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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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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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."

U.S. to Donate 10 Percent of Swine Flu Vaccine to WHO

The United States plans to donate 10 percent of its supply of pandemic H1N1 influenza vaccine to the World Health Organization for use in low-income countries.

The nation has on order 195 million doses of the swine flu vaccine, which is due to start arriving early next month. The White House said it "is taking this action in concert" with eight other countries.

The White House released no details about the program, such as timetables and total amounts of vaccine to be donated. Officials at the Geneva-based WHO did not respond to phone and e-mail inquiries.

The other countries making donations are Australia, Brazil, Britain, France, Italy, New Zealand, Norway and Switzerland.

Earlier this summer, two vaccine manufacturers, Sanofi Aventis and GlaxoSmithKline, said they would donate 150 million doses of pandemic vaccine to WHO. Global production, by about 20 makers in all, is projected to be 2 billion to 4 billion doses over a year.

The number of people who could be protected is uncertain. The first tests of the pandemic vaccine showed that adults will need only one shot, not two as some experts predicted. Children, however, are likely to need two.

"The United States recognizes that just as this challenge transcends borders, so must our response. We invite other nations to join in this urgent global effort," the White House said.

The statement noted as well that "we remain confident that the United States will have sufficient doses of the vaccine to ensure that every American who wants a vaccine is able to receive one."

WHO officials have grappled all summer with how to prevent virtually all the supply of vaccine and antiviral drugs from going to rich countries, leaving poor countries unprotected.

"Improving access to vaccine is the central global issue at this time," Keiji Fukuda, WHO's assistant director general, told epidemiologists and influenza researchers in Washington this week. They were meeting at the Institute of Medicine to discuss events of the first five months of the pandemic.

Negotiations between WHO, the United Nations, vaccine manufacturers and wealthy countries that have standing orders for an essentially limitless supply of pandemic flu vaccine have been "slow and time-consuming," Fukuda said.

Without them "the least developed countries are not really going to have a chance of getting the vaccine." But he acknowledged that "nobody expects the numbers to work out in this pandemic."

Fukuda said that "prolonged ad hoc negotiations" like the ones this summer would be unrealistic in a pandemic more severe than this one.

In 2007, when researchers complained that Indonesia was not making samples of H5N1 "bird flu" available for study, WHO convened intergovernmental negotiations to try to reach an agreement for sharing both virus samples and the benefits that might result from them, such as vaccines. The negotiations ended this year without a full agreement.


P.S. boost your immune system thru Vitamin C nutrition.



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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.

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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.”

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Swine Flu - What You Need to Know

"Information is the best prevention".

This pandemic is still a very serious threat to the people. Medical companies are racing against time to combat this dreaded disease which already claimed thousands.

As the government scrambles to provide vaccine for Swine Flu and contain the spread of the disease, perhaps the best tool available for you is the right information.

What is Swine Flu and how is it different from varieties of influenza we've seen before?

H1N1, or "Swine Flu" contains genetic material from swine, avian and human flu viruses. H1N1 viruses often circulate harmlessly, but since it's a new type of virus, humans don't normally have immunity to it. There are predictions worldwide about the spread of Swine Flu, but nobody is sure how far the disease will spread.

What are the symptoms?

These include:

* Fever
* Cough
* Sore throat
* Runny nose
* Body aches
* Chills
* Fatigue

Some cases also involve diarrhea and vomiting.

These symptoms are relatively common in most types of influenza. Your doctor can give you a Swine Flu test, though the results are not always definitive.

A fever is defined as having a body temperature of 100 degrees or greater.

Swine flu can also cause neurological problems in children, as do other types of flu. The disease is fatal in rare cases.

Who's at the highest risk?

Most U.S. cases have involved young adults and older children. A large number have involved those with morbid obesity.

Experts still caution that those at the highest risk from Swine Flu are young children, the elderly, those with immune disorders and other chronic illnesses.

How can I tell of co-workers, family members or others have Swine Flu?

It's virtually impossible to tell, as Swine Flu symptoms are similar to those of other types of flu. Still, experts advise you to stay six feet from those who appear sick. It's not necessary to wear a face mask, but it can help prevent you from spreading your flu virus to others.

How can I avoid infection

The CDC says hand washing is one of the best ways to reduce your risk of infection. Also, staying away from those who exhibit symptoms is also effective. A personal distance of six feet is recommended.

All household surfaces should be kept clean. Experts say the flu virus (H1N1 included) can stay alive on doorknobs, books, counters, sinks and desks for up to 8 hours.

What vaccines are available?

Vaccines are being prepared in large numbers. Millions of doses will be available in October with more being distributed each month thereafter. The CDC says children ages 6 months to 19 should get a flu shot each year.

What medications are effective?

Tamiflu (oseltamivir) and Relenza (zanamivir) are thought to be the most effective medications to combat H1N1. Doctors advise taking these drugs as soon as possible after symptoms are exhibited. The CDC adds that those who have been to areas with widespread infection should talk to their doctors about taking one of these antiviral medicines.

Health officials don't advise stockpiling Tamiflu and Relenza, though there have been reports in recent years about public health workers doing just that. Still, the government recommends leaving available medicines for those truly in need.

How do I prepare my family for a possible major outbreak?

The government web site Flu.gov advises that you keep a two week supply of food and water in the house. You should also make sure you have a large supply of any prescription drugs on hand. Make sure your children know to always wash their hands and stay away from others who are sick. Parents should cover coughs and sneezes with tissues and model that behavior for the children.

Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home. Parents should make plans for child care in the event they themselves become sick.

What if a family member becomes sick?

Call your doctor. If you, your spouse or the kids are coughing and sneezing it could just be a cold. But if there's a fever, headache and other flu symptoms, that's an indication that it could be Swine Flu or some other strain of season influenza.

Also, anyone who's sick should stay home and avoid public areas.

What about travel? Is it safe?

Experts advise caution when traveling to Mexico since there have been large numbers of people infected with Swine Flu there. But you should check with your airline, and websites for the CDC and WHO before traveling since new advisories are constantly posted.

Why have so many people died from Swine Flu in Mexico but not in the U.S.?

Nobody is excactly sure, but it's possible that Americans generally get better, faster medical care. But some experts worry that the number of U.S. deaths could increase as the disease spreads.

Should we avoid pork?

That's not necessary. Swine Flu or H1N1 virus is spread between individuals or by touching surfaces contaminated with the virus. Pork has nothing to do with it.


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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.


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A(H1N1) vaccine to be made available to Filipinos in October

The vaccine against the A(H1N1) virus will finally be made available to Filipinos in October, the local distributor has said.

An information officer of distributor Vaxcen told GMANews.TV on Monday that they have yet to receive a go ahead from their head office to release the name of the pharmaceutical company that would produce the vaccine.

What is sure is that the vaccine will be made available through the company’s vaccine centers starting October, said the Vaxcen officer who refused to be named, citing company policy.

“We assure you it’s from a reputable company," said the officer.

National Epidemiology Center head Dr. Eric Tayag said in a separate interview that they have already received reports regarding such announcements from Vaxcen.

“We’re looking into it, we still have to check and verify these orders. The problem is that we still have no guidelines or policies regarding the distribution of the vaccines," said Tayag.

A previous announcement made by the Department of Health said that health care workers would be the first recipients of some 100,000 A(H1N1) vaccines ordered by the Philippine government from the World Health Organization (WHO). [See: DOH: Health workers to get first batch of A(H1N1) vaccines]

Health Secretary Francisco Duque III also said that the WHO will “draw up" a formula of how to allocate the vaccines to each country.

But Vaxcen said that it is now accepting reservations for the vaccine for P750. The worth of the vaccine is P1,500. It added that interested buyers may call their centers in Quezon City at 421-2493 or in Pasay City at 556-0414.

Tayag said it is possible that the vaccine manufacturers are taking orders through Vaxcen.

“Kung matutuloy yan, chances are hiwalay sila sa guidelines (If their vaccine distribution goes through, then they must be exempted from the guidelines," he said.

As of early July, more than 2,688 cases of A(H1N1) had been recorded in the country with a 95 percent rate of recovery. Since July 9, the DOH has stopped daily updates on the cases of A(H1N1) in the country and instead focused its resources on mitigating the spread of the disease.

In its July 27 update, WHO recorded 134,503 confirmed cases worldwide with 816 deaths. Of these figures, 87,965 or 65 percent of the infections and 707 deaths (86 percent) were recorded in the Americas.


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Swine Flu: Why You Should Still Be Worried

Swine flu is spreading faster than ever — so much so that the World Health Organization has decided to stop tracking cases. All over the world almost everyday, we hear of swine flu cases and deaths. Medical companies are racing against time to come up with a vaccine to prevent the spread and cure existing swine flu illnesses.

Read full story.


P.S. Boost your immune system. check this out.

Swine flu will be biggest pandemic ever, warns world health chief

As swine flu sweeps the planet, Margaret Chan, head of the World Health Organisation, tells how she is leading the battle against it – and the personal price she is paying although she would no doubt point out that swine flu should properly be called H1N1, there is something pleasing in the fact that the first thing Margaret Chan, director-general of the World Health Organisation, does when I enter her office is pick up a cut-out of a pig that has fallen on its face and carefully place it upright. A pink and gilt confection, it's left over from celebrating the Chinese year of the pig in 2007: it was so cute, she says, that she couldn't bear to throw it out.

A year earlier, Chan had been a surprise candidate in a surprise election (the previous incumbent died halfway through his term), but she won with a clear majority to become the first Chinese national to run a major UN agency. A rule change in 2005 (the WHO no longer has to beg states for information about threats to global health, but can just demand it) also makes her the most powerful public health official in history.

Tiny in her orange jacket and neat little orange-brown Miu Miu mules, she wears that authority not lightly, exactly, but naturally: in an organisation famed for its bureaucratic circumlocutions, she is refreshingly direct. It's a strength she's aware of – "I have a reputation for being a straight-talker, I will tell them the story like it is" – but that makes it no less striking, or true. (Also striking, for those who have witnessed it, is her penchant for bursting into song: she once punctured a tense moment at a summit about bird flu by singing a few lines of Getting To Know You, from The King and I.)

Months later, on 11 June 2009, she found herself the first WHO chief in 41 years to stand before the world and announce that a new virus had reached pandemic proportions. Right up until the last minute, scientists were calling her up and warning her to be careful about raising the threat alert so high — but the strict definition of "pandemic" is a new disease spreading uncontrollably through numerous countries, and on that count her decision has been completely borne out. On 11 June, swine flu had been registered in 74 countries; when we meet in Geneva four weeks later, it has just been confirmed in 140 countries.

Born in another year of the pig, 62 years ago, Chan began her career as a liberal arts graduate and a high school teacher of home economics, Chinese and English, but when her boyfriend moved to Canada to study medicine, she followed him. Finding that she still saw him very little, she applied to study medicine herself, in the same class. When they graduated they returned to Hong Kong, and in 1994 she was appointed as director of health there, with a staff of 7,000. Three years later, she faced a major outbreak of bird flu.

Chan learned then that clarity of communication is of utmost importance, and that over-reassurance can be as bad as no reassurance at all. She has in mind the (infamous in Hong Kong) moment when she was trying to tell people that it was still safe to eat chicken. "They asked me, 'Do you eat chicken?' and I said, 'Yes, I do. I eat chicken every day.'" It's the last sentence she regrets, because it is so patently undermining. No one would go on that kind of diet, right?

Her critics were not to know that it was, in fact, true: Chan did eat chicken every day, just as she has had a tuna sandwich every single lunchtime (barring official functions) for the five years she has lived in Geneva. Her job is so big, so unpredictable, that she says these fixed points are crucially important "to maintain my sanity". So now it's a tuna sandwich every day, and a session on a treadmill every morning.

But in Hong Kong the damage was done, and she eventually ordered a cull of all 1.5m chickens in the country. By the time the Sars epidemic came round in 2003, she was experienced and tough enough to have earned the nickname "Iron Lady"; although 299 people died in Hong Kong, and she was criticised in some quarters for being slow off the mark (she replied that she had found it hard to get accurate information from mainland China), most experts applauded her efficiency. She was headhunted to improve the WHO's response to infectious disease threats because, as the then director-general told her, "You are the only person who has managed crises. I have many armchair experts. I need generals."

Chan's war has arrived with a vengeance. A 2007 WHO report, A Safer Future, estimated that a flu pandemic could affect more than 1.5 bn people, or 25% of the world's population. Could swine flu be that big? "Quite likely. Quite likely. But it probably won't happen in one run. It will probably come back [in two or three waves]."

How does she expect it to compare to other pandemics? "In terms of the number of countries affected and the number of people infected, this has got to be the biggest."

Bigger than 1918? "If you're talking about mortality then it's different. 1918 is the biggest in terms of mortality. I would not like to make any predictions . . . I hope we don't see the 1918 picture. But we should expect to see more people infected, and more severe cases coming up, including deaths."

Swine flu is probably already much bigger than anyone knows. Ten days ago, only six countries in Africa had reported cases, but as Chan readily admits, this is rather misleading: until the WHO started sending out lab kits in early May, many developing countries had no means of testing for it. Furthermore, modelling suggests that swine flu has an attack rate of 30% — once it enters a country, the likelihood is 30% of citizens will catch it at some point.

In wealthy countries such as Britain, she observes, "The disease is self-limiting. Some even recover without medicine. But is it going to be the same in a country where they have a high proportion of people suffering from HIV? Or chronic malnutrition? Or diabetes? [all of which damage immune systems]?"

Pregnant women are among the groups most severely affected; already, every minute of every day, a woman dies in childbirth or pregnancy. Furthermore, unlike seasonal flu, H1N1 tends to affect previously healthy 30-50 year-olds; developing countries have large, young populations often living in crowded conditions.

As well as having no testing facilities, these countries will often have almost no access to antivirals such as Tamiflu. "Is it fair," demands Chan, rhetorically, "for these countries to go into a pandemic empty-handed?" So she has gone, cap in hand, to the companies that produce them: Roche has just provided 5.6m free doses of antivirals, which Chan has dispatched to the developing world; she is angling for another 5-6m, and hopes they will soon come through.

"Vaccines are much more difficult," she says with some understatement, "because of the limitations in production capacity." Companies in Europe and North America, and a few small ones in Asia, are racing to make a vaccine to combat this new disease. "One should be available soon, in August. But having a vaccine available is not the same as having a vaccine that is proven safe. Clinical trial data will not be available for another two to three months."

The process of acquiring a vaccine is already a salutary lesson in health inequality. "Most of the production capacity has already been booked up by wealthy countries. Again I have to ask the question: do the developing countries have to wait at the end of the queue? Because if that's the case, they won't have a vaccine for six months."

So Chan is trying to persuade manufacturers to free up a percentage of their production capacity for developing countries – 10% is her modest request. "The most important thing is to have a supply of vaccine to protect, first and foremost, a functioning health system. It is always important to keep taking care of pregnant women, cancer patients, diabetics and so forth. And I'm also mindful that a certain amount of vaccine should be provided to countries so they can maintain a stable society — that they must vaccinate law enforcement officers, and fire brigades, for example. Making sure that society can function in a normal way."

There is, of course, the caveat that swine flu has been "mild so far". Many countries may opt not to vaccinate at all, or not to make it compulsory. But it is also the case that an estimated 250,000-500,000 people die every year from seasonal flu (not including those who die of respiratory failure or heart disease which hasn't been traced back to an initial flu virus), and that the situation with swine flu could change at any moment. British scientists admitted this week that they were taken by surprise by swine flu's sudden spread; Chan is aware that while it could work itself out with comparatively minimal damage, she could also suddenly find herself dealing with a far more virulent, more deadly mutation.

And that, of course, would be on top of the myriad other epidemics and crises currently demanding her attention; the massive health impacts of climate change, for example, which she is in no doubt "will be the defining issue of the 21st century".

Declining food security will, she predicts, mean massive rises in people dying from malnutrition and diarrhoea, and probably more wars. More floods will mean more water contamination and issues with water security, and more deaths due to injuries and drowning. More waterlogged areas and changes in temperature will mean sharp rises in vector-borne diseases such as malaria and dengue fever.

"The prediction is that, within the next 10-20 years, food production in Africa will drop by 50%. If that's the case, how many more people will go hungry? Remember that malnourished, stunted children cannot reach their education potential, which will have a massive social and economic impact."

Chan worries, too, about massive rises in non-communicable diseases (cancer, diabetes, smoking-related illnesses) outside their traditional stamping grounds of the well-fed west. The trouble, from her point of view, is that these diseases attract nothing like the funds that, say, malaria or polio or HIV/AIDS do: "60-80% of the disease burden in developing countries is now due to so-called lifestyle diseases" – and yet, until the last two years when the Bloomberg and Gates foundations got in on the act, non-communicable diseases received no donor funds at all.

Then, of course, there are the ongoing battles — malaria (at least seven African regions have reduced deaths by half), polio, measles, HIV and TB, where another crisis of global proportions threatens: "The challenge is drug-resistant TB. And this is really huge. If it gets out of control," Chan warns, "it will take us back to the pre-antibiotic era."

And so her days begin at 7am, on her treadmill, and end hunched over her files late at night. Her husband opted not to come with her to Geneva (there would be nothing for him to do, and she travels frequently), so she lives alone in a flat five minutes' walk away from WHO headquarters. She does not drive, and speaks so little French that when she first came she couldn't even find a tin-opener in the shops.For 30 years her husband did all the cooking, so she had forgotten how – after a year and a half she fell ill with anaemia. Living apart from him for the first time in 50 years is taking its toll.

"I'm sorry!" she says, flapping her hands helplessly and wiping tears away. "When I talk about my husband . . . you know, he is so interesting, he is such a lovely man. I once said, 'David, can I have a contract?' He said, 'What do you mean?' I said, 'Can I marry you again in the next life?' It's not easy. But it is the kind of sacrifice I think you have to make in the interests of global health."

And it is a fixed term; she will be done in another two-and-a-half years. In the meantime, there are aeroplanes. The day after we met, Chan flew to Sharm-el-Sheikh to address the spouses of world leaders on maternal death rates; it was a brief stop on her way home to Hong Kong for a couple of weeks' annual holiday. Although "with a pandemic," Chan says wryly, "you can't really be on leave" •


By: Aida Edemariam
The Guardian
July 16, 2009

Benefits of Vitamin C

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DOH launches A(H1N1) hot line

GMANews.TV - Wednesday, June 24

MANILA, Philippines — Got any questions about A(H1N1)?

Try calling Hotline 155, a help line set up by the Department of Health (DOH) in partnership with Smart Communications, Inc.

Launched on Tuesday, the hot line will be manned by call center agents trained by the DOH to accommodate A(H1N1)- or swine flu-related queries.

The service, however, is available only to Smart, Talk and Text, and Red Mobile subscribers, which means queries can only be made using a cellular phone.

Smart public affairs head Ramon Isberto also clarified that the services are not free and normal rates apply “to screen out prank calls." Isberto said it would consider the suggestion of Health Secretary Francisco Duque III about giving discounted call and text rates for the DOH hot line.

In addition to Hotline 155, Smart subscribers can also reach the DOH via “Text 700-DOH." To use the service type: DOH (space) FEEDBACK (space) question and send to 700364.

Isberto said Hotline 155 is available from Monday to Friday, 8 a.m. to 5 p.m, while Text 700DOH functions 24 hours.

He clarified that it is the DOH that would reply to queries via text messaging.

Secretary Duque, meanwhile, reported that the number of A(H1N1) cases in the Philippines has jumped to 473 after 28 more people tested positive for the new strain.

In a press conference, Duque said the new cases included 16 males and 12 females, with ages ranging from seven months to 49 years old.

The good news is that 400 of those infected have recovered, or an 85 percent recovery rate. No additional Influenza A(H1N1)-related death have been recorded in the Philippines, he added.

Mark Merueňas and Aie Balagtas See, GMANews.TV

Swine Flu updates

Update 53 - Duque Orders DOH to Bolster Mitigation Efforts Against A (H1N1)

01 July 2009

H1N1 UPDATE NO. 53Health Secretary Francisco T. Duque III today reported that the Department of Health (DOH) is further bolstering its mitigation efforts against Influenza A(H1N1) in light of the anticipated rise of cases in the country.

On June 30, Duque convened another DOH Command Conference attended by members of the A (H1N1) Task Force, the DOH regional health directors, the chiefs of hospitals of all the 72 DOH-retained hospitals in the country, and some representatives from the private sector.

“As we anticipate more cases in the coming months, we must institute effective mitigation measures to save lives and prevent deaths and to reduce the impact of the pandemic to our nation and the economy,” Duque said.

With the shift toward the mitigation strategy, the DOH is ensuring that all government hospitals, both at the national and local government levels have the capacity to administer care to high-risk patients where the severe manifestations of the A (H1N1) virus are frequently seen. This is in accordance with the directives of President Gloria-Macapagal Arroyo last week to prepare well-equipped isolation wards in all state-run hospitals throughout the country.

High risk patients include patients with preexisting medical conditions such as asthma, diabetes, cardiovascular disease, immunosuppression, HIV/AIDs, TB, pregnant women and the very young and the elderly.

Duque also called for a meeting with the member agencies of the National Disaster Coordinating Council (NDCC) to engage them, particularly the DILG, in strengthening the involvement of local government units in the A (H1N1) response. This is to make sure that local governments have surveillance, monitoring and response systems in place and that hospitals and primary health care facilities under their jurisdiction are able to identify, treat and manage A (H1N1) cases.

“We have also requested the NDCC member agencies, especially DepEd, CHED and TESDA and PIA to help us in our nationwide campaign against A (H1N1). This is to make sure that our information and education activities reach all schools, barangays and provinces in the country,” Duque added.

Come next week, DOH is also set to meet with the Philippine Medical Association (PMA) and hospital groups like the Philippine Hospital Association (PHA) and the Philippine Hospital Infection Control Society (PHICS) to engage all hospitals and healthcare providers in the appropriate treatment and management of A (H1N1) patients according to the set interim guidelines of the DOH.

Meanwhile, Duque announced that 1,709 confirmed A (H1N1) cases have been reported to the DOH from the 1st week of May up to June 27, 2009. Eighty-six percent (86%) or 1,485 of these cases have already recovered, while the remaining 224 (14%) are still under treatment at present, most of them under home management.

“All cases exhibited mild symptoms with the most common as fever (86%), cough (81%), and nasal congestion (49%),” Duque said, noting however, that there was one reported death.

“The ages of cases range from 5 months to 79 years old, with 18 years old as median age. Most of them belonged to the 10-19 years age group (831 or 49%). Majority of the cases were male (894 or 52%),” Duque described.

Duque disclosed that of the 1,709 reported cases, 1,568 (92%) were Filipinos; the rest were American (with 17), Japanese (8), Chine (4), Korean (3), German (2), and one each from Australia, Canada, India, Iran, Kyrgyzstan, Lebanon, Sweden, Thailand, and Turkey.

“Two hundred and eighty-five cases (17%) had history of travel to a country which has reported A (H1N1) cases. Most came from the USA, China, Japan and Singapore,” Duque noted.

Duque said that as far as the geographic profile of the 1,709 cases is concerned the National Capital Region has the most number of patients: comprising 72% (1,225). Cases from NCR mostly came from Quezon City, Manila, Parañaque, Pasig and Makati.

The three other regions that reported the most number of cases were: Regions IV-A, III and VIII.

As far as the global report is concerned, the World Health Organization, as of June 29, has recorded 70,893 cases with 311 deaths from 109 reporting countries.

Department of Health

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