Archive for the ‘H1N1 Swine Flu Updates’ Category
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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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)
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.”
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.”
