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

Pinay with lung problem dies of H1N1 in Bahrain

A runaway Filipina overseas worker with a pre-existing health condition was the first person reported to have died from A(H1N1) virus in Bahrain.

According to the report written by Mandeep Singh and Patrick Solomon and published online by the Gulf Daily News (GDN), OFW Jane Tamad Diale, 30, passed away in Salmaniya Medical Complex (SMC) Sunday.

The report said an extremely ill Diale was rushed to the hospital last Wednesday by an unidentified friend.

Diale’s father, Abdul Maguid Diale, reportedly requested her cousin Fatima to look for her when she came home during her vacation. Diale was traced at the SMC.

Fatima, too, was tested positive for H1N1 and is being treated and quarantined at home.

"I got the virus from the hospital but my condition was immediately detected. The doctors have told me to remain in isolation for a few days,” Fatima said in the report.

GDN was able to interview Mr. Diale who recently received photographs of his daughter who seemed to be in good health despite suffering from a lung condition.

"She had been suffering from a lung condition for several years, so when we heard she was in hospital, we thought her condition had aggravated," Mr. Diale said.

"In her latest photographs, she looked so beautiful, without a worry in the world. It was a beautiful smiling face, she looked so beautiful," her father added in the GDN report.

The last conversation he had with his daughter was around 10 days ago. He added that the family was aware that she ran away from her sponsor several months ago.

It was in 1999 when Diale went to work in Saudi Arabia for three years. Her condition started when she was working there. After that she moved to Dubai and then to Bahrain where her condition reportedly worsened.

GDN quoted SMC Infection Control head Dr. Jameela Salman as saying that people with H1N1 should not delay treatment as the virus could be fatal.

Dr. Salman said Diale could have been saved if she was treated earlier.



source

WHO - Swine Flu Deaths surge to 2,837

GENEVA — The World Health Organization says at least 625 people have been reported dead from swine flu in the last week.

The swine flu virus has caused at least 2,837 deaths since it emerged in Mexico and the United States earlier this year and developed into a full-blown global epidemic. Most of the deaths are in the Western Hemisphere.

WHO said Friday that laboratory-confirmed cases of the disease have now reached 254,206.

Spokesman Gregory Hartl says the figure far understates the actual number of cases because countries are no longer required to report each infection as the caseload is so high.

He says the number of deaths is growing proportionately to the increase in number of infected people.


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

Swine flu’s re-emergence: Questions and answers

Swine flu is expected to re-emerge potent and pervasive this fall, infecting as much as half the U.S. population, hospitalizing 2 million people and killing up to 90,000, according to federal officials.

Like pandemic strains of the past, H1N1 has a predilection for infecting young people. And because schools and colleges have long served as veritable cauldrons of flu activity, the combination of a new strain and the opportunity for its spread pose new concerns.

Yet neither state nor federal health officials are recommending surgical masks be added to backpacks when kids return to school. Instead, experts are urging a swine flu vaccination when it’s ready, a seasonal flu vaccination now, and developing a family pandemic plan.

Public health experts say preparedness is the best weapon against an infection that has already hit more than 1 million people in the United States, hospitalized 7,983 and killed 522. Yet given influenza’s extraordinary unpredictability, flu scientists can’t say for sure what the upcoming season will be like.

Is it certain H1N1 will recur in the fall?

Yes. Worldwide surveillance shows H1N1 as the predominant strain circling the globe. Low levels of flu activity are being reported nationwide and all of it is H1N1. Usually at this time of year, there is virtually no flu present, so even low-level activity is uncommon. With so much H1N1 in circulation globally, computer modeling suggests the potential for a strong resurgence.

Will H1N1 become more virulent?

No one can say with certainty. Influenza — especially pandemic flu — is highly unpredictable. Based on what physicians have seen to date, the majority of cases have been mild illnesses of only a few days’ duration.

What are the symptoms?

Identical to seasonal flu: high fever, muscle aches, dry cough and general malaise. Anyone with the flu is urged to stay home during the illness. State and federal health guidelines recommend not returning to school until 24 hours after fever has subsided without the aid of fever-reducing medication.

How does H1N1 differ from seasonal flu?

The virus has a novel gene arrangement that is new to human populations worldwide. It also behaves differently from seasonal flu, which has its greatest impact on the elderly. H1N1 disproportionately affects young people, particularly pregnant women, newborns and people up to 24 years old.

Why are people of school and college age so vulnerable?

It is a new virus that has never been encountered by the human immune system, which means no natural defense. Pandemic strains historically have a greater impact on young, robust people. Opportunity also plays a role. Flu strains tend to proliferate in schools and colleges because people are in close contact. Poor hygiene — coughing, sneezing into a hand — then touching objects that others handle helps spread the virus.

How can parents help children guard against swine flu?

Stress the importance of hygiene. Frequent hand washing and/or use of alcohol-based hand sanitizers are helpful. Public health experts recommend packing a container of hand sanitizer, which can be used when students can’t be excused to use soap and water.

Will schools close when one or two cases are confirmed?

No. New federal guidelines stress the importance of keeping schools open. Long Island school district officials say their aim is to keep schools running as usual. Less H1N1 data was available during the spring when several school closures were ordered. Scientists have since learned H1N1’s infectiousness is comparable to seasonal flu and that the vast majority of people who contract it recover quickly.

Should medically fragile children avoid school entirely this year?

Children who are ventilator-dependent, or who have muscular dystrophy, cerebral palsy or other medical conditions, are being encouraged to attend school. Schools for these children as well as those for pregnant teens face different school-closure recommendations. Unlike mainstream schools, state and federal guidelines recommend closure of schools for medically fragile children when even a single case emerges.

Will there be a vaccine?

Yes. A vaccine is in clinical trials at several centers around the country and is expected by mid-October. Flu scientists are testing the vaccine in pediatric populations.

Will there be enough vaccine for everybody?

No. Health authorities originally had hoped for 120 million doses, but the five manufacturers supplying the United States estimate about 45 million will be available by October. However, manufacturers will continue producing H1N1 vaccines throughout the fall and winter.

Why is the vaccine in short supply?

Flu vaccine production is a long, laborious process. Generally, it requires about nine months to produce seasonal flu vaccines. The H1N1 vaccine is new and requires clinical safety and efficacy testing, which takes time. However, because scientists were able to quickly identify the virus, which is needed as “seed stock” to make the doses, it is helping manufacturers fast-track production even as clinical testing is under way.

Are children and young adults first in line for vaccination?

Yes. Priority groups include: pregnant women; household contacts of infants younger than 6 months old; children and young adults 6 months to 24 years; health care and emergency service workers; and people 25-64 with medical problems, such as asthma, heart disease, diabetes, cancer, etc. Government health officials estimate those groups total 159 million people.

How safe is the vaccine?

Data emerging from clinical trials suggest the vaccine is both safe and effective.

How many doses are required?

The H1N1 flu vaccine is a two-dose immunization taken three weeks apart. Full immunity occurs about two weeks after the second dose. For most people receiving the vaccine, immunity probably won’t be achieved until Thanksgiving or later.

Will the vaccine contain the preservative thimerosal?

Some H1N1 vaccines will contain thimerosal, a chemical preservative activists have linked to autism. However, there is no scientific basis for that claim. Manufacturers are also producing thimerosal-free doses. If you have concerns, ask your child’s physician for a thimerosal-free vaccine.

Once you are exposed to swine flu or already sick, are antiviral drugs effective?

Yes. They can shorten the course of influenza. But they have to be judiciously prescribed. Currently, there are no dramatic signs of drug resistance. But public health agencies urge caution because only two medications are available to treat swine flu: Tamiflu (oseltamivir) and Relenza (zanamivir). Tamiflu when taken within 48 hours of flu exposure can prevent infection. Misuse of either medication can lead to resistance, making the drugs useless.

Who should take an antiviral?

The World Health Organization says otherwise healthy people with mild to moderate cases of swine flu do not need an antiviral. But anyone who is young, old, pregnant or has an underlying health problem can benefit.

If you had swine flu during the outbreak last spring, should you get the new vaccine?

No. If you had a confirmed diagnosis of H1N1, that infection should provide immunity.

What about if the case was not confirmed?

If you fall into one of the targeted groups, but the case wasn’t confirmed, you should consult a physician.


source