HOW TO AVOID THE FLU

2013-08-06T21:22:00.001-07:00

H7N9 Bird Flu Drug Resistance a Concern

The researchers said resistance emerged with "apparent ease" and was "concerning". There have been no new cases of the infection for more than two weeks. Resistance. Doctors analysed the virus in 14 patients. All had pneumonia and half needed ventilation to keep them alive.

Treatment with antivirals reduced levels of H7N9 in most patients and led to an improvement in symptoms. Yet the treatment failed in three patients. Genetic testing of the virus in these patients showed it had acquired the mutations needed to resist the drugs. The doctors believe that in at least one patient the emergence of resistance was a direct consequence of treatment with Tamiflu.
Such antiviral drugs are the only way of treating the infection.

The researchers said: "The apparent ease with which antiviral resistance emerges in H7N9 viruses is concerning, it needs to be closely monitored and considered in future pandemic response plans."
There have been 131 confirmed cases and 36 deaths since the virus was first reported early this year.
However, the most recent case reported was on 8 May. Efforts to close poultry markets are thought to have significantly reduced the spread of the virus.

By James Gallagher Health and science reporter, BBC News
Sourced from www.bbc.com

2013-08-06T21:13:00.001-07:00

Researchers have reported the first case of human-to-human transmission of the new strain of bird flu that has emerged in China.

The British Medical Journal said a 32-year-old woman was infected after caring for her father. Both later died. Until now there had been no evidence of anyone catching the H7N9 virus other than after direct contact with birds. But experts stressed it does not mean the virus has developed the ability to spread easily between humans.

By 30 June there had been 133 cases of H7N9 bird flu reported in eastern China and 43 deaths.
Most people had visited live poultry markets or had close contact with live poultry in the week or two before they became ill.

Intensive care
Yet researchers found that the 32-year-old woman had become infected in March after caring for her 60-year-old father in hospital. Unlike her father - who had visited a poultry market in the week before falling ill - she had no known exposure to live poultry but fell ill six days after her last contact with him.
Both died in intensive care of multiple organ failure.

Tests on the virus taken from both patients showed the strains were almost genetically identical, which supports the theory that the daughter was infected directly from her father rather than another source.
Public health officials tested 43 close contacts of the patients but all tested negative for H7N9, suggesting the ability of the virus to spread was limited.

The researchers said that while there was no evidence to suggest the virus had gained the ability to spread from person to person efficiently, this was the first case of a "probable transmission" from human to human.

Strong warning sign

"Our findings reinforce that the novel virus possesses the potential for pandemic spread," they concluded. Dr James Rudge, of the London School of Hygiene and Tropical Medicine, said that limited transmission between humans is not surprising and has been seen before in other bird flu viruses, such as H5N1. He added: "It would be a worry if we start to see longer chains of transmission between people, when one person infects someone else, who in turn infects more people, and so on. "And particularly if each infected case goes on to infect, on average, more than one other person, this would be a strong warning sign that we might be in the early stages of an epidemic".

An accompanying editorial in the BMJ, co-authored by Dr Rudge, concluded that while this study might not suggest that H7N9 is any closer to delivering the next pandemic, "it does provide a timely reminder of the need to remain extremely vigilant".

Sourced from www.bbc.com

2013-04-04T01:58:00.003-07:00

Frequently Asked Questions on human infection with influenza A(H7N9) virus, China

Update as of 3 April 2013

1. What is the influenza A(H7N9) virus?

Influenza A H7 viruses are a group of influenza viruses that normally circulate among birds. The influenza A(H7N9) virus is one subgroup among the larger group of H7 viruses. Although some H7 viruses (H7N2, H7N3 and H7N7) have occasionally been found to infect humans, no human infections with H7N9 viruses have been reported until recent reports from China.

2. What are the main symptoms of human infection with influenza A(H7N9) virus?

Thus far, patients with this infection have had severe pneumonia. Symptoms include fever, cough and shortness of breath. However, information is still limited about the full spectrum of disease that infection with influenza A(H7N9) virus might cause.

3. How many human cases of influenza A(H7N9) virus have been reported in China to date?

As of 3 April 2013, seven laboratory-confirmed cases have been detected in China. Details of the most current information on cases can be found in Disease Outbreak News.

4. Why is this virus infecting humans now?

We do not know the answer to this question yet, because we do not know the source of exposure for these human infections. However, analysis of the genes of these viruses suggests that although they have evolved from avian (bird) viruses, they show signs of adaption to growth in mammalian species. These adaptations include an ability to bind to mammalian cells, and to grow at temperatures close to the normal body temperature of mammals (which is lower than that of birds).

5. What is known about previous human infections with H7 influenza viruses globally?

From 1996 to 2012, human infections with H7 influenza viruses (H7N2, H7N3, and H7N7) were reported in Netherlands, Italy, Canada, USA, Mexico and the United Kingdom. Most of these infections occurred in association with poultry outbreaks. The infections mainly resulted in conjunctivitis and mild upper respiratory symptoms, with the exception of one death, which occurred in the Netherlands. Until now, no human infections with H7 influenza viruses have been reported in China.

6. Is the influenza A(H7N9) virus different from influenza A(H1N1) and A(H5N1) viruses?

Yes. All three viruses are influenza A viruses but they are distinct from each other. H7N9 and H5N1 are considered animal influenza viruses that sometimes infect people. H1N1 viruses can be divided into those that normally infect people and those that normally infect animals.

7. How did people become infected with the influenza A(H7N9) virus?

Some of the confirmed cases had contact with animals or with an animal environment but the virus has not thus far been found in animals. It is not yet known how these persons became infected. The possibility of animal-to-human transmission is being investigated, as is the possibility of person-to-person transmission.

8. How can infection with influenza A(H7N9) virus be prevented?

Although both the source of infection and the mode of transmission are uncertain, it is prudent to follow basic hygienic practices to prevent infection. They include hand and respiratory hygiene and food safety measures.

Hand hygiene:
• Wash your hands before, during, and after you prepare food; before you eat; after you use the toilet; after handling animals or animal waste; when your hands are dirty; and when providing care when someone in your home is sick. Hand hygiene will also prevent the transmission of infections to yourself (from touching contaminated surfaces) and in hospitals to patients, health care workers and others.
• Wash your hands with soap and running water when visibly dirty; if not visibly dirty, wash your hands with soap and water or use an alcohol-based hand cleanser.

Respiratory hygiene:
• Cover your mouth and nose with a medical mask, tissue, or a sleeve or flexed elbow when coughing or sneezing; throw the used tissue into a closed bin immediately after use; perform hand hygiene after contact with respiratory secretions.

9. Is it safe to eat meat, i.e. poultry and pork products?

Although we do not yet know the mode of transmission, it is prudent to follow basic principles of hygienic food preparation, as follows: Diseased animals should not be eaten. Otherwise, it is safe to eat properly prepared and cooked meat. Because influenza viruses are inactivated by sufficient heating, normal temperatures used for cooking (such that food reaches 70°C in all parts— "piping" hot — no "pink" parts) will kill the virus. In areas experiencing outbreaks, meat products can be safely consumed provided that these items are properly cooked and properly handled during food preparation. The consumption of raw meat and uncooked blood-based dishes is a high-risk practice and is discouraged. Always keep raw meat separate from cooked or ready-to-eat foods to avoid contamination. Do not use the same chopping board or the same knife for raw meat and other foods. Do not handle both raw and cooked foods without washing your hands in between and do not place cooked meat back on the same plate or surface it was on before cooking. Do not use raw or soft-boiled eggs in food preparations that will not be heat treated or cooked. After handling raw meat, wash your hands thoroughly with soap and water. Wash and disinfect all surfaces and utensils that have been in contact with raw meat.

10. Is there a vaccine for the influenza A(H7N9) virus?

No vaccine for the prevention of influenza A(H7N9) infections is currently available. However, viruses have already been isolated and characterized from the initial cases. The first step in development of a vaccine is the selection of candidate viruses that could go into a vaccine. WHO, in collaboration with partners, will continue to characterize available influenza A(H7N9) viruses to identify the best candidate viruses. These candidate vaccine viruses can then be used for the manufacture of vaccine if this step becomes necessary.

11. Does treatment exist for influenza A(H7N9) infection?

Laboratory testing conducted in China has shown that the influenza A(H7N9) viruses are sensitive to the anti-influenza drugs known as neuraminidase inhibitors (oseltamivir and zanamivir). When these drugs are given early in the course of illness, they have been found to be effective against seasonal influenza virus and influenza A(H5N1) virus infection. However, at this time, there is no experience with the use of these drugs for the treatment of H7N9 infection.

12. Is the general population at risk from the influenza A(H7N9) virus?

We do not yet know enough about these infections to determine whether there is a significant risk of community spread. This possibility is the subject of epidemiological investigations that are now taking place.

13. Are health care workers at risk from the influenza A(H7N9) influenza virus?

Health care workers often come into contact with patients with infectious diseases. Therefore, WHO recommends that appropriate infection prevention and control measures be consistently applied in health care settings, and that the health status of health care workers be closely monitored. Together with standard precautions, health care workers caring for those suspected or confirmed to have influenza A(H7N9) infection should use additional precautions (http://www.who.int/csr/resources/publications/swineflu/WHO_CDS_EPR_2007_6/en/index.html).

14. What investigations have begun?

Local and national health authorities are taking the following measures, among others:
• Enhanced surveillance for pneumonia cases of unknown origin to ensure early detection and laboratory confirmation of new cases;
• Epidemiological investigation, including assessment of suspected cases and contacts of known cases;
• Close collaboration with animal health authorities to determine the source of the infection.

15. Does this influenza virus pose a pandemic threat?

Any animal influenza virus that develops the ability to infect people is a theoretical risk to cause a pandemic. However, whether the influenza A(H7N9) virus could actually cause a pandemic is unknown. Other animal influenza viruses that have been found to occasionally infect people have not gone on to cause a pandemic.

16. Is it safe to travel to China?

The number of cases identified in China is very low. WHO does not advise the application of any travel measures with respect to visitors to China nor to persons leaving China.

17. Are Chinese products safe?

There is no evidence to link the current cases with any Chinese products. WHO advises against any restrictions to trade at this time.

Sourced from the WHO (World Health Organization) web site.

2013-04-04T01:47:00.005-07:00

China: Four more infected with H7N9 bird flu

H7N9 is a form of bird flu

A further four cases of a bird flu virus not previously seen in humans have been reported by authorities in China. Three women aged 32, 45 and 48, and an 83-year-old man were diagnosed between 19 and 21 March and are critically ill. There have now been seven confirmed cases of the H7N9 virus, the World Health Organization said. Two people have died. But the WHO says there is no evidence of human-to-human transmission. However more than 160 people who have had contact with the individuals are being closely monitored. So far, none has developed symptoms.

The latest cases were seen in the Jiangsu province while the earlier cases were in the Shanghai and Anhui provinces. Two contacts of one of the Shanghai cases who developed symptoms are being retrospectively investigated. One died and the other recovered, but as yet there has been no laboratory confirmation of whether they were infected with H7N9.

Hygiene measures

The Chinese government has increased disease surveillance, infection prevention and control and communication between human and animal health and industry sectors.

" By identifying the source of infection measures can be taken to reduce human exposure”

Dr John McCauley MRC National Institute for Medical Research

It has advised the population to maintain good personal hygiene, including frequent hand-washing and avoiding direct contact with sick or dead animals. The WHO is not recommending any travel or trade restrictions. Dr John McCauley, Director of WHO Collaborating Centre on Influenza at the MRC National Institute for Medical Research, said: "The virus belongs to the A(H7N9) sub-type, a sub-type that has not previously infected humans, and has emerged from the reservoir of avian influenza viruses.
"It is not known how the virus was transmitted. By identifying the source of infection, measures can be taken to reduce human exposure". "The Chinese Center for Disease Control and Prevention is investigating whether there has been any human-to-human transmission tests suggest the virus could be treated with the anti-influenza drugs Tamiflu and Relenza.

Sourced from the BBC web site.
www.bbc.co.uk

2013-03-18T17:10:00.005-07:00

Tamiflu-resistant swine flu spreads 'between patients'

Health officials say a Tamiflu-resistant strain of swine flu has spread between hospital patients.

Five patients on a unit treating people with severe underlying health conditions at the University Hospital of Wales, Cardiff, were infected. Three appear to have acquired the infection in hospital.
They are thought to be the first confirmed cases of person-to-person transmission of a Tamiflu-resistant strain in the world. There have been several dozen reports around the world of people developing resistance to Tamiflu while taking the drug - but they have not passed on the strain to others.
Just one possible case of person-to-person transmission of a resistant strain has been recorded - between two people at a US summer camp - and this has never been confirmed.

Two of the University Hospital of Wales patients have recovered and have been discharged from hospital; one is in critical care and two are being treated on the ward. The health officials stressed there was no risk to anyone else. They said tests were being carried out to confirm exactly what happened.
The UK has bought enough doses of Tamiflu, which can shorten the duration of swine flu and reduce the risk of complications, for half the population.

Serious concern

So any spread of a Tamiflu-resistant strain of the illness is a serious public health concern.
The H1N1 virus has been remarkably stable since it emerged in April, but virologists had been half expecting new resistant strains to emerge. Dr Roland Salmon, director of the National Public Health Service for Wales' Communicable Disease Surveillance Centre, said: "The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment.
"In this case, the resistant strain of swine flu does not appear to be any more severe than the swine flu virus that has been circulating since April." Dr Tony Jewell, Chief Medical Officer for Wales, said: "We know that people with suppressed immune systems are more susceptible to the swine flu virus, which is why they are a priority group under the first phase of the vaccination programme in Wales which is progressing at pace. "We have stringent processes in place for monitoring for antiviral resistance in the UK so that we can spot resistance early and the causes can be investigated and the cases managed.
"Identifying these cases shows that our systems are working so patients should be reassured.
"Treatment with Tamiflu is still appropriate for swine flu and people should continue to take Tamiflu when they are prescribed it. "It's also important that good hygiene practices are followed to further prevent the spread of the virus."

Professor Peter Openshaw, a respiratory physician at Imperial College London, said of the spread: "It's not surprising that this has happened, indeed it has always been anticipated". Dr Ronald Cutler, deputy director of biomedical science at Queen Mary, University of London, said: "Shortening the time taken to produce new vaccines and improving the methods to control and treat the disease while vaccines are being made would be a way forward". On Thursday it was announced that more than three million healthy children under five across the UK will be offered the swine flu jab. Figures released on Thursday showed an estimated 53,000 new cases of swine flu in England in the last week, down from 64,000 in the week before. In Scotland, the figure was 21,200, down from about 21,500 in the previous seven days.
The rate of flu-like illnesses diagnosed by GPs in Wales dropped to 36 cases for every 100,000 people from 65.8 the previous week.

By Fergus Walsh
Health correspondent, BBC News

2013-03-18T17:06:00.004-07:00

DRUG RESISTANT FLU WARNING

Australian experts are concerned about the threat of a new type of drug-resistant pandemic flu that is circulating in the population at large. The swine flu strain has learned how to dodge the antiviral Tamiflu and, though rare, is emerging outside of hospitals. The team who have studied it say the virus is "fitter" than other drug-resistant strains and the world should be on alert for outbreaks.

UK experts say they have seen a handful of similar cases. The UK's Health Protection Agency said it would be closely monitoring the situation. The Australian investigators presented their findings at a meeting on major infectious diseases.

Swine flu

H1N1 caused a swine flu pandemic (an extensive outbreak in many countries) in 2009 infecting a fifth of the population
Many people now have some immunity to H1N1 as a result of this exposure
Vaccines are available that can stop H1N1 infections
Some people - the sick, elderly, young infants and pregnant women - are at particular risk of complications of they catch H1N1
Antiviral drugs like Tamiflu can lessen the severity of symptoms in those who catch H1N1

Experts at the Annual Scientific Meeting of the Australasian Society for Infectious Diseases heard how the 'H1N1pdm09' swine flu virus is still sensitive to another antiviral drug Relenza (zanamivir).

But Tamiflu (oseltamivir) is now powerless against the strain that has been found in people in the community rather than sick patients with serious underlying conditions and weak immune systems.
Vaccines can prevent infection occurring in the first place.

Lead investigator Dr Aeron Hurt, from the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne, said: "The greatest concern is that these resistant viruses could spread globally, similar to that seen in 2008 when the former seasonal H1N1 virus developed oseltamivir resistance and spread worldwide in less than 12 months."
The new strain that they have been examining is emerging among people who have never been treated with Tamiflu, suggesting it is very good at spreading from person to person.
Dr Hurt says animal studies by his team confirm this. Although the Tamiflu-resistant strain is still relatively rare, affecting about 2% of people with swine flu in the Australian population that they studied, Dr Hurt is concerned that it has the potential to turn global. Similar resistant strains have been detected in Europe but at this stage only on an ad hoc basis, says Dr Hurt. "The widespread transmission and circulation of oseltamivir-resistant H1N1pdm09 viruses remains a risk in the future. "Close monitoring of resistant viruses in both treated and community patients remains important."

Pandemic potential In the UK, the HPA has recorded eight cases of oseltamivir-resistant H1N1pdm09 in the community setting. The HPA's head of flu surveillance Dr Richard Pebody said: "While the frequency of oseltamivir resistance in community settings has increased slightly since the 2009-10 pandemic from 1-2% in the 2012/13 flu season, rates of detection remain low." Swine flu (H1N1) infected a fifth of people during the first year of the pandemic in 2009, data suggest.
It is thought the virus killed 200,000 people globally. Although the pandemic has been declared by officials as over, the virus is still circulating. During the pandemic, the H1N1 virus crowded out other influenza viruses to become the dominant virus. This is no longer the case. Many countries are reporting a mix of influenza viruses.

Sourced from www.bbc.com

H1N1 STILL CIRCULATING

2010-01-07T18:18:00.000-08:00

The CDC is encouraging more people to get vaccinated against the H1N1 virus.

"Many people are still susceptible ... and would benefit from vaccination," says official
At least 60 million Americans have received the H1N1 vaccine, says CDC official
136 million doses are currently available for states to order, official says

Washington (CNN) -- The H1N1 influenza virus is still circulating and causing illness, hospitalization and death, the Centers for Disease Control and Prevention said Thursday as officials made another call for vaccination.

"Many people are still susceptible to this virus and would benefit from vaccination," said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the CDC. "We want to avoid complacency. We have a very good supply of the H1N1 vaccine all around the country."
Schuchat estimated that at least 60 million Americans have received the H1N1 vaccine. She said 136 million doses are currently available for states to order and should be easily accessible through doctor's offices, local health departments, community and school clinics as well as pharmacies and retail centers.

Four states -- Delaware, New Jersey, Maine and Virginia -- still report widespread H1N1 activity. Schuchat said that while the number of people getting sick is declining, officials are still seeing more activity than is usual for this time of year. And it's all H1N1, as seasonal flu strains have yet to emerge she said.

According to the CDC, there was a slight increase in flu-like illness cases presenting at doctors offices and emergency rooms last week, and a rise in pneumonia and/or influenza deaths this past week.
Expecting the virus to continue circulating for some time, Schuchat is urging doctors to "stay vigilant" by continuing to test patients with severe respiratory illness in an effort to prevent additional cases. But she stressed vaccination is still the best course of action.

"I am concerned that people maybe complacent, that people may think this is all over. I would hate for people to make decisions thinking this is over and then get sick or severely ill," Schuchat said. Vaccinations provide a "chance for people to protect themselves and reduce the risk of serious complications. So I think complacency is probably our top enemy right now."
The CDC is kicking off National Influenza Vaccine Week this weekend, a campaign designed to encourage more to get vaccinated, particularly those considered to be at high risk for complications -- pregnant women, adults with chronic complications like emphysema, seniors and children who have yet to be vaccinated.

Schuchat said she doesn't know if the unusually cold temperatures sweeping the country will result in flu transmission, but vaccination will help reduce that risk.
With the flu season fully underway, health officials say now is the time for children under the age of 9 to receive a second dose of the H1N1 vaccine.
Health and Human Services Secretary Kathleen Sebelius visited Carlin Springs Elementary School in Arlington County, Virginia, Thursday, as more than 200 students lined up to receive a second round of the vaccine.

She praised Arlington County officials for their school-based flu clinics.

By Saundra Young CNN

January 7, 2010 8:30 p.m. EST

COMPARING FLU DEATHS

2010-01-07T03:15:00.000-08:00

PANDEMIC vs. SEASONAL

Pandemic (H1N1)

22 DECEMBER 2009 | GENEVA -- Efforts to assess the severity of the H1N1 influenza pandemic sometimes compare numbers of confirmed deaths with those estimated for seasonal influenza, either nationally or worldwide. Such comparisons are not reliable for several reasons and can be misleading.
Numbers of deaths for seasonal influenza are estimates. They use statistical models designed to calculate so-called excess mortality that occurs during the period when influenza viruses are circulating widely in a given population.

Estimates using all-cause mortality

The models use data, as recorded in death certificates and medical records, indicating mortality from all causes, and compare the number of deaths during epidemics of seasonal influenza with baseline data on deaths during the rest of the year. The assumption is that infections with influenza viruses contribute to the “excess mortality” observed during the influenza season.
During epidemics of seasonal influenza, around 90% of deaths occur in the frail elderly, who often suffer from one or more chronic medical conditions. Although influenza can worsen these conditions and contribute to death, testing for influenza viruses is not done in most cases, and deaths are usually attributed to an underlying medical condition.
Methods for estimating excess mortality were introduced in the 19th century to capture these influenza-associated deaths that would otherwise be missed. Such estimates have helped counter assumptions that influenza is a mild illness that rarely kills.

Laboratory-confirmed deaths

In contrast, numbers of deaths from pandemic influenza, as notified by national authorities and tabulated by WHO, are laboratory-confirmed deaths, not estimates. For several reasons, these numbers do not give a true picture of mortality during the pandemic, which is unquestionably higher than indicated by laboratory-confirmed cases.
As pandemic influenza mimics the signs and symptoms of many common infectious diseases, doctors often do not suspect H1N1 infection and do not test. This is especially true in developing countries, where deaths from respiratory diseases, including pneumonia, are common occurrences. Moreover, routine testing for pandemic influenza is costly and demanding, and beyond the reach of most countries.
When testing confirms H1N1 infection in patients with underlying medical conditions, many doctors record these deaths as due to the medical condition, and not to the pandemic virus. These cases are also missed in official statistics.
As recent studies have shown, some tests for H1N1 infection are not entirely reliable, and false-negative results are a frequent problem. Accurate test results further depend on how and when samples were taken. Even in the best-equipped hospitals, doctors have reported seeing patients with distinctive and virtually identical disease profiles, yet only some have positive test results.
Moreover, in a large number of developing countries, systems for vital registration are either weak or non-existent, meaning that most deaths are neither investigated nor certified in terms of the cause.

Younger age groups

Comparisons of deaths from pandemic and seasonal influenza do not accurately measure the impact of the pandemic for another reason. Compared with seasonal influenza, the H1N1 virus affects a much younger age group in all categories – those most frequently infected, hospitalized, requiring intensive care, and dying.
WHO continues to assess the impact of the influenza pandemic as moderate. Accurate assessments of mortality and mortality rates will likely be possible only one to two years after the pandemic has peaked, and will rely on methods similar to those used to calculate excess mortality during seasonal influenza epidemics.

...sourced from the WHO

MASSIVE VACCINE RECALL - 800,000 DOSES

2009-12-15T18:29:00.000-08:00

STORY HIGHLIGHTS

Safety, effectiveness of vaccine is not at issue, manufacturer and CDC emphasize
Sanofi Pasteur is voluntarily recalling about 800,000 doses
CDC: The four batches were shipped in November, distributed throughout U.S.
Spokesman: Recalled vaccine was 12 percent below the point where it should have been

Sanofi Pasteur produces these vials of H1N1 vaccine in France.

U.S. version is made in Pennsylvania

(CNN) -- One of the five manufacturers supplying H1N1 vaccine to the United States is recalling hundreds of thousands of flu shots because they aren't as potent as they should be.
The French manufacturer Sanofi Pasteur is voluntarily recalling about 800,000 doses of vaccine meant for children between the ages of 6 months and 35 months.

The company and the Centers for Disease Control and Prevention emphasized that the recall was not prompted by safety concerns, and that even though the vaccine isn't quite as potent as it's supposed to be, children who received it don't have to be immunized again against H1N1.
The CDC emphasized that there is no danger for any child who received this type of vaccine.
When asked what parents should do, CDC spokesman Tom Skinner said, "absolutely nothing." He said if children receive this vaccine, they will be fine.

Sanofi Pasteur spokesman Len Lavenda said that the company's test results found the recalled vaccine's potency was 12 percent below the point where it should have been. He added that the company has done studies in the past that showed "vaccine containing as little as half of the recommended dosage" still created the necessary immune response in children.

Lavenda said Sanofi Pasteur has never had this happen with a flu vaccine before, and the company is having all of its experts investigate the cause of this loss in potency.
Lavenda told CNN that it takes about three to four months to produce flu vaccine. He said 85 percent of that time is spent on testing.

"In order for vaccine to move to next phase of production it [the vaccine] has to pass all tests and at the end, it has to pass another battery of tests before it can be shipped out," Lavenda said. The company also keeps samples of each batch of vaccine, "to periodically test them to see if they stay within specification until expiration date."

Four batches -- or lots -- of H1N1 vaccine in question were shipped in early November. Lavenda said all four lots passed every test before they left the factory. However, on December 7, the company learned that all "four lots we tested failed," according to the spokesman.
That's when the company notified the CDC and the Food and Drug Administration, which asked them to retest the samples. Results from the subsequent sample came in on Monday, according to Lavenda, who said it takes about a week to complete these tests.

According to Sanofi Pasteur, it is unclear how many doses of this particular vaccine are still in circulation. This particular vaccine was targeted for infants and toddlers between the ages of 6 months and 35 months -- children who need to get two shots several weeks apart, but only get half of a regular dose each time.

The vaccine was shipped in 0.25-milliliter pre-filled syringes, which contain half a dose of vaccine in each shot. Children 3 years old and older would have been given a shot with a full dose.
According to the CDC's vaccine recommendations, children younger than 9 years need to have two flu shots to be fully protected against the H1N1 virus.

The CDC's Skinner said there is scientific evidence that when there's a slight drop in vaccine potency, the immune response is still sufficient.

"We're very confident that children who received this vaccine are properly protected, provided that they get the second dose that is recommended," Skinner said.
According to the CDC, this vaccine was distributed throughout the United States. Doctors and providers are urged to check their vaccines and return any to Sanofi Pasteur if they come from the following lots:

0.25 mL pre-filled syringes, 10-packs (NDC . 49281-650-25, sometimes coded as 49281-0650-25): UT023DA, UT028DA, UT028CB

0.25 mL pre-filled syringes, 25-packs (NDC . 49281-650-70, sometimes coded as 49281-0650-70): UT030CA.

The vaccine was manufactured in Sanofi Pasteur's Swiftwater, Pennsylvania, factory.

...reblog from www.cnn.com

NATURAL WAYS TO AVOID FLU

2009-12-11T01:05:00.000-08:00

With cold and flu season in full bloom, it is important to discuss the H1N1 vaccine and regular flu vaccine with your doctor. It is also more important than ever to bolster your immune system right now.

Here are some natural, simple solutions that will help you during this season!

Treat your body right - Encourage your body to fight flu and other infections by giving it the care it needs.

Get at least seven hours of quality uninterrupted sleep every night. Studies show that the average immune system function drops by an average of 60% after just three nights of poor sleep.
Keep your stress level low with meditation, tai chi, or yoga. It is well known that stress hormones stress the immune system and make one susceptible to cold, flu, and infections.
Dry body brushing daily and slough off dead skin, activate surface immunity, promote lymph circulation that is important to clear out toxic debris, and stimulate immune function.

Stimulate your thymus - Your thymus is a golf ball sized gland located behind your sternum in the center of your chest. He plays a critical role in the functioning of the lymphatic and immune systems.

To Support thymus Health, chinese medicine devised a simple way to stimulate your thymus using acupressure. With your index and middle finger together, gently tap against the sternum (midway between the nipples ) 50 times, in the morning and the evening.

Chestnuts bolsters immunity.

Chestnuts differ from other nuts with their low-fat content and high fiber. An excellent source of potassium, folate, vitamins B6 and C, chestnut strengthen the kidney-adrenal system and bolster the immune system to fight off the flu and combat infections.
This FLU season, introduce more chestnuts into your cooking, they are good oven roasted, cooked with chicken, lamb, or other meats, or in any dish with beans and legumes.

Immune supporting herbs - You can use the following herbs to help strengthen your immune system.

Ligustrum has been the focus of much research recently, which has revealed the herbs immune boosting functions. It's actions include increasing white blood cell production, phagocytosis, and T-lymphocyte helper cell activities.
Cherokee Rose is traditionally used to protect the body from external pathogens with its astringent properties. It is also one of the highest natural sources of vitamin C.
Honeysuckle is a natural anti-microbial herb that has been used for centuries to increase immune resistance and fight against bacterial, viral, and fungal infections.
You can find decent and other herbs in the health food stores, online.

Beta-carotene builds Immunity.

Beta carotene is a powerful antioxidant that improves immune function and promotes mucous membrane health. In fact, a 1997 study conducted by the Institute of food research in the United Kingdom suggested that the dietary intake of beta carotene can enhance cell mediated immune responses.
Eat more orange colored vegetables, including carrots, winter squash, butternut squash, pumpkins, sweet potatoes, and yams. Additionally, these are all an excellent source of vitamin C, a famous immune support.

If you feel your immune system has already been compromised and illness is on the way, see your healthcare practitioner immediately.

Do not underestimate the FLU !

Thousands of patients die of the flu and its complications each year in the US alone. Help yourself and your loved ones by keeping your immune system strong.

We wish you good health.

HYGIENE - WASHING HANDS VIDEO

2009-12-08T16:39:00.000-08:00

The VIDEO promotes effective hand hygiene for hospital patients and visitors.

Hand hygiene is the best way to prevent infection and illness.

Clean hands prevent infections. Keeping hands clean prevents illness at home, at school, and at work. Hand hygiene practices are key prevention measures in healthcare settings, in daycare facilities, in schools and public institutions, and for the safety of our food.

In healthcare settings, hand hygiene can prevent potentially fatal infections from spreading from patient to patient and from patient to healthcare worker and vice-versa.

To that end, CDC has developed resources for patients and healthcare providers.

CDC partnered with the Association for Professionals in Infection Control and Epidemiology and Safe Care Campaign to develop and launch a hand hygiene video for patients and visitors in hospitals. The video teaches two key points to patients to help prevent infections: the importance of practicing hand hygiene while in the hospital and the appropriateness of asking or reminding their healthcare providers to practice hand hygiene.

Modeled after the video that airline passengers are required to view prior to take-off on a flight, this new video is intended to be shown to patients upon admission to the hospital. The goal is to inform patients at the beginning of their hospital stay about what they can do to help prevent infections throughout the duration of their stay.

The 5-minute video begins with a brief introduction on healthcare-associated infections. It is then narrated by a nurse character named Gayle who stresses the importance of hand hygiene for both patients and healthcare providers. There are two patient room scenes in which patients and visitors model the behavior of asking one another as well as their healthcare providers to perform hand hygiene – with positive results.

CLICK HERE TO START VIDEO - ENGLISH VERSION

CLICK HERE TO START VIDEO - SPANISH VERSION

...sourced from the CDC website

BEWARE FRAUDULENT PRODUCTS

2009-12-02T11:13:00.000-08:00

Purpose of the Fraudulent Products List

This list is intended to alert consumers about Web sites that are or were illegally marketing unapproved, uncleared, or unauthorized products in relation to the 2009 H1N1 Flu Virus (sometimes referred to as the “swine flu” virus). Note that until evidence to the contrary is presented to FDA, the owner of the listed Web site is considered responsible for promoting the unapproved, uncleared, or unauthorized products. The uses related to the 2009 H1N1 Flu Virus are not necessarily being promoted by the manufacturers of the products.

Consumer Considerations about the Products List

This list does not include every Web site that is marketing products related to the 2009 H1N1 Flu Virus without FDA approval, clearance, or authorization, only those Web sites to which FDA has issued a warning letter.
Even if a Web site is not included in this list, consumers should exercise caution before purchasing over the Internet any product purporting to diagnose, mitigate, prevent, treat, or cure the 2009 H1N1 Flu Virus.
Please note that some of these products may be approved or cleared by FDA for other medical uses. The fact that a product is listed on this page indicates ONLY that the products are not cleared, approved, or authorized for the diagnosis, mitigation, prevention, treatment, or cure of the 2009 H1N1 flu virus.

Once included, all Web sites and products will remain listed. After FDA has verified that the products or the objectionable claims related to the 2009 H1N1 Flu Virus have been removed from the Web site, this information will be added to the list.
The information is current as of the date indicated. If we learn that any information is not accurate, we will revise the list as soon as possible.

View Products List
Important note: Consumers are advised that FDA has not determined whether these Web sites include products promoted for uses not related to the 2009 H1N1 Flu Virus that are also illegally marketed because they are not approved, cleared, or authorized by FDA for those other uses.

( CLICK ON THE BELOW CATEGORIES / PRODUCTS TO EXPAND )

Fraudulent Products

    Air System Products

    Antiseptic Products

    Body Wash Products

    Device Products

    Drug Products

    Gel Products

    Gloves Products

    Hand Sanitizer Products

    Herbal Extract Products

    Immunization Products

    Inhaler Products

    Kit Products

    Mask Products

    Shampoo Products

    Spray Products

    Supplement Products

    Tea Products

    Test Products

Air System Products

AUV Eliminator

AirFree

AllerAir

American Ultraviolet

Breathe More Easy

Cleanaer

Eliminator

FlexAir PAPR

Sanuvox

UV Aire

Verilux

Antiseptic Products

Silver Soft

Body Wash Products

Q-Based Solutions, Inc.

Device Products

Swine Flu Advisor

Drug Products

Zeolite

SkinWear

Soapopular

Viraban

staSAFE

Herbal Extract Products

Amrita

TCM Help Me

Immunization Products

Buy Best

Swine Flu

Inhaler Products

Flu Away

No Colds, No Flus

Kit Products

911 Water

Boss Safety

Duram

Emergency Distaster Systems

Express Medical Supplies

FlexAir PAPR

Life Secure

Q-Based Solutions, Inc.

Quake Kare

SilverCure

Mask Products

Noveko

Safe Life

SpectraShield

Triosyn

Shampoo Products

SilverCure

Spray Products

Nozin

Q-Based Solutions, Inc.

Secrets of Eden

Susan Ambrosino's Herb Club, Inc.

Supplement Products

4 Life Transfer Factor Plus

Acai Burn

Ageless Herbs

Allera

Back to Health

BioSET

Buried Treasure

CeraFlu

Defend-Rx

Dr. Coldwell's

Dr. Weil

Extreme Immunity

Fitura

Flucinex

GlycoMeds

Guardian

Health Food Emporium

Healthy Choice Nutritionals

Herbal Remedies

Hi-Tech Pharmaceuticals

Living Streams

Macro Greens

Master Supplements, Inc.

Mbi Nutraceuticals

Meridian Lifeforce, Inc

Miracle Reds

NZYMES

Natren

Nature's Health Supply

Nature's Sunshine

Perelandra

Royal Camu

Simple Clinic

Super Spectrim

Susan Ambrosino's Herb Club, Inc.

The New Silver Solution

Universal Health Services

Vitacroft

Wellness Resources

Tea Products

TCM Discovery

TCM Help Me

Test Products

LightMix

Luminex

Prodesse

SURGICAL MASK vs. RESPIRATOR

2009-11-28T14:14:00.000-08:00

THIS IS THE N95 RESPIRATOR

A preliminary report suggesting that N95 respirators -- filtering devices worn over the mouth and nose -- protect against swine FLU better than surgical face masks seems to be incorrect, researchers revealed during a meeting of the Infectious Diseases Society of America (IDSA).

In fact, surgical face masks, which are cheaper and easier to wear, may be just as good as N95 respirators. At the very least, researchers can't prove that one is better than the other. It's the latest wrinkle in a continuing debate over how to protect health-care workers from the H1N1 virus, also known as swine flu.

THESE ARE SURGICAL MASKS

Raina MacIntyre, Ph.D., a professor of infectious diseases epidemiology and the head of the University of New South Wales School of Public Health and Community Medicine, in Sydney, Australia, says the research team didn't exactly retract the findings.

"I would certainly wear an N95 respirator if I were exposed to infectious patients". --Raina MacIntyre, Ph.D.

For the new analysis, the researchers removed a control group of nearly 500 health-care workers and made other statistical adjustments. Ultimately, the difference in infection rates between mask and respirator users was not statistically significant.

"[The study] still shows a likely superiority of N95s, with half the rate of infection compared to surgical [masks]," MacIntyre says. "But the study was probably underpowered to pick up statistical significance when we removed the control group."

The N95 respirator is a tightly fitted facial mask designed to filter out even very fine airborne particles, according to the U.S. Food and Drug Administration. Looser-fitting surgical masks protect against large-particle droplets, splashes, sprays, or splatter, the FDA says, but they don't completely block the germs from coughs and sneezes.

To figure out which protective device is best, MacIntyre and her colleagues tracked hospital workers in Beijing, China, who wore surgical masks or N95 respirators, and compared rates of influenza and respiratory illness. Preliminary findings were presented at a meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy in September 2009. Final results have yet to be published.

.......sourced from health.com

NEW VACCINE AND UPDATE

2009-11-28T13:27:00.000-08:00

STORY HIGHLIGHTS

The U.S. Food and Drug Administration said Friday it has approved a new vaccine to prevent seasonal influenza.Agriflu, made by Novartis Vaccines and Diagnostics, is not intended to protect against the H1N1 virus, commonly known as swine flu.

The vaccine was approved using an accelerated approval process, the FDA said. Novartis demonstrated that the vaccine induces levels of antibodies in the blood that are effective in preventing seasonal influenza, but it still needs to conduct further studies.

Agriflu, for ages 18 and older, is administered as a single injection in the upper arm and is available in single-dose, prefilled syringes, according to the FDA. Novartis produces another licensed vaccine for seasonal influenza, Fluvirin, approved for ages 4 and older. Although no vaccine is 100 percent effective in preventing disease, vaccination is the key to flu prevention, according to the FDA. Novartis spokesman Eric Althoff said Agriflu is made in Siena, Italy, with eggs, and it has been available in Europe under the brand name Aggripal. This approval, he said, will add to future seasonal vaccine supplies.

The WHO supports the use of vaccines against the H1N1 flu.

The H1N1 virus has now become the dominant influenza virus around the globe, with high levels and an increase of activity in many regions, the World Health Organization said Thursday.

In a weekly update, the WHO's point person on the H1N1 virus, Dr. Keiji Fukuda, also warned the public not to treat the virus like just another flu. Like seasonal flu, H1N1 is more active in the winter than in the summer, and a majority of infected people get better on their own, Fukuda said. H1N1 also is as transmissible and infectious as seasonal flu, he said.

But unusually for influenza, Fukuda said, H1N1 continues at high levels over the summer months, and many of the serious illnesses and deaths are concentrated in people younger than 65. Seven months into the pandemic, the virus commonly known as swine flu remains at high levels and continues to increase in North America, Fukuda said. Mexico, for example, has seen more cases from September to November than they saw in the preceding months from April, when the virus emerged, he said.

The virus is also becoming more active in Europe and Central and Western Asia, Fukuda said.   Health officials this week reported an outbreak of cases in Ukraine, which now has more than 250,000 cases of influenza-like illness, with 235 patients requiring intensive care, the WHO said.   Activity is picking up in East Asia, Fukuda said. Mongolia reported "a number" of cases over the past week, he said.

"East Asia is one of the parts of the world where seasonal influenza viruses have remained in reasonably high circulation," Fukuda said. "But even in that part of the world, the pandemic virus is becoming dominant."

More cases are being reported from a number of Caribbean countries such as Cuba and Haiti, he said.   In Central America and the Southern Hemisphere, however, activity levels have dropped as those regions enter the summer season, Fukuda said.   "There are several regions in the world -- North America, Europe, Northern and Central Asia -- where we are clearly seeing pandemic influenza activity increase," he said, but "there is no one single place in the world where we are focused on."
Disease activity has been difficult to predict, Fukuda said.

"We really are not going to know what the future is going to bring, and so the main focus of our effort here is ... what steps are needed to make sure countries are as prepared as possible to deal with disease levels," he said. H1N1poses different challenges in different countries, but it does seem to be affecting indigenous groups more heavily than nonindigenous groups, he said. In Australia, for example, "aboriginal groups are disproportionately represented in people who end up in hospitals from diseases related to the pandemic," Fukuda said. The WHO still doesn't know whether the effect on indigenous groups is because of the pandemic itself or because of underlying factors.

Because most people infected with swine flu tend to recover on their own and don't suffer major problems afterwards, some people are tempted to dismiss the infection and think it's not serious. But Fukuda said that's a dangerous mind-set. "At WHO, we remain quite concerned about the patterns we are seeing, particularly because a sizable number of people develop complications [that lead to death]," he said. "We do see that the serious complications are concentrated in the younger age groups rather than the older age groups."

While the complications are most often seen in people who have chronic, underlying health conditions and in pregnant women, they also can develop in people "who are currently healthy and young."

But contrary to some reports, Fukuda said, the WHO has not seen big mutations in the virus since it first emerged. He said viruses being isolated now are "generally similar" to those isolated over the past several months, indicating they haven't changed much. The WHO also has no evidence of widespread resistance to antiviral medication, Fukuda said. There have been sporadic instances of resistance to oseltamivir -- the generic name for Tamiflu, one of the main drugs used against influenza -- but such cases are still "isolated and infrequent," he said.

Antivirals are quite useful against these infections.

Fukuda praised as "innovative" the decision by Norway to distribute antiviral medication over the counter for a limited period of time. The move can help take stress off the primary health system and allow patients to get the medicine more quickly, he said. Other useful protections against H1N1 are vaccines, which the WHO recommends against pandemic infections, Fukuda said.   "These vaccines now have been used in a significant number of countries ... and based on this experience, in which millions of people have now received vaccine, we in fact see that these vaccines are very safe," he said.

The only side effects are swelling and pain at the injection site, but "these are occurring at rates that are expected and usually seen with seasonal influenza vaccine," Fukuda said.   "WHO, along with other public health authorities, believes that these vaccines are very useful against pandemic infections and [we] do support their use," he said.

..............sourced from CNN

CURRENT FLU FORECAST AND TRENDS

2009-11-19T16:11:00.000-08:00

United States

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Explore FLU trends around the world

Click this link to Learn more »

U.S. Confirmed Influenza Cases


Influenza Cases	Hospitalizations	Deaths
	26,315	1,049

Estimates made on Data current through November 18, 2009.

SIGNS OF FLU - AND WHAT TO DO

2009-11-06T19:23:00.000-08:00

CDC Video Player.
Flash Player 9 is required.

6 MILLION CASES REPORTED

2009-10-30T04:05:00.000-07:00

As many as 5.7 million Americans were infected with swine flu during the first few months of the pandemic, according to estimates from federal health officials. Scientists at the Centers for Disease Control and Prevention estimate that between 1.8 million and 5.7 million Americans were infected from mid-April through July 23. The figures are the CDC's most specific calculation to date.
They also estimated that between 9,000 and 21,000 hospitalizations occurred during that time. The estimates are in a CDC publication, Emerging Infectious Diseases, and were posted on the journal's Web site this week. To come up with the numbers, the scientists assumed that most people infected with swine flu had only mild illnesses and did not get medical care or get tested.

For every confirmed case, they estimated that probably 80 others occurred. Rates of testing and hospitalization have dropped since the pandemic began, so the same calculation couldn't be done for cases since late July. For that reason, CDC officials are saying simply that "many millions" of Americans have been infected to date, the CDC's Dr. Anne Schuchat said at a press conference Thursday in Atlanta. Schuchat also provided an update on a shortage of the children's version of the drug Tamiflu, a first-line treatment for swine flu. The shortage first emerged last month. Since then, the federal government has released 300,000 pediatric Tamiflu doses to the states from a national medicine stockpile. The shortage occurred because the drug's manufacturer, Switzerland-based Roche Holdings, decided to focus production on adult-strength capsules as it dealt with increasing demand for the medication. The company increased the capsules' production as a way to ensure more medicine was made in the fastest way possible. Though there are scattered shortages of pediatric doses, adult-strength Tamiflu pills are in good supply and pharmacies can turn them into a Tamiflu syrup for children, said Schuchat, who heads the CDC's National Center for Immunization and Respiratory Diseases.

FROM CANADA; H1N1 exposes problems in System

With flu-shot clinics clogged nationwide for a fourth day and frustration rising yesterday, provinces and territories have been warned by the federal government to expect "significantly less" of the H1N1 vaccine over the next few weeks than had been anticipated. Provincial health authorities are awaiting final numbers on what portion of their orders they will have at their disposal - but if this week's overwhelmed flu-shot clinics are any indication, their shipments could easily fall short of demand.
The Manitoba and Ontario governments confirmed they are bracing for fewer doses of the vaccine.

"There is a suggestion, that we have received, that there may be less available over the next two weeks," said Ontario's chief medical officer of health, Arlene King. "I look forward to hearing more from the federal government." Ontario's health minister, Deb Matthews, said the federal government had not told the province officially what the reduced amount "might be" and that she was hoping to learn the final number by today.

The last-minute numbers mean local public health units, which are responsible for administering the vaccine, may have to modify plans over the weekend for how they operate clinics next week.

The federal government said it was informed by Canada's H1N1 vaccine manufacturer, GlaxoSmithKline, that vaccine supply will be lower next week because its facility only has one production line for two types of vaccine. GlaxoSmithKline first produced batches of vaccine with an adjuvant - an additive that boosts the immune system - and by the end of today, 6 million doses will have been shipped to the provinces and territories. It temporarily switched its production line to manufacture 1.8 million doses of vaccine without the adjuvant, the vaccine that is preferred for pregnant women. It has now switched back to making the adjuvanted vaccine but because of the interruption caused by making the unadjuvanted vaccine, there is a reduced number of doses for next week.

"It is important to also note that every batch of vaccine is quality-tested before it is shipped to the provinces and territories. This also affects the amount of vaccine delivered each week," said a statement from Health Minister Leona Aglukkaq. "GSK assures us that they will be back up to providing the provinces and territories with millions of doses the following week." The minister said the goal is to have Canadians who want the shot immunized by Christmas and that "we remain on track to meet this goal."

News of the reduced supply comes as two more Canadian H1N1 deaths were reported: a middle-age woman from Edmonton and a man from Calgary. Meanwhile, people anxious for their shot continued to swamp clinics and parents worried about their sick children flooded hospital emergency rooms across the country.

FLU MYTHS THAT COULD KILL YOU

Myth 1 - The symptoms are like regular flu, such as fever. Testing for fever may not be a reliable way of diagnosing swine flu. Up to half the people who get swine flu never develop a fever, and some suffer from gastrointestinal symptoms as well as more standard flu symptoms.

Myth 2 - This is just mild flu. The death rates are even lower than for normal flu. Swine flu is killing young people rather than the very elderly, and although winter is just starting, more young people have already died of flu than normally die over the entire winter.

Myth 3 - Healthy people are safe. Only sick, weak people get really ill. Most of the kids who have died of swine flu were perfectly healthy beforehand, and many of the adult victims also had no underlying conditions.

Myth 4 - Eating organic food, taking vitamins, wearing a mask, washing hands and drinking plenty of fluids will offer protection. Getting vaccinated is by far the most effective thing you can do to protect yourself and your family from swine flu.

Myth 5 - No worries, now that vaccine are available. Vaccines will save lives, but only if they get through in time. Even in rich countries, it will be months before everyone who wants the vaccine can get it. Poor countries will get little if any vaccine.

Myth 6 -The vaccine isn’t safe. No point taking the risk to prevent mild flu. During past pandemics, a third or more of the entire population has got flu, and the risks of flu killing you or causing nasty problems such as Guillain-Barré syndrome are far greater than those of the vaccines.

Myth 7 - This virus won’t get deadlier. Flu viruses do sometimes get nastier. No one can be sure how 2009 flu will evolve, but it’s certainly not going away.

Myth 8 - Once this pandemic is over, world will be safe for another few decades. Another animal flu virus could jump to humans tomorrow and start another pandemic, which could be far worse than 2009 swine flu.

HOW DO YOU FEEL?

2009-10-30T01:21:00.001-07:00

LOOK FOR SWINE FLU SYMPTOMS

Typical symptoms :

Sudden fever (38C or above) and sudden cough

1. Other symptoms include: Tiredness and chills

2. Headache, sore throat, runny nose and sneezing

3. Stomach upset, loss of appetite, diarrhea
4. Aching muscles, limb or joint pain

CARE FOR SICK PERSON - IN HOUSE

2009-10-27T04:38:00.000-07:00

How Flu Spreads

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

People with H1N1 who are cared for at home should:

check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
check with their health care provider about whether they should take antiviral medications
keep away from others as much as possible. This is to keep from making others sick. Do not go to work or school while ill
stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)
get plenty of rest
drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
cover coughs and sneezes. Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.*
wear a facemask – if available and tolerable – when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza.
be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention.

Medications to Lessen Symptoms

Check with your healthcare provider or pharmacist for correct, safe use of medications

Antiviral medications can sometimes help lessen influenza symptoms, but require a prescription. Most people do not need these antiviral drugs to fully recover from the flu. However, persons at higher risk for severe flu complications, or those with severe flu illness who require hospitalization, might benefit from antiviral medications. Antiviral medications are available for persons 1 year of age and older. Ask your health care provider whether you need antiviral medication.
Influenza infections can lead to or occur with bacterial infections. Therefore, some people will also need to take antibiotics. More severe or prolonged illness or illness that seems to get better, but then gets worse again may be an indication that a person has a bacterial infection. Check with your health care provider if you have concerns.
Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome.

Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.
The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS). Examples of these kinds of medications include:

Generic Name	Brand Name(s)
Acetaminophen	Tylenol®
Ibuprofen	Advil®, Motrin®, Nuprin®
Naproxen	Aleve

Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.
Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications—don’t double dose! Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.

Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.For more information on products for treating flu symptoms, see the FDA web site

When to Seek Emergency Medical Care

Get medical care right away if the sick person at home:

has difficulty breathing or chest pain
has purple or blue discoloration of the lips
is vomiting and unable to keep liquids down
has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
has seizures (for example, uncontrolled convulsions)
is less responsive than normal or becomes confused

Lessen the Spread of Flu in the Home

When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

keep the sick person away from other people as much as possible (see “placement of the sick person”) especially others who are at high risk for complications from influenza
remind the sick person to cover their coughs, and clean their hands with soap and water often. If soap and water are not available, they should use an alcohol-based hand rub, especially after coughing and/or sneezing
have everyone in the household clean their hands often, using soap and water (or an alcohol-based hand rub, if soap and water are not available). Children may need reminders or help keeping their hands clean
ask your health care provider if household contacts of the sick person—particularly those contacts who may be pregnant or have chronic health conditions—should take antiviral medications such as oseltamivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu
If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. Infants should not be cared for by sick family members.
For more information- Interim Recommendations for Facemask and Respirator Use

Placement of the sick person

Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.
Unless necessary for medical care or other necessities, people who are sick with an influenza-like-illness should stay home and keep away from others as much as possible, including avoiding travel, for at least 24 hours after fever is gone except to get medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine). This is to keep from making others sick. Children, especially younger children, might potentially be contagious for longer periods.
If persons with the flu need to leave the home (for example, for medical care), they should wear a facemask if they can bear it, and cover their nose and mouth when coughing or sneezing.
Have the sick person wear a facemask – if available and tolerable – if they need to be in a common area of the house near other persons.
If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant (see below).

Protect other persons in the home

The sick person should not have visitors other than caregivers. A phone call is safer than a visit.
If possible, have only one adult in the home take care of the sick person. People at increased risk of severe illness from flu should not be the designated caretaker, if possible.
If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable. For more information, see the Interim Recommendations for Facemask and Respirator Use.
Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).
Avoid having sick family members care for infants and other groups at high risk for complications of influenza.
All persons in the household should clean their hands with soap and water frequently, including after every contact with the sick person or the person’s room or bathroom.
Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.
If soap and water are not available, persons should use an alcohol-based hand rub.*
If possible, consideration should be given to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).
Antiviral medications can be used to prevent the flu, so check with your health care provider to see if some persons in the home should use antiviral medications.

If you are the caregiver

Avoid being face-to-face with the sick person.
When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
Clean your hands with soap and water after you touch the sick person or handle used tissues, or laundry. If soap and water are not available, use an alcohol-based hand rub
Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.
If you are at high risk of influenza associated complications, you should not be the designated caretaker, if possible.
If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. Designate a person who is not at high risk of flu associated complications as the primary caretaker of household members who are sick with influenza, if at all possible. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable.
Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur.

Using Facemasks or Respirators

Avoid close contact (less than about 6 feet away) with the sick person as much as possible.
If you must have close contact with the sick person (for example, hold a sick infant), spend the least amount of time possible in close contact and try to wear a facemask (for example, surgical mask) or N95 disposable respirator.
An N95 respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through an N95 mask for long periods of time. More information on facemasks and respirators can be found at H1N1 Flu (Swine Flu) website.
Facemasks and respirators may be purchased at a pharmacy, building supply or hardware store.
Wear an N95 respirator if you help a sick person with respiratory treatments using a nebulizer or inhaler, as directed by their doctor. Respiratory treatments should be performed in a separate room away from common areas of the house when at all possible.
Used facemasks and N95 respirators should be taken off and placed immediately in the regular trash so they don’t touch anything else.
Avoid re-using disposable facemasks and N95 respirators, if possible. If a reusable fabric facemask is used, it should be laundered with normal laundry detergent and tumble-dried in a hot dryer.
After you take off a facemask or N95 respirator, clean your hands with soap and water or an alcohol-based hand sanitizer.

Cleaning, Laundry, and Waste Disposal

Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water right after handling dirty laundry. If soap and water are not available, use an alcohol-based hand rub.
Eating utensils should be washed either in a dishwasher or by hand with water and soap.

2009 H1N1 flu virus infection (formerly known as swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1, and have respiratory symptoms without a fever. Like seasonal flu, 2009 H1N1 flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death is possible with 2009 H1N1 flu infection. Certain groups might be more likely to develop a severe illness from 2009 H1N1 flu infection, such as pregnant women and persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.

For More Information

The Centers for Disease Control and Prevention

(CDC) Hotline (1-800-CDC-INFO)

English and Spanish, 24 hours a day, 7 days a week.

.....................sourced from the CDC

PUBLIC VACCINE INTEREST

2009-10-27T04:17:00.000-07:00

PLANNING TO GET THE VACCINE

Canada 36%
United States 26%
United Kingdom 20%

NOT PLANNING TO GET THE VACCINE

Canada 39%
United States 51%
United Kingdom 50%

H1N1 NATIONAL EMERGENCY

2009-10-24T22:46:00.000-07:00

President Obama has declared a national emergency to deal with the "rapid increase in illness" from the H1N1 influenza virus.

"The 2009 H1N1 pandemic continues to evolve. The rates of illness continue to rise rapidly within many communities across the nation, and the potential exists for the pandemic to overburden health care resources in some localities," Obama said in a statement.

"Thus, in recognition of the continuing progression of the pandemic, and in further preparation as a nation, we are taking additional steps to facilitate our response."

The president signed the declaration late Friday and announced it Saturday. Calling the emergency declaration "an important tool in our kit going forward," one administration official called Obama's action a "proactive measure that's not in response to any new development."

Another administration official said the move is "not tied to the current case count" and "gives the federal government more power to help states" by lifting bureaucratic requirements -- both in treating patients and moving equipment to where it's most needed.

The officials didn't want their names used because they were not authorized to speak on the record.
Obama's action allows Health and Human Services Secretary Kathleen Sebelius "to temporarily waive or modify certain requirements" to help health care facilities enact emergency plans to deal with the pandemic.

Those requirements are contained in Medicare, Medicaid and state Children's Health Insurance programs, and the Health Insurance Portability and Accountability Act privacy rule. Since the H1N1 flu pandemic began in April, millions of people in the United States have been infected, at least 20,000 have been hospitalized and more than 1,000 have died, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Frieden said that having 46 states reporting widespread flu transmission is traditionally the hallmark of the peak of flu season. To have the flu season peak at this time of the year is "extremely unusual."

The CDC said 16.1 million doses of H1N1, or swine flu, vaccine had been made by Friday -- 2 million more than two days earlier. About 11.3 million of those had been distributed throughout the United States, Frieden said.

"We are nowhere near where we thought we would be," Frieden said, acknowledging that manufacturing delays have contributed to less vaccine being available than expected. "As public health professionals, vaccination is our strongest tool. Not having enough is frustrating to all of us."

Frieden said that while the way vaccine is manufactured is "tried and true," it's not well-suited for ramping up production during a pandemic because it takes at least six months. The vaccine is produced by growing weakened virus in eggs.

................sourced from www.cnn.com

VIRUS INVASION VIDEO

2009-10-23T21:54:00.001-07:00

VACCINE SUPPLY ISSUES

2009-10-23T21:52:00.000-07:00

The Centers for Disease Control is just as unhappy as the rest of us about the tight supply of swine flu vaccine, we heard today.

Nurses in Indianapolis prepare the swine flu vaccine for another overwhelmed clinic.

In an afternoon briefing today, CDC Director Dr. Thomas Frieden talked about the problems, saying the means of vaccine production aren't exactly modern and are definitely not suited to responding to this pandemic. In short, manufacturers are having more trouble growing the virus for the vaccine than they originally expected. But, Frieden says, the method is the "tried and true" way that seasonal vaccines are produced, so at least we know it's safe.

Another problem, Bloomberg reported today, is that some vaccine is held up by regulatory issues--not just manufacturing bottlenecks. GlaxoSmithKline still doesn't have the US's go-ahead for its H1N1 vaccine without an adjuvant, or immune-system booster, according to Bloomberg.

But Frieden focused on problems the vaccine makers are having in cultivating the virus. "Even if you yell at them, they don't grow faster," he said about the virus cultures.

More than 11 million doses of the vaccine have been shipped out for public use so far, bringing the total doses that have become available up to 16 million this week, the CDC said. That's a far cry from the 195 million doses the CDC planned for by the end of the year and tensions are running high.
Frieden encourages people to get immunized when the vaccine becomes available, especially those at high risk, such as children and pregnant women.

As for the spread of the virus, swine flu is now widespread in 46 states. That's on par with the top of the season for garden-variety flu, said Frieden, so it's quite something in October. As for the new H1N1 virus, the CDC isn't seeing any genetic changes in the virus.

Since the first outbreak of the virus in April in the US, 1,000 people have died and 20,000 have been hospitalized. Frieden says he's confident that everyone who wants to be vaccinated will have eventually be able to--just probably not as soon as they would like. For now, the CDC is steering clear of making any more projections and focusing on getting the vaccines to people as it becomes available.

sourced from.................. www.npr.com

FLU FORECAST

2009-10-23T21:19:00.000-07:00

VACCINE ALERT - IMPORTANT

2009-10-23T06:24:00.000-07:00

Rheumatoid Arthritis and the Flu:

The CDC has an important message for people with immune systems compromised by diseases such as rheumatoid arthritis . You are at risk for both seasonal and 2009 H1N1 flu complications and should be vaccinated as soon as the vaccine becomes available in your community. To find a vaccination location near you, search the CDC website. The CDC suggested that patients with inflammatory rheumatic disease receive the 2009 H1N1 vaccine and the seasonal flu vaccine.

Young people and the Flu:

The CDC held the first of their two weekly H1N1 briefings today and said that young people continue to be hit especially hard by the 2009 H1N1 virus. More than half of the hospitalizations from 2009 H1N1 flu reported by 27 states from September 1^st and October 10^th were people age 24 and younger. About 23 percent of the deaths reported from 28 states during this period were in this age group.
In addition, about 90 percent of the hospitalizations and deaths from the 2009 H1N1 flu are in people age 64 and younger. With seasonal flu, we usually see the reverse – 60 percent of the hospitalizations and 90 percent of deaths from seasonal flu are in people age 65 and older.

Yesterday, the CDC circulated an alert reminding health care providers about early treatment of flu for patients at increased risk of complications. The CDC urges health care providers to start antiviral treatment as soon as possible when flu is suspected in these patients at risk and not wait for laboratory confirmation.

To help get antivirals to states, 300,000 additional doses of liquid Tamiflu for children were recently distributed through the Strategic National Stockpile. In addition, many pharmacies can create doses appropriate for children from existing supplies through a process called “compounding.” Many drug stores across the country, including Walgreens and Wal-Mart, are compounding antivirals locally to meet the needs of young children.

Pregnant Women and the Flu:

Five things you need to know

Pregnant women, even ones who are healthy, can have medical complications from the seasonal and H1N1 (Swine) flu. If you are pregnant, use the following 5 tips to prepare for the upcoming flu season.

1. Get vaccinated. If you are pregnant, you should get both the seasonal flu vaccine and H1N1 (Swine) flu vaccine as soon as possible. Pregnant women are among the priority groups to receive the H1N1 (Swine) flu vaccine. Use our Flu Shot Locator to get vaccinated where you live.

Note that pregnant women should not be given the nasal-spray flu vaccine LAIV (FluMist®)

2. Pay attention to your body. If you are pregnant, you should pay close attention to your body and how you are feeling. If you get sick with flu-like symptoms:

Stay home, limit contact with others, and call your doctor. Your doctor will decide if testing or treatment is needed. Tests may include a nasal swab which is best to do within the first 4-5 days of getting sick.
If you are alone, have someone check in with you often if you are feeling ill. This is always a good idea.
If you have close contact with someone who has H1N1 (Swine) flu or is being treated for exposure to H1N1 (Swine) flu, contact your doctor to discuss whether you need treatment to reduce your chances of getting the flu.

3. If you are diagnosed with the flu, get treatment:

Treat any fever right away. Acetaminophen (Tylenol®) is the best treatment of fever in pregnancy.

Drink plenty of fluids to replace those you lose when you are sick.

Your doctor will decide if you need antiviral drugs such as Oseltamivir (Tamiflu®) or Zanamivir (Relenza®). These medicines can make you feel better faster and make your symptoms milder. Because of its systemic activity, oseltamivir (Tamiflu®) is preferred for treatment of pregnant women.
Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) work best when started soon after symptoms begin (within two [2] days), but they may also be given to very sick or high risk people (like pregnant women) even after 48 hours. Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) are taken for 10 days.

There is little information about the effect of antiviral drugs in pregnant women or their babies, but no serious side effects have been reported. If you do think you have had a side effect to antiviral drugs, call your doctor right away.

4. Seek emergency medical care right away if you have:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Decreased or no movement of your baby
A high fever not responding to Tylenol®

5. Keep Breastfeeding

A mother’s milk is made to fight diseases in her baby. This is highly important in young babies whose immune system is still growing. Do not stop breastfeeding if you are ill. Mothers who are breastfeeding can continue to nurse their babies while being treated for the flu.
Breastfeed early and often. Limit formula feeds if you can. This will help protect your baby from infection.
If you do get the flu, be careful not to cough or sneeze in the baby’s face and wash your hands often with soap and water. Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby. If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby.