'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.

source

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.



source

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.



source

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.

source

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.



source

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.




source

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.



source

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............




source

Swine flu's tendency to strike the young is causing confusion

As health officials brace for a new onslaught of illness from the novel H1N1 virus, they remain perplexed by one of the most unusual and unsettling patterns to emerge from this pandemic -- the tendency of the so-called swine flu to strike younger, healthier people.

The initial explanation was that the elderly, who are usually most vulnerable to the flu, have built-in immunity as a result of their exposure more than 50 years ago to ancestors of today's pandemic strain. But the limits of the theory are becoming more clear. For starters, only a third actually have antibodies to the new H1N1.

"It doesn't quite look as though it's the whole story," said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville.

Further, the flu's two key genes came directly from pigs and are new to everyone. That means all age groups should be equally vulnerable since no one has encountered the genes before. Yet infants seem to be in less danger than older children and most adults.

Unraveling these mysteries will be crucial to designing a strong defense against this tenacious virus. Tests in animals strongly suggest that H1N1 will be with us for the foreseeable future, supplanting the strains that cause seasonal flu within a year or two.

Understanding the virus' inner workings will also help scientists prepare for future influenza pandemics.

H1N1's unorthodox nature became apparent as soon as the virus burst onto the scene in early spring: Most of the earliest cases in the U.S. and Mexico occurred in children rather than the elderly.

In the U.S., half of the people with confirmed H1N1 cases have been 12 or younger, according to the Centers for Disease Control and Prevention. Until July 24, when the CDC stopped counting new cases, 60% of patients whose ages were known were between 5 and 24 years old. An additional 20% were in the 25-to-49 age group. Only 1% of those sickened had reached the age of 65.

Younger people also appear to be getting the most severe cases of pandemic flu. The median age of patients requiring hospitalization is 20, according to the CDC. In fatal cases, the median age is 37.

Those figures are in stark contrast to the seasonal flu, which is most likely to sicken people who are elderly, very young or chronically ill. More than 90% of fatal cases involve senior citizens.

H1N1's link to 1918

Scientists had theorized that the new H1N1 swine flu descended from the 1918 Spanish flu, an H1N1 strain that killed an estimated 50 million people worldwide. Older people who had been exposed to that virus must have built up immunity that protected them against the new pandemic strain.

But an analysis published last week in the New England Journal of Medicine found H1N1 antibodies in blood samples from only 39 of 115 people born before 1950, a rate of 34%. The results supported a similar analysis released in May.

Over the summer, researchers who tested blood samples from Japan found that few people born after 1918 had antibodies that protected them against the new H1N1. But most of the people over the age of 90 did.

That suggests immunity came only from the initial versions of Spanish flu, not from the myriad offshoots to which most elderly people were exposed. For them, protection came from something else.

"Other components of the immune response no doubt also contribute to reduce disease," said Jacqueline Katz, chief of immunology and pathogenesis in the CDC's Influenza Division. But she said that scientists didn't know what those might be.

Then there's the matter of the key H and N genes in the new H1N1 virus. Although they have much in common with the corresponding genes from the 1918 strains, both came directly from pigs. No one should have immunity.

Baffled by fatalities

It may turn out that prior experience with H1N1 has very little effect on who will wind up with the most severe cases of swine flu.

Consider this alternative explanation for the unusually young age of H1N1 victims from Dr. Peter Wenger, a professor of preventive medicine and community health at New Jersey Medical School in Newark: Perhaps their more vigorous immune systems are simply mounting stronger challenges to the flu virus.

If bodies overreact and release too many infection-fighting proteins called cytokines, the resulting "cytokine storm" can cause severe inflammation that overwhelms the lungs and respiratory tract. In extreme cases, the reaction can be fatal.

Many scientists have speculated that this kind of calamitous immune response may have been at work in 1918. But the theory is difficult to test.

"The immune system is such a finely modulated system," he said. "When you start pulling out cells and putting them in test tubes, it gives you some idea, but is it really what happened?"

Though the overall H1N1 fatality rate remained low over the summer during the Southern Hemisphere's flu season, deaths continued to be concentrated among middle-aged adults.

For example, in New South Wales, Australia's most populous state, half of the 48 deaths were in people in their 40s and 50s, according to figures from the government's health department.

Though children and young adults have higher rates of H1N1 infection, the fatal cases are more likely to involve middle-aged adults because they have higher rates of the underlying medical conditions that make H1N1 deadly, such as asthma, diabetes and heart disease, said CDC spokeswoman Artealia Gilliard.

Dr. Harry Greenberg, a professor of microbiology and immunology at Stanford University School of Medicine, said he was puzzled about why H1N1 had caused relatively few deaths in infants and young children considering that they lack the antibodies that appear to be protecting the elderly.

"I don't have a good explanation to totally account for this," he said, "except to say it's early in the data-gathering business."


P.S. boost your immune system by eating vitamin C fruits and foods now.



source

Swine flu vaccine expected to arrive in October

More than a million doses of swine flu vaccine a week are expected to start rolling in next month, state health officials said Thursday, but the first batches probably won't be enough to vaccinate everyone considered most at risk.

Texas will receive 1.1 million doses of the vaccine a week for three weeks and 1.5 million a week after that, said James Zoretic, regional medical director for the Texas Department of State Health Services.

A department spokesman said the first shipments could arrive as soon as early October – though no date is yet certain.

The numbers were released at a regional pandemic influenza conference in Arlington, attended by state and local health officials.

Also on Thursday, U.S. and Australian researchers announced findings that one shot of the vaccine, rather than two, should adequately protect adults from the disease.

The H1N1 vaccine, which is different from the one for seasonal flu, will be distributed to hospitals and clinics with guidelines to inoculate priority population groups – pregnant women, people 6 months to 24 years old, and those ages 64 or younger who have certain medical conditions, among others.

Several counties, including Dallas and Tarrant, have stopped counting cases of swine flu. Instead, health officials monitor emergency room reports of fevers, coughs and sore throats to gauge the disease's spread.

So far, such reports are up about 5 percent over the same period last year – a "slight uptick," said John Carlo, medical director for Dallas County Health and Human Services.

He said officials will be carefully watching that number to see if it increases over the flu season.

Officials are also monitoring school absentee rates for signs of classroom outbreaks. So far, those numbers are "fluctuating" quite a bit, said Carlo.

He cautioned that erratic absentee rates are not unusual for the beginning of the school year.

source

A(H1N1) deaths in RP now at 28, says report

MANILA, Philippines—The number of fatalities in the Philippines due to the Influenza A(H1N1) virus has reached 28 as of Sept. 3, the Trade Union Congress of the Philippines (TUCP) said Sunday, citing a report from the Stockholm, Sweden-based European Center for Disease Prevention and Control (ECDC).

In a statement, TUCP secretary general Ernesto Herrera said the ECDC’s daily update on the A(H1N1) pandemic as of Sept. 3 stated that “20 new fatal cases have been reported in the Philippines since the country last accounted for only eight deaths on July 29.”

The ECDC’s daily updates offer statistics of A(H1N1) confirmed cases and deaths in countries and territories belonging to the European Union and/or covered by the European Free Trade Agreement. The number of deaths for selected countries, including the Philippines and seven other Southeast Asian countries, was included in the report.

There were no figures for cases in non-European countries and territories.

Herrera pointed out that the statistics on the non-European countries were based by the ECDC on “official information provided by national public health websites, or through other official communication channels.”

The daily updates may be viewed at the ECDC website (http://ecdc.europa.eu/en/healthtopics/Pages/Pandemic_%28H1N1%29_2009_Daily_Update.aspx). The Inquirer checked the latest posted daily report, dated Sept. 5, which still placed the number of fatalities in the Philippines at 28.

Figure could be higher

The former senator expressed concern that the actual number of A(H1N1) deaths in the country could possibly be higher than reported. He noted that Thailand and Malaysia, which both have superior surveillance of the disease, have already reported dozens of deaths.

The ECDC’s latest daily update listed a total of 262 confirmed A(H1N1) deaths in Southeast Asia, broken down as follows: Thailand, 130; Malaysia, 73; the Philippines, 28; Singapore, 17; Indonesia, 10; Vietnam, two; and Brunei and Laos, one each.

Globally, the ECDC said A(H1N1) had already claimed a total of 3,315 lives, according to the ECDC report.

The TUCP has been urging corporations to adopt “workplace continuity plans” to assure workers “the least possible interruption to their jobs and income” as the virus spreads more aggressively.

Weekly disclosure

Herrera also earlier urged the Department of Health (DoH) to resume its weekly disclosure of confirmed A(H1N1) cases “to keep the public in an elevated state of readiness” in dealing with the potentially faster spread of the virus. He cited the need to put “everyone in a constant high state of alertness, particularly in avoidance.”

The DoH recently ceased testing and reporting individual cases of A(H1N1), after the World Health Organization (WHO) stopped compelling countries to do so.

On Sunday, Herrera urged the DoH to consider routinely divulging to the public “at least the number of A(H1N1) cases admitted to hospitals and intensive care units, just like what health authorities are doing in other countries.”

Malacañang on Friday ordered the DoH to establish extra laboratories in public hospitals “to effectively manage” A(H1N1) cases. It also instructed the DoH to heighten the monitoring of the A(H1N1) virus and improve coordination with the WHO for real time exchange of information on the disease.

The WHO has warned governments around the world of an imminent surge in A(H1N1) cases. It said countries could see cases double every three to four days for several months, and “it is certain there will be more deaths.”

source

Palace to DOH: Monitor A (H1N1) second wave

MANILA - President Arroyo on Friday ordered the Department of Health to step up its monitoring of the spread of Influenza A (H1N1) cases in the country amid fears that a second wave of the virus could affect nine million Filipinos.

Press Secretary Cerge Remonde said the President has instructed the DOH to improve its coordination with the World Health Organization as to real-time exchange of information and data on the A (H1N1) virus.

"The President also ordered hastening of the capacitation of the laboratories of government hospitals for more testing in case of epidemics. She also provisioned that government hospitals to be better prepared to manage complicated cases that may be exacerbated by the virus," Remonde told reporters.

Health Secretary Francisco Duque III earlier said a second wave of A (H1N1) infections in the Philippines could affect one-tenth of the population or about nine million Filipinos, but stressed there are no indications that the virus would worsen.

“So if our population is about 90 million, a second wave of A(H1N1) could affect as many as nine million Filipinos,” Duque told the Philippine Star during a cluster meeting of mayors from Mindanao under the League of Municipalities of the Philippines (LMP).

But Duque said he recently got assurance from a WHO official that there were no indications that the A(H1N1) virus has mutated into a more virulent strain.

Duque noted that dengue fever and even ordinary flu were more fatal than A(H1N1) in the Philippines.

DOH records show 28 people infected with A(H1N1) have died in the country as of August 28. Nearly 5,000 have been infected though more than 96 percent of the cases have fully recovered.


source

DOH: Second wave of H1N1 more virulent

MANILA - The Department of Health on Friday warned that a more virulent strain of the Influenza A (H1N1) virus could hit the country even as experts search for a vaccine to defeat the virus.

Dr. Eric Tayag, chief of the DOH Epidemiology Center, said A(H1N1) virulence's could be seen in how fast it spread globaly. The disease, which was first detected in Mexico, is the first pandemic of the 21st century and in 41 years.

"There will be a second wave of cases. These will come from Europe and the United States. Since it's flu season, we have to take steps to ensure that it doesn't spread [in the country]," Tayag told ABS-CBN.

The DOH official said a vaccine is still in the testing stage and could be released in January.

He said the DOH continues to make the rounds of hospital nationwide to ensure their preparedness for a possible second wave of A(H1N1) infections.

DOH records show 28 people infected with A(H1N1) have died in the country. Nearly 5,000 have been infected though more than 96 percent of the cases have fully recovered.

Globally, a total of 2,185 people have died from A(H1N1), with some tropical countries reporting "moderate strains" on their healthcare systems amid surges in infections.


source

Single swine flu vaccine dose may be enough

Novartis AG trumpeted the effectiveness of a single dose of its swine flu vaccine, boosting hopes that potentially tight supplies could go further when mass immunization programs start this month.

The outbreak of the H1N1 strain of flu, declared a pandemic on June 11, has spread around the world and could eventually affect 2 billion people, according to World Health Organization (WHO) estimates.

Many experts expected that two doses per person would be needed by health authorities preparing for a possible second wave of infections at the start of winter in the northern hemisphere.

Vaccination is expected to get under way in some countries this month with many others starting in October.

Novartis said on Thursday that its Celtura H1N1 vaccine had a strong immune response after just one dose in a pilot trial, and Chinese health authorities gave a green light to Sinovac, which says its vaccine also needs only one shot to be effective.

"This is good news as one dose of Celtura may be sufficient to protect adults against the swine flu. This potentially boosts that availability of flu vaccines for the upcoming flu season when a large outbreak of swing flu is expected," said Karl-Heinz Koch, an analyst at Swiss brokerage Helvea.

Another key variable is vaccine yield in the manufacturing process. Yields were initially low but the WHO said last month they were improving and one strain seemed to be yielding the same amount as seasonal vaccine.

Cell-based vaccines like Novartis's are quicker and easier to manufacture than traditional flu vaccines, which are grown in chicken eggs. However, supplies are limited for now -- they currently make up about 30 percent of the Swiss group's capacity.

Novartis said a pilot trial of Celtura run by Britain's Leicester University with 100 volunteers showed a potentially protective immune response in 80 percent of the subjects after one dose and more than 90 percent after two doses. Other studies with more than 6,000 adults and children are continuing.

Sinovac, the first company to complete clinical trials, received approval from Chinese health authorities to mass produce a vaccine for the new strain of H1N1 and raised its annual sales forecast.

Sinovac shares rose some 16 percent to $9.90 by 1351 GMT, while Novartis slipped 0.8 percent to 48.62 Swiss francs, in line with the DJ Stoxx European healthcare sector.

WINDFALLS

Other pharmaceutical companies like Sanofi Aventis, GlaxoSmithKline and AstraZeneca's MedImmune unit are also racing to develop H1N1 vaccine as governments scramble to secure supplies.

Australia's CSL is already producing H1N1 vaccine and is making 1.0 million to 1.5 million doses per week until it fills all orders.

Antiviral drugs which treat flu rather than immunize -- Glaxo's Relenza and Tamiflu, made by Switzerland's Roche -- are also in high demand.

Sales to governments will provide a revenue and profit windfall for many drugmakers this year and in 2010.

"At the beginning of this year, we forecast our sales would rise by 20 percent," Sinovac Chief Executive Yin Weidong said on Thursday. "Looking at things now, H1N1 has given us an opportunity, so the rise should be more than 20 percent."

H1N1 vaccines would be given separately from regular seasonal flu shots.

Vaccines arrived too late in the 1957 and 1968 flu pandemics to be of much use, and flu vaccines had not been developed in the 1918 "Spanish flu" pandemic which killed an estimated 50 million people.


source

WHO Warns Of Severe Form Of Swine Flu

WASHINGTON (Reuters) - Doctors are reporting a severe form of swine flu that goes straight to the lungs, causing severe illness in otherwise healthy young people and requiring expensive hospital treatment, the World Health Organisation said Friday.

Some countries are reporting that as many as 15 percent of patients hospitalized with the new H1N1 pandemic virus need intensive care, further straining already overburdened healthcare systems, WHO said in an update on the pandemic.

"During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services," it said.

"Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases."

Earlier, WHO reported that H1N1 had reached epidemic levels in Japan, signalling an early start to what may be a long influenza season this year, and that it was also worsening in tropical regions.

"Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections," WHO said.

"In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays."


MINORITIES AT RISK

Minority groups and indigenous populations may also have a higher risk of being severely ill with H1N1.

"In some studies, the risk in these groups is four to five times higher than in the general population," WHO said.

"Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension."

WHO said it was advising countries in the Northern Hemisphere to prepare for a second wave of pandemic spread. "Countries with tropical climates, where the pandemic virus arrived later than elsewhere, also need to prepare for an increasing number of cases," it said.

Every year, seasonal flu infects between 5 percent and 20 percent of a given population and kills between 250,000 and 500,000 people globally. Because hardly anyone has immunity to the new H1N1 virus, experts believe it will infect far more people than usual, as much as a third of the population.

It also disproportionately affects younger people, unlike seasonal flu which mainly burdens the elderly, and thus may cause more severe illness and deaths among young adults and children than seasonal flu does.

"Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression," WHO said.

"When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people."

WHO estimates that more than 230 million people globally have asthma, and more than 220 million have diabetes. Obesity may also worsen the risk of severe infection, WHO said.

The good news -- people infected with AIDS virus do not seem to be at special risk from H1N1, WHO said.


source

Vaccinate kids, parents to manage flu spread: study

WASHINGTON — Targeting vaccines to school-age children and their parents could help manage potential outbreaks of swine and seasonal flu and avert worrisome vaccine shortages, researchers suggested on Thursday.

The study in the August 21 issue of the journal Science comes as the Northern Hemisphere braces for the start of its influenza season in the coming months, while deaths from swine flu mount in countries where it is winter.

The approach runs counter to typical recommendations to battle seasonal flu, which urge the vaccination of children under five as well as all people over the age of 50, noted study co-author Jan Medlock, a mathematician at Clemson University in South Carolina.

But "vaccines would be better used to prevent transmission within schools and out to parents, who then spread the flu to the rest of the population," Medlock said.

His research used a mathematical model to demonstrate cases of flu spreading in which limited vaccine doses were given to school-aged children and adults age 30-39 -- parents in contact with the students.

Looking at the influenza pandemics of 1918 and 1957, researchers determined that even with just 63 million doses of vaccine, they could be given first to children 5-19, the group in which the greatest amount of spreading takes place, and adults 30-39, most often infected by their children.

Following the traditional protocols, the United States uses more than 80 million doses of seasonal flu vaccine every year to combat influenza, which kills about 36,000 Americans annually.

But faced with the swine flu, or (A)H1N1 global pandemic, which has already killed 1,799 people worldwide according to the World Health Organization, experts have raised concerns about the availability of enough vaccine to administer to at-risk groups.

In July, the Centers for Disease Control (CDC) said children and pregnant women should be among the first to receive a swine flu vaccine, and warned that the total at-risk population would number around 160 million.

Those targets also include caretakers and others in contact with children under six months old, healthcare workers, youths between the ages of six months and 24 years, and adults with underlying medical conditions.

Officials at that time forecast a shortage of vaccines, with only 120 million doses likely to be available by October.

But in August, US health officials issued a more dire warning that only 45 million swine flu doses would be ready by mid-October, with 20 million doses delivered each week thereafter.

The WHO has forecast possible shortages in the production of (A)H1N1 vaccines this year due to the slow growth of the swine-origin (A)H1N1 in chicken eggs.

Unlike seasonal flu, which usually hits elderly people the hardest, the (A)H1N1 virus has mostly infected the young. It emerged in Mexico in April and has since spread to 170 countries.

Deaths from swine flu in Latin America -- the worst-hit region in the world -- rose to more than 1,300 this week after governments added to tolls from the disease.

South America has seen the (A)H1N1 flu spread widely during its southern hemisphere winter. In several countries, it has overtaken ordinary seasonal flu.

And with vaccines against swine flu still more than a month away from being available -- and wealthy countries snapping up all available pre-orders from the big drug companies -- Latin American nations are looking at ignoring patents to produce their own.

Worldwide, there have been 177,457 confirmed cases of swine flu, according to the World Health Organization.

More than two million people have probably been infected by the swine flu virus in the United States, including 7,511 who have been hospitalized and 477 who have died, according to the most recent figures of the Centers for Disease Control and Prevention.

NBI seizes P4M worth of fake flu vaccines

The scare over A(H1N1) had prompted some traders to cash in by selling vaccines that they claim to cure the disease. In mid-July, the National Bureau of Investigation arrested a businesswoman in Laguna province for selling what she claimed to be A(H1N1) vaccines.

Amid the scramble for immunity against the dreaded A(H1N1) virus, government agents seized some P4 million worth of fake flu vaccines in a sting operation targeting a businesswoman in Laguna province last week.

The National Bureau of Investigation (NBI) has said its agents nabbed the suspect Jennifer Cristobal, 28, in her home at 19 Lily St., Sampaguita Village in San Pedro City in Laguna.

Radio dzBB reported Wednesday that Cristobal sold the vaccines at P3,000 per vial, about P1,000 cheaper than the genuine product.

NBI Anti-Fraud and Computer Crimes Division agents seized several cardboard boxes of fake flu vaccines, which turned out to contain water, during the raid on Cristobal's house.

A press statement on the NBI Web site said Cristobal's arrest stemmed from a complaint lodged by Sanofi Pasteur, maker of the Vaxigrip (inactivated influenza vaccine).

Investigation showed Cristobal's KNJ Marketing was selling fake products and passing them off as products of Sanofi Pasteur.

After a test-buy of Cristobal's vaccines proved positive, the NBI obtained a search warrant from San Pedro Regional Trial Court Branch 31.

Last Friday, the NBI arrested Cristobal and raided her house, where they found 180 vials of Vaxigrip vaccines, 10 boxes of syringes, official and delivery receipts, certificate of product registration, labels, marketing paraphernalia, computers, a telefax machine, and printers.

Cristobal is being detained at the NBI jail and is facing charges of sale of counterfeit drugs.


source

43-year-old teacher is 4th A(H1N1)-related death in RP

The dreaded Swine Flu A(H1N1)has claimed another life here in the Philippines. We must be aware and vigilant on this disease. follow the tips recommended by the D.O.H. .....READ MORE!!!

P.S. pls visit my blog and know tips in prevention of the disease.

superoyee