Australia to begin first human test of swine flu vaccine
(CNN) — The first human trials of a swine flu vaccine are expected to start in Australia Wednesday, as the World Health Organization confirmed that more than 700 people had died from the virus worldwide.
A scientist examines samples from suspected swine flu patients at a WHO laboratory in Melbourne, Australia.
Melbourne-based company CSL Ltd. plans to test a vaccine for the H1N1 virus, also known as swine flu, on 240 volunteers, a company representative said.The test will be conducted on healthy adults between the ages of 18-64. Participants will receive two shots three weeks apart and will undergo blood tests to determine if they are generating an appropriate immune response to the virus, the company said.
“We appreciate that new influenza strains like the ‘swine flu’ can surprise us with properties that mean they might require higher dosing and two injections rather than one to provoke the desired level of immune response in humans,” said Dr. Russell Basser, global director of clinical development for CSL.
The World Health Organization revealed Tuesday that more than 700 people had died after contracting the virus, 260 more than the latest death toll, released July 6. The jump in the death toll is due simply to the two-week gap in reporting cases, a WHO spokeswoman explained.
The H1N1 virus has spread around the world with unprecedented speed, according to the WHO. Past influenza viruses have needed more than six months to spread as widely as the current H1N1 virus has spread in less than six weeks, it said.
Because there are so many cases emerging so quickly, the WHO changed its reporting guidelines last week. It decided to stop giving a tally of cases and focus instead on identifying unusual patterns. The counting of all cases is no longer essential because it is exhausting countries’ resources, the organization said Monday, commenting on the policy change.
While the virus is spreading quickly, the WHO offered some reassurance to those concerned about the disease. It said the virus has so far been characterized by mild symptoms in most patients, who usually recover — even without medical treatment — within a week of developing symptoms.
Meanwhile, a group of British children and teachers quarantined for almost one week in a Beijing hotel because of swine flu fears have been allowed to leave their hotel.
A spokesman from Britain’s Foreign Office could not confirm the number of children and teachers released from quarantine, but said they were among a group of 111 that was sequestered in a Beijing hotel six days ago.
The students and teachers came from various schools in Britain and were all traveling to China together as members of the same British school association, the Specialist Schools and Academies Trust.
Twelve children were hospitalized and diagnosed with the H1N1 virus, commonly known as swine flu. One child is in the hospital awaiting test results to confirm the virus, the Foreign Office said.
The group released from quarantine Tuesday will now be moved to a different hotel, the Foreign Office said. The second group is due to be released from quarantine Wednesday, the Foreign Office said.
WHO declared H1N1 a global pandemic on June 11. More than 120 countries have reported cases of human infection since the virus was first identified in Mexico in April. There are more than 98,000 documented cases worldwide.
Airlines stop swine flu victims flying
LONDON, England (CNN) — British airlines have put into effect measures to stop people with swine flu boarding flights in a bid to prevent the virus from spreading further.
Medical screening for the swine flu virus has been introduced at many airports.
British Airways said there had been a “very small number of cases” where people who had checked in with symptoms of H1N1 had been advised not to travel after having medical checks.
Virgin Atlantic also said victims would not be allowed to board one of its planes without a fit-to-fly certificate from their doctor or a hospital, though there had been no cases yet.
The World Health Organization declared the virus a global pandemic June 11. More than 120 countries have reported cases of human infection. About 98,000 cases have been documented worldwide, with 440 deaths, according to the WHO.
With 29 deaths and a huge rise in the number of cases, Britain has the worst swine flu figures in Europe.
Eight British schoolchildren remained in hospital in China on Monday after contracting swine flu on a trip to the country, the Foreign Office said. The teenagers were diagnosed with the H1N1 virus in Beijing. More than 50 of their classmates and teachers are also quarantined in a hotel.
Medical screening for the swine flu virus has been introduced at many airports around the world for passengers arriving on international flights but there are concerns that many people may not be aware they are infected.
Those who do have symptoms have been advised by Britain’s health authorities to delay their journeys until the signs have cleared up.
“We have a medical team within the airline as well as a contingency planning group which has met for the past few years to look at the issue of a flu pandemic,” A British Airways spokeswoman said.
“We have a wide range of contingency plans in place which we can use depending on how the situation may evolve.
“If we have concerns about a customer or the customer is concerned, then we have a 24-hour medical service we can call to give advice to staff.
“They will speak to the customer and an assessment will be made about their fitness to fly.
“There have been a number of cases where we have advised customers not to fly on the basis of their diagnosis or symptoms of H1N1.”
BA told CNN Monday though that it was “business as usual” and all flights were operating normally.
Virgin Atlantic spokesman Paul Charles said: “If there are signs of something being wrong, be it excessive sneezing or coughing, not looking well, high temperature, then the airport staff can call in a medical team for extra advice.
“If the medical team believe there are reasons not to fly, the passenger will be asked to produce a fit to fly certificate from their doctor or a hospital, and they will be put at our cost on to the next available flight.”
Swine flu has spread so rapidly and extensively around the globe that the World Health Organization is changing tactics against the H1N1 virus, including stopping a tally of cases and focusing on unusual patterns.
“At this point, further spread of the pandemic, within affected countries and to new countries, is considered inevitable,” the WHO said.
The counting of all cases is no longer essential because it is exhausting countries’ resources, the organization said.
“In some countries, this strategy is absorbing most national laboratory and response capacity, leaving little capacity for the monitoring and investigation of severe cases, and other exceptional events.”
Monitoring is still required, the organization urged, but should focus on exceptional patterns.
“Because the numbers of cases have increased in so many countries, it is very hard to keep up,” Keiji Fukuda, WHO assistant director-general, said earlier this month.
Laboratories have been inundated with testing requests and the virus is showing up in most lab tests in countries with major outbreaks, he said.
The organization said it will not issue global tables showing confirmed cases for countries that have reported cases, according to the release.
However, it will still report on nations that have not had cases so that its presence can be confirmed. “WHO will continue to request that these countries report the first confirmed cases and, as far as feasible, provide weekly aggregated case numbers and descriptive epidemiology of the early cases.”
Meanwhile, governments should should be on the lookout for unusual patterns, the organization said.
While most patients have reported mild symptoms, a rise in severe symptoms or respiratory ailments that require hospitalization should be cause for concern, it said. Governments should also pay attention to unusual patterns linked to fatal cases, the WHO said.
Any changes in prevailing patterns should be flagged, including a rise in school and job absenteeism, and an increase in visits to the emergency room.
An overwhelmed health system may mean there is a rise in severe cases, the organization said.
New Push in H1N1 Flu Fight Set for Start of School
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July 18, 2009
U.S. health officials are preparing intensively to combat an anticipated wave of outbreaks of the new H1N1 flu when children return to school and the pace of cases picks up.
Zuma PressKenya Bell, left, stands with daughter, Nyeree, who along with several others came down with the flu at an American Lung Association camp in California.
Anne Schuchat, chief of immunization and respiratory diseases at the U.S. Centers for Disease Control and Prevention, said Friday that the agency expects an increase in cases before the normal start of the flu season in mid-autumn, because children are likely to spread it to one another once they go back to school. Infectious diseases normally spread readily among children, and this virus has hit children and young adults harder than the elderly, who normally suffer the heaviest toll from flu.
“We’ve seen it in camps and military units,” Dr. Schuchat said. “I’m expecting when school reopens and kids are all back together, in some communities at least we may see an increase.”
The number of confirmed U.S. infections is now 40,617, with 263 deaths, the CDC said Friday. But the agency believes that more than one million people have been infected and weren’t tested for the virus or didn’t visit a doctor. The disease has become so widespread that the agency will probably suspend tallying individual case counts within the next few weeks and focus instead on tracking clusters, severe cases, deaths and other unusual events — a more traditional approach to tracking diseases, Dr. Schuchat said.
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The CDC would be following the WHO, which said on Thursday that it is abandoning individual case counts.
Most of those who have the new flu get only mildly ill for a few days and don’t need treatment. But officials are concerned about the virus because it is new and could easily mutate and become more virulent as it spreads through the population. Argentina declared a nationwide animal-health emergency Friday after finding the virus possibly jumped from humans to two pig herds, a development that flu experts say could potentially spur mutations. The country’s death toll from the virus stands at 137.
Global officials are also concerned because the new H1N1 virus has caused severe illness in some children and young people. Some recently published studies suggest it can cause more severe illness than seasonal flu. Deaths from flu are normally rare among children and young adults, who account for the bulk of the U.S. deaths from the pandemic strain. Nor is it clear why the virus is striking pregnant women, as well as people with asthma, diabetes and other conditions hard.
To combat the virus, federal officials are preparing to mount a massive immunization campaign, and are also urging communities, businesses and individuals to make contingency plans for possible school closures, multiple employee absences for illness, surges of patients in hospitals and other effects of potentially widespread outbreaks.
Clinical trials are expected to begin later this month to test whether a vaccine developed to combat the virus is safe and effective, and the CDC is working with state and local public-health authorities to figure out how to get as many as 600 million doses, or two for every U.S. resident, into people’s arms. Results of the trials aren’t expected until early October, but officials say they expect to have the first 100 million doses of vaccine ready by mid-October.
The WHO and some vaccine manufacturers reported this week that the vaccine was proving difficult to manufacture because the viruses used to make the shots are yielding only 25% to 50% of the active ingredient they normally get for flu vaccines.
But Dr. Schuchat said that wasn’t affecting the U.S. government’s plans. “We haven’t heard news that has changed our expectations for vaccine availability in the fall,” she said. “Based on what has been described to us so far, it’s within the range of our planning assumptions, but that doesn’t mean we won’t have more surprises.”
Key Facts About Swine Influenza – CDC/Control & Prevention
http://www.cdc.gov/h1n1flu/key_facts.htm
Swine Flu
What is Swine Influenza?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. The classical swine flu virus (an influenza type A H1N1 virus) was first isolated from a pig in 1930.
How many swine flu viruses are there?
Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Over the years, different variations of swine flu viruses have emerged. At this time, there are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.
Swine Flu in Humans
Can humans catch swine flu?
Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others. For example, an outbreak of apparent swine flu infection in pigs in Wisconsin in 1988 resulted in multiple human infections, and, although no community outbreak resulted, there was antibody evidence of virus transmission from the patient to health care workers who had close contact with the patient.
How common is swine flu infection in humans?
In the past, CDC received reports of approximately one human swine influenza virus infection every one to two years in the U.S., but from December 2005 through February 2009, 12 cases of human infection with swine influenza have been reported. For information on the number of probable and confirmed cases of novel H1N1 flu in humans see Novel H1N1 Flu Situation Update.
Can people catch swine flu from eating pork?
No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses.
How does swine flu spread?
Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Human-to-human transmission of swine flu can also occur. This is thought to occur in the same way as seasonal flu occurs in people, which is mainly person-to-person transmission through coughing or sneezing of people infected with the influenza virus. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.
What do we know about human-to-human spread of swine flu?
In September 1988, a previously healthy 32-year-old pregnant woman was hospitalized for pneumonia and died 8 days later. A swine H1N1 flu virus was detected. Four days before getting sick, the patient visited a county fair swine exhibition where there was widespread influenza-like illness among the swine. In follow-up studies, 76% of swine exhibitors tested had antibody evidence of swine flu infection but no serious illnesses were detected among this group. Additional studies suggest that one to three health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection.
How can human infections with swine influenza be diagnosed?
To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 7 days or longer. Identification as a swine flu influenza A virus requires sending the specimen to CDC for laboratory testing.
What medications are available to treat swine flu infections in humans?
There are four different antiviral drugs that are licensed for use in the US for the treatment of influenza: amantadine, rimantadine, oseltamivir and zanamivir. While most swine influenza viruses have been susceptible to all four drugs, the most recent H1N1 influenza viruses isolated from humans are resistant to amantadine and rimantadine.
What other examples of swine flu outbreaks are there?
Probably the most well known is an outbreak of swine flu among soldiers in Fort Dix, New Jersey in 1976. The virus caused disease with x-ray evidence of pneumonia in at least 4 soldiers and 1 death; all of these patients had previously been healthy. The virus was transmitted to close contacts in a basic training environment, with limited transmission outside the basic training group. The virus is thought to have circulated for a month and disappeared. The source of the virus, the exact time of its introduction into Fort Dix, and factors limiting its spread and duration are unknown. The Fort Dix outbreak may have been caused by introduction of an animal virus into a stressed human population in close contact in crowded facilities during the winter. The swine influenza A virus collected from a Fort Dix soldier was named A/New Jersey/76 (Hsw1N1).
Swine Flu in Pigs
How does swine flu spread among pigs?
Swine flu viruses are thought to be spread mostly through close contact among pigs and possibly from contaminated objects moving between infected and uninfected pigs. Herds with continuous swine flu infections and herds that are vaccinated against swine flu may have sporadic disease, or may show only mild or no symptoms of infection.
What are signs of swine flu in pigs?
Signs of swine flu in pigs can include sudden onset of fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed.
How common is swine flu among pigs?
H1N1 and H3N2 swine flu viruses are endemic among pig populations in the United States and something that the industry deals with routinely. Outbreaks among pigs normally occur in colder weather months (late fall and winter) and sometimes with the introduction of new pigs into susceptible herds. Studies have shown that the swine flu H1N1 is common throughout pig populations worldwide, with 25 percent of animals showing antibody evidence of infection. In the U.S. studies have shown that 30 percent of the pig population has antibody evidence of having had H1N1 infection. More specifically, 51 percent of pigs in the north-central U.S. have been shown to have antibody evidence of infection with swine H1N1. Human infections with swine flu H1N1 viruses are rare. There is currently no way to differentiate antibody produced in response to flu vaccination in pigs from antibody made in response to pig infections with swine H1N1 influenza.
Is there a vaccine for swine flu?
Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine will likely help provide partial protection against swine H3N2, but not swine H1N1 viruses.
WHO Chief declares Swine Flu Speading with ‘Unprecedented Speed’
By Shirley S. Wang
July 16, 2009
The World Health Organization says it’s going to stop counting cases of the new H1N1 flu, according to a note posted on its website.
The virus is spreading with “unprecedented speedâ€, wrote the WHO. “At this point, further spread of the pandemic, within affected countries and to new countries, is considered inevitable.â€
But countries need to continue to closely monitor “unusual events†like clusters of severe virus infections or unusual patterns of these serious cases. These signals might come from noticing an increase in the number of people staying home from work or school, or by an increase in emergency room visits.
Obese Suffer Most from Swine Flu
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July 11, 2009
The swine flu, like Brett Favre, is a subject that just won’t go away. Despite the fact that we all wish we didn’t have to hear about it, it still makes news. The latest bit is that researchers believe there is a link between the disease and obesity.
While anyone (obese or not) can still get the swine flu, there is some question as to how well a patient can recover from the disease if they are obese.
Apparently “health officials in the U.S. and Europe said, after a report showed a “striking†prevalence of obesity among patients hospitalized in Michigan.†The report indicated that when the obese were hit with swine flu, they became “severely ill†even if they didn’t have any other health problems.
 Image: sxc.hu
H1N1 pandemic spreading too fast to count – WHO
 
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Thu Jul 16, 2009 1:10pm EDT
 * H1N1 virus has spread more quickly than other pandemics
* WHO says pointless to count individual cases
* But countries should track deaths, unusual patterns
By Stephanie Nebehay
GENEVA, July 16 (Reuters) – The World Health Organisation (WHO) said on Thursday that the H1N1 flu pandemic was the fastest-moving pandemic ever and that it was now pointless to count every case.
The United Nations agency, which declared an influenza pandemic on June 11, revised its requirements so that national health authorities need only report clusters of severe cases or deaths caused by the new virus or unusual clinical patterns.
“The 2009 influenza pandemic has spread internationally with unprecedented speed. In past pandemics, influenza viruses have needed more than six months to spread as widely as the new H1N1 virus has spread in less than six weeks,” it said in a statement on the new strain, commonly known as swine flu.
It has become nearly impossible for health authorities and laboratories to keep count of individual cases — which have mostly been mild — as the virus spreads, according to the 193 member-state agency.
Flu experts say at least a million people are infected in the United States alone, and the WHO says the pandemic is unstoppable.
“It is very much agreed that trying to register and report every single case is a huge waste of resources,” WHO spokesman Gregory Hartl said.
Such tracking has limited authorities’ capacity to investigate serious cases and is no longer essential to monitor the level or nature of the risk posed by the virus, WHO said.
However, all countries should still closely monitor unusual clusters of severe or fatal infections from the pandemic virus, clusters of respiratory illness requiring hospitalisation or unexplained or unusual clinical patterns.
“Signals to be vigilant for include spikes in rates of absenteeism from schools or workplaces, or a more severe disease pattern, as suggested by, for example, a surge in emergency department visits,” it said.
Britain reported on Thursday that 29 people had died to date after contracting the virus. Health Minister Andy Burnham said this month the government was projecting more than 100,000 new cases a day of the flu in the country by the end of August.
The WHO will no longer issue global tables showing the numbers of confirmed cases for all countries — which stood at 94,512 cases with 429 deaths as of its last update on July 6.
Instead, it will issue regular updates on the situation in newly affected countries, which should report the first confirmed cases, weekly figures and epidemiological details.
Countries should still test a limited number of virus samples weekly to confirm that disease is actually due to the pandemic virus and to monitor any virological changes that may be important for the development of vaccines, it said.
At least 50 governments have placed orders for vaccines against the new H1N1 strain or negotiating with drug makers, WHO vaccine chief Marie-Paule Kieny told Reuters. [ID:nLG225946]
The WHO does not report figures for cases of seasonal influenza, which it says is linked to 250,000 to 500,000 deaths a year globally. (For the WHO statement go to: here) (Additional reporting by Peter Griffiths in London)
Swine flu will keep one in eight workers at home
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July 17, 2009
Businesses will be crippled within two months as swine flu forces one in eight workers to stay at home, according to official figures Marie Claire has obtained.
Across the first wave of the pandemic this summer up to 30% of the population may catch swine flu, the figures suggest. It is feared that the combination of high sickness levels and holiday absences will put pressure on businesses already struggling with the recession.
Cases of swine flu have risen by almost 50% in a week, figures suggested on Wednesday, as Sir Liam Donaldson the Chief Medical Officer said that ‘glitches’ could delay delivery of the first vaccine against the virus.
The infection is continuing to spread and new ‘hot spots’ of disease are emerging, according to experts. In some parts of England, reported cases of influenza-like illness have increased sixfold over the past seven days.
There has been a slight fall in London, although the capital remains the worst affected area. The number of infections remains high in Birmingham, and Leicester is starting to see large numbers of patients affected.
Sir Liam said he expected that the first doses of the vaccine against the virus would be available towards the end of August. ‘That is assuming that the manufacturers continue to produce it in the way that is scheduled,’ he said. ‘It is a complex process and sometimes there can be glitches.’
Researchers have said that early tests indicate yields of the vaccine could be smaller than those expected with normal seasonal flu. This could potentially lengthen the production process, although new strains of the injection are currently being developed to try to improve yield.
Spreading the word about swine flu
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Although  swine flu isn’t the permanent news headline it was a few months ago, it’s still very much a virus whose spread and effects around the world become more alarming-looking whenever news about it is reported.
That’s beginning to happen again with increasing frequency.
Here in the UK, we’ve had 17 deaths so far, reported infections are more than 9,700, and the government has moved its health focus from containment to treatment. There’s even talk about vaccinating the entire population (there’s 60 million of us here).
One thing seems clear to me and that is the compelling need for reliable information, to understand the risks this virus presents, what to do about it and who to go to for help and advice.
All this needs to be done in a way that doesn’t tie up healthcare resources providing information to people that’s better done on a self-service basis.
In many countries, governments and others are providing news and information via many channels: toll-free phone numbers, the web, printed material, etc.
There’s lots of information, unquestionably, especially online.
Much of that information, though, is contradictory, inconsistent, hard to understand clearly and, above all, unreliable.
So a post on ReadWriteWeb reporting an initiative between Wikipedia and the US National Institutes of Health suggests a great way forward in creating useful and reliable content for online consumption on Wikipedia.
[…] Some of the nation’s top health, science, and medical minds will take a one day course on the mechanics and formatting of Wikipedia. Said Sue Gardner, executive director of the Wikimedia Foundation, “With the broad range of experts from the National Institutes of Health, we see a great opportunity for increasing the quality of all health-related information on Wikipedia.”
This is a significant event, not only because the Wikipedia Academy training will be the first of its kind in the US, but also because Wikipedia is often at the top of results when the general public searches for online health information.
The bold text is my emphasis. That’s what I see here, too – in any Google search on words like ‘flu,’ ‘swine flu,’ influenza,’ even the official name ‘influenza A(H1N1),’ the Wikipedia entry is usually in the first 5 results.
According to the Wikipedia blog, the 2009 swine flu pandemic page “got about 16,000 page hits on April 23, and this number increased to a dizzying 2.86 million page hits only a week later.” The article began as a mere stub and has since expanded to a  21 page article with multiple iterations and discussions.
It’s a terrific idea, one that captures the  wisdom of the crowd and could provide complementary information to that already available. I can’t see any reason why similar training couldn’t happen here in the UK.
[Later] A BBC News report this morning says that the number of people in the UK contacting their doctor over fears they have swine flu has jumped almost 50% in the last week to 40,000 a week.
The news report also says that, in evidence to a  House of Lords committee, the Royal College of GPs said concerns had been raised about a lack of information and out of hours care.
Complaints include poor communication from primary care trusts and different advice on obtaining Tamiflu.
The Department of Health says it listens to feedback and works with the Royal College to improve its response.
All the more reason for employing all effective means at providing access to reliable and timely information.
