WHO Chief Warns – Swine Flu “Unstoppable”!
Swine flu will be biggest pandemic ever, warns world health chiefAs swine flu sweeps the planet, Margaret Chan, head of the World Health Organisation, tells how she is leading the battle against it – and the personal price she is paying.
Chan’s war has arrived with a vengeance. A 2007 WHO report, A Safer Future, estimated that a flu pandemic could affect more than 1.5 bn people, or 25% of the world’s population. Could swine flu be that big? “Quite likely. Quite likely. But it probably won’t happen in one run. It will probably come back [in two or three waves].”
How does she expect it to compare to other pandemics? “In terms of the number of countries affected and the number of people infected, this has got to be the biggest.”  read more here
CNN – Expert Answers – Keeping Your Family Healthy
CNN – Living Well Expert Dr. Jennifer Shu Pediatrician,Children’s Medical Group -Â answers a viewers question -Â How can I keep my family healthy if one of us has H1N1?
Asked by Kim, Georgia
“My son was found to have H1N1 flu and has to stay home from school. How can we keep the rest of the family from getting sick?”
Expert answer
Thanks for your question. Many of the patients I see in my practice have voiced similar concerns. The Centers for Disease Control and Prevention estimates that more than 1 million Americans have been infected with H1N1 influenza since April 2009. There is a 10 to 20 percent chance of getting H1N1 from a household contact, although studies vary, and the risk may be much higher. Here are some steps I advise my patients to take to minimize their chances of getting this illness.
Keep your distance. Place your child in a separate room of house as much as possible, and consider taking his meals to him. People who are at high risk of complications from influenza (such as young children under 5, pregnant women and individuals with certain medical conditions such as asthma or heart disease) are advised to stay at least 6 feet away, so as to avoid being exposed to droplets from the sick person’s coughs or sneezes.
Hands off. Avoid holding or shaking hands with sick people in general. In fact, I try to avoid shaking hands whenever possible, especially during cold and flu season. If hand-to-hand contact occurs, wash your hands or use a sanitizer rub immediately afterwards.
Keep objects and surfaces clean. Occupy your child with books and toys that can be washed easily. Clean doorknobs, refrigerator handles and sink faucets with a household disinfectant.
Discourage sharing. Germs are one of the few things in life you won’t want your child to share so avoid sharing drinks, utensils and towels.
Cover the cough. Teach your child to cough or sneeze into a tissue (and then throw it away and wash his hands right away) or into his sleeve or elbow. You may also wish to cover his face (or yours) with a face mask that fits as snugly as comfortably possible.
Consider antiviral medicines. Medications such as oseltamivir (Tamiflu) and zanamivir (Relenza) taken by household members may help prevent them from developing H1N1 infection. Ask your doctor if this type of prevention is recommended for your situation.
Cuddle carefully. If you hug your child while he’s sick, do so with your face turned away from his. Avoid kissing on the mouth.
Air out your home. Open the windows or turn on a fan in common areas such as kitchens, family rooms and bathrooms.
Bide your time. People tend to get sick from H1N1 within about seven days of being exposed to someone with the illness. The sick person is most contagious during the first few days of influenza, although infants and young children can continue shedding the virus for longer than a week. If a week has passed since your son first got sick and you don’t have any symptoms, there’s a good chance you will not become infected by him.
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CDC’s Advice to Parents: Swine Flu Shots for All
Here’s the most important advice you’ll get on how to protect your family during the Swine Flu Pandemic. Straightforward, no nonsense insight on how to keep swine flu at bay – keep your children from getting the flu AND what to do if you or your kids become infected with the swine flu. Did you know there are two types of swine flu? Read more here
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Tuesday, August 25, 2009Â
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The first swine flu precaution that the Centers for Disease Control and Prevention suggests for parents: As soon as a vaccine is available, try to get it for everyone in your family.
Following are other CDC recommendations for parents:
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– All members of the household should wash their hands frequently, using soap and water or alcohol-based hand sanitizer. Antibacterial soaps are no better than ordinary soaps, since swine flu is caused by a virus, not by bacteria.
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– Teach children to use tissues to cover the nose and mouth when sneezing or coughing. If tissues are unavailable, the crook of an elbow or a shoulder is a good substitute — not the hands, which can spread the virus to whatever they touch.
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– Anyone who becomes sick — flu symptoms include fever, sore throat, coughing, chills, fatigue and a runny nose — should stay home for at least 24 hours after the fever is gone. If symptoms worsen, children should extend their stay at home for seven more days, no matter how soon they feel better. This means home, not just out of school: “Children shouldn’t be . . . mixing in crowds or going to malls when they are sick,” said Lance Chilton, a member of the CDC’s advisory committee on immunization practices. And once any member of a household gets sick, all school-age children should remain home for five days.
– Children should receive emergency care if their breathing becomes rapid or if they have trouble breathing, develop bluish or gray skin color or severe or persistent vomiting, or if their flulike symptoms improve but come back with a fever and more severe cough. Resistance to drinking adequate amounts of water, irritability and a difficulty waking up and interacting with others are also warning signs.
Adults who experience difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting and flulike symptoms that improve but come back with a fever and more severe cough should also seek emergency care.
Besides the CDC Web site, http://www.cdc.gov, information on the H1N1 virus can be found at these sites:
The Mayo Clinic: http://www.mayoclinic.com/health/swine-flu/AN02000
U.S. government: http://www.flu.gov
WHO official predicts H1N1 ‘explosion’
BEIJING, China (CNN) — The world will soon see an “explosion” of swine flu cases as the H1N1 virus spreads rapidly around the world, a top World Health Organization official said Friday.
Spread of the H1N1 virus is entering an “acceleration period,” WHO official says.
Spread of the virus is entering an “acceleration period” and it is certain that there will be more cases and more deaths, said Dr. Shin Young-soo, the organization’s regional director for the Western Pacific.
“Most countries may see a doubling of cases every three to four days for two months until peak transmission is reached,” he said at a symposium in Beijing, China. “At a certain point, there will seem to be an explosion in case numbers. I believe it is very likely that all countries will see community-level transmission by the end of the year.”
More than 1,490 people around the world have died from the virus since it emerged this spring, Shin said.
Swine flu is the first influenza pandemic in more than 40 years. So far, it has caused mostly mild illness, but Shin warned “the virus has a sting in its tail” because it is very infectious and “has the potential to cause more serious disease.”
Any widespread resistance to antiviral drugs, expected to be available this fall, could make the situation worse, he said.
The virus so far has shown itself to be unpredictable, Shin said, so the public needs to be prepared. He called for accurate and timely public health messages and early treatment of severe cases.
The public needs to comply with these health messages, and everyone needs to be able to recognize symptoms early and get timely medical care, he said.
“We will only be safe when we have applied these lessons in every country dealing with this virus,” Shin said. “We need to learn quickly since, as I believe, it appears that this pandemic will get worse before the situation gets better.”
Russia Urges Boycott of UK Travel Over Swine Flu
By Tony Halpin in Moscow and David Rose
Russia’s leading health official urged a boycott of Britain over swine flu yesterday as he appealed to his country’s football fans not to travel to Wales for a World Cup qualifying match.
Science News – CDC Anticipates H1N1 Pandemic
The most at-risk segment of the population — pregnant women, those with chronic diseases, healthcare and emergency medical workers, and children — will be the first recipients, the Centers for Disease Control indicated.
Public health experts say people might be asked to stay away from crowded areas for up to four months to keep spread of H1N1 to a minimum. Dr. Bruce Lee, a University of Pittsburgh infectious diseases expert, said such “social distancing” measures can help to lessen the epidemic.
“Pay very close attention to what the CDC and what other public health officials are saying and take it seriously,” he said.
Some federal government estimates indicate up to 40 percent of the population could get swine flu in the next two years.
Handwashing, facemasks to prevent flu spread at home
By Tan Ee Lyn
HONG KONG (Reuters) – Frequent handwashing and the wearing of face masks at home can help reduce the transmission of influenza viruses within the household if the measures are implemented in good time, a study in Hong Kong has found.
The findings, published in the Annals of Internal Medicine, are seen as important as patients may need to be quarantined at home in a pandemic if hospitals run short of isolation facilities.
“During a pandemic, resources may not be available to isolate all infected individuals, and home isolation of some patients may be required,” the researchers wrote.
“Our results suggest that hand hygiene and facemasks can reduce influenza virus transmission if implemented early after symptom onset in an index patient.”
Led by public health expert Ben Cowling at the University of Hong Kong, the researchers recruited patients who tested positive for either influenza A or B.
Along with other household members, they were then randomly assigned to one of three groups – one with some health education, a second that undertook to wash hands frequently and a third undertook to wash hands and wear surgical facemasks.
Of the 259 households completing the study, 60 household members were found infected in the seven days after the measures were introduced. But there were fewer transmissions in households where the two measures were implemented in timely fashion.
“Hand hygiene and facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset,” the researchers wrote.
“These findings suggest that non-pharmaceutical interventions are important for mitigation of pandemic and interpandemic influenza.”
(Editing by Ron Popeski)
2 Moms Die of Swine Flu
By Lisa M. Krieger
lkrieger@mercurynews.com
Updated: 07/31/2009 01:04:27 PM PDT
Swine-flu virus has claimed the lives of two Bay Area women who recently gave birth, adding to the growing body of evidence that pregnancy puts women at increased risk of flu-related hospitalization and death.
News of the deaths comes as the federal Centers for Disease Control and Prevention recommends that pregnant women be among the first to receive a vaccine, when it’s available. The CDC also urges that anti-viral drugs like Tamiflu or Relenza be quickly administered to pregnant women with suspected influenza.
Pregnancy changes both the lung capacity and immunology of women, making it harder for them to fend off respiratory infections. But while health officials are urging quicker response, they say vigilance and common sense can reduce the risk of infection.
“The most important thing is hand hygiene: soap and water, or alcohol-based products,” said Dr. Steven Parodi, regional chief of infectious disease with Kaiser Permanente, which was not involved in either death.
In Marin County, 33-year-old Jamie Norman was hospitalized in June with flu symptoms and gave birth to her son nearly two months early. She was able to hold Jack, her first child, but died June 30.
In Alameda County, the coroner’s office confirmed this week that Hayward resident Nicole Savoy, 33, died July 12 of pneumonia due to the virus. She had given birth June 15 and was released to go home the following day, but began to feel sick a few days later. On June 21, she returned to the hospital, where she remained until she died July 12 of pneumonia caused by the virus.
The CDC has details on 266 of the 305 U.S. swine-flu deaths reported as of July 29. Fifteen of these 266 deaths — about 6 percent — were among pregnant women. At any time, only 1 percent of the general population is pregnant.Â
While many victims of swine-flu virus are vulnerable due to other health problems, like emphysema, heart disease or diabetes, most pregnant women who have died of swine flu were healthy when they caught the pandemic virus.
One CDC study found that all of the pregnant women who died had been healthy before contracting swine flu — but subsequently developed primary viral pneumonia and had to be put on ventilators. They, or their doctors, waited too long to start them on anti-viral drugs like Tamiflu or Relenza. These drugs work best when started within two days of symptoms.
It’s general wisdom to avoid unnecessary medications during pregnancy, but anti-viral treatment poses far less risk than the flu virus itself.
Although pregnant women have many of the same initial virus symptoms as other people, they face greater odds of complications, Parodi said.
“During pregnancy, the immune system has different components. A pregnant woman’s immune system shifts away from the ability to fight off viruses and shifts more toward fighting bacteria,” Parodi said. “It puts them at higher risk of viral influenza.”
The growth of the baby compresses a woman’s lungs, so her breathing capacity is reduced. “With less lung capacity, you’re more likely to get sick,” he said. “And if you get an infection, it’s harder to clear.”
Flu seems to also increase the risk of delivery complications, such as spontaneous abortion and preterm birth, especially among women with pneumonia.
Additionally, it poses problems for the baby, if the woman has high fever. Studies show that maternal fever during the first trimester doubles the risk of neural tube defects and other birth defects. Maternal fever during labor is a risk factor for seizures, encephalopathy, cerebral palsy and infant death. Doctors recommend treatment with acetaminophen to reduce a pregnant woman’s fever.
In England, initial hysteria over infection caused the nation’s Department of Health to advise women to consider delaying conception until the pandemic passed. The Royal College of Midwives and the Royal College of Obstetricians and Gynecologists also advised pregnant women to avoid rush hour, stay indoors and restrict the movement of other children so the virus didn’t get brought home. But both groups have since softened their stance.
Pregnant women should feel free to work, play and do other normal activities, Parodi said.
“Pregnant women should avoid people who are coughing or actively ill,” he said. “And if we’re ill, we should protect them, by not going to work. It’s a way we can all help.”
An elevated number of influenza-associated deaths among pregnant women were reported during the pandemics of 1918-1919 and 1957-1958. In a study of 1,350 women who had flu during the 1918 pandemic, about half the women got pneumonia and about half of the women with pneumonia died — a case-fatality rate of 27 percent. During the 1957 flu pandemic, pregnant women accounted for half of the flu deaths in a study of Minnesota women of reproductive age.
“If you’re pregnant, take precautions,” Parodi said. “And when a vaccine is available, get vaccinated.”
CDC Says Pregnant Women With Flu Symptoms Should Receive Anti-Viral Drugs
 
JULY 29, 2009, 12:18 P.M. ETÂ Â
WASHINGTON — The Centers for Disease Control and Prevention said Wednesday pregnant women suspected of having the flu should be promptly treated with antiviral medications.
The CDC, in a study set to be published in the medical journal Lancet, said pregnant women are more severely impacted by the H1N1 virus. CDC said pregnant women had higher rates of hospitalization and a greater risk of death compared to the general population.
The study looked at the impact of H1N1 flu on pregnant women from mid-April, when the new virus was first discovered, to June 16. Of 45 U.S. deaths from the H1N1 flu, six were in pregnant women, which represented 13% of deaths at the time. CDC said of the 34 cases of pandemic H1N1 in pregnant women were reported to the agency from April 15 to May 18, 11 women, or 32% were admitted to the hospital.
The CDC has said more than one million Americans have likely been sickened by the H1N1 flu and more than 300 people have died as of July 24.
The lead author of the study, Denise Jamieson, said doctors who treat pregnant women shouldn’t delay in starting antiviral treatment with Tamiflu, made by Roche Holding AG, or GlaxoSmithKline PLC’s Relenza.
“Some clinicians hesitate treating pregnant women with antiviral medications because of concerns for the developing fetus, but this is the wrong approach,” she said.
All of the pregnant women who died from H1N1 complications flu were healthy prior to infection of H1N1. They subsequently developed viral pneumonia, and later died. CDC said they did not receive antivirals soon enough to benefit their treatment. It’s recommended that antiviral treatment be started within 48 hours after symptoms begin.
CDC’s Advisory Committee on Immunization Practices meets later Wednesday to discuss which groups should be vaccinated if government officials decide to move forward with an H1N1 influenza vaccination campaign. Pregnant women, school-age children and health-care workers are expected to be at the top of the list. The earliest an H1N1 vaccine would be available would be mid-October.
Most companies making the vaccines for the U.S. market, including Sanofi Aventis, Novartis AG, GlaxoSmithKline PLC and CSL Ltd, have said the viruses used to make the active ingredient are producing yields of just 30% of what’s typically seen with seasonal vaccines.
Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com
Federal panel issues H1N1 vaccine guidelines
CNN Senior Medical Producer
ATLANTA, Georgia (CNN) — A federal advisory committee issued sweeping guidelines Wednesday for a vaccination campaign against the pandemic swine flu strain, identifying more than half the U.S. population as targets for the first round of vaccinations.
The advisory panel’s guidelines don’t trigger the start of vaccinations but are usually accepted by the government.
The priority groups include pregnant women; health care and emergency services personnel; children, adolescents and young adults up to age 24; household and caregiver contacts of children younger than six months; and healthy adults with certain medical conditions.
The guidelines were approved in a near-unanimous vote by the 15-member Advisory Committee on Immunization Practices. One person dissented on whether to include people ages 19 to 24 among those targeted.
The vote does not trigger a decision to vaccinate against the disease, also called H1N1, but the federal government typically follows the committee’s recommendations.
The recommendations could prove especially important if the pandemic strain, which emerged this spring, spreads widely before sufficient quantities of vaccine can be produced to protect everyone. The recommendations are intended to ensure that members of the most vulnerable groups get priority.
Earlier Wednesday, federal officials said they are on track to initiate a mass vaccination campaign by October, although many details remain to be worked out. Clinical trials to assess vaccine safety and efficacy are just getting under way at a handful of centers across the country.
Dr. William Schaffner, a flu researcher at Vanderbilt University, which is running one of the clinical trials, played down safety concerns that have been raised because safety data are limited.
“There is no alternative” to approving the new vaccine based on the limited data, he said. Fortunately, he added, “the novel H1N1 vaccine is created exactly the same way our seasonal vaccine is created, year in and year out.”
Dr. Wellington Sun of the Food and Drug Administration said data from those trials would probably be available in September.
However, Dr. Robin Robinson, director of the Biomedical Advanced Research and Development Authority at the Department of Health and Human Services, said that that even if federal regulators determine that the vaccine is safe and effective, it would take an additional four to six weeks before it could be packaged and available to the public.
About half of Americans — 159 million — fall into one of the five main target groups, including 102 million people aged 6 to 18.
Robinson had predicted earlier that 120 million vaccine doses would most likely be available within a month after the campaign starts.
Dr. Anthony Fiore of the Centers for Disease Control and Prevention, who led the group’s deliberations, said it made sense to target such a large group because it appears that vaccine supplies will be sufficient.
Part of that estimate is based on experience with seasonal flu vaccine; Fiore said that, typically, only 20 percent to 50 percent of people in targeted groups seek out seasonal flu vaccine.
Even if two doses of the swine flu vaccine are required to confer protection — something that will be determined in clinical trials — suppliers would probably be able to ramp up production quickly enough to meet demand, Fiore said.
But the advisory committee approved a backup plan in case supplies are more limited. In such a case, the priority groups would be pregnant women, health care and emergency services workers with direct patient contact, household contacts of children younger than 6 months, children age 6 months to 4 years and children younger than 19 with chronic medical conditions — a total of 42 million people.
The panel also recommended that, once sufficient supplies exist to meet the needs of all targeted groups, the vaccine should be offered to healthy adults ages 25 to 64. Once those needs are met, vaccinations would be recommended for people older than 65.
The targeted groups differ starkly from the recommendations for seasonal flu vaccine campaigns, which include people 65 and older in the highest-risk group.
The difference is based largely on data showing vastly higher infection rates among younger people; the rate of laboratory-confirmed cases in Americans 65 and older is just 0.06 per 100,000, compared with 2.6 per 100,000 for the group with the highest infection rates, children 5 to 11.
Studies have found that many older Americans carry at least some antibody protection against the new virus, probably because it is similar to flu viruses that circulated widely in the 1920s through the early 1950s.
Some of the most alarming complications have been seen in pregnant women. A paper published Wednesday in the journal Lancet reported that pregnant women infected with H1N1 are more likely to be hospitalized and even die. Of the 45 H1N1 deaths reported to the CDC between April 15 and June 16, six (13 percent) were among pregnant women.
Obesity has not been determined to be a risk factor, Fiore said.
The H1N1 flu vaccination campaign would run concurrent with the usual seasonal flu campaign, which the committee recommended get under way as soon as possible.
Vanderbilt’s Schaffner said patients should get the seasonal vaccine before distribution centers are swamped with demand for the pandemic vaccine.
But he also warned that the new vaccine might be of limited use. “The virus and the vaccine are in a race; the virus may win,” he said.
If the pandemic strain starts spreading fast between now and October, he said, hospitals and medical personnel will be pushed to the limit.
“It’s like thinking about a hurricane. You batten down the hatches. You do everything you can. But when the hurricane arrives, damage will occur. This one is going to be a doozy.”
