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

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

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

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

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

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

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

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

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

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

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

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

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

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

CDC swine flu update

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

H1N1 mutation D225G/D225N

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

New York swine flu victims show lung damage

Utah patient with lung hemmorhaging

Source of swine flu samples may explain low numbers of D225G

Swine flu vaccine ineffective against D225G in Ukraine

H1N1 deaths increase as mutations combine

Fatality in France due to mixture of swine flu mutations

Iowa medical examiner reports local H1N1 lung damage

Demographic information in Ukraine fatalities linked to D225G receptor binding domain

D225G swine flu mutation same as Spanish flu

Swine flu mutation H274Y/H274Y

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

Tamiflu-resistant H1N1 spreading

Swine flu pandemic complicated by antiviral resistance

Tamiflu doesn't work anymore

Tamiflu-resistant strain of H1N1 found around the world


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



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H1N1 Swine Flu Less Severe Than Feared

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

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

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

There are some big asterisks next to that prediction:

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

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

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

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

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

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

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

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

Strikingly, the damage was very familiar.

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


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



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RP gets 1st batch of A(H1N1) vaccines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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



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Swine flu facts, signs and reminders

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

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

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

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

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

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

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

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

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


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




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Swine Flu May Infect Internet Too ( Part 2 )

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

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

Some of the GAO's other conclusions included:

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

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

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

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



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Swine flu: Answers to your H1N1 questions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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




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Obama Declares Swine Flu a National Emergency

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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



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

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

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

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

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

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

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

Half the Yield

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

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

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

Novartis Statement

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

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

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

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

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



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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.


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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.

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.


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Swine flu pandemic now 'unstoppable' -- WHO official

This is a very serious threat. this pandemic is on a global scale. no one is immune to it. read more....

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