesday’s leg will mark the 80th day Dufault has spent on the trail.

Dufault said she hopes her success will inspire the 10 million Americans who suffer from the disorder. “There’s not a whole lot of positive information out there about people getting their lives back after fibromyalgia.”

Fibromyalgia’s symptoms include chronic, widespread body pain, according to the National Fibromyalgia Association. Symptoms can stem from an acute illness or injury, as in Dufault’s case. Her diagnosis came in 1998, a year after she was hit by a car as she crossed a street. For months afterward, even as her initial injuries healed, Dufault’s pain and fatigue worsened.

“I saw her probably at her worst,” said Angi Edge, a nurse and massage therapist who treated Dufault after her diagnosis and became a fast friend. “So many people give up on themselves. They become their disease. She was just not going to give up.”

Dufault’s pain has not flared up in a major way in the past three years, she said. “I attribute that to being very, very active.”

For her next big adventure, Dufault might hike the Tonto Trail in the Grand Canyon. She walked 25 miles of that 90-mile trail last winter.

———

Read about Sirena Dufault’s experiences hiking the Arizona Trail in her online journal: www.aztrail4fms.org.

PHOENIX – The Arizona House has approved legislation to allow private health insurance policies for uninsured individuals that would omit some coverages normally mandated by the state.

The bill was sent to the Senate on a 48-12 vote Wednesday but its fate in the current legislative session is uncertain because the Senate has a months-old embargo on nonbudget bills.

Supporters said the business-backed bill (HB 2324) would help make health insurance less expensive for uninsured people.

One legislator who voted against the bill said Arizonans could be hurt by having insurance that doesn’t cover things such as treatment for alcoholism.

The state already has a law allowing “mandate light” policies for small groups of people, such as employees of businesses.

Fourth-grader gets early birthday party Saturday

Arthur Paz

Family and friends of Arthur Paz gave him an early birthday party Saturday.

The 10-year-old, who had battled cancer since he was an infant, wasn’t going to make it to his 11th birthday.

In fact, “Baby Arthur” as his loved ones call him, died in his mother’s arms a day later.

While Arthur’s last days were filled with pain and he was in and out of consciousness, there was joy for him as well, his mother, Tammy Robles, said.

One of his teachers at Santa Clara Elementary, where he was a fourth-grader, videotaped his classmates saying they missed him and wanted him to come back.

“He really enjoyed that,” his mom said.

He came home for the last time from the hospital on Thursday.

The following day was the annual Cinco de Mayo festival at Santa Clara, where Arthur loved being part of the folklorico group.

His fellow members danced without him, dedicating their performance to their friend. The school parent-teacher organization is donating about $1,600 from food sales at the event to his family to help cover funeral costs, but members know it won’t be nearly enough.

It also has set up a fund where donations can be sent: Santa Clara PTO (for Arthur Paz), 6910 S. Santa Clara Ave.; Tucson, AZ 85756. For more information, call Sylvia Tautimer at 545-3791.

Viewing will be from 5 to 10 p.m. Friday at Carrillo’s Tucson Mortuary, 204 S. Stone Ave. A funeral Mass will be at 2 p.m. Saturday at Santa Monica Catholic Church, 212 W. Medina Road.

Arthur’s mother said he was mostly asleep Saturday when relatives and friends brought him presents, which his 8-year-old sister, Anisia, opened for him.

They weren’t sure he was aware of what was going on.

But early the next day, when he was awake, his mom and sister asked him if he remembered the presents and he acknowledged that he did.

“He was a wonderful, very courageous, little boy, said his great aunt, Patricia Paz – Tía Pat. “Although his whole life he was back and forth to hospital and doing chemo, he was a very happy little boy.”

His mom said she could see he had little time on Sunday, but he was fighting to stay alive.

“It was hard, but I said, ‘OK baby, I give you all my permission that you can go with God. It’s OK and everybody is going to be fine because when you get to heaven you’re going to be our little angel up there.’ ”

Health officials on Tuesday afternoon confirmed another four swine flu cases in Pima County, bringing the total to 10.

The newly confirmed cases include an infant, two teenagers and a young adult, according to Pima County Health Department spokeswoman Patti Woodcock. All four have recovered from the virus. Woodcock did not release any more information about the new cases.

Statewide, the number of confirmed swine flu cases rose to 49 Tuesday.

Pima County officials on Sunday confirmed the first six cases of the H1N1 influenza virus, including four on the Tohono O’odham Nation and one each in Marana and in Tucson.

County health officials continue investigating the most recent confirmed cases.

Although the swine flu turned out to be less serious than originally feared, Arizona officials learned vital lessons that will help the state if an epidemic hits in the future, Arizona’s interim public health director Will Humble said Tuesday.

Humble said he doesn’t believe state officials overreacted to the swine flu by shutting down schools. They were simply reacting to data coming from Mexico that indicated a possible pandemic.

He said the lessons officials learned during their response will help in the event of a truly serious virus.

Arizona has been relying on the federal Centers for Disease Control and Prevention to test its suspected cases, and an additional 150 to 200 possible cases are outstanding. But the state laboratory will take over those duties later this week now that new tests for the specific strain have been received from the federal lab.

Citizen staff Writer Ty Bowers contributed to this article.

On Arizona Skin Cancer Institute’s Web site

A new tool to detect skin cancer has been made public by the Arizona Cancer Center’s Skin Cancer Institute.

“Skin Cancer: Learn to Spot it Early” is a 12-minute video that shows how to do skin self-exams to find growths that could be or lead to cancers, said Lois Loescher, the institute’s director of education and behavior research.

The video may be found at www.azskincancerinstitute.org/SCVideos.aspx.

“The whole purpose of doing the video is getting people to do skin self-exams,” she said. “Everyone should know how to examine his or her skin regardless of risk factor.

“Early detection really plays a role in survival from skin cancer,” Loescher said. “It’s very important to protect yourself from the sun, but if you don’t catch it early, you increase your chances of having the disease be much more serious.”

A study proved the video’s effectiveness, she said.

“We found a highly significant change – more people were doing skin self-exams after viewing the video,” Loescher said. “We also found a very significant change in knowledge; they had more knowledge about melanoma.”

The video stresses the importance of early detection of skin cancers. Melanoma survival rates are 98 percent if detected early, she said.

The video recommends that people carefully examine their skin each month for changes in moles and spots.

Hand-held and full-length mirrors are needed for an effective self-exam.

Things to look for in moles and spots include asymmetry, border irregularities, color variation, diameter larger than a pencil eraser and changing appearance and feel.

People finding anything suspicious should contact their primary care physician or dermatologist.

Producing the video and testing its effectiveness were funded with a $25,000 Laurence B. Emmons Endowment, said Loescher, principal investigator of the project.

The video was released on the institute’s Web site Friday and shown at a Living in Harmony with the Sun event Saturday and Sunday at the Arizona-Sonora Desert Museum. The event was to promote sun safety, awareness and skin cancer prevention.

A follow-up video on skin cancer prevention tactics is planned, Loescher said.

The video won the American Academy of Dermatology’s Gold Triangle Award, said Jennifer L. Allyn, spokeswomen for the Schaumburg, Ill., organization.

The award recognizes efforts that further understanding of dermatologic issues and encourage healthy behaviors in the care of skin, hair and nails, Allyn said.

———

RELATED

Arizona Cancer Center Skin Cancer Institutes video site: www.azskincancerinstitute.org/SCVideos.aspx

4 cases confirmed on Nation; classes to resume May 12

Eleven schools on the Tohono O’odham Nation are closed Tuesday through May 11 because of four confirmed cases of the swine flu.

The action came half a day before the Centers for Disease Control and Prevention reversed its recommendation on closing schools. The new recommendation, based on a lower severity of the flu, is to keep schools open.

On Monday, the Indian Oasis-Baboquivari Unified School District board voted to close all its schools. All other tribal, private and Bureau of Indian Education schools and the Tohono O’odham Community College followed suit, officials said in a news release.

Classes are scheduled to resume May 12.

Despite the CDC reversal Tuesday, Indian Oasis-Baboquivari district and Bureau of Indian Education schools will remain closed, said Andrew Lorrentine, deputy director of the Tohono O’odham Nation’s Health and Human Services Department.

He said officials from the other schools are meeting to review the new recommendation.

The schools are San Simon School (K-8), Santa Rosa Boarding and Day School (K-8) and Tohono O’odham High School from the BIE; Ha:san Middle School and Ha:san Preparatory and Leadership School; the district’s Indian Oasis Primary School, Indian Oasis Intermediate School and Baboquivari Middle/High School; and San Xavier Mission School, Southwest Living Word Academy and the Tohono O’odham Community College.

None of those who contracted the H1N1 virus was hospitalized, the release read, and all are recovering.

Meanwhile, 10 schools in Nogales remain closed until Monday as a precautionary measure after one elementary school student tested positive for swine flu.

One Marana Unified School District student and one in Tucson Unified also came down with swine flu, but those districts opted to keep schools open.

Most students showed up for classes on Monday at Tortolita Middle School in Marana, but about 175 students, or 40 percent, at Safford Engineering/Technology Magnet Middle School in TUSD did not. On Tuesday, absences at Safford were reported at 150.

On the Tohono O’odham Nation, school closures were “precautionary” and no other cases have been confirmed, the release read.

The Indian Health Service set up a call center to answer health-related questions: 877-606-9301.

Even with the five days off, the elementary and high schools will have enough days to meet the state’s requirement of 180, officials said. The district’s middle school will have to make up four hours and will do so by adding 20 minutes a day for 12 school days.

The University of Arizona has rescheduled for next month a lecture about genetic and environmental causes of asthma and allergies.

Asthma expert Fernando Martinez had been scheduled to give a public lecture on the subject this week. Instead, he will make his presentation – “Genes and Environment at the Onset of Asthma and Allergies” – from noon to 1 p.m. June 30 at the Kiewit Auditorium at the Arizona Cancer Center, 1515 N. Campbell Ave.

Martinez, who serves as the interim director of UA’s Bio5 Institute and heads the Arizona Respiratory Center, researches the natural history of childhood asthma and the genetic, physiological and environmental factors behind it.

The lecture is open to the public at no cost. A reception will follow at 1:30 p.m.

University Physicians Healthcare Hospital at Kino will lose an estimated $184 million over the next five years, according to a consultant hired by Pima County.

The anticipated losses, mostly for providing indigent care, are driving the hospital’s request for $31 million in taxpayer support for fiscal 2010, which begins July 1, and nearly $30 million a year in county money in the years to come.

The county in March agreed to pay HFS Consultants $30,000 to review expenses at Kino. The group’s report, released Friday, paints a bleak picture of the hospital’s finances and managers’ actions to curb spiraling costs.

In a letter accompanying the report, County Administrator Chuck Huckelberry cautioned the Board of Supervisors against “drawing specific conclusions regarding the snapshot analysis conducted by HFS Consultants.”

UPH officials said the report offers county leaders at best an incomplete picture of operations at Kino.

“We were somewhat stunned,” UPH CEO/President Larry Aldrich said Monday. “It’s flat-out wrong in so many areas.”

Consultants criticize UPH’s methods for writing off bad debts, saying that the hospital is too quick to refer late payers to collection agencies. The hospital should wait longer to find out if those patients qualify for the state equivalent of Medicaid, the report said.

“UPH does not give patients adequate time to pay prior to referral to a collections agency, which hurts the patient’s credit rating and causes bad public relations in an already disadvantaged population,” the report said.

Providing care to those without insurance will cost the hospital about $12 million in fiscal 2010 and up to $17 million by fiscal 2014. Anticipating the increase, UPH management should work harder to find ways to reduce the cost of providing such care, the report said.

Instead, consultants “didn’t find evidence of (hospital financial counselors) aggressively working with the patients to obtain charity care.”

“There’s a fixed amount of indigent care that won’t go away,” said William Crist, vice president for health affairs at the Arizona Health Sciences Center at the University of Arizona. “I understand the county has needs, and one of them is poor, sick patients.”

The university has begun, under Crist’s leadership, to forge a better working relationship between Kino Hospital and University Medical Center. Doing so might lower some of Kino’s operating costs, Crist said.

But providing care to those who can’t afford it gets expensive, Crist said, and much of those expenses fall to Kino, the only hospital south of Broadway.

The HFS report noted that “the county has very little control over hospital operations, which makes the subsidy request tantamount to allowing UPH to operate the hospital as they see fit while shifting the financial risk to the county.”

Supervisor Ray Carroll, for one, can’t stomach spending another $31 million to keep Kino running.

“I won’t support that,” Carroll said Monday. “We have to get the issue out in the community. I think we need to have some stakeholder meetings.”

Under the terms of a 2004 contract, the county in fiscal 2010 would pay UPH $10 million to operate the hospital.

That’s all Carroll plans to support paying UPH.

“This hospital cannot be run for $10 million,” Aldrich said. “That cannot happen.”

Shutting it down would thrust an estimated 42,000 emergency room patients, including psychiatric patients, into other hospitals in the region, documents show.

“That’s not a very well thought-out position,” board Chairman Richard Elías said. “I think there are some things we can do to improve the patient mix that, if it doesn’t reduce costs, puts a hedge on them.”

In its response to the consultants’ report, UPH said no amount of effort on its part would reduce the cost to the county of caring for uninsured patients.

County hospitals across the country require significant taxpayer subsidies to cover such costs, Crist said.

In 2003, the last year the county ran Kino, it lost an estimated $33 million, officials said. The hospital that year had relatively few patients, most of them in the psychiatric ward.

“Yes, we’re still spending $31 million, but we’re spending it a lot better,” Crist said.

———

Finances at UPH

A county-commissioned report on the operations at University Physicians Hospital at Kino outlined several reasons for ongoing financial losses, including:

• Writing off too many accounts to bad debt.

• Being too quick to send accounts to collection agencies, rather than waiting to see if those patients qualify for Arizona’s version of Medicaid.

• Not identifying enough ways for patients to qualify for charity care.

• Poor overall financial management.

All told, the Kino center will spend an estimated $12 million providing uncompensated care in fiscal 2010, said the report by HFS Consultants. By 2014, the amount likely will increase to $17 million, the report said.

UPH officials, who had one week to respond to the report, said the consultants miscalculated certain losses and that the conclusions don’t fit the facts, namely that the hospital aggressively seeks to reduce its level of uncompensated care.

A lecture Tuesday about genetic and environmental causes of asthma and allergies at the University of Arizona has been postponed.

Fernando Martinez, a noted asthma expert and director of the university’s Arizona Respiratory Center, was to give a public lecture on the subject. Martinez’s research focuses on the natural history of childhood asthma and the genetic, physiological and environmental factors behind it.

The talk, to have taken place at 5:30 p.m. at the University Medical Center DuVal Auditorium, 1501 N. Campbell Ave., has not yet been rescheduled.

Pima County Health Department officials were still waiting late Monday for word on whether 11 more county residents whose samples had been submitted for testing actually had swine flu, according to agency spokeswoman Patti Woodcock.

Health officials over the weekend confirmed six cases of swine flu in the county – one in Marana Unified School District; one in Tucson Unified; and four on the Tohono O’odham reservation. As of Monday afternoon, 11 additional cases had been confirmed in three other Arizona counties – nine in Maricopa, and one each in Santa Cruz and Yuma.

A total of 175 students out of 472 were absent Monday from TUSD’s Safford Engineering/Technology Magnet Middle School, 200 East 13th St. A normal day’s absence there is around 45, said TUSD spokeswoman Chyrl Hill Lander.

Parents of 25 students called in saying their children had flu symptoms; 16 said their children had colds, sore throats and coughs and about half a dozen had medical appointments.

Lander said another 14 students were sent home from school when it was determined they had flu symptoms and fever.

The total number of students out Monday was 189, about 40 percent of the school.

Safford also had about 60 calls from worried parents saying they were not going to send their children to school because it had a confirmed swine flu case.

Lander said she fielded one call from a parent irate that TUSD had not closed the school.

The situation was quite different at Marana’s Tortolita Middle School, 4101 W. Hardy Road.

A day after learning that a classmate had had swine flu, only 40 of the 986 students there stayed home because of their parents’ flu concerns, fewer than had been absent any day in the last week, according to district spokeswoman Tamara Crawley.

Meanwhile, hospitals were not reporting a flood of flu-fearing patients.

“We’re not seeing a big jump in the (University Medical Center) emergency department, but we are getting a lot of phone calls,” spokeswoman Katie Riley said.

“We had really no surge” Sunday or Monday, Northwest Medical Center spokeswoman Kim Chimene said Monday.

Health officials have encouraged those experiencing flu-like symptoms to call their doctors instead of going to emergency rooms and possibly spreading the virus.

Most who tested positive for swine flu here already had recovered by the time the diagnoses were made, Woodcock said. For that reason, county health officials do not plan to retrace the patients’ contacts or comb through their medical charts.

Instead, the Health Department will continue working with hospitals and clinics to monitor patients, Woodcock said. The department on Tuesday plans to release its stores of antiviral medications to hospitals.

The medicines will go only to ill patients who have been admitted or whom doctors planned to admit, Woodcock explained. Antiviral drugs would go to patients with fevers above 100 degrees and experiencing respiratory distress or other signs of infection.

State health officials said Monday that swine flu doesn’t appear to be more severe than normal flu but they cautioned that the threat isn’t over.

“It’s still the flu, and the flu kills,” said Laura Oxley, a spokeswoman for the state health department. “So we cannot say that the concern is over.”

Oxley said the number of swine flu cases in Arizona is expected to increase in coming days. Officials stressed the important thing is not the number of cases, but their severity.

Citizen Staff Writer Mary Bustamante and The Associated Press contributed to this report.

Want to know what in the environment or in your genes causes your allergy or asthma symptoms?

Fernando Martinez, a noted asthma expert and director of the Arizona Respiratory Center at the University of Arizona, probably could tell you.

Martinez, who also heads the UA BIO5 Institute, will lecture on the subject Tuesday.

The event, which is free of charge and open to the public, begins at 5 p.m. at the University Medical Center Duval Auditorium, 1501 N. Campbell Ave.

Martinez’s research focuses on the natural history of childhood asthma and the genetic, physiological and environmental factors behind it. The doctor’s May 5 lecture is titled “Genes and Environment at the Onset of Asthma and Allergies.”

For more information, go to www.bio5.org.