Iraq: Situation report on influenza A H1N1 pandemic (as of 15 Nov 2009)

Full_Report (pdf* format - 65.3 Kbytes)

As of 15th November 2009, 9:00 AM Baghdad time, 18 governorates ( All Iraq governorates) have reported 1835 laboratory confirmed cases of Influenza A H1N1 including 9 deaths. Out of the total cases 480 are members of the multinational forces.

Table-1: Laboratory confirmed H1N1 cases reported in Iraq

Governorate	Number of cases	Number of deaths
Baghdad	808	7
Wassit	212	0
Basra	38	1
Babel	7	0
Kirkuk	49	0
Suleimaniyah	10	0
Kerbala	12	0
Erbil	12	0
Najaf	50	1
Thiqar	25	0
Diala	30	0
Missan	11	0
Diwaniyah	64	0
Ninewah	2	0
Salaheddin	2	0
Muthana	10	0
Anbar	11	0
Dahuk	2	0
Multinational forces	480
Total	1835	9

At the EMR regional level, As of 7 November 2009, 23:00 hours, Cairo time, 25,531 laboratory-confirmed cases of Pandemic (H1N1) 2009 were reported to WHO by 22 out of 22 Member States of WHO Eastern Mediterranean Region. Somalia has reported the first 2 cases on the beginning of November. There are 153 related deaths from Pandemic (H1N1) 2009 reported, so far, from 14 member states in the Region. These deaths were reported from Saudi Arabia (28), Oman (25), Islamic Republic of Iran (22), Kuwait (17), Yemen (17), Afghanistan (11), Iraq (9), Bahrain (6), Syria (6), Egypt (5), Jordan (3), Lebanon (2), Palestine (1), and Qatar (1).

As of 8 November 2009, worldwide more than 206 countries and overseas territories/communities have reported over 503,536 laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 6,260 deaths. As many countries have stopped counting individual cases, particularly of milder illness, the case count is likely to be significantly lower than the actual number of cases that have occurred. WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data.

* The financial support of the European Committee and their continued follow-up is greatly acknowledged

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Influenza stumbled on the epidemic threshold

/ / The epidemic in the capital will decline

on 14/11/2009

Influenza epidemic in Moscow, according to Rospotrebnadzor, Monday will go down. The last weekly monitoring has shown that the increase in the incidence of influenza has declined by almost 15%. Meanwhile, in 17 regions of Russia and 42 cities of the epidemic threshold for influenza is exceeded several times. In the cities of the Urals and Siberia, indefinitely extended the autumn school holidays and closed schools.

In Moscow, according to the capital Rospotrebnadzor, for the last week of SARS and flu are sick 142 thousand, 77.5 thousand of them - children. In the department noted that compared to last week incidence decreased by 14.5%, and among high school students - 48%. At the same time in 1396 people confirmed diagnosis of "swine flu" virus (A/H1N1). "The situation was brought under control - said Kommersant's chief sanitary doctor, Gennady Onishchenko, Russia .- Monday will be confident to talk about reducing the rate of morbidity in some regions and Moscow. What made it possible, in particular in the capital to begin a new academic quarter, with due control over the state of children. "

The population of Moscow continued to mass instilled from influenza. According to the latest Capital of Rospotrebnadzor, in clinics, as well as at work or school vaccinated 1.791 million people. Deputy Mayor of Moscow Lyudmila Shvetsova promised that before the end of November "vaccination campaign against influenza in Moscow will be completed. Nevertheless, the epidemic threshold in the capital still exceeded, and security measures remain at the maximum level. Thus, each of the 70 thousand fans who will come in "Luzhniki" at a football match Russia-Slovenia, will receive anti-virus mask. They are, according to Mrs. Shvetsova, will be handed out in the Moscow theater. Masked Monday will work all host population metropolitan officials. As already reported yesterday, "Kommersant, Moscow Mayor Yuri Luzhkov has promised to select the license of those metropolitan pharmacies in stock that are not masks and influenza drugs.

In Russia, according to Rospotrebnadzor, the epidemic threshold for influenza exceeded in 17 regions. In the most common flu in Siberia. In particular, in Chita, the epidemic threshold is exceeded by more than five times, and local authorities yesterday announced a state of emergency in nine districts of the Trans-Baikal region. In Blagoveshchensk threshold is exceeded in 5.9 times, in Yakutsk and the Amur region - in 3,4 times. In Chelyabinsk and Yekaterinburg today and at least a week closed all universities, schools and institutions of secondary vocational education, as in Buryatia local government Rospotrebnadzor shut them indefinitely. In the Krasnoyarsk region, where on November 13 confirmed 936 cases of swine influenza (two died), Vacation in schools extended to November 17 inclusive, all public events canceled.

Of the regions of European part of Russia most difficult situation in the Voronezh region, where over the last week registered 7 thousand ill SARS and influenza, and doctors predict that by Monday they will be 12-13 thousand here identified 221 cases of swine flu. All educational institutions of the city will be closed to quarantine on Monday. Recall that MHSD RF reported that of acute respiratory viral infections in Russia, 439 people died. Yesterday swine flu death another man, who lived in Syktyvkar.

The St. Petersburg Institute of Influenza Kommersant reported yesterday about the beginning of mass production "kit for the prevention and treatment of influenza. It consists of two drugs - Alfaron and Ingaron "which, according to the Institute, effective, and to prevent A/H1N1. The end of November will be issued 350 thousand packages set in December and January - to 1.2 million packages. In the sale throughout the country, they arrive at the price of 350-390 USD.

Two more Czech hospitals close their doors to visitors as swine flu spreads

Two more hospitals have closed their doors to visitors and others are considering doing the same as the swine flu virus continues to spread across the country. Over 480 people in the Czech Republic have been diagnosed with the H1N1 virus, of that 92 in the last week alone. Three people have died of related complication after getting the swine flu. The third death was reported from Ostrava on Saturday, where a middle-aged man succumbed to pneumonia after contracting the swine flu virus.

Four schools were closed down this week and the authorities registered the first case of health-workers getting infected from patients. The process of vaccinating people at risk has not yet begun and the Czech Doctors’ Chamber has criticized the government for the delay, warning that for many the vaccine may come too late.

China Investigates Deaths After Swine Flu Shot

By Alice Park Sunday, Nov. 15, 2009

Students at a high school receive vaccine injections against H1N1 Swine Flu in Shenyang, northeast China, November 12, 2009.

Chinese health officials reported on Friday the first deaths in people who received the H1N1 vaccine. The Ministry of Health announced that the two people, including one teacher from Hunan province, died hours after receiving their inoculations. Since September, when the Ministry began its H1N1 immunization program, 12 million Chinese have received the pandemic flu shot.

A preliminary autopsy revealed that the teacher died of an apparent heart attack while playing basketball, and a Ministry spokesperson told the China Daily newspaper that the death was "a coincidental medical incident" and not related to the vaccine. No details on the second victim have been released so far. As they conduct an autopsy investigation into the second death, Chinese health officials have pulled all vaccines manufactured in the same batch used to inoculate the teacher. Although the H1N1 vaccine has been rigorously tested and vetted for safety, no inoculation can be considered 100% safe and may cause adverse events, including death, in some people.

Taking an aggressive approach to the pandemic flu, back in June the Chinese government asked 11 biotech companies to develop a pandemic H1N1 vaccine. Beijing-based Sinovac succeeded in developing the world's first approved swine flu shot. The company raced to conduct clinical trials, and was the first to report that a single dose of vaccine, instead of the two doses that most flu experts had believed would be necessary, was sufficient to protect against 2009 H1N1. In early September, China became the first country to begin swine flu inoculations.

But by the end of October, 54% of Chinese residents reported in a China Daily survey that they would not get the H1N1 vaccine because of concerns about the shot's safety. That prompted the director of the World Health Organization's Beijing office, Dr. Michael O'Leary, to tell the newspaper, "The H1N1 vaccine is one of the safest vaccines being used. When it's available to me, I would not hesitate to get the vaccine developed and produced by China."Three vaccine manufacturers in China, including Sinovac, have received orders from the government for more than 34 million doses. Among the 12 million inoculated so far, 1,235 have complained of side effects, ranging from sore arms, rashes, and headaches, to anaphylactic shock and sudden drops in blood pressure.

While the Chinese government has been criticized for its draconian public health response to swine flu — using quarantines, canceling school and detaining entire planeloads of people when a single passenger appears to have flulike symptoms — the country's officials say the strict measures helped stem the spread of flu. So far, China reports about 36 deaths and 62,800 H1N1 cases — compared with U.S. government estimates of 4,000 American deaths and 22 million infections. China plans to immunize 65 million citizens, or 5% of the country's population, by the end of the year. As in the U.S., health officials are targeting high priority groups first, including the military, police, health-care workers, teachers, students and those with chronic diseases.

Slovakia not to let buses from Ukraine

00:45 / 16.11.2009

A regular bus service with Ukraine disrupted because of the threat of the influenza epidemic

Told the press secretary of the Ministry of Transport of Slovakia Stanislav Yurikovich, said Korrespondent.net

"Passenger routes will be resumed when the epidemiological situation in this country will improve", - said Yurikovich.

Reported earlier that Bratislava had closed most of the road checkpoints on the border with Ukraine. Open remains the only CAT near settlements cherry German.

Citizens with signs of influenza Slovak authorities to refuse entry into the republic.

In late October, the control on the border with Ukraine, Belarus increased. Latvians and Estonians power of these republics were advised to refuse to travel to Ukraine. Russia in turn said that he would not close the border with Ukraine, which declared a flu epidemic.

City prepares for seriously ill swine-flu patients

By Cai Wenjun 2009-11-16
EXPERTS from the Shanghai Public Health Clinical Center, a designated hospital for swine-flu treatment, expect an increase in patients seriously sickened by the virus.

Their fears come as the number of swine-flu cases balloons in both China and many parts of the world.

The hospital has made preparations for extra medication, respiratory machines, staff training and wards to accommodate more than 500 seriously sick patients.

The possibility of serious effects from swine flu is usually one to three people in every 1,000 cases.

Early detection and treatment for serious cases were the major challenges for the medical field, Dr Lu Hongzhou, vice president of the center, told a Sino-Australian seminar on infectious diseases in Shanghai yesterday.

Experts are encouraging high-risk people to undergo shots for both swine and seasonal flu, adding that pregnant women should be included.

Officials from the Shanghai Health Bureau said yesterday that since giving swine-flu vaccinations to at-risk people from mid-October, there had been no serious adverse reactions reported in the city.

Lu, a member of both the Shanghai and national expert panels for swine-flu prevention and control, said the government should adjust its policy to include pregnant women in the free-shots program, as Western countries do.

"The Chinese mainland hasn't given pregnant women the free shots because of a lack of clinical tests to show their effects and safety on such people," Lu said.

"Since both the source of the virus strain and the production technology and procedure at home and abroad are the same, domestic authorities can follow Western countries to vaccinate pregnant women."

As clinical tests in China and overseas on the vaccine have not included children aged under three, experts suggest parents not take toddlers to crowded places.
A person starts to produce antibodies three weeks after catching swine flu or two weeks after receiving vaccinations. Clinically using vaccinated people's serum may help treat seriously ill patients.

"We have collected serum from vaccinated staff and carried out research," Lu said. "This serum may be used to treat seriously sick patients in the future."

As of last Thursday, the city had detected 1,538 cases of swine flu since the first was found in May.

Only two patients have become seriously ill in Shanghai with swine flu and both have recovered.

In Ukraine, 299 victims of the epidemic influenza

[15.11.2009 21:05] • "Pershodzherelo"
Today, 15 November, the Ministry of Health reported that the number of victims of influenza and SARS in Ukraine has risen to 299 people.

According to the Ministry, over the past day from the disease and complications (pneumonia), 17 people died.

In this case the Ministry of Health does not provide operational data on cases of the disease pandemic influenza A/H1N1.

Total in the country pointed 1 million 364 thousand 939 cases, 75 thousand 862 people hospitalized.

In the intensive care unit are 354 people.

However, among the hospitalized were discharged from hospital 40.5 thousand people.

In Kiev registered 99 190 ill influenza and SARS.

The epidemic threshold is exceeded in Vinnitsa, Volyn, Donetsk, Zhytomyr, Transcarpathian, Zaporizhzhya, Ivano-Frankivsk, Kyiv, Kirovograd, Lugansk, Lvov, Nikolaev, Poltava, Rivne, Sumy, Ternopil, Khmelnytsky, Cherkasy, Chernihiv, Chernivtsi regions, as well as in Kiev.

Thus, the epidemic threshold is not exceeded only in 4 regions (Dnipropetrovsk, Odessa, Kharkiv and Kherson), as well as in the Crimea and Sevastopol.

WHO reports several cases of co-infection with H1N1 influenza and dengue fever

November 14, 8:01 PM

Vietnam has had several cases of dual infection with H1N1 and dengue fever
Soo Ann Woon

To date the World Health Organization has reported several cases of patients afflicted with co-infections of H1N1 influenza and dengue fever.

Most reported cases were from Vietnam and the island of Barbados. There have been two deaths reported in Vietnam this week from the dual infections.

In Barbados, 8 cases were confirmed (confirmation by RT-PCR) and reported on the West Indies island this week.

The increased risk of dengue virus co-infection on the outcome of infection with the pandemic H1N1 2009 influenza virus cannot be quantified. However, in endemic areas, dengue virus co-infection is likely to increase the risk of a fatal outcome.

Korea - Bird flu back with a vengence

14 Nov 2009

Just when things were settling down, avian flu strikes again. The resurgence of bird flu in South Korea is causing concerns to health authorities as the H1N1 flu scare continues, reports state.
A low pathogenic avian influenza virus was discovered in excrement of migratory birds in a reservoir in Chuncheon, Gangwon Province. Despite the low infectiousness, health authorities claim they cannot rule out danger to humans or mutation and pledged to stay alert.

The worst-case scenario is that patients infected with the H1N1 virus could additionally contract bird flu, leading to a mutation that gives rise to a new supervirus, reports The Chosun Ilbo.

"But that doesn't necessarily mean that a new form of virus will be formed when the bird flu virus appears amid the spread of H1N1 virus," said a health official. "But if that did actually happen, the situation we've seen so far would be a mere shadow of what lies ahead. That's why we have to take preventive measures."

Disease prevention headquarters said it will vaccinate about 40,000 fowl breeders from the third week of this month instead of December as originally planned.

Thailand's North alerted of bird flu outbreak

08:54, November 13, 2009

Thailand's North has alerted of the bird flu outbreak after almost 100 poultries died recently in a northern province of Nan.

As Thailand's North is now experiencing the winter, during Oct.7 to Nov. 5 some 79 poultries died in six districts of Nan province, a senior official at Nan's livestock department said Thursday, Thai News Agency reported.

The department collected some examples of the dead poultries and sent them to a nearby province of Lam-pang, where a regional office of the National Institute of Animal Health, is located, to examine, the official said.

It will take about two weeks to know if the dead poultries were affected with the bird flu or A/H1N1 influenza, the official said.

Playing chicken with a nightmare flu

By Alan Sipress

Sunday, November 15, 2009

When swine flu erupted this spring in the southwestern United States and Mexico, it had been 40 years since the last flu pandemic. The outbreak has dispelled any illusion that pandemic influenza belonged to a bygone era, like smallpox, polio or scarlet fever. But we haven't seen how bad things might yet get.

What's the worst-case scenario? It could be a continuing vaccine shortage. It might be a mutation in the swine flu virus that suddenly makes the strain resistant to Tamiflu, as some seasonal flu strains already are. Or it could be that hospital ICUs become so overwhelmed that people who could have been saved die.

These are all unnerving possibilities. Yet many flu specialists say their real nightmare is that swine flu could meet up and swap genetic material -- or reassort, as these scientists say -- with another, deadlier flu strain, breeding a new virus that is as contagious as H1N1 but far more savage.

Such a strain is already circulating in Asia and Africa, and it could be ready for a chance encounter with swine flu. It is called bird flu. Unlike swine flu, which is no worse than a seasonal flu bug for most people, bird flu kills more than half of those who contract it: While there have been only 460 confirmed human cases of bird flu, 268 of those people died. And even more than swine flu, bird flu preys on the young and healthy, ravaging their lungs, a modus operandi reminiscent of the 1918 flu that killed as many as 50 million people.

So far, scientists haven't found proof that swine and bird flu are about to merge and spawn a deadlier virus. But the prospect is so chilling that health officials have been warning about it since earlier this year. Margaret Chan, director general of the World Health Organization, urged public health experts not to take their eyes off H5N1 bird flu even as H1N1 swine flu was sweeping the globe this spring. "No one can say how this avian virus will behave when pressured by large numbers of people infected with the new H1N1 virus," she told an assembly of the world's top health officials in May. Separately, she appealed to Asian health ministers: "Do not drop the ball on monitoring H5N1."

Influenza is a cruel wonder of nature, one of the most promiscuous microbes. Its viruses have a rare gift for swapping genetic material with each other. This is because the genetic material in a flu virus -- unlike in nearly all other viruses -- is composed of segments that can be individually replaced. If two different strains invade the same cell, they can trade attributes, then dispatch that progeny back into the world. And so the WHO and other health agencies are watching closely as swine flu spreads to countries where bird flu is well established, in particular Egypt and Vietnam.

As a correspondent, I tracked the bird flu virus for several years starting in early 2004. My travels took me across nine Asian countries, from jungle villages to squalid urban quarters, through run-down hospitals and cutting-edge labs. Along the way, I discovered how economic, political and cultural realities were conspiring to imperil us. In a single generation, East Asia's surging demand for protein has led to an explosion in poultry farming, and these flocks have become perfect breeding grounds for a pandemic strain. At the same time, age-old customs have facilitated the virus's spread.

In Thailand, I went to cockfights at makeshift arenas to see how fans crowd around birds that may be carrying the disease. I visited breeders of fighting cocks, witnessing how they cradle the birds, wiping down their bloodied feathers and even sucking mucus from their beaks. At live poultry markets in Indonesia, China and Vietnam, where the air was rank with the odor of chickens and ducks, and the floors slick with their blood, I saw how people and livestock were crammed together, a crucial nexus in the spread of the virus.

Despite the threat to humanity, several Asian countries (notably China, Indonesia, Thailand and Vietnam) covered up their bird flu outbreaks, in some instances until it was too late to contain the virus's spread. Subsequently, these governments claimed to have cornered the virus. But it keeps coming back -- fresh reports are circulating about renewed outbreaks among poultry in Indonesia and Thailand -- and each time it does, it gets another chance to reassort with another virus.

And now, along comes swine flu. Although its mortality rate is well below 1 percent, there have already been tens of millions of cases worldwide. Is this more-contagious virus the key that might unlock bird flu's terrible full potential? The swine flu virus is so new that researchers have yet to plumb its secrets. How exactly does it pass from one person to another? How does it attack the human body, and why, in a small percentage of cases, is this assault catastrophic? Could it reassort with another flu strain?

This summer, scientists from the University of Maryland, the Virginia-Maryland Regional College of Veterinary Medicine and the National University of Colombia published the results of their swine flu research on ferrets. (Ferrets are widely used in flu research because they are susceptible to human flu viruses and display some of the same symptoms as people.) The study suggested that swine flu is unlikely to reassort with ordinary seasonal strains and instead is more apt to crowd them out. We can only hope that it will be equally chaste when it comes to bird flu.

But another study, also published this summer, offers reason to worry about bird flu's potential for a sinister tryst with another virus. The research showed that bird flu has the ability to reassort with at least some other strains of flu. A team at the Centers for Disease Control and Prevention in Atlanta confirmed this by simultaneously infecting ferrets with bird flu and a strain of ordinary seasonal flu. When they later tested secretions from the ferrets' noses, the researchers found that they carried new flu strains that contained genetic material from both of the parent strains.

We cannot confidently predict the twists and turns of the flu virus, which has repeatedly confounded some of the world's brightest scientists. No one expected that bird flu would leap from birds to humans -- until it did. Its initial, withering attack on a young boy in Hong Kong 12 years ago was like a "visitation from outer space," according to flu specialist Keiji Fukuda, who was dispatched by the CDC to investigate the initial occurrences.

He recalled how the Hong Kong outbreak eluded understanding, even as it spread and began resembling the 1918 Spanish flu. "You feel like: 'I don't know what is going to happen. I don't know what is going on. But what is going on is not good, and it reminds me of the worst not-good of the century,' " he said. Today, Fukuda is WHO's top flu official and says he remains humbled by flu's stubborn unpredictability.

Already, the swine flu epidemic has chastened us by revealing the sorry state of our antiquated technology for producing vaccines and the limits of our brittle, underfunded system for emergency medical care. But swine flu is not merely a warning shot. The virus itself could be the catalyst for a new flu -- and an even deadlier pandemic.

Alan Sipress is the economics editor of The Washington Post and the author of "The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic

Slovakiya closed the border with Ukraine

November 14, 2009


Slovakia because of the threat of a new influenza epidemic interrupted regular bus service to Ukraine, ITAR-TASS.
"Passenger routes will be restored when the epidemiological situation in this country will improve," - told journalists on the press-secretary of the Ministry of Transport of Slovakia Stanislav Yurikovich.

Bratislava previously covered the majority of automobile checkpoints on the border with Ukraine.

Open remains the only CAT near the settlement of Vishnu-German. Arriving in Ukraine are subject to strict medical supervision. Citizens with signs of influenza authorities denied entry into the republic.

How sobschalos earlier, State Sanitary Inspectorate (GIS) in Poland as of 29 October did not see the reason for the restriction or closure of traffic on the common border with Ukraine

German doctors have shared with recipes Klitschko fight flu

November 14, 2009 22:54
To observe the basic rules of hygiene, take antiviral drugs, only in case of illness, and more importantly - do not panic. This recipe Fight "swine" flu from the German doctors.

In Germany, where the virus A/H1N1 dead 14 people, and chickenpox more than 40 thousand, is now conducting mass vaccination of the population. Although experts say that the new disease, in most cases, not more dangerous than normal seasonal influenza. Complications occur mostly among people who belong to the so-called risk groups - children, people with weakened immunity and chronic diseases. Recipe Fight "swine" influenza German experts shared with Vitali Klitschko. Ukrainian boxer, who is now preparing for a fight with Kevin Johnson, specially came to Hamburg to discuss with experts the situation in Ukraine.

Frederick Hagenmyuller director of the clinic "Asklepios":

- The number of confirmed cases of "swine" flu in Ukraine is even lower than in Germany. I feel panic and fear of going out is not worth it. The main thing to observe rules of hygiene and contact with patients. And, of course, if there is a malaise - to comply with bed rest and call a doctor.

Vitali Klitschko:

- In Ukraine, we see the empty shops, streets, restaurants, public areas, we see people who walk all day in masks. And a lot of questions to those people who are specialists, that is the cause. Rather, the general panic, blown by people who are interested in the fact that the problem of "pork" flu has eclipsed all the problems.

FDA considers new flu vaccine process

WASHINGTON, Nov. 14 ,2009

(UPI) -- An experimental flu vaccine that relies on fermentation rather than chicken eggs is under consideration by the U.S. Food and Drug Administration.

For decades, chicken eggs have been used to grow viruses used in flu shots, but the process takes as long as six months and requires millions of eggs.

Protein Sciences Corp.of Meriden, Conn., makes its experimental FluBok vaccine by taking a gene from a flu virus and inserting it into cells from a virus that infects caterpillars, The Wall Street Journal reported Saturday. Those cells are put in a fermentation vessel to multiply and produce a protein that is made into flu vaccine.

Beginning to end, the FluBok process takes no more than six weeks, company officials said.

An FDA panel is to meet next week to consider the company's request to produce a seasonal flu vaccine, though the same process could be used to make an H1N1 swine flu vaccine, the Journal reported.

. Korean teenager jumps from apartment after taking Tamiflu

2009/11/14

SEOUL: A South Korean teenager who took Tamiflu, an antiviral drug, leaped from an apartment window after suffering from auditory hallucination, China's Xinhua news agency said citing a local media report today.

According to the Korea Food and Drug Administration (KFDA), the country's drug safety watchdog, the 14-year-old student living in Bucheon, Gyeonggi Province near capital Seoul, took Tamiflu on Oct 30, and was later found at the bottom of his family's apartment building on the same day.

Local media said he is likely to have jumped from his family's sixth-floor apartment after he fell asleep. He had just returned from the hospital where he was prescribed to take Tamiflu for his high fever.

He suffered serious bone fractures on his leg and arms, but none of the injuries were life-threatening, the reports added.

It is the first report of hallucinations as a side effect of Tamiflu in the country, a KFDA official told media, noting that the KFDA and the Korea Centers for Disease Control and Prevention will launch an investigation to find out whether there are any links between the drug and the case.

As the A/H1N1 flu is spreading rapidly in South Korea, Tamiflu is regarded as a specific drug for the treatment.

The KFDA has issued safety warnings on the use of Tamiflu in 2007 following reports of bizarre behaviour by users of the drug in Japan.

It advised medical experts to report immediately to officials when witnessing similar mental symptoms.

In the neighbouring Japan, Tamiflu is advised not to be given to teenagers. - Bernama

Can we trust the CDC?

By Dr. Theo on November 14th, 2009

CDC, Atlanta Campus

In a press conference this week representatives of the Centers for Disease Control revealed estimates of the extent of the H1N1 Influenza pandemic that increased by several orders of magnitude from previous estimates. For instance the number of pediatric cases reported by the CDC on November 6th was 129, but on November 12th, the date of this news conference, it was reported to be 540! Other surprising numbers revealed included the following:

• CDC estimates that between 14 million and 34 million cases of 2009 H1N1 occurred between April and October 17, 2009.
• CDC estimates that between about 63,000 and 153,000 2009 H1N1-related hospitalizations occurred between April and October 17, 2009.
• CDC estimates that between about 2,500 and 6,000 2009 H1N1-related deaths occurred between April and October 17, 2009.

I currently help staff an urgent care facility that sees nearly 100 patients per day. We have seen very large numbers of people with complaints that could be due to influenza, yet have documented only about five to ten per week and that only began about the first of October. We have hospitalized no patients and our parent hospital that serves a population of about 150,000 has reported one death due to H1N1 and that was in a child with severe underlying immunological disease.

I know that anecdotal reports are not always representative of a situation, but still the new CDC estimates seemed so far off from what many of us front-line docs are actually seeing that I had to investigate this further.

I read the entire transcript of the news conference as well as the accompanying press release to try to get a better idea of what the CDC is now reporting. Amongst a lot of uncipherable medico-babble (e.g., “Emerging infection programming network is one key source for our estimate. We also are using data from other symptoms like aggregate state reporting of laboratory hospitalizations and death.”) I think I determined the fundamental problem with these latest figures.

The CDC has adopted, for the first time in epidemiological methodology, a technique that extrapolates numbers from very limited and dubious samplings. Reports were compiled 64 counties from ten states. How many counties are there in our fifty states, total? I didn’t feel it necessary to calculate an exact number, but Indiana has 92 and South Dakota has 66. Can we conclude that we are working with a very small sample?

Next, researches at the CDC used the “Emerging infection programming network” that compiles data and “develop[s] new methods for gathering epidemiological and clinical information.” Some of those new techniques are a bit over-reaching. For instance they have determined that for every case of “flu” reported (and not necessarily proven by testing) there are 79 cases that are unreported. Similarly, the number of hospitalizations due to flu is “corrected” by a factor of 2.7. In those cases in which an influenza test was done and found to be negative researchers at the CDC have determined that up to 30% were actually H1N1 and should be counted. Additionally, deaths from what could be a complication of influenza, such as pneumococcal pneumonia, are assumed to be related to the H1N1 virus. (Pneumococcal pneumonia is the most common type of pneumonia and claims tens of thousands of lives every year.)

In short, I am very skeptical of the latest estimates from the CDC. I fear this organization that was once scrupulously devoted to science and working only for the best interest of the American people has been corrupted by politics and now serves as a propaganda arm of the entrenched bureaucracy. Yet another example of how the government can screw-up most anything it touches.

Two die after getting Chinese H1N1 vaccine

Sunday, November 15, 2009


PTI Beijing

Two people have died in China after receiving domestically manufactured vaccines against swine flu, Government said on Saturday.

The preliminary autopsy report of one of the deceased showed that the patient suffered a sudden cardiac death while results of the autopsy on the second person are still awaited, the Ministry of Health was quoted as saying by the Xinhua news agency.

“Experts have basically ruled out the possibility that the patient’s sudden death was the result of immediate allergic reactions to the flu vaccines,” a statement on Ministry’s Website said.

H1N1 Swine Flu symptoms have worldwide reach; statistics updated by WHO 11-13-2009

November 14, 1:25 AM

The World Health Organization (WHO) issued an update on November 13th on the worldwide pandemic 2009 H1N1 virus, current through November 8th.

What is the Current Reach of the H1N1 Swine Flu Virus?

As of 11-8-2009, according to the WHO, "more than 206 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009." This means the virus has spread over virtually the entire globe, as there are only 195 sovereign countries.

How Many Cases of H1N1 Symptoms Are There?

Because most countries have virtually quit testing in all but the more severe cases, the number of confirmed cases is likely significantly higher than the current figures.

The total number of cases worldwide confirmed to be H1N1 symptoms is just over 500,000. Close to half – over 190,000 – of those cases are from North America.

Total deaths worldwide from confirmed H1N1 swine flu symptoms is 6,260, but again this number is likely quite lower than reality, as many countries are not counting individual cases anymore. North America accounts for some two thirds of that number, at over 4,500.

Other Information of Note in the Update

• Canada has reported a sharp increase in the number of cases of influenza-like illness (ILI) reported, confirmed H1N1 virus infections, and school absenteeism due to swine flu symptoms.
• In the US, ILI reports remain widespread, but largely unchanged from the previous week.
• Europe and Central Asia continues to have increasing numbers of flu symptoms reported. Although many cases were not tested, 99% of those that were, were H1N1, except in the Russian Federation, where it is closer to 90%. The remaining less than 10% were H3N2 and seasonal H1N1.
• Western Asia observed increased rates of ILI and acute respiratory illness (ARI), particularly in Israel and Afghanistan.
• East Asia also continues to have increasing influenza and ARI cases, particularly in Mongolia and Japan. The rate of influenza confirmed as H1N1 in China was around 80%.
• H1N1 swine flu activity in most of the Caribbean seems to have peaked, as there was a slight decrease in ARI symptoms.
• Most areas of Central and South America and South and Southeast Asia report continued declines in cases of both ILI and confirmed H1N1 swine flu

Second wave of H1N1 hitting Montreal

It's official – the second wave of the swine flu pandemic has hit Montreal, and public health authorities are responding by opening the floodgates of vaccination centres to all 5- to 19-year-olds, a group hit particularly hard by the potentially fatal H1N1 virus.

Citing new numbers in Montreal hospitals, Dr. Richard Lessard, the director of Montreal's public health agency, said yesterday the spike in the number of hospitalizations because of acute symptoms is worrisome - with 10 new admissions in the previous 24 hours alone, most in the 10 to 29 age range.

That's compared to 78 hospitalizations in Montreal from Aug. 30 to Nov. 10.

According to the Quebec government, 20 people in the province have died since Aug. 30; it is not known how many were from Montreal.

"Until now, the second wave of swine flu has been (felt) outside of Montreal," Lessard said at a press conference yesterday. "But it's really hitting us now in Montreal. ... What we're beginning to see is an increase in the number of kids in particular being hospitalized, some in intensive care. It's just beginning in Montreal, but we know it will increase."

Starting yesterday, all 15 vaccination centres in Montreal were open to children and youths 5 to 19 years old, as well as the families of children 6 months to 5 years old, and the families of people who are immunosuppressed, groups initially turned away because of a perceived shortage of doses.

In fact, only 15,000 to 20,000 people per day have going to the centres, which Lessard said can inoculate up to 40,000 a day for the next five days, until the 200,000 doses of vaccine in reserve run out.

Public health authorities around the world believe the vaccine - now available with or without an adjuvant, or booster - is the best protection against the virus, though it does take 10 to 14 days before it confers complete immunity.

More vaccine will be coming soon, Lessard said, though he couldn't say how much.

Of particular concern are all those living with chronic diseases in Montreal that make them susceptible to developing a more severe case of the swine flu, Lessard said.

Of an estimated 453,000 people in Montreal living with asthma, heart disease, lung disease, cancer and other chronic ailments, only half have been vaccinated.

"There are many people with chronic illnesses in Montreal and I invite them to get vaccinated before the vaccination begins of thousands of schoolchildren," Lessard said. "By presenting themselves now, they will not have to wait long hours in line and they will be protected sooner from the H1N1 virus."

Quebec health authorities are working on a plan to begin busing schoolchildren to vaccination centres, but no details have been made public yet.

Still off the list of eligible groups, however, are daycare workers and schoolteachers, a paradox Lessard did not wish to address, saying only that priority has been given to those groups most at risk.

For some reason, school-age children are being disproportionately affected by the virus, said Deborah Bonney of the Agence de la santé et des services sociaux de Montréal, which includes the Montreal public health agency.

"All we know is this new virus has a very different profile from the regular seasonal flu that always targeted the elderly," Bonney said. "It's clear from the data that young people are being targeted."

Indeed, 52 per cent of all 923 hospitalizations in Quebec since Aug. 30 have been of individuals who are under 29 years old.

But schools themselves may be contributing to the phenomenon, because of the "density of kids spending all day together," Lessard said.

Also off the list for now are seniors, including those with chronic illnesses. People 65 and over with chronic illnesses will be eligible as of Nov. 30, and all healthy adults over 20 as of Dec. 7.

The good news, Lessard said yesterday, is that it appears that children 3 years old and over will not need a second shot to be fully protected, though the Montreal public health agency is still waiting for its provincial counterparts to issue official guidelines on the subject.

Co-infection of H1N1 and Dengue fever in Vietnam

November 15, 2009 00:54 GMT +7
Peak One of the two diseases co-infected patients with influenza A/H1N1 and dengue fever (SXH) died, the other serious illness also apply home. This information has been doctor Nguyen Hong Ha, Vice Director of the Institute for infectious diseases and tropical countries, said.

Thus, from the week, the Barbados broadcast notices discovered seven ca 2 co-infected patients with acute (influenza A/H1N1 - SXH) and a ca died, U.S. announced Monday that the two patients detected the first human infection.

Can be said that the treatment for both these two ca failed. Failure that makes people very worried by several reasons.
First, the capacity of treatment in medical facilities than in hospitals in Vietnam are very far distance. The National Institute of Infectious Diseases and Tropical Research National treatment is not for the two patients infected with influenza A/H1N1 - SXH first, though not sufficient basis to say anything much about mortality song clearly, if fall on the basis of the medical treatment will be more difficult and more easy to defeat.


Monday, SXH online services quickly to the more complicated development makes a series of hospitals throughout the country fell into overload. Data by the Ministry of Health announced that the country has over 74,240 people infected SXH, including 58 deaths. Over the same period in 2008, the number of SXH grew 16.8%.

Peak service SXH annual fall around September to November. This is also a time when health experts have warned the peak of the epidemic influenza A/H1N1. The peak at the disease, the number of patients infected with influenza A/H1N1 - SXH will certainly not less.


According to Vu Sinh Nam, Deputy Director Department of Preventive Health and Environment - Ministry of Health, if infected with influenza A/H1N1 at - at SXH be heavy, especially with more of an impact on other diseases, to the value will be very difficult. In the meantime, only the examination and treatment of influenza A/H1N1, not just health areas that right away in big cities such as Ho Chi Minh City, Hanoi, Da Nang ... past have revealed a lot of confusion.

If this happens the same series of patients infected with influenza A/H1N1 - SXH, the health system of our popular response would be difficult if not necessarily right for the necessary preparation.


Experience of other countries shows that in the situations, the health sector must be immediately drastic actions, especially to maximize health experts to support medical facilities not stop Left in the broadcast of general direction. Ministry of Health hope our country will in time make the script to deal not embarrassing as happened with the anti-influenza A/H1N1 support services.

Three more Oregon ferrets diagnosed with pandemic influenza H1N1

November 13, 9:05 PM

Three more ferrets in Oregon have tested positive for the 2009 pandemic influenza H1N1 virus, state officials confirmed this week. There are now four confirmed cases in the state. In early October, 2009, an Oregon ferret was diagnosed with the H1N1 virus which has since recovered.

Oregon state public health veterinarian Dr. Emilio DeBess confirmed the ferrets that tested positive for the H1N1 virus live in a group of nine ferrets that live with a Roseburg, Oregon area family. DeBess stated that members of the family that owns the ferrets displayed flu-like symptoms the week prior to the ferrets becoming ill. All nine ferrets were reported to have exhibited flu-like symptoms but only three were taken to a veterinarian where they tested positive for H1N1.

Dr. DeBess states there is no evidence that ferrets pass the virus to people or any other species.

Oregon public health veterinarians remind pet owners that if their pets show any signs of illness to immediately take precautions to reduce the spread of influenza between themselves and their pets. Precautions include washing your hands frequently, covering your cough and sneeze and avoid contaminating anything your pet comes in contact with.

The American Veterinary Medical Association (AVMA) is monitoring reports of H1N1 in animals and provides updates on its website. The Oregon Veterinary Medical Association provides information on its website as well.

Young children need 2 doses of H1N1 vaccine: U.S.

16 mins ago

WASHINGTON (Reuters) – Younger children will need two doses of the vaccine against the new pandemic of H1N1 influenza, U.S. officials said on Monday.

They said tests of Sanofi-Pasteur's swine flu vaccine showed that children respond to it just as they do with seasonal flu vaccines, with children over 10 needing just a single dose.

Dr. Anthony Fauci, director of the U.S. Institute of Allergy and Infectious Diseases, said young children will likely need to have their doses 21 days apart, but he said they could receive seasonal flu shots and H1N1 shots on the same day -- something that could ease the logistics of vaccinating children multiple times.

"Immunologically this is acting like seasonal flu and we are very pleased with that," Fauci told reporters in a telephone briefing. "The response in younger children is less robust but that is not unexpected."

The children up to age 17 all mounted an immune response that should protect them from H1N1 within 8 to 10 days, Fauci said.

The U.S. Centers for Disease Control and Prevention said 46 U.S. children have died from swine flu.

(Reporting by Maggie Fox, Editing by Sandra Maler)

A CBS Video - Unplugged: H1N1 Vaccine Dangers

August 12, 2009 11:00 AM

Sharyl Attkisson, CBS News Medical Correspondent Dr. Jennifer Ashton and NVIC's Barbara Loe Fisher discuss the possible dangers with the H1N1 vaccine.

Fairfax Schools Air CDC's Strategy for Swine Flu's Return

By Nelson Hernandez
Washington Post Staff Writer
Wednesday, August 12, 2009

The expected resurgence of swine flu this fall could lead some public schools to become mass inoculation clinics. Infected students could be forced to wear surgical masks and put in isolation rooms before being sent home.

But school officials predict that the wave of school closings that caused much angst in the spring is unlikely to be repeated.
"School closures aren't really on the table," said Fred Ellis, director of safety and security for Fairfax County public schools. Unless the virus, known as H1N1, mutates to become more severe, health officials said, they will try to keep schools open and prevent the spread of the virus through other means.

"We really want people to get sick and tired, as I know you already are, of hand-washing and coughing etiquette," Ellis told about 200 Fairfax principals who had gathered for a back-to-school briefing Tuesday. A school might still be closed if there aren't enough healthy teachers and staff members to run the school or bus drivers to transport students, Ellis said.

The session at Luther Jackson Middle School, in the Falls Church area, offered a window into the preparations underway across the country as school officials pore over the latest guidance from the Centers for Disease Control and Prevention in the weeks before classes resume.

In the spring, when little was known about how deadly the disease might be, the CDC's advice frustrated some health officials, school principals and parents. Initially, a school could be closed for a week or more because of a single confirmed case of swine flu, and it seemed that the entire school year could crash to a halt. But that directive quickly changed because the virus's effects appeared to be fairly mild.

The CDC's latest advice gives local school systems more flexibility in dealing with the illness and on closing schools.

Students and staff members who are sick should stay home and should not return to school until at least 24 hours after the fever has broken, the CDC says.

Under CDC guidelines, sick students who do go to school would be asked to wear a surgical mask and sent to a quarantine room to be watched over by an adult also wearing a mask. The students would remain quarantined until their parents picked them up.



There could be more changes to the guidelines, particularly after a vaccine begins to be administered to the public en masse.

At the University of Maryland School of Medicine in Baltimore, 66 adult volunteers have received the first of two doses of an H1N1 vaccine. The university is one of 10 sites for national clinical trials of the vaccine, which started Monday.

The goal of the clinical trials is to determine how strong a dose is required to protect different age groups. To that end, researchers will test for antibodies in the volunteers' blood to assess their immunity.

Once testing is complete, the vaccine is to be given to states and local governments and administered to millions of Americans, starting with vulnerable populations such as children and young adults, pregnant women and people with weak immune systems. But there is no timeline or firm idea of how the vaccinations will be administered.

"Right now, we cannot stand here and tell you what the vaccination plan is going to look like," Ellis said. "We have no idea."

One option discussed would use schools as mass inoculation clinics. But Ellis also said Fairfax County's plan for dealing with the virus is "flexible and fluid," one of several remarks that drew laughs.

The H1N1 vaccine will not be a substitute for seasonal flu vaccine, and health officials recommended that their employees and everyone else get both.

Seasonal flu shots will be free for all school employees.

At Tuesday's briefing, Fairfax principals wrote out questions on blue index cards for health and school officials to answer. There were queries about the vaccine's effects (it should be as safe as a seasonal flu shot); about how to clean rooms in schools (with standard cleaning products, because antibacterial soap isn't any more effective against a virus); and about who will pay for cleaning products (the school system).

As they left the meeting, the principals seemed ready to face what will come.

"I think people are much more comfortable at this point in time," said Theresa West, principal of McNair Elementary School in Herndon. "Last spring, nobody knew what was happening. There was fear, getting in planes and everything else. Information, it helps people be calm."

CIDRAP-States to designate providers to give H1N1 vaccines

Robert Roos News Editor

Aug 10, 2009 ( News) – State health departments will decide which providers will administer the pandemic H1N1 influenza vaccine this fall, and a single company will be the distributor for all the doses, it was announced today.
McKesson Corp., based in San Francisco, announced it will be the central distributor of H1N1 vaccines under a contract with the Centers for Disease Control and Prevention (CDC). McKesson currently distributes vaccines under the CDC's Vaccines for Children (VFC) program.
"McKesson's role will be to distribute the vaccine to sites designated by state health departments across the country," the company said in a press release. "Each state will designate the providers who will receive and administer the vaccine."
That's different from how seasonal flu vaccines are handled, noted Jim Blumenstock, chief program officer for public health practice at the Association of State and Territorial Health Officials in Washington, DC.
"This is a government-controlled program, so it'll be the state agencies working with local partners and the CDC that will make the determination as to where the public will be able to get vaccine," Blumenstock said. "This is not like your seasonal flu [vaccination] program where healthcare providers decide whether or not they want to do it and then submit private orders."
Meanwhile, the CDC released a statement today saying that using a single vaccine distributor will be more efficient than having vaccine manufacturers ship doses directly to customers. The agency also repeated previous government predictions that vaccine shipments are likely to begin about mid-October, though a late September start for shipments remains a possibility. It said each person will probably need two doses.
"One of the key benefits of using a centralized, third-party distributor to support H1N1 vaccine distribution is that it allows distribution of doses to a much larger number of provider sites than would be feasible with direct manufacturer distribution," the CDC said in a question-and-answer document about H1N1 vaccination planning.
The McKesson statement said, "The H1N1 vaccine distribution effort will include the centralized distribution of the H1N1 flu vaccine to as many as 90,000 sites across the country, making it the largest public health initiative in the CDC's history."
The company said it distributes 80 million doses of vaccine to more than 40,000 providers each year under the VFC program, which serves uninsured and Medicaid-eligible children and children of Native Americans and Alaska natives.
The CDC said the same distribution process used in the VFC program will be harnessed for the H1N1 effort, but it will be "substantially enhanced" to increase capacity. Vaccine providers are likely to include a mix of public health and private sector sites.
Blumenstock said state health departments would probably consider requests from large employers who want vaccine for their workers, but he noted that the general population of healthy adults is not among the groups targeted for the first doses that become available.
The CDC recently announced that the initial target groups for immunization are pregnant women, close contacts of babies under 6 months old, healthcare and emergency medical workers, young people from ages 6 months through 24 years, and nonelderly adults with chronic health conditions.
State health departments are currently planning how to designate providers, Blumenstock said. "The CDC has drafted a provider agreement that will lay out terms and conditions for participation, so everyone going into this will know what's expected of a provider" and what support the states will provide, he said.
The federal government will pay for the vaccine and related supplies, including needles, syringes, and sharps containers, the CDC noted.
Funds for administering the vaccines will have to come from elsewhere, and today the CDC said a trade association of health insurance companies stated that its members will cover the administration costs for private-sector providers.

The group America's Health Insurance Plans (AHIP) told the CDC, "Public health planners can make the assumption that health plans will provide reimbursement for the administration of a novel (A) H1N1 vaccine to their members by private sector providers in both traditional settings . . . and in nontraditional settings, where contracts with insurers have been established."

The CDC also said today that vaccination planners should consider two scenarios for vaccine availability. The first possibility is that about 120 million doses will be released starting in mid-October and continuing over 4 weeks, followed by 80 million doses per month after that. The second scenario envisions about 20 million doses being released starting in late September, followed by 20 million doses a week thereafter.

On other points, the CDC said:

• Though it is uncertain until clinical trial results are in, planners should assume that each person will need two doses of vaccine.
• Practical considerations will make it difficult to ensure that any given person's first and second doses of vaccine will be the same product (five manufacturers are supplying vaccine).
• The CDC's goal is to have enough preservative-free (ie, thimerosal-free) vaccine available for young children and pregnant women, in single-dose vials or nasal sprayers.
• It is expected that seasonal flu vaccine and the pandemic vaccine may be administered together.
• There will be no federal requirement for vaccinators to require people to provide proof of priority-group status, such as a doctor's note documenting pregnancy or risk status.
• The CDC is not currently recommending pneumococcal vaccine to anyone not already covered by such a recommendation. Pneumococcal vaccination has been suggested as a way to reduce the risk of secondary bacterial pneumonia in H1N1 flu patients.

CDC: Leave school closings to local officials

By Craig Schneider

The Atlanta Journal-Constitution

U.S. health officials said Friday they are discouraging the quick closure of schools where swine flu appears, a shift from recommendations in the spring that prompted many closures and disrupted the lives of many families.

In addition, the federal officials who gathered for a morning media conference in Washington said the decision to close schools should be left to local school and health officials.

“Closure of schools is rarely indicated,” said Dr. Thomas Frieden, director of the Atlanta-based U.S. Centers for Disease Control and Prevention.

He said local officials must weigh the options of closing a school, which can throw families off their normal routines and hamper education, against the need to stop what may be widespread flu in the school.

The updated school recommendations, which carry great weight with local and state education and health officials, come as some Georgia school systems resumed classes this week. Most of the state’s systems begin the 2009-2010 school year Monday.

While Georgia officials say many schools have put in place a line of defense against swine flu -- planning for increased sanitary education and practices and sending out preventative information to parents -- the officials acknowledge that important aspects of planning awaited these CDC recommendations.

State education and health officials said they agree that the closing of schools should be discouraged and that the decisions should be left to local school officials, with input from local health boards.

“The decision is best left up to the local officials, since they know their kids best,” said Matt Cardoza, spokesman for the Georgia Department of Education.

The new CDC guidelines say, “The decision to dismiss students should be made locally and should balance the goal of reducing the number of people who become seriously ill or die from influenza with the goal of minimizing social disruption.”

CDC officials say they expect a vaccine to be available for swine flu, also called novel H1N1, by mid-October.

Children with seasonal flu 'shouldn't take Tamiflu'

Writer: AFP

Published: 10/08/2009 at 09:00 PM

Children with seasonal flu should not be given antivirals such as Tamiflu because harmful side effects outweigh relatively meager benefits, according to a study released on Monday.

Boxes of Tamiflu. Children with seasonal flu should not be given antivirals such as Tamiflu because harmful side effects outweigh relatively meager benefits, according to a study by British researchers.

In some children Tamiflu caused nausea and vomiting, which can lead to dehydration and other complications, researchers reported.

The study did not cover the current outbreak of swine flu, but its conclusions suggest that antivirals may not significantly reduce the length of illness or prevent complications in children infected with the new A(H1N1) virus, the researchers said.

Carl Henegan, a doctor at John Radcliffe Hospital in Oxford and co-author of the study, said the current practice of giving Tamiflu for mild illness was "an inappropriate strategy."

"The downside of the harms outweigh the one-day reduction in symptomatic benefits," he said.

The research showed that antivirals oseltamivir and zanamivir shortened the duration of seasonal flu by up to a day and a half.

But the drugs had little or no effect on asthma flare-ups, increased ear infections or the need for antibiotics.

Tamiflu, the brand name for oseltamivir, was also linked to an increased risk of vomiting. Zanamivir is marketed under the name Relenza.

The study, published in the British Medical Journal, comes 10 days after Britain's Health Protection Agency (HPA) reported that more than half of 248 students given Tamiflu after a classmate fell ill with swine flu suffered side-effects such as nausea, insomnia and nightmares.

Most of the students did not have the flu when they were given the drug.

Preparing for 2nd flu wave

H1N1 FLU PANDEMIC



WASHINGTON - THE US and other countries in the Northern Hemisphere are bracing themselves for a second wave of Influenza A (H1N1) infections that could strike millions of people and contribute to the hospitalisation and deaths of thousands, including many children and young adults.


While flu viruses are notoriously capricious, making any firm predictions impossible, a second wave could hit the Northern Hemisphere within weeks and lead to major disruptions in schools, workplaces and hospitals, according to US and international health officials.

Since emerging last spring in Mexico, the H1N1 virus has spread to 168 countries at least, causing over 162,000 confirmed cases and playing a role in at least 1,154 deaths, including 436 in the US. As the first flu pandemic in 41 years spread through the Southern Hemisphere's winter recently, scientists have been closely monitoring the virus for clues to how much of a threat it might pose this autumn.

So far, no signs have emerged that the microbe has mutated into a more dangerous form. Most people who get infected seem to experience relatively mild illness.

Still, in the Southern Hemisphere, which experiences winter during the Northern Hemisphere's summer, the virus caused a more intense and somewhat earlier flu season in some places.

Its appearance in countries such as South Africa and India, both of which have just recorded their first deaths, is raising concern that the pandemic could be devastating if it begins to sicken large numbers of people in places with fewer resources.

Meanwhile, concern about a second wave has prompted a flurry of activity by federal, state and local officials in the United States.

Many experts suspect the second wave could be more severe than an average flu season, which hospitalises an estimated 200,000 Americans and contributes to 36,000 deaths. Because the virus is new, most people have no immunity against it.

The number of cases could increase rapidly as soon as schools begin to reopen in the next few weeks and could accelerate further as cooler, drier temperatures return, possibly peaking in October.

That is much earlier than the usual flu season, and it could create confusion. People could start getting sick with the H1N1 flu before a vaccine is widely available and nonetheless be urged to get vaccinated against the regular seasonal flu, which will be available first.

WASHINGTON POST

H1N1 Vaccines Not Expected Until Fall

Federal Officials Urge Preparedness

POSTED: 3:53 pm EDT August 10, 2009
UPDATED: 3:56 pm EDT August 10, 2009

BOSTON -- Federal health officials said Monday that it could be Thanksgiving before there is widespread protection from the H1N1 flu.

The prediction was based on the belief that the first batches of the vaccine will be available to the public in mid-October. Children, whom they said would be among the first to receive the vaccination, will require two doses, two weeks apart.

Centers for Disease Control and Prevention Director Dr. Thomas Frieden said given that timetable, he would not expect large numbers of the population to have immunity to the virus until approximately one month after the first dose is given.

Frieden said he believes “there will be plenty of vaccine” for everyone who wants to get the H1N1 shot to get it, but that the complete supply will not be available all at once.

Frieden and U.S. education secretary Arne Duncan held a conference call with reporters to brief the media on federal preparedness for the upcoming school year, which will begin before the H1N1 vaccine is available. There is growing concern that schools could become a hotbed for the virus to spread.

So far in Massachusetts, according to the Department of Public Health, there have been 1,383 confirmed cases of H1N1. Nearly half of all cases have involved children between the ages of 5 and 18.

That’s one reason why children 6 months and up will be first in line to receive the vaccine when it becomes available. So will pregnant women, health care workers, and people who care for infants under 6 months of age.

In Massachusetts, according to the DPH statistics, so far 51 of the confirmed H1N1 cases have been pregnant women. One hundred and seventy six of the 1,383 have required hospitalization and there have been 10 deaths attributed to the virus in the state.

The CDC recently released $260 million to states to prepare for the potential of widespread outbreaks this fall. Federal officials confirmed any decision to close specific schools would be made on a state or local level.

Even without a vaccine, the administration urged parents, students, teachers and members of the general public to follow three common sense steps to prevent the spread of the virus. They said if you’re sick, stay home until at least 24 hours after your fever is gone. Cover coughs and sneezes with a tissue, or cough and sneeze into your elbow. And third, they suggested everyone wash hands often.

Frieden said he does not expect side effects from the H1N1 vaccine to vary from those commonly seen after patients receive the seasonal flu vaccine, which, he said, 100 million Americans get every year.

U.S. Homeland Security Secretary: H1N1 Flu will get jump on H1N1 Vaccine

August 9th, 2009 at 2:17 pm

Homeland Security Secretary Janet Napolitano said Tuesday that pandemic H1N1 flu probably will flare up soon after schools open at the end of August for this fall, before vaccine is available.

Napolitano also acknowledged that there would not be enough pandemic flu vaccine for everyone, at least in the early stages of the flu season. "There will be prioritization of vaccinations," she told members of the USA TODAY editorial board.

The flu strain causing the pandemic, a new H1N1 virus also known as swine flu, is especially dangerous because it differs from every other known flu virus. As a result, most people are defenseless against it. That makes a vaccine the keystone of any effort to prevent illness and save lives. The first batches of the vaccine are due in mid-October.

Napolitano said this year's flu season probably will be severe but not as severe as the 1918 pandemic, the world's worst. In 1918, flu killed at least 675,000 people in the USA and up to 50 million worldwide. She said it's more likely that the pandemic would mirror 1957, when flu killed about 70,000 people in the USA and 1 million to 2 million people worldwide, according to the Centers for Disease Control and Prevention.

About 36,000 people in the USA die and 200,000 are hospitalized in typical flu seaons.

William Schaffner, a flu expert at Vanderbilt University, cautions that "flu is fickle" and there's no way to predict precisely how the coming flu season will unfold. One difference between H1N1 flu and the 1957 version is that the new virus strikes a higher proportion of children and young people than the elderly. "If that holds, the group most vulnerable to the complications of influenza will continue to be spared," Schaffner says. "But H1N1 has a tremendous capacity to make children and young adults very sick."

Last week, a panel of experts advised the CDC that the first vaccinations should go to pregnant women; parents and contacts of children younger than 6 months; health care workers; all children and young adults; and all non-elderly adults with chronic medical conditions. The government recommends vaccinations for seasonal and swine flu.

WHO cautions against random purchase of antiviral drugs in India

The Daily
Srinagar, Aug 9

With the sudden rise in the frequency of pandemic H1N1 flu (Swine Flu) in India, World Health Organization Sunday issued a warning on the purchase of antiviral drugs without the prescription while four students with suspected Swine Flu symptoms were quarantined at Government Medical College Jammu.
“Two cases of suspected swine flu have been reported in Jammu,” said Medical Superintendent of GMC Jammu Ramesh Gupta.
He said the students - one studying in Bangalore and another in Pune, have been kept in isolation. “They had returned home to spend summer vacations here. One of them was staying in Kathua and the other at Nanak Nagar Jammu”.
“The blood samples of these suspects have been sent to Delhi,” Gupta added.
“Two more students checked into the hospital in similar condition and were quarantined by a special team of doctors,” Principal GMC hospital, Rajinder Singh told wire news agency.
Meanwhile, Communication Chief, UNICEF India Angela Walker while talking to Rising Kashmir over phone from New Delhi on behalf of WHO said, “WHO has advised people not to purchase medicines to fight or prevent influenza A (H1N1) unless prescribed by a health care practitioner in line with national pandemic influenza preparedness plans”.
“Testing has shown that the currently circulating influenza (H1N1) virus is sensitive to anti-virals such as Oseltmivir or Zanamivir, which are authorized in a number of WHO member States,” she informed.
The step, WHO India authorities say, has been taken as the widespread inappropriate use of these medicines could increase the risk of the virus developing resistance in them. “Antivirals should therefore only be purchased with a prescription from a health practitioner who has examined the patient,” Walker added.
The warning further says the products sold outside the authorized ‘national medicine supply chains’ should not be purchased. “Besides caution should be exercised in buying antivirals over the internet,” it said.
The warning further states that unlicensed and illegal internet pharmacies take orders and payments with no assurance of the medicines being delivered.
WHO had last month sounded an all-India alert saying that the pandemic can spread like never before in the coming flu seasons especially in tourist destinations all over India.
Symptoms/Precautions
So far most of people, who have contracted the new influenza A (H1N1) virus have experienced influenza-like symptoms such as sore throat, cough, runny nose, fever, malaise, headache, joint/muscle pain.
WHO has issued following advice to those who experience flu-like symptoms:
. Stay home and avoid close contact with others until at least 24 hours after the symptoms are completely gone.
. Wash hands frequently and always cover his mouth and nose while coughing or sneezing.
. Wear a simple surgical mask when meeting others
. In case of severe symptoms like difficulty in breathing, pain or pressure in the chest abdomen, sudden dizziness confusion and severe or persistent vomiting, one should seek medical care immediately.

Int’l Swine Flu Conference Add More Breakout Sessions

Press Releases August 9th, 2009


Organizing Committee adds more sessions to conference as a result of delegates input

The International Swine Flu Conference organizing committee has responded to the needs of the ISFC delegates by adding more breakout sessions to the upcoming event. Sessions added include presentations on the school/university pandemic planning, continuity of operations (COOP) and government planning, Infectious Medical Waste, Psychological Issues and many more. ISFC will be held at the Hyatt Regency Washington DC on Capitol Hill, August 19-20 and will be followed by all day hands-on workshops on the 21st.

“Our delegates requested for more sessions at the conference and we responded,” said Ahmed Farajallah, Senior Vice President, events and conferences, New Fields. “Emergency Preparedness Leaders, Health and School Officials, Business, Public and Private sector Partners will have access to H1N1 Flu experts from around the world to address the issues of continuous planning for a possible severe outbreak of H1N1 flu this fall.”

The ongoing Swine Flu pandemic proved that now more than ever health, education, government, non-profit organizations, and business executives need to focus, discuss and share best practices and lessons that will be learned during this pandemic in the age of globalization.

With delegates from Tribal, local, state, federal along with 32 countries already registered, the ISFC will provide a platform for public health officials and community stakeholders to come together, to network and exchange preparedness and response efforts. Priority will be placed on identifying the responsibilities of various stakeholders in order to improve global communication coordination and collaboration.

Each day of the conference will offer papers on a wide range of topics including:
Preparing Community Strategies
Local Partnership and Participation
Delivery of Vaccine and Antiviral Medication
Emergency Response and Hospital/Healthcare Coordination
Prevention Education Efforts and Risk Communication
Command, Control and Management
Business Community’s Role

Panel Discussions include:
Clinical Picture: Country Report & Situation Update
Clinical Picture: Impact of US Export Regulations on International Cooperation in the H1N1 Pandemic Flu Response
Risk Communication, Prevention Education Efforts and Risk Communication
Understanding the Connection Between Human and Animal Disease, Exploring One World, One Health
Vaccines delivery

Over 20 breakout sessions will be offered addressing a wide range of issues, including:
Breakout- Agricultural Perspective: Socio-Economic Impact on Swine Industry
Breakout: Schools/University Planning: How and When to Close Schools
Breakout: Mass Fatality Management Planning
Breakout: Business Continuity Planning, “Pandemic Showstoppers: What leads to Success or Failure at the local Community level”
Breakout: School Emergency Preparedness
Breakout: Hospital and Emergency Medical Services
Breakout- COOP and Continuity of Gov’t Planning: “Gearing up for the Fall: Rapid Training & Exercises for Health Department Staff & Partners”
Breakout- Business Continuity: Preparing the Community for a Severe H1N1
Breakout- Business Continuity: Global Pandemic Planning at Visa
Breakout: Schools/University Planning: The Uniqueness of Planning for Swine Flu in Higher Education: We are Much Different than the k-12 System
Breakout: Prevention for Schools for Students, School Personnel, Parents and Communities
Breakout: Emergency Management: States Perspective and Strategy for Pandemic Influenza- Command, Control and Management
Breakout- Hospital & Emergency Medical Services: Impact of Swine Flu on Emergency Medical Services
Breakout- Community-Based Planning, Community Preparedness
Breakout: COOP & Continuity Govt Planning

And many more…

Workshops include:
Learn How to Plan – Contingency Scenario Exercise for Pandemic Influenza
Learn How to Plan
Protect your Community
Enhancing Pandemic Preparedness Through Volunteer Resources
Know How to Respond
Plan to Continue

Registration:

The 2-day event is open to all interested governmental agencies, organizations, and businesses from all countries. To register, Call us at 202-536-5000, or download a registration form: www.new-fields.com/isfc/registration.pdf. Complete and fax to 202-280-1239.

Those interested in making presentations related to the Swine Flu or pandemic preparedness, please contact our research department by e-mail at Research {at} new-fields(.)com.

About New Fields:

The International Swine Flu Conference is organized by New Fields Exhibitions, Washington, DC, international specialists in public health and emergency planning events and disaster recovery conferences. For expedited registration and other information, contact 202-536-5000. To learn more about latest conference developments please visit: www.New-Fields.com/isfc.

Contacts

New Fields Exhibitions, Inc.
Ahmed Farajallah
202-536-5000

Egyptian authorities fear swine flu mutation

by
Martin Morris

on Sunday, 09 August 2009

SWINE FLU: Egyptian authorities fear H1N1 virus may combine with avian flu and mutate. (Getty Images)

Egyptian health authorities are concerned about the risk that the H1N1 swine flu virus and the much deadlier H5N1 avian flu virus could combine with seasonal human influenza.

Speaking to KUNA, Egyptian Minister of Health Hatem Al-Gabali said the bird and swine flu pose the same source of danger to human health.

The minister has urged all citizens to be vigilant and take seriously preventative measures designed to limit the spread of avian flu that has now become endemic in Egypt.

He added that Egypt had reported a total of 82 avian flu human cases since the virus first surfaced in the country, including 27 deaths - the highest rate in the world.

The Egyptian government has set in motion a preventive plan to curb the disease ahead of the school year, scheduled to start on September 26.

To date, 329 swine flu cases have been detected in Egypt so far, with just only death.
case, while 236 have recovered, and the remaining cases are still receiving medication at hospital.

The World Health Organization (WHO) has said that while the H1N1 virus was stable and there was no sign of it mixing with avian flu or other influenza viruses it has warned that the influenza virus is highly unpredictable and has potential for mutation.

refered by ...... ->
url is -> www.arabianbusiness.com%2F564266-egyptian-authorities-fear-swine-flu-mutation

Obama Heads to Summit as North America Braces for Swine Flu

By Roger Runningen and Nicholas Johnston

Aug. 9 (Bloomberg) -- President Barack Obama leaves today for a summit with his counterparts from Mexico and Canada as all three nations brace for a rebound of the deadly H1N1 swine flu, which may threaten cross-border commerce.

The two-day meeting in Guadalajara among Obama, Mexican President Felipe Calderon and Canadian Prime Minister Stephen Harper is to include talks on easing trade friction, dealing with the recession, battling drug crime and paving the way for climate talks later this year. A pressing topic is the return of the pandemic flu, which emerged in Mexico earlier this year.

“Everybody recognizes that H1N1 is going to be a challenge for all of us and there are going to be people getting sick in the fall and die,” John Brennan, Obama’s deputy national security adviser, said.

Officials are concerned that a widespread outbreak of the H1N1 virus as the regular flu season gets under way in the Northern Hemisphere’s fall may disrupt airline schedules and slow cross-border imports and exports.

All three countries still are being battered by the recession, and economics defines the relationship among them. Canada and Mexico are the U.S.’s first- and third-largest trading partners, generating more than $950 billion of imports and exports last year. Canada and Mexico account for 28 percent of all U.S. trade.

Common Strategy

At the North American Leaders Summit, Obama, 48, Calderon, 46, and Harper, 50, will focus on joint strategies for coordinating medical information, stockpiling vaccines and reviewing distribution plans to “minimize the impact and severity,” Brennan said at an Aug. 6 White House briefing.