Tuesday, November 17, 2009

Six transported to hospital after getting swine flu vaccine

Contributor: Marisa Yamane
Last Update: 11/16 10:15 pm

Paramedics were called to Sacred Hearts Academy today after about a dozen people appeared to have a reaction to the H1N1 swine flu vaccine.
Officials say the apparent reactions could have a lot to do with anxiety rather than the vaccine itself.

Approximately 300 students and 100 faculty at Sacred Hearts Academy got armed against the H1N1 swine flu Monday morning in the State's school vaccination clinic.

Kindergartener Tai Martinez was one of those students.

"Under the recommendations of her pediatrician we felt confident," said Tai's mother Jade Martinez.

But school officials say about a dozen people had an apparent reaction minutes after getting vaccinated.

"It ranged from a rash on the arm, to breathing problems, their neck tightened up. A couple became nauseous. The most common complaint was light headedness," said Betty White, Head of Sacred Hearts Academy.

The clinic manager called EMS four times, and altogether paramedics took five students and one adult to the hospital.

All were released by noon, except for one student who has asthma

When asked if she thinks they overreacted, State Epidemiologist Sarah Park said: "I think we're still looking into things but it does sound like probably we could've been a little been less reactive."

Park says according to protocol, she and a state pediatrician are standing by to answer any questions by phone.

"But if she's, if any of our clinic managers are in a pinch and they have to make a decision and they're not certain then yes the protocol is to call EMS for help," said Park.

Park says the clinic manager was new, Rolling Eyes and that the symptoms were actually side effects sometimes seen at the seasonal flu clinics, often due to anxiety and nerves.

"Bottom line for today -- what we heard about was not unusual. the only unusual thing was that they were clustered but anything with the kids they're fine it was a matter of being safe than sorry," said Park.

The Health Department began its H1N1 vaccination clinics on Friday and today held five clinics at schools across Oahu.

Officials say none of the other clinics reported any problems.

Pregnant B.C. teachers refuse work, saying schools unsafe because of H1N1 virus

By Janet Steffenhagen, Vancouver Sun
November 17, 2009 3:02 AM

VANCOUVER — A few teachers recently refused to work in British Columbia public schools because they said the prevalence of H1N1 illness among students had created an unsafe workplace.

The first reports were filed late last month by pregnant teachers in Victoria who walked away from their classrooms. Another report was filed this month by a Prince George teacher.

By law, employees have a right to refuse work if there is a reasonable cause to believe it poses a health or safety hazard.

The Victoria teachers' claims of unsafe work prompted an on-site inspection by WorkSafe BC to determine if the schools had implemented a proper "exposure control plan" to minimize the risk of H1N1 infection, Ray Roch, a WorkSafe BC regional director who handles H1N1 issues, explained in an interview Monday.

With a proper exposure control plan, the H1N1 risk for employees likely will be lower than the risk in the general community, he added. Such plans should include daily efforts to identify and isolate students who have coughs and fevers, as well as those whose immediate family members are ill.

The inspectors in Victoria also reviewed materials submitted by the teachers' union, but concluded that the schools did not pose an undue hazard. In fact, Roch said that as of Monday, inspections had not identified a single work site in any sector that was hazardous due to the virus.

The B.C. Public School Employers' Association has advised school districts that based on the WorkSafe BC findings, "it will not be deemed to be unsafe for a pregnant teacher to go to work in the classroom where the potential to contract H1N1 exists."

Nevertheless, the B.C. Teachers' Federation (BCTF) is urging members who are pregnant or have compromised immune systems to take steps to protect themselves if there is a high rate of infection in their schools. Susan Lambert, the union vice-president, said the first action should be a request for re-assignment to reduce exposure to the virus.

If that's refused, the union advises them to refuse to work, Lambert said. But only at schools where there is an outbreak.

Anne Guthrie Warman, president of the Vancouver Secondary Teachers' Association, suggested teachers should not be discouraged from making a claim because of the recent WorkSafe BC rulings. Decisions are made on a case-by-case basis, she noted.

It hasn't been a problem in Vancouver, she noted, because the district is accommodating requests for re-assignment.

Scott McCloy, a WorkSafe BC spokesman, said the organization understands that pregnant women are worried about H1N1. "There's an emotional response and a rational response," he said, but the latter suggests the risk in schools is not as great as it is elsewhere in the community.

Vancouver teachers, meanwhile, are questioning the decision to make students a priority for vaccination, but not their teachers. "Teachers who work alongside students all day . . . are most vulnerable currently when there is an outbreak," she said in an e-mail.

Vaccination will be available in specific Vancouver schools over the next four weeks

Utah cat tests positive for H1N1 flu

Nov 16, 2009


Prospector, Utah -- What's believed to be the second case of an H1N1-infected cat surfaced in Utah, and one of the cat's owners also tested positive for the virus.

Like the cat diagnosed with H1N1 last week in Iowa, the most recent case involves a 13-year-old domestic shorthair spayed female that presented with breathing problems, Dr. Carl Prior, owner of Park City Animal Hospital, tells DVM Newsmagazine. Prior and his associate, Dr. Angela West, treated the cat, which the owner described as breathing with its mouth open.

“I was thinking pneumonia or cancer of the lungs, it looked so sick,” says Prior, who first saw the cat Nov. 3 – the day the story broke of the H1N1 case in the Iowa cat.

The cat was placed in an oxygen chamber set at about 50 percent for the first hour, then reduced over the next four to five hours, he says. Once the cat relaxed, he was able to take X-rays and blood samples. The blood test showed a low white blood cell count, and a human A/B-type influenza test obtained locally came back positive, Prior says.

He and West hadn’t really considered H1N1 until the story of the Iowa cat broke later that day, and they realized at least one of the owners had a confirmed case. Staff members had mentioned they were upset the owner had come into the clinic at all, since she said she had been confirmed to have H1N1. Another member of the household was believed to have H1N1, but that case was not confirmed, Prior says.

A test from Iowa State University College of Veterinary Medicine's diagnostic laboratory, and it came back seropositive, he says. So Iowa sent more samples, including a PCR test, which came back negative. Prior says officials at the school were surprised at the negative reading, but told him their cat had tested the same way.

Perhaps the virus isn't shed for very long, Prior suggests, adding that a follow-up blood test at Iowa again confirmed a positive H1N1 diagnosis.

The cat's health improved after several hours in the clinic with antibiotics and oxygen care and was sent home the night it was brought in, Prior says. He and West will continue to monitor the cat, checking its serum every few weeks, he says, adding that another cat in the household will be tested too. It hasn't shown any signs of illness, Prior says, but he will monitor to see whether cat-to-cat transmission may occur.

Prior expected more testing requests since the first H1N1 cat case surfaced, but his clients are asking more questions. Treat the animals like a sick family member, Prior advises, avoiding them if they are sick themselves and isolating them from other pets that might be ill.

ht Dutchy

Monday, November 16, 2009

Number of victims of influenza and pneumonia in Ukraine has reached 315 people - Ministry of Health

Number of victims of influenza and SARS rose in Ukraine up to 315 people as of Monday evening, November 16.

According to the operative data of the Ministry of Health, over the past day from the disease and complications (pneumonia) died 16 people, including a pregnant woman.

As of Sunday night was 299 victims.

Ministry of Health does not provide operational data on cases of the disease pandemic influenza A/H1N1. According to information made public on Monday afternoon, in Ukraine, 166 laboratory-confirmed cases of A/H1N1, including 15 - fatal.

According to the Ministry of Health, the average number of deaths per day in the current year is less than in 2008, when the figure was 18 people per day.

Since the beginning of the epidemic (29 October), the largest number of deaths from influenza and ARI recorded in Lviv (89), Ivano-Frankivsk (38), Chernivtsi (25 people) and Ternopil (22 people) areas.

In Kiev during the epidemic of influenza and SARS deaths of 11 people.

Since the beginning of the epidemic has not been the victims in only one of the Luhansk region.

Total number of cases since the epidemic began was 1 million 400 thousand 999 people, the last day - 36 060 persons. Hospitalized for the last day of 4464 people.

Since the beginning of the epidemic were hospitalized, 78 326 people. To date issued, 48,155 thousand patients.

South still leads in child deaths from swine flu

Three weeks ago, Facing South reported that two-thirds of child deaths attributed to the H1N1 virus, or swine flu, had happened in states centered in the South.

Here's an update: The South's share of H1N1 fatalities has declined, but children in Southern states are still bearing the brunt of the epidemic.

The latest data from the Centers for Disease Control show that, out of 117 pediatric deaths directly related to swine flu, 49 have come from two areas in or near the South.

The CDC collects data in 10 regions nationally. Region 6, which includes Arkansas, Louisiana, New Mexico, Oklahoma and Texas, leads the nation with 44 H1N1 deaths among children.

Region 4, which includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee, has the second-highest figure: 25.

Together, the two regions make up 42% of the total child deaths from H1N1.

Why has swine flu been uniquely devastating in Southern states? The high rate of children without health insurance in many Southern states, and therefore limited health care options, could be one factor.

Another is timing: Swine flu hit the South first, so it's claimed more victims in the region. Other areas might well catch up as the H1N1 virus makes its way through populations in places like the Northeast (one of the few where the documented cases of the virus isn't in decline).

Here's a Google Flu Trends map that shows which states first documented 5,000 cases of H1N1:


As Nate Silver at (not just election analysis!) observes:
Although the initial outbreak of H1N1 back in April was centered on Texas, California, New York, Illinois and South Carolina, the place where the flu first hit critical mass several months later was in Louisiana. It then slowly radiated its way outward to most of the neighboring states -- Maine finally hit the 5,000-point threshold just last week.

Vietnam-Ministry of Health interview

Concerns the combination of influenza A/H1N1 and influenza A/H5N1
Monday, 16/11/2009-2: 22 PM)

Nguyen Huy Nga.
KTNT - After some time im Ang, influenza A/H5N1 services began to appear in the service influenza A/H1N1 and dengue fever are still complicated development. How to deal with all kinds of diseases are the concern of many people. Around this problem, we had a talk with Mr. Nguyen Huy Nga, Director of Department of Preventive Health and Environment (Ministry of Health).

He said Russia:
Notified by the World Health Organization (WHO), some countries in the Americas appeared song the dengue and influenza A/H1N1 in an individual. In Vietnam, the Institute of Infectious Diseases and Tropical countries also announced a second case of simultaneous development of both influenza A/H1N1 virus and dengue fever.

However, there are no studies showing that there is a combination of these two viruses. The two co-infected with this disease more difficult for the treatment of disease diagnosis and clinical landscape is worse than when infected with a disease alone. Next time, the Health Ministry will conduct training for health workers in line to update knowledge of the influenza A/H1N1 infection and hemorrhage, as well as patients likely infected with the other, to minimize complications and mortality for patients.

In the north, entering the winter, do people fear the emergence of influenza A/H5N1, sir?

We in the North, translated dengue tend to decrease. It influenza A/H1N1 and influenza A/H5N1 often appear in cold weather, wet. Thus, when entering the northern winter is the flu outbreak of this kind can occur completely.

The only measure to prevent influenza is vaccination effective vaccines. Could you tell us, never the first batch of vaccine to be about our country and the audience will be given priority?

We do not have a formal announcement on the timing of vaccine to Vietnam. According to the WHO final report, expected in November will have the vaccine but the first or between December we have.

Quality of vaccines produced in the world can not meet at once to all global citizens. WHO recommends, will for the immediate object is high risk of death as pregnant women, people infected chronic ... Therefore, we propose the plan to prioritize vaccination of pregnant women from January 3 or more, patients with diabetes, cardiovascular ... Medical staff directly treating patients infected influenza will also be a priority.

We will concentrate in those regions in which the limited amount of vaccine?

Ministry of Health are asking for detailed guidance. Advisory Council vaccines, the Steering Committee to organize vaccination campaigns have also proposed a number of options. First, the vaccine for all pregnant women over 3 months in all provinces and cities. Second, if there are more vaccines, we will organize a vaccination for the country. Where high population density, with deaths due to influenza A/H1N1, which dispersed power service, many people with chronic diseases focus ... will be the priority areas.

The goal of the first vaccination is not reducing the number of questions reduced incidence in people at high risk, serious complications or death.

However, some research results showed that side effects of flu vaccines A/H1N1co may occur in some rare cases such as mild fever, a sore, nausea, sore throat. The symptoms from the mild and quickly through.

So, the vaccination will be conducted how, sir?

Vietnam is the world rated as a national immunization system expansion relatively good. We would normally immunization of pregnant women to prevent tetanus, so the problem completely nothing worrying. Commune health stations will directly conduct the vaccination.

Attack H5N1 Luwuk

Monday, November 16, 2009, 11:59:00
LUWUK-Indonesia was not yet free of bird flu or H5N1. The virus is deadly dangerous and it was entered into Luwuk District, Central Sulawesi. Exactly peterankan chicken attack in District Kintom

Chairman of the Banggai Livestock Association, Nasrun Bandiong said about 20 chicken farms in the district's community Kintom tested positive for bird flu. However, not known from where the virus originated.

"Department of agriculture has made vaccination and cleaning the cage in an area that this H5N1 virus," said Nasrun.

In addition, he beber, citizens also volunteered to do the destruction of infected cattle is believed to H5N1 virus. Nasrun also asked the Department of Health to immediately fall into Sub Kintom to check people in the area, to mengansipasi these viruses do not infect humans.

"The H5N1 virus is more dangerous than the H1N1 virus (swine flu) and can be quickly transmitted to humans. So the Department of Health to intervene," he concluded

Swine flu afflictions on the rise.

Monday, November 16, 2009
State health officials have boosted the numbers of fatalities they say are related to the H1N1 flu virus to more than 500, compared to some 297 deaths compared to a swine flu in California update, up from 266 reported on Oct. 31.

California Department of Public Health Director Dr. Mark Horton said Thursday in Sacramento that the virus is widespread in California, and has caused 5,380 hospitalizations to date, up from 4,820.

Horton says the vaccine's arrival has been slower than expected in California, with about 4.5 million doses shipped to the state so far.

First H1N1 infection reported at joint park in North Korea

By Kim Hyun
SEOUL, Nov. 16 (Yonhap) -- A South Korean man working at a North Korean industrial park has been confirmed to have the Influenza A virus, the first such infection to be detected north of the border, the Unification Ministry said Monday.

The worker, 32, who authorities would only identify by his family name Seo, was urgently transferred to South Korea on Saturday morning on signs of high temperature at the joint park in the North's border town of Kaesong, said ministry spokesman Chun Hae-sung. He tested positive for H1N1 infection late night Saturday.

"He was brought here because there's no facility at Kaesong park to test for the new flu," Chun said, adding he was now in stable condition.

Seo's case raised concerns of possible infection of North Korean workers at the factory park, where about 40,000 North Koreans work for about 110 South Korean businesses. Chun said Seo has mostly worked in his company office in Kaesong and had little contact with local workers at its factory.
Three other South Korean workers who were in frequent contact with Seo also returned to the South for checkups. "All of them tested negative," the spokesman said.

In an Oct. 30 report, North Korea said no Influenza A cases have been reported in the country, a claim that remains highly dubious amid the rapid spread of the pandemic in the cold weather. Sixty-four South Koreans have died of the disease as of Monday.

Any contact with the H1N1 virus could be particularly dangerous to people in North Korea, many of whom are undernourished and may have impaired immune systems, North Korea watchers say.

The South Korean government provided 30 doses of the anti-viral drug Tamiflu for South Korean workers at the Kaesong park last week.

In May, the World Health Organization supplied an emergency stockpile of 35,000 Tamiflu tablets each to North Korea and about 70 developing countries.

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
Number of cases
Number of deaths
Multinational forces


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

Full_Report (pdf* format - 65.3 Kbytes

Sunday, November 15, 2009

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

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

"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.

Saturday, November 14, 2009

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
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


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?

CDC, Atlanta Campus

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.

Monday, September 21, 2009

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

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)

Wednesday, August 12, 2009

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."

Tuesday, August 11, 2009

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.

Monday, August 10, 2009

CDC: Leave school closings to local officials

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.