'Rapidly fatal' swine flu kills in different ways: study

WASHINGTON — People who die of swine flu contract a "rapidly fatal" form of the disease and tend to die of lung injury, although it strikes different people in different ways, an autopsy study showed Thursday.

In the first study of its kind, researchers in Brazil examined 21 patients aged one to 68 who died in Sao Paulo with confirmed (A)H1N1 infections in July and August.

All 21 patients "presented a progressive and rapidly fatal form of the disease," the study, which will be published in the January 1 issue of the American Thoracic Society's "American Journal of Respiratory and Critical Care Medicine", found.

All were found to have died of severe acute lung injury, but with three distinct patterns of damage to the lungs, the study said, indicating to the researchers that swine flu "killed in distinct ways".

"All patients have a picture of acute lung injury," said the study's lead author, Thais Mauad, an associate professor of the Department of Pathology at Sao Paulo University.

But some of the patients had only acute lung injury while in others it was associated with necrotizing bronchiolitis -- severe inflammation of the small airway passages in the lungs -- and in others there was "a hemorrhagic pattern," Mauad said.

Patients with necrotizing bronchiolitis were more likely to also have a bacterial co-infection, while patients with heart disease and cancer were more likely to have a hemorrhagic condition in their lungs.

"It is important to bear in mind that patients with underlying medical conditions must be adequately monitored, since they are at greater risk of developing a severe H1N1 infection," said Mauad.

Sixteen of the patients had chronic underlying health conditions, such as heart disease or cancer, the study found.

The researchers also found evidence of an "aberrant immune response" in the lungs of some of the patients, which "suggests that an overly vigorous host inflammatory response triggered by the viral infection may spill over to and damage lung tissue, causing acute lung injury and fatal respiratory failure," said John Heffner, a former president of the American Thoracic Society.

P.S. Boost your immune system by eating Vitamin C and Vitamin D rich foods and fruits.

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H1N1 flu activity down, H1N1 flu-associated deaths up-Is H1N1 getting more deadly?

The latest U.S. Centers for Disease Control and Prevention (CDC) swine flu update shows that H1N1 flu activity is decreasing once more, for the 6th week in a row. H1N1 swine flu-associated deaths, however, are going up. At the same time, reports of an H1N1 mutation that attacks the lungs and is resistant to the antiviral medication Tamiflu are circulating here in the U.S., as well as other locations around the world.

CDC swine flu update

According to the CDC swine flu update for December 11, 2009, key flu indicators are all decreasing, except for H1N1 flu-related deaths. Doctor's visits for flu and hospitalizations for flu have gone down for the 6th week in a row, and there are now only 14 states reporting widespread flu activity. At the same time, swine flu-related deaths have increased. This may result from the spread of a deadlier strain of H1N1 mutation that attacks the lungs and is resistant to the antiviral medication Tamiflu.

H1N1 mutation D225G/D225N

Learn more about the H1N1 mutation that attacks the lungs here:

New York swine flu victims show lung damage

Utah patient with lung hemmorhaging

Source of swine flu samples may explain low numbers of D225G

Swine flu vaccine ineffective against D225G in Ukraine

H1N1 deaths increase as mutations combine

Fatality in France due to mixture of swine flu mutations

Iowa medical examiner reports local H1N1 lung damage

Demographic information in Ukraine fatalities linked to D225G receptor binding domain

D225G swine flu mutation same as Spanish flu

Swine flu mutation H274Y/H274Y

Learn more about the swine flu mutation that is resistant to Tamiflu here:

Tamiflu-resistant H1N1 spreading

Swine flu pandemic complicated by antiviral resistance

Tamiflu doesn't work anymore

Tamiflu-resistant strain of H1N1 found around the world


P.S. BOOST your immunity by eating Vitamin C and Vitamin D rich foods and fruits.



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H1N1 Swine Flu Less Severe Than Feared

H1N1 swine flu won't be as severe as was feared, but the pandemic is nothing to sneeze at, new predictions suggest.

When the fall/winter wave of H1N1 swine flu is over, it will have been no more severe than an average flu season, predict Harvard researcher Marc Lipsitch, DPhil, and colleagues from the U.K. Medical Research Council and the CDC.

"The good news is that ... the severity of the H1N1 flu may be less than initially feared," Lipsitch says in a news release.

There are some big asterisks next to that prediction:

* Most of the deaths and hospitalizations in a typical flu season are elderly people. Most of those killed or hospitalized in the H1N1 swine flu pandemic are children and young adults.
* Deaths attributed to seasonal flu include heart attacks, strokes, and other fatal conditions triggered by the flu. Nearly all deaths attributed to H1N1 flu are due to flu or to bacterial complications of flu.
* The new predictions would be four or five times higher in populations without access to mechanical ventilation or intensive care.
* All bets are off if the H1N1 swine flu shifts to older populations.

Even so, the new numbers are cause for relief if not for celebration. Before the 2009 H1N1 swine flu came along, planners were preparing for a pandemic with a case/fatality ratio of 0.1% -- that is, for one death in every 1,000 symptomatic infections.

The Lipsitch team now calculates that the H1N1 swine flu has a case/fatality ratio no higher than 0.048% -- and maybe seven to nine times lower, depending on the methods used for calculation.

"This is a serious disease," Lipsitch says in the news release. He noted that between one in 70 and one in 600 people who fall ill with H1N1 swine flu will be hospitalized.

The CDC has been careful not to characterize the severity of the 2009 H1N1 pandemic. The new predictions are very much in line with CDC's working estimates, says Beth Bell, MD, MPH, associate director for science at the CDC's immunization and respiratory disease center.

"This study sends the message that this is primarily a young person's disease and highlights the importance of taking advantage of this window of opportunity to get the vaccine and take preventive measures," Bell tells WebMD. "While most people who get this illness do OK, it can be very severe -- and the severity is concentrated in younger people."
H1N1 Swine Flu: Same Lung Damage as 1918 Flu

Highlighting the H1N1 flu's ability to turn deadly is a new study from James R. Gill, MD, from the New York City Medical Examiner's office, and Jeffrey Taubenberger, MD, PhD, of the National Institutes of Health.

Detailed autopsies of 34 people who died of H1N1 swine flu show that the virus typically kills by damaging the upper airways, although damage in the lower airways and deep lung was not uncommon.

Strikingly, the damage was very familiar.

"This pattern of pathology in the airway tissues is similar to that reported in autopsy findings of victims of both the 1918 and 1957 influenza pandemics," Taubenberger says in a news release.


P.S. Boost your immunity by eating Vitamin C and Vitamin D rich foods and fruits.



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A "window of opportunity" for preventing another wave of Swine Flu

With activity of the pandemic H1N1 influenza virus declining across the country and the availability of the vaccine against it growing, health authorities have "a window of opportunity" for preventing or minimizing another wave of infections in the coming months, said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, at a news conference this morning.

In planning for the short-term future, CDC officials conducted an informal poll of about a dozen internationally recognized flu experts, asking them if they thought there would be another wave of infection this winter. "About half said yes, half said no, and one said 'Flip a coin,' " Frieden said. "We don't know what the future will hold."

Figures released Monday showed that influenza activity had declined for the fourth consecutive week, with only 32 states now reporting widespread activity, down from 48 states a month ago. "Flu is going down, but it is far from gone," Frieden said. "The flu season lasts until May. Only time will tell what the flu season will bring."

Frieden said nearly 70 million doses of swine flu vaccine are now available, an increase of 9 million since Wednesday. "We are seeing that more people are getting vaccinated and protected and, as that happens, it becomes harder for the virus to spread," he said. But he also cautioned that, as more people become immune, that puts increasing pressure on the virus to mutate to a new form.

Frieden spoke briefly about the mutated strains of the virus that have been detected in some patients recently in Norway and China. There has been speculation that the mutant form may be somewhat more virulent because it is able to penetrate farther into the lungs. But Frieden noted that the virus has been observed sporadically during the pandemic and many scientists believe that it is a mutation that evolves in an infected patient, allowing the virus to burrow farther into the lungs. He noted that physicians have seen patients with the mutant strain deep in the lungs and a different strain higher up, suggesting that the mutant strain was created in situ. In any case, he added, there is no evidence that the mutant strain is spreading and "it is not likely to become the dominant strain."

P.S. Boost your immunity by eating Vitamin C and Vitamin D rich foods and fruits.

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RP gets 1st batch of A(H1N1) vaccines

The Philippines received its first batch of A(H1N1) vaccines from the World Health Organization (WHO) Thursday morning, Malacañang said.

A Palace statement said that the WHO turned over the influenza vaccines to the Philippine government during a ceremony at Bahay Pangarap in Malacañang.

President Gloria Macapagal Arroyo received the vaccines from Dr. Soe-Nyunt-U, WHO country representative to the Philippines, the statement said.

The donation was made under a memorandum of agreement signed by WHO Director General Dr. Margaret Chan and Health Secretary Francisco Duque III last Nov. 25.

WHO will supply the country's need for the flu vaccines manufactured by CSL Limited, GlaxoSmithKline Biologicals SA, Green Cross Corporation, MedImmune LLC, Novartis AG and Sanofi Pasteur SA.

The Philippines is the first country to receive such a donation, the statement noted.

Government is undertaking preemptive moves for a possible second wave of A(H1N1) infections, even as health officials reassured the public there is no sign of the A(H1N1) virus growing nastier.

Last month, Duque said his department is in constant communication with the WHO, and there is no sign of a more severe strain of the A(H1N1) virus.

“We are in constant contact with WHO. There is no evidence up to now of a nastier strain of the AH1N1 virus. So our mitigation and containment measures will remain," Duque said in a radio interview then.

Duque reiterated there is no cause for alarm as far as A(H1N1) is concerned even if the virus is already in the Philippines, saying it is already considered a pandemic.

Besides, he said, more than 99 percent of A(H1N1) cases in the Philippines had recovered, with the 30 who died having suffered from other diseases like heart and liver disease.

In August 5, 2009, the WHO reported that 1,154 have died since the virus emerged in April.

More than 300 of the new deaths were in the Americas, bringing the death toll in that region to 1,008 since the virus first emerged in Mexico and the United States, and developed into the global epidemic, the WHO said.

It added that is no evidence that the new virus is mutating into a more dangerous form.

On the other hand, Duque had said that the government already issued 19 guidelines on what to do with A(H1N1) cases, adding that the DOH will monitor developments on the virus.


P.S. Boost your immune system by eating lots of Vitamin C and Vitamin D foods and fruits.



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Swine flu facts, signs and reminders

H1N1 is not any worse than the seasonal flu it's just who is being more greatly affected that is different that includes children.

So we have some reminders for parents when it comes to what to look for and when to call the doctor.

The symptoms of all types of flu include: fever, coughing, sore throat, headache, chills and fatigue. With the H1N1 virus these symptoms could be more severe. They may also include vomiting and diarrhea.

But even though most cases of the virus are mild we do know children are at a greater risk.

So far, 95 children have died from H1N1 since the spring. That's more than the number of kids who die from the seasonal flu each year.

Because of that parents should be on the lookout and call your doctor if your child does not seem to be getting better or could be getting worse. Virtua E.R. Doctor F.J. Campbell says those signs include: a fever that lasts more than a couple of days or any difficulty breathing.

"If you really see them really taking much deeper breaths and more rapid breaths that's the time to really pay attention and make that phone call and let your doctor make the decision if it's serious or not."

And he says for parents of kids with respiratory problems such as asthma they should be in contact with their child's doctor if they get sick. Kids with underlying problems are at a greater risk for complications. It's also recommended all children get the H1N1 vaccine as soon as it's available.

One more tip for parents if your child is sick with a fever then seems to get better but then a few days later they have a fever again that's another sign to call your doctor.


P.S. Boost your immunity by eating Vitamin C and Vitamin D rich foods and fruits.




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Swine Flu May Infect Internet Too ( Part 2 )

Such a reduction would require adjusting the configuration file within each customer's modem to temporarily reduce the maximum transmission speed that that modem was capable of performing—for example, by reducing its incoming capability from 7 Mbps to 1 Mbps.

However, according to providers the GAO spoke with for its report, such reductions could violate the agreed-upon customer service levels for which customers have paid. In the end the GAO said that technically feasible options would likely require a government directive.

Some of the GAO's other conclusions included:

•Voluntary actions taken by the general public could have significant potential to reduce the surges in traffic loads that residential users may experience during a pandemic. For example, the general public could be asked to limit video streaming, gaming, and peer-to-peer and other bandwidth-intensive applications during daytime work hours.

•Shutting down specific Internet sites would also reduce congestion, although the GAO said many industry players expressed concerns about the feasibility of such an approach. Overall Internet congestion could be reduced if Web sites that accounted for significant amounts of traffic—such as those with video streaming—were shut down during a pandemic.

•Providers could help reduce the potential for a pandemic to cause Internet congestion by ongoing expansions of their networks' capacities. Some providers are upgrading their networks by moving to higher capacity modems or fiber-to-the-home systems. For example, some cable providers are introducing a network specification that will increase the down load capacity of residential networks from the 38 Mbps to about 152 to 155 Mbps.

•Until DHS develops an effective response strategy, coordinates with federal and other partners on actions to take, determines whether sufficient authorities to act exist or are sought, and evaluates the need for a public campaign, employees in critical sectors of the nation's economy, including those in financial services, might not be able to effectively telework or otherwise communicate or transmit data over the Internet during a pandemic.



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Swine Flu May Infect Internet Too ( Part 1 )

Government watchdogs are warning that the H1N1 pandemic will led to increased Internet usage. This could create serious network access congestion, says Network

World While sounding a bit like Chicken Little, Federal government watchdogs today said that the H1N1 pandemic will cause a significant increase in the use of the Internet by students and teleworkers that would create serious network access congestion. Such problems may need to be fixed by government involvement or service providers limiting network access or by asking people to lay off the streaming videos for a while.

Congestion affecting home users is likely to occur because the parts of providers' DSL, cable, satellite, and other types of networks that provide Internet access from residential neighborhoods are not designed to carry all the potential traffic that users could generate in a particular neighborhood or that all connect to a particular aggregating device, a Government Accountability Office report looking at the impact of a pandemic on the Internet stated.

Internet congestion will be exacerbated by localities which may choose to close schools and these students, confined at home, will likely look to the Internet for entertainment, including downloading or streaming videos, playing online games, and engaging in potential activities that may consume large amounts of network capacity, the GAO stated.

Although predicting that the most severe congestion would occur within residential access networks, a study overseen by the Department of Homeland Security also noted that pandemic-related congestion was possible in other parts of the networks that comprise the Internet, the GAO stated. DHS is responsible for ensuring that critical telecommunications infrastructure stays up and running during periods of national duress.

For example, users could experience congestion at peering points where traffic is transferred between service providers because of potential differences in transmission capacity. Additionally, teleworkers connecting to their enterprise networks could overload various components of these networks, such as firewalls or servers that provide access to various applications because some businesses' networks may not have scaled these devices to accommodate the anticipated increase in telecommuting traffic during a pandemic, the GAO stated.

Can service providers ease the pain? Maybe. Providers' options for addressing expected pandemic-related Internet congestion include providing extra capacity, using network management controls, installing direct lines to organizations, temporarily reducing the maximum transmission rate, and shutting down some Internet sites. Each of these methods is limited either by technical difficulties or questions of authority, the GAO stated.

Providers said they would focus on ensuring services for the federal government priority communication programs and performing network management techniques to re-route traffic around congested areas in regional networks or the national backbone. However, these activities would likely not relieve congestion in the residential Internet access networks, the GAO stated.

In the current network environment, providers' capability to address pandemic-related Internet congestion by prioritizing certain users' traffic, including that of financial sector teleworkers, is limited. Although providers cannot identify users at the computer level to manage traffic from that point, two providers told the GAO that if the residential Internet access network in a particular neighborhood was experiencing congestion, a provider could attempt to reduce congestion by reducing the amount of traffic that each user could send to and receive from his or her network.

To be continued............




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Swine flu: Answers to your H1N1 questions

As more and more people are getting infected by the dreaded swine flu, questions linger about the dangers of the virus and the effectiveness of inoculations. Here are edited queries from Tribune readers, with answers:

Q: What is the comparison between the fatality rates for H1N1 flu and seasonal flu, and is H1N1 considered more of a danger than seasonal flu?

A: Since the pandemic began in April, more than 1,000 deaths from H1N1 have occurred, including about 100 children, and more than 20,000 hospitalizations in the United States, according to the U.S. Centers for Disease Control and Prevention. The CDC estimates that about 36,000 people die of seasonal flu-related causes annually, although the number fluctuates.

It is good news, according to Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, that the swine flu continues to be "very mild" for most people. "But there is no question we are seeing very severe cases hit in populations normally not susceptible to the flu, and without underlying health conditions in some cases," she said this week. "Young people and pregnant women have been particular targets of that."

Q: Is it true that people who get the H1N1 mist are getting a live virus which they can shed, infecting people with depressed immune systems?

A: The nasal spray is made from live, weakened virus. There is a bit of "shedding" -- where some of the vaccine escapes. But the amount is so small, there is no need to worry about spreading it in the general population, according to Dr. Julie Morita, medical director of the Chicago Department of Public Health's immunization program.

The only concern, she said, is among health care professionals who care for people whose immune system is compromised. "A doctor in a regular setting can get the nasal spray and not worry about shedding, but those taking care of people with a weakened system should not get the vaccine or go to work immediately after taking it," she said.

Clinical studies show the risk of getting infected after contact with attenuated, or weakened, vaccine virus is minuscule -- between 0.6 and 2.4 percent.

Q: My children, ages 2 and 5, got the first round of H1N1 shots, but the doctor said she wasn't sure she will have the second dose a month later. Are they protected with just one shot?

A: Health officials recommend that children under the age of 10 receive two doses of vaccine, separated by four weeks. Health officials said every attempt should be made to obtain the second dose in order to achieve full protection. More vaccine is on its way so people should check regularly with their doctor, school and local health departments.

Q: Our mom is really sick and we aren't sure if it's swine flu. If we wear masks and sort of keep a distance from her, will we be OK?

A: A bit more than that is needed to avoid the virus, according to the CDC. If possible, your mom should be in a private room away from common areas of the house and use a separate bathroom. If she has to be around others, she should wear a mask. Everyone should wash hands regularly. If you are under 24, you might consider getting an H1N1 vaccine.

Q: I am pregnant with triplets, due to give birth in 10 days. I brought my 2-year-old son, my husband and my mom (our caretaker) to Truman College's clinic on Saturday. We waited in line for 5 1/2 hours for the vaccine. ... What kind of screening are they doing for these shots, just first come, first served?

A: With a limited supply of vaccine at each clinic, Chicago Health Department officials are trying to limit it to high-priority groups. But mostly they are relying on people being honest when asked in line if they fall into one of those groups.

"We're trusting people to do the right thing," said Julie Morita, director of the department's immunization program.

According to Tim Hadac, a department spokesman, officials are confident that nearly everyone who got vaccines at the first clinics was in a high risk group, although a "small percentage" might have slipped through. Some people had asthma, diabetes, immune disorders and other chronic illnesses that would not always be obvious to other people in line, he said.

Overall, those eligible for early vaccines are health care workers; pregnant women; children and young adults ages 6 months to 24 years; people who live with or care for infants younger than 6 months; and people ages 25 to 64 with chronic health conditions. The public clinics are being offered Tuesdays, Thursdays and Saturdays at six City Colleges campuses as long as there is demand and supply.

Q: We are going to visit my in-laws for Thanksgiving and we were told we can't see my father-in-law unless we have H1N1 shots. I have chronic sinusitis plus a diminished immune system, so how likely am I to find the vaccine before Thanksgiving? Is there a list of locations that have the vaccine?

A: You should call your doctor or health care provider to see if it is available, and where. Once the vaccine is readily available, a list of health departments and pharmacies will be made available on the Illinois Department of Public Health Web site, www.idph.state.il.us.

The vaccine continues to be in short supply across the country because of production delays. Health officials have said they expect a better supply by mid-November and that by early December, the vaccine should be widely available. Most vaccine is now going to local health departments and hospitals.

Q: The city of Chicago has the vaccine. DuPage County has it. Cook County Department of Health -- nada. Why is Cook County so behind?

A: Cook County Health Department officials said they got their initial 20,000 doses of vaccine late last week. Six thousand doses were allocated to hospitals in suburban Cook County and about 5,000 doses to public schools in Palatine, the first district designated for student vaccinations. Other doses have been reserved for health care workers at the county Health Department. No vaccine is currently available for public clinics, a county spokesman said. Officials were "cautiously optimistic" the department will get more vaccine early next week that will allow for public clinics to begin soon in suburban Cook County.

Q: Are there precautions a family should take regarding trick-or-treat candy this Halloween?

A: State and local health officials recommend giving out wrapped candy. Rather than allowing children to reach into a bowl, hand it to them. Children should wash their hands, use sanitizer and wash any fruit or other food.


P.S. Boost your natural immunity by eating lots of Vitamin C and Vitamin D rich foods and fruits.




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Obama Declares Swine Flu a National Emergency

President Barack Obama has declared the H1N1 swine flu a national emergency.

His proclamation, signed Friday night and released by the White House Saturday morning, will allow hospitals and doctors' offices to get legal waivers of federal rules so they can handle large numbers of sick people as the outbreak spreads.

"The H1N1 is moving rapidly, as expected. By the time regions or health-care systems recognize they are becoming overburdened, they need to implement disaster plans quickly," White House spokesman Reid Cherlin said Saturday, according to the Washington Post.

The waivers, which will be issued by U.S. Health and Human Services Secretary Kathleen Sebelius, still require individual requests by the hospitals, Cherlin noted.

The goal, according to the Associated Press, is to remove bureaucratic roadblocks and make it easier for sick people to seek treatment and for medical personnel to provide it immediately. That could mean fewer hurdles involving Medicare, Medicaid or health privacy regulations, the AP added.

The H1N1 swine flu is now widespread in 46 states, and there have been 1,000 laboratory-confirmed deaths since April, according to the latest estimates released Friday by U.S. health officials.

Dr. Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention, told a news conference Friday, "We have already had millions of cases of pandemic influenza in the United States, and the numbers continue to increase."

At the same time, he said, production delays continue to hamper distribution of the H1N1 swine flu vaccine.

The vaccine is growing more slowly in egg-based cultures than manufacturers had anticipated, resulting in fewer available doses at this time, Frieden explained.

As of Friday, there were 16.1 million doses on hand nationwide, up from 14.1 on Wednesday, Frieden said. And there will be far fewer than the 40 million doses originally planned for the end of October, he added.

"Vaccine availability is increasing steadily, but far too slowly," Frieden said. "It's frustrating to all of us. We are nowhere near where we thought we would be by now. We are not near where the vaccine manufacturers predicted we would be."

The vaccine that is available comes in both nasal mist and injectable forms. The first doses were only the nasal spray, called FluMist, designed for healthy people 2 to 49 years of age. But now, more than half the doses are injectable, he said.

While children continue to be particularly vulnerable to the disease, Freiden said, "we are seeing it increasingly affect young adults as well as children. We are still not seeing significant numbers of cases among the elderly, and that's characteristic of this virus."

That's also a marked difference from run-of-the-mill seasonal flu, which typically poses a much bigger threat to the elderly.

There is encouraging news, Frieden said. The genetic makeup of the H1N1 virus hasn't changed, meaning the swine flu vaccine and the antiviral drug Tamiflu are a good match.

Frieden said the H1N1 flu would probably occur in waves, but "we can't predict how high, how far or long the wave will go, or when the next will come."

"We are now in the second wave of pandemic influenza and whether this will continue through the fall into the winter, whether it will go away and come back in traditional flu season, only time will tell," he said.


P.S. Boost your resistance against swine flu by eating lots of Vitamin C and Vitamin D rich foods and fruits.



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Novartis Says Most U.S. Swine Flu Shots Ready in 2010

Most of Novartis AG’s swine flu vaccine may not reach the U.S. until the first quarter of 2010, almost at the end of flu season, Chief Executive Officer Daniel Vasella said today in an interview on CNBC.

“I feel compassion for those people who are waiting,” he said.

The Basel, Switzerland, drugmaker is the biggest U.S. supplier of the new vaccine, and U.S. health officials have reported the country’s overall supply will reach 28 million doses by the end of the month after previously projecting 40 million to 50 million by mid-October. H1N1 is widespread in 41 states, has hospitalized more than 5,000 and has caused the deaths of 292 people since Sept. 1, 90 percent of whom were younger than 65, the U.S. Centers for Disease Control and Prevention reported Oct. 20.

Production at Novartis is not being held up now, Vasella said today. The initial problem was the lack of antigen, the key ingredient that induces immunity, he said.

“There was one-fifth of the normal yield,” Vasella said.

Novartis received the first seed strains from the CDC and Geneva-based World Health Organization and was forced to go back and get others, Sarah Coles, a spokeswoman for the company, said in an e-mail.

Half the Yield

All the other vaccine makers with contracts to supply to the U.S. -- Paris-based Sanofi-Aventis SA, London-based GlaxoSmithKline Plc and AstraZeneca Plc, and CSL Ltd. based in Melbourne -- received seed strains at the same time to develop the shots, CDC officials have said. The strains yielded half as much antigen as that for a typical seasonal flu, Aphaluck Bhatiasevi, a WHO spokesman, said Sept. 18.

Novartis is moving swiftly to increase the pace of its output including transferring 300 workers to the swine flu vaccine production lines, Vasella said.

U.S. Health and Human Services Secretary Kathleen Sebelius said yesterday there were “manufacturing glitches” because new production lines were set up to accommodate the swine flu vaccine. Sebelius didn’t specify which companies had the glitches. Novartis is contracted to deliver about 35 percent of the 250 million doses ordered by the U.S. government, according to statements from HHS.

Novartis Statement

“Novartis has taken steps to accelerate the post- production process and delivery of vaccine,” according to a statement from the company released after Vasella’s interview. “Among other things, we have prioritized production of pre- filled syringes despite substantially slower filling rates. Along with the low yields, these efforts have led to delays in vaccine supply.”

Novartis began a large-scale fill-and-finish operation on the swine flu vaccine in early September after completing its seasonal flu campaign, the company said in its statement.

AstraZeneca’s MedImmune Inc., producer of a nasal spray version of the vaccine, was about 300,000 doses behind in its production, Karen Lancaster, a company spokeswoman, said Oct. 20. MedImmune, based in Gaithersburg, Maryland, had shipped at least 6.5 million doses to the U.S. government and planned to send a total of 11 million by the end of October, she said.

Sanofi said it began shipping its vaccine on Sept. 29, “a little bit earlier than anticipated,” and was tracking “pretty much on schedule,” Donna Cary, a spokeswoman, said Oct. 20.

CSL was “on schedule” to delivery its 36 million doses, Sheila Burke, a spokeswoman, said Oct. 20.



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FDA warns: Swine flu scams lurk on the Internet

People be warned. Many people feared this pandemic and are desperate themselves to seek a vaccine which could protect them against this dreaded disease. But some are capitalizing on this tragic event by claiming they have the means to battle this global pandemic.

Air "sterilizers." A photon machine. Supplement pills to boost the immune system. Protective shampoos and face masks. Even fake Tamiflu.

These and other products making bogus claims to prevent or treat swine flu are flooding the Internet as scam artists prey on the public's fears while the vaccine is delayed and real Tamiflu — made by Switzerland's Roche Group — is rationed.

Every problem, it would seem, is a sales opportunity. Some of the products appear to have been pitched for other emergencies, such as one called "Quake Kare" and masks and purifiers sold during the SARS scare.

Federal officials have sent warning letters to promoters of more than 140 swine flu-related products, including well-known alternative medicine advocate Dr. Andrew Weil for his "Immune Support Formula."

Consumer Reports also has warned subscribers to be wary.

"It's harmful, disappointing, frustrating to see folks take advantage of the public like this," said Dr. John Santa, who evaluates health claims for Consumer Reports.

Fraudulent products emerged shortly after swine flu did last spring — about 10 a day, said Alyson Saben, head of a swine flu consumer fraud team formed by the Food and Drug Administration. The pace slowed over the summer as the flu abated, but "it's picked up" in recent weeks, she said. "We are seeing new sites pop up."

Most worrisome: sites that claim to sell Tamiflu without a prescription. The FDA bought and tested five such products. One contained powdered talc and generic Tylenol — no Tamiflu. Several others contained some Tamiflu but were not approved for sale in the U.S.

"We have no idea of the conditions under which they were manufactured. They could contain contaminated, counterfeit, impure or subpotent or superpotent ingredients," Saben said.

Tamiflu and GlaxoSmithKline's Relenza are the only drugs recommended for treating swine flu.

Rogue Web sites are not the only ones trying to cash in on flu fears. Makers of some well-established products are making claims that may be close to the line, the FDA says.

This week, the makers of Dial Soap, Kleenex, Clorox and other big brands launched a joint promotional campaign costing up to $1 million. The FDA is reviewing the campaign, which includes a video that says:

"Germs are tiny organisms that can cause disease. According to the CDC, up to 80 percent of infectious diseases, like the flu, are spread by your hands. That's why frequent, proper handwashing is so important in preventing spread of the flu, other viruses and germs. An antibacterial soap like Dial Complete foaming hand wash kills 99.9 percent of germs."

Flu is caused by a virus, so killing bacteria is of uncertain benefit.

The campaign is "not being specific down to swine flu," said Scott Moffitt, an official with Dial Corp.'s parent company, Germany-based Henkel AG. He also contends the video is not misleading, even though the germ-killing claim follows a sentence about flu and other viruses.

One product that drew a warning letter from the FDA is the Photon Genie, a gadget that delivers "energy waves." Its Web site claimed it "helps strengthen the immune system, and a strong immune system is KEY to preventing swine flu symptoms and KEY to treating swine flu."

The site has since removed the swine flu claim but "other claims remain," Saben said.

The group behind the Web site, the Skilling Institute of Phoenix, "is not marketing, and will not market in the future, any product that is intended to diagnose, mitigate, prevent, treat or cure the H1N1 flu virus," its director, Warren Starnes, wrote in an e-mail.

Some products the FDA warned about contain silver, such as "Swine Flu...Gone," made by Secrets of Eden.

"Spray 'Swine Flu...Gone' with ionic silver on your hands and on any surface where these germs may exist and kill the virus," its site had claimed.

Secrets of Eden sells supplements and oils with a biblical flair, said its general manager, Rick Strawcutter, a former pastor in Adrian, Mich. The staff "got a little carried away" on marketing for one product and "drew the ire of the FDA," he said.

"It was not worth contesting," so he ordered a stop to it, Strawcutter said.

The federal Agency for Toxic Substances and Disease Registry says silver "may cause harmful health effects," depending on the amount and type of exposure.

Dr. Andrew Weil's site had this problem language, the FDA's warning letter said: "...during the flu season, I suggest taking a daily antioxidant, multivitamin-mineral supplement, as well as astragalus, a well-known immune-boosting herb that can help ward off colds and flu. You might also consider ... the Weil Immune Support Formula which contains both astragalus and immune-supportive polypore mushrooms."

Weil issued a statement saying the content "was primarily educational" about how to avoid the flu, and that he had directed his Web site team to remove and review it for compliance with federal rules.

Doctors, too, are being warned not to prescribe unproven remedies, such as drugs not shown to be safe and effective for swine flu. In this week's New England Journal of Medicine, three FDA doctors caution against use of ribavirin, a drug approved in the U.S. for treating hepatitis C and respiratory syncytial virus, or RSV, a childhood illness.

There have been reports of doctors wanting to try it for seriously ill flu patients, but it can cause a dangerous type of anemia and cannot be used in pregnant women because of the risk of birth defects, said the FDA's Dr. Debra Birnkrant.

"It shouldn't be used lightly" and needs to be tested in a clinical trial for flu, she said.

P.S. Boost your immune system by eating lots of Vitamin C or Vitamin D rich foods or fruits.

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Flu Story: A Pregnant Woman’s Ordeal

The group most threatened by swine flu and most in need of the new vaccine, world health authorities agree, is that of pregnant women.

For example, Aubrey Opdyke.

On June 27, Ms. Opdyke, a 27-year-old waitress and former high-school swimmer who weighed 135 pounds before her pregnancy and had no health risks other than a smoking habit, came down with mild flu symptoms.

She finally came home from the hospital three weeks ago.

“At first, I didn’t think anything of it — just another flu bug,” Ms. Opdyke said recently. “But it really wrecked me. I probably shouldn’t have made it.”

In the four months she was hospitalized, she spent five weeks in a coma, suffered six collapsed lungs and a near-fatal seizure. High-pressure ventilation blew her up like a molten balloon until “she looked like she weighed 400 pounds,” her husband, Bryan, said, and she has stretch marks from her neck to her ankles. Her muscles and lungs are still so weak that she uses a walker.

While hospitalized, she missed seeing her 4-year-old daughter, Hope, learn to swim and start pre-school.

And, most important, she lost her baby. Parker Christine Opdyke, almost 27 weeks in the womb, was delivered by emergency Caesarean section on July 18, when her fetal heart rate plummeted during Ms. Opdyke’s third lung collapse. Her airways were too blocked to let a breathing tube in, possibly a side effect of the drugs saving her mother. She lived seven minutes.

On Oct. 1, the Centers for Disease Control and Prevention said 100 pregnant women had been in intensive care with swine flu and 28 had died. That is a tiny fraction of what are believed to have been millions of cases in the country. But it is the best argument, federal officials say, for the drawn-out, expensive effort to make a swine flu vaccine.

Pregnant women are particularly susceptible because they are in the younger age group most likely to catch this new virus, while those over 50 who have had more flus rarely catch it. Moreover, pregnancy suppresses the immune system to protect the fetus, and the growing baby makes it harder for a mother to clear her lungs.

All but a few of the pregnant women who have died or been near death from swine flu are unknown. Privacy laws prevent health departments from releasing their names, and few families come forward.

The Opdykes did because “we wanted to get it out there how dangerous it can be,” Ms. Opdyke said.

“We have friends who get flu symptoms and say, ‘Oh, I’m not going to a doctor,’ ” Mr. Opdyke added. “And we say, ‘Do you not understand what we went through?’ I can’t imagine why there’s so much nonchalance.”

That nonchalance strikes close to home.

As they said this, Ms. Opdyke was doing her daily physical therapy, struggling to lift one-pound weights. Her therapist interrupted to announce that she opposed flu shots.

“Have you ever read the labels?” she asked. “They’re so full of toxins.”

Asked if she realized that a shot, had it existed in June, might have saved her client and her baby, she frowned and went back to her clipboard.

Unlike some other families that came forward, the Opdykes are not threatening to sue anyone.

They do not blame her obstetrician, even though she suggested acetaminophen the first time Ms. Opdyke called her and prescribed an antibiotic the second.

“Swine flu just wasn’t on our minds at all,” Ms. Opdyke said.

Nor are they angry at the Wellington Regional Medical Center. “I don’t think if I’d taken her anywhere else, she would have survived,” Mr. Opdyke said.

Her flu came on gradually, and she never had a high fever. But after a week of feeling exhausted and achy, she became delirious. When Mr. Opdyke drove her to the hospital, with his finger on the door-lock button for fear she would jump out, she could not tell the triage nurse her name.

Her blood oxygen level was below 70; normal is 95, and below 80 is life-threatening. Both lungs were full of fluid.

Thrashing, she knocked off oxygen masks and pulled out an intubation tube. Panic made her hyperventilate. Doctors finally sedated her into a paralytic coma to let the ventilator work.

She survived near-failure of her kidneys, then her lungs, damaged by continuous high-pressure oxygen, began collapsing. Mr. Opdyke was warned he might have to choose — her life or that of the baby, who was just at the border of survivability outside the womb.

“I said, ‘Save Aubrey,’ ” he said of the woman he married last year. “I can make another baby, but I can’t replace her.”

Her third lung collapse forced the issue. Parker had to be delivered, but she did not survive.

Now I Lay Me Down to Sleep, a photographers’ charity for families of premature infants, offered to take black-and-white pictures. Ms. Opdyke’s mother bathed Parker and brushed her hair.

“Some people don’t agree,” Mr. Opdyke said about having the photographs taken. “But for me there was no option. Aubrey wasn’t awake, she didn’t get to bond. If I didn’t do it, there’s no way I could make it up to her.”

Aubrey Opdyke started to recover, then developed a bacterial infection common to ventilator patients. She nearly succumbed, then rallied and doctors started to wean her off the coma-inducing drugs. She had weeks of hallucinations about a friendly white dog visiting her but could not ask about it because of the tube.

Mr. Opdyke took comfort from what he saw as divine signs. Dog is “God” backwards, he noted. And one day, in a panic because he had forgotten to wear his wife’s wedding ring around his neck, he saw a license plate reading “FAITH.”

Ms. Opdyke’s last crisis was a still-unexplained seizure during a family visit. Her mother had been painting her nails and blamed herself, thinking the fumes had done it.

Now that she is home, in the townhouse complex they rent near the West Palm Beach airport, Ms. Opdyke is struggling to regain her strength. Muscles atrophy into rubber bands; every day in a coma means two days’ recovery.

She apologizes for the messy yard; she would pick it up but barely has the strength to get upstairs to bed. Mr. Opdyke has gone back part-time to his job at UPS.

Mr. Opdyke worries he gave her the flu. “I was sick two weeks before,” he said. “I touch packages that have been touched a thousand times. If anybody’s going to catch it, it’s me.”

He said he had not yet looked at the bills. His insurance covered most, he said, “but it had to be over a million, and we owe 20 percent; I’m not ready for that many commas.”

Friends from their jobs and a Girl Scout charity that Ms. Opdyke once ran with her mother have raised over $10,000 by holding benefits, and small checks have come in after articles by local journalists. “It’s a lot of help,” Ms. Opdyke said. “It really shows the compassion of people.”

And does she want another baby?

“Yes,” she says firmly. “At first, I didn’t. Now I do. But I’ve got to get my strength back.”


P.S. Boost your immune system by eating Vitamin C & Vitamin D rich Foods and Fruits.



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Have H1N1 Swine Flu Symptoms? Beware false internet treatment promises

The U.S. Food and Drug Administration (FDA) issued an advisory on October 15th warning consumers to use caution when ordering anything from the internet that claims to "diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus", as many of these claims are questionable at best, even up to being outright lies. In addition, over 80 internet sellers of various products, largely dietary supplements, were warned on the 18th to remove claims that their products prevented or treated the H1N1 swine flu virus.

What Kind of Products for Swine Flu Were Being Offered?

Perhaps the most dangerous are false claims of supposed anti-viral drugs. One such product ordered by the FDA researchers, received in an unmarked envelope from India, contained no anti-viral drug at all, only talcum powder and acetaminophen.

Other products, the subject of the warning letters from the FDA, include ultraviolet lights which claim to kill the H1N1 swine flu virus, hand sanitizers, air filters, inhalers, and of course dietary supplements — one of which even claimed to be "more effective that the swine flu shot."

Does This Mean These Products are Completely Ineffective?

Not necessarily. What it means, is that none of these products have been scientifically tested for effectiveness against the H1N1 swine flu virus, and so under federal regulations they are not allowed to claim that they are. Many of them do help to combat viruses or help build the immune system to allow the body to fight off infection and symptoms. But the only products scientifically proven to be effective against the H1N1 swine flu virus, the FDA insists, are the swine flu vaccines, and the two anti-virals drugs approved for use with swine flu symptoms, Tamiflu and Relenza, and urges caution when considering anything else that claims to prevent or treat the H1N1 virus or swine flu symptoms.

P.S. boost your immune system by taking Vitamin C or Vitamin D rich Foods and Fruits.

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H1N1 Influenza Vaccine Trial in People with Asthma

NIH prepares to launch 2009 H1N1 influenza vaccine trial in people with asthma.

The National Institutes of Health is preparing to launch the first government-sponsored clinical trial to determine what dose of the 2009 H1N1 influenza vaccine is needed to induce a protective immune response in people with asthma, especially those with severe disease. The study is cosponsored by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Heart, Lung, and Blood Institute (NHLBI), both part of NIH.

"People with severe asthma often take high doses of glucocorticoids that can suppress their immune system, placing them at greater risk for infection and possibly serious disease caused by 2009 H1N1 influenza virus," says NIAID Director Anthony S. Fauci, M.D. "We need to determine the optimal dose of 2009 H1N1 influenza vaccine that can be safely administered to this at-risk population and whether one or two doses are needed to produce an immune response that is predictive of protection."

The study plan has been submitted to the Food and Drug Administration for review. With FDA allowing it to proceed, the clinical trial will be conducted at seven sites across the United States that participate in NHLBI's Severe Asthma Research Program.

This program already has a well-characterized group of participants with mild, moderate or severe asthma who may be eligible for this new study. These groups are largely distinguished by the amount and frequency of glucocorticoids needed to control asthma symptoms. People with mild disease may not need glucocorticoids, or may require low doses of inhaled glucocorticoids; those with moderate asthma need low to moderate doses of inhaled glucocorticoids; and those with severe asthma need high doses of inhaled glucocorticoids and frequently use oral glucocorticoids as well.

Individuals who already have been infected with 2009 H1N1 influenza or have received a 2009 H1N1 influenza vaccination will not be eligible for the study.

"The results of this study will have immediate implications for individuals with severe asthma as well as those who have milder asthma," says NHLBI Director Elizabeth G. Nabel, M.D.
Early results from other clinical trials of 2009 H1N1 influenza vaccines in healthy adults have shown that a single 15-microgram dose of 2009 H1N1 influenza vaccine without adjuvant is well tolerated and induces a strong immune response in most participants. The same vaccine also generates an immune response that is expected to be protective in healthy children ages 10 to 17 years. Ongoing trials are comparing the immune response to one and two doses of 15- or 30-micrograms of vaccine given three weeks apart in various populations.

The Centers for Disease Control and Prevention has recommended that certain at-risk populations receive the new H1N1 vaccine as a priority before the general population. These target populations include pregnant women, health care providers and individuals with underlying chronic medical conditions, including asthma.

People who have severe asthma may be particularly at risk for infection with the 2009 H1N1 influenza virus. A report published in 2004 suggested that some people who took high doses of glucocorticoids to treat their asthma may receive less protection from influenza vaccines against some strains of influenza. Early in the 2009 H1N1 flu outbreak a CDC review of hospital records found that people with asthma have a four-fold increased risk of being hospitalized with infection compared to the general population.

The study will enroll approximately 350 people with mild, moderate and severe asthma. Participants will be organized into two groups: those with mild or moderate asthma and those with severe asthma. Half of the participants in each group will receive a 15-microgram dose of vaccine, and the other half a 30-microgram dose. Three weeks later, each participant will receive a second dose of the same amount. The strength of the immune response induced by the vaccine will be determined in blood samples by measuring the level of antibodies against 2009 H1N1 flu virus.

Safety data will be collected and examined throughout the course of the study by trial investigators and by an independent safety monitoring committee. Participants will be monitored for any side effects they may experience because of the vaccine, as well as asthma attacks that occur during the study period.

The vaccine to be used in the trial, manufactured by Novartis, contains inactivated 2009 H1N1 influenza virus and therefore cannot cause anyone to become infected with the virus.

The trial will be conducted at the following locations:
Cleveland Clinic, Ohio
Emory University, Atlanta
University of Pittsburgh Asthma Institute
University of Virginia, Charlottesville
University of Wisconsin, Madison
Wake Forest University, Winston-Salem, N.C.
Washington University School of Medicine, St. Louis

Detailed information about this study can be found on the ClinicalTrials.gov Web site at http://clinicaltrials.gov/ct2/results?term=H1N1+AND+asthma.

Additional information about NIAID-sponsored clinical trials of candidate H1N1 vaccines can be found here: Clinical Trials of 2009 H1N1 Influenza Vaccines Conducted by the NIAID-Supported Vaccine and Treatment Evaluation Units

(http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm); Pediatric Trials of Candidate 2009 H1N1 Vaccine at NIAID Vaccine and Treatment Evaluation Units (VTEUs)

(http://www3.niaid.nih.gov/news/QA/qaH1N1pedvax.htm); NIAID Launches 2009 H1N1 Influenza Vaccine Trial in Pregnant Women

(http://www3.niaid.nih.gov/news/QA/H1N1pregnanttrials.htm); NIH Launches 2009 H1N1 Influenza Vaccine Trial in HIV-Infected Pregnant Women: Trial in HIV-Infected Children, Youth to Begin Next Week

(http://www3.niaid.nih.gov/news/newsreleases/2009/H1N1HIVTrials.htm).
Visit www.flu.gov for one-stop access to U.S. government information on avian and pandemic influenza.

Also, visit NIAID's Web sites for more information about flu(http://www3.niaid.nih.gov/topics/Flu/) and asthma (http://www3.niaid.nih.gov/topics/asthma/) and NHLBI's Web site for more information about asthma (http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html) .

For additional information about the NHLBI's Severe Asthma Research Program, contact the NHLBI Office of Communications at (301) 496-4236 or e-mail nhlbi_news@nhlbi.nih.gov.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at www.niaid.nih.gov.

Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at www.nhlbi.nih.gov.

The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.



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Benefits of swine flu vaccine greatly exceed the risks

In a typical year, seasonal flu kills about 36,000 people — nearly all of them older than 65 and many with underlying health problems. But that's not the way the H1N1 swine flu will look this year. It strikes hardest at children and young adults, who have none of the immunity to the strain that older people apparently have. And though only a fraction of 1% of sufferers is likely to get seriously ill, almost a third of those who die may be otherwise healthy and robust.

Such an outcome, says Anthony Fauci, the federal government's top infectious disease expert, is "almost unheard of." Fauci told USA TODAY's editorial board this week that he has been dealing with infectious diseases for decades, "and I've never seen, in seasonal flu, a normal, robust healthy person die from influenza."

Yet, that tragic scenario is already playing out around the nation with swine flu. H1N1 influenza has killed 28 pregnant women and 60 children since April, according to the Centers for Disease Control and Prevention. Officials don't know why some otherwise healthy people die from H1N1, and they won't predict how many more might. But the trends suggest that thousands of young lives are at stake.

This picture, based not on conjecture but on science and observation, is not meant to frighten. It is meant as a sobering counter to those who apparently have no use for science, government or vaccines and are warning people to forgo protection against a very real threat.

Typical of the skeptics is political pundit Bill Maher, who tweeted this sage advice to thousands of Twitter followers last month: "If u get a swine flu shot ur an idiot."

As the H1N1 vaccine is about to become widely available, the saddest thing is that many people seem to be listening to the Mahers of the world. A University of Michigan poll in August found that only 40% of parents planned to get the H1N1 shot for their children. Some parents are even holding ill-advised "flu parties" to expose their children to H1N1 — a potentially fatal disease.

Some of the antipathy to the shots no doubt dates to the 1976 swine flu outbreak at Fort Dix, N.J., which caused one death and sent the government into overdrive down a tragic path. President Ford pledged to vaccinate everyone in the USA against an expected epidemic. But the flu never escaped Fort Dix. More than 500 of the 45 million people vaccinated got a rare neurological illness, Guillain-Barré. Dozens died.

Whether that was related to the vaccine is still unclear. But the program, quickly suspended, left many Americans with a fear of vaccines. Little wonder. The episode involved all risk and no benefit, because the flu turned out to be no threat.

That is clearly not the case today. Around the world, H1N1 has sickened millions, and 4,100 deaths have been reported. In the USA, since Aug. 30, more than 16,000 people have been hospitalized and nearly 1,400 have died from H1N1 or seasonal flu. The benefits of the vaccine, which authorities say is as safe as the seasonal flu shot, far outweigh any risk of side effects.

The decision whether to get it, for yourself or your children, should be driven by facts and science, not advice from people who play doctors on TV or the Internet.


P.S. Boost your immune system by taking Vitamin C rich foods and fruits.




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Protect your baby against swine flu by getting vaccinated, CDC says

Babies can't get vaccinated for H1N1 virus, so parents and siblings should. Newborns have incomplete immune systems, putting them at higher risk for H1N1 flu virus. Babies under age 6 months cannot get flu vaccine, so the federal Centers for Disease Control and Prevention says parents and siblings living with infants should get vaccinated. Caregivers of those babies are first in line for swine flu vaccine, as are children up to age 4.

If you get sick, try to stay away from the baby. Have a healthy person take over care duties. If you can't, consider wearing a surgical mask when in close contact with the baby. A blanket between mother and baby can block the virus. And of course, wash hands and keep them away from the mouth, eyes and nose.

Mothers should keep breast-feeding even if they get sick. Mother's milk is a baby's best food, filled with antibodies that can fight infections (unclear if it fights swine flu). The virus does not travel in mother's milk and it's OK to take flu medicine while nursing. If sick, express the milk and have others do the feeding.


P.S. Boost your immune system by knowing Vitamin C Benefits.




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Swine flu nasal spray or shot?

We now know the first batch of the much anticipated swine flu vaccine has been shipped from the manufacturer and is on its way to undisclosed distribution centers around the country, including here in Central Florida. And according to the Orange County Health Department who gets its information from the State Health Department, the first batch is coming in the form of a nasal spray.

The next batch will be shipped next week, and is expected to come in the form of the shot. The mist, of course, is really geared toward children and adults who just don't like needles. But results of a new study just released comparing the seasonal flu shot with the flu mist show the shot is twice as effective. However, there have been no studies done comparing the swine flu mist vs. the shot.

In fact, health officials say that may not be the case with the swine flu, that the shot and the spray may be equally effective. Unfortunately for now, we'll have to wait to find out. The Orange County Health Department says both the mist and the shot will be available here in Central Florida by mid-October, but supplies will be limited.

"It's going to arrive initially in small amounts. Then we'll get more. People getting it first will be those at risk" "But with the FluMist, one little caveat, it has to go to healthy people, not the ones with underlying conditions and those at risk," said Orange County Health Department spokesman Dain Weister

The Health Department tells us anyone between the ages of 2 and 49 without any underlying health problems can get the nasal spray.

P.S. boost your immune system by heavy intake of vitamin C foods and supplements.

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Hong Kong swine flu precautions: chief executive

HONG KONG — Hong Kong's chief executive said Monday authorities would take no chance in dealing with swine flu despite accusations of over-reacting since its first confirmed case was reported in May.

"We have taken every precaution to prevent the spread of the virus," the city's chief executive, Donald Tsang, said at the opening ceremony of the World Health Organization's annual Western Pacific meeting here.

"In some cases we have even been accused of over-reacting," he said, adding: "Following our relatively recent experiences with Avian Influenza and SARS, the government has not, and will not take any chances."

The 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) killed almost 300 people in the city.

Hong Kong was also the scene of the world's first reported major H5N1 bird flu outbreak among humans, in 1997, when six people died.

The city's hygiene campaign was ramped up when swine flu reached Asia, most notably when an entire hotel was locked down for a week in May with hundreds of guests inside after a Mexican guest was found to be infected with the virus.

In the few weeks following the hotel closure, Hong Kong saw a frenetic scramble for face masks at pharmacies and supermarkets.

The city's inhabitants frequently wear face masks in public and the government has run an extensive public information campaign on personal hygiene.

The government was criticised for over-reacting at the time.

With schools re-opening after the summer holidays in recent weeks, the virus has spread among children, forcing some schools to close again temporarily.

However, the authorities' vigilance seems to have paid dividends with only 13 people dying so far of the disease in Hong Kong, out of the total number of 22,054 confirmed cases as of Sunday.

The Department of Health has said the number of fatalities was only 0.07 percent of overall cases -- far lower than the global average of 0.6 percent.

P.S., Boost your immune system. Know more about Vitamin C Benefits.

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New swine flu wave hits Mexico, closings unlikely

Looks like the dreaded Swine Flu is here to stay. The next wave of swine flu has arrived, and Mexicans are bracing for an outbreak that may be even larger than the one here last spring that became a pandemic.

Daily diagnoses reached higher levels in September than the H1N1 peak in April, with 483 new cases in just one day this month alone.

It's unlikely there will be large-scale closings of schools and stadiums, however, because health officials know the virus is usually mild if treated early.

"We know the situation is not as serious" as officials feared last spring, said Health Secretary Jose Angel Cordova.

Still, 3,000 schools across Mexico were closed earlier this week as a result of the virus. That number has dropped to 128, Education Secretary Alonso Lujambio told senators Wednesday, as he said officials are still developing the criteria they will use to shut down schools in the future.

When the first cases of swine flu were confirmed in late April, Mexico's government immediately ordered the closure of all schools, museums, libraries and theaters in the capital. Within days, schools nationwide, restaurant dining rooms and other businesses shut down, streets mostly emptied and soldiers handed out millions of face masks.

Mexico could see up to 5 million cases of swine flu during this winter's flu season and deaths could reach 2,000, Cordova said.

Some hospitals already have the same number of swine flu patients as they had in April, he said Thursday. Officials are negotiating with laboratories to secure doses of a vaccine by October, he added.

Mexico had 29,417 reported cases and 226 deaths as of Friday.

The World Health Organization says more than 300,000 cases of H1N1 have been confirmed throughout the world, and more than 3,900 people have died from the virus.

P.S. Boost your immune system with Vitamin C rich foods and fruits.

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U.S.: Oct flu vaccination to be "a little bumpy"

A top U.S. health official says the first weeks of October are going to be "a little bumpy" as the government distributes the supply the swine flu vaccine ready next week, knowing it will not be enough.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, said on Friday his agency faced a dilemma because most of the U.S. H1N1 vaccine will be unavailable until mid- to late October.

"The choice was having vaccine stack up in a warehouse ... or getting it out as soon as it became available. We feel the only right answer is to get it out as rapidly as possible," Frieden told reporters in a telephone briefing.

But that move will add to the strain on state and local health departments that likely will have to turn people away.

"It's going to be a little bumpy," said Frieden.

The U.S. government said this week it will have 6 million to 7 million doses of swine flu vaccine ready next week, and another 40 million does by mid- to late October.

Production was expected to continue at a rate of 10 million to 20 million doses per week to a total of more than 250 million by year end.

Most of the vaccine that will be ready early will be the nasal spray vaccine made by AstraZeneca's MedImmune unit. It is approved for people aged 2-49, but is not recommended for people with certain underlying health problems, who have a higher risk of becoming severely ill if infected with the flu.


'BATCH BY BATCH'

The United States has ordered vaccine from five companies -- MedImmune, Sanofi-Aventis, Australia's CSL, GlaxoSmithKline and Novartis.

Frieden said the problem arose from working with different manufacturers. "It doesn't come out in one big drop. It comes out batch by batch," he said.

Frieden said vaccine was the best tool for fighting swine flu, which was declared a pandemic in June and is spreading widely in most of the United States.

Frieden urged Americans not to underestimate influenza, noting that many people mix up flu with mild respiratory viruses.

"Flu makes you pretty sick. You feel bad. If you've got an underlying health problem or you are unlucky, you can get very sick. You need to take the flu seriously," Frieden said.

Frieden addressed concerns about an unpublished study reported by Canadian media suggesting that people in Canada who were vaccinated against seasonal flu last spring had double the risk of becoming infected with pandemic H1N1 flu.

Frieden said the CDC has analyzed data from New York and other parts of the United States and data from Australia.

"Nothing we've seen suggest that is likely to be a problem," he said. "If there is preliminary data, we'd like to see it."


P.S., Boost your immune system. Read more about Vitamin C Benefits.



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Objections over swine flu vaccine

THE OBJECTIONS

Some are suspicious of the new vaccine because the government's swine flu vaccine in 1976 caused some people to contract Guillain-Barré syndrome, a sometimes deadly nervous-system disorder. (They are different vaccines based on two different viruses).

Others see this as an issue of workers' rights, that the government should not be allowed to require vaccinations.

SHUNNING THE VACCINE

Several groups are opposed to vaccination of any kind, often citing philosophical reasons. Here is a look at some of the vaccine objectors.

Some health care workers are opposed to mandatory vaccination, but not to all vaccines.

Parents of children with autism spectrum disorders have long objected to vaccinations, based on the widely disputed notion that autism-related conditions are caused by vaccines and vaccine additives.

People with allergies to eggs oppose flu shots because eggs are used in vaccine production.

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Flu Can Raise Chances of Heart Attack

People suffering from the flu may be at higher risk for having a heart attack, especially those with heart disease and diabetes, British researchers report.

Because both seasonal and the pandemic H1N1 swine flu are circulating this fall and winter, people at risk for heart attacks are urged to get a seasonal flu shot and an H1N1 flu shot, which may reduce the chance of getting the flu and thereby lower the risk for a heart attack, experts say.

"Influenza is most concerning because of its secondary complications," said Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine in New York City.

"Most of the time with influenza, death or hospitalization isn't because of the influenza, it's because influenza puts you in a weakened state -- it's a stress on the system," he said. "So, it is not surprising that you would have the increased risk of a myocardial infarction during or right after an influenza infection."

In addition, the flu virus may have a negative effect directly on the heart, Siegel said. "Flu stresses and strains the system," he added.

To determine the risk of heart attack among those with flu, a research team led by Andrew C. Hayward, a senior lecturer in infectious disease epidemiology at the UCL Centre for Infectious Disease Epidemiology in London, looked at 39 studies conducted between 1932 and 2008.

The studies showed an increase in deaths from heart disease and more heart attacks during flu season. In fact, excess deaths because of heart disease averaged 35 percent to 50 percent, according to the report in the October issue of The Lancet Infectious Diseases.

But the studies also showed that getting a flu shot reduced the risk of dying from heart disease or suffering a heart attack, Hayward's group found.

"We believe influenza vaccination should be encouraged wherever indicated, especially in those people with existing cardiovascular disease. Further evidence is needed on the effectiveness of influenza vaccines to reduce the risk of cardiac events in people without established vascular disease," Hayward's team concluded.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, agreed that flu shots appear to reduce the risk of heart attacks.

"It has long been hypothesized that influenza infection results in an acute inflammatory response that can also trigger the onset of cardiovascular events such as heart attack and stroke in vulnerable individuals," Fonarow said.

A number of observational studies have suggested more cardiovascular events occur in patients with influenza than otherwise expected and that individuals who receive annual flu shots are much less likely to have fatal or nonfatal cardiovascular events or be hospitalized for heart failure, he said.

"Guidelines from the American Heart Association and American College of Cardiology strongly recommend that all individuals with cardiovascular disease receive annual influenza vaccination," Fonarow said.

However, Dr. Pascal James Imperato, dean and distinguished service professor at the School of Public Health at the State University of New York Downstate Medical Center in Brooklyn, said the role of flu shots in preventing heart attack has not been proven conclusively.

"The role of severe respiratory infections in precipitating myocardial infarctions in vulnerable individuals is well-established," Imperato said. "However, the role of influenza vaccines in protecting such individuals is less clear from the limited scientific evidence available."