6.8.13

 

H7N9 Bird Flu Drug Resistance a Concern


Drug resistance has been detected in patients infected with the new bird flu that has emerged in China, say doctors.  The H7N9 virus became resistant to Tamiflu in three out of 14 patients treated with antiviral drugs at Shanghai Public Health Clinical Centre.

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.



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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
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4.4.13

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.
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China: Four more infected with H7N9 bird flu

Chickens in Shanghai market 
 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


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18.3.13

Tamiflu-resistant swine flu spreads 'between patients'


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

 Tamiflu

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

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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 virus
  • 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
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7.1.10

H1N1 STILL CIRCULATING

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


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COMPARING FLU DEATHS

 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
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15.12.09

MASSIVE VACCINE RECALL - 800,000 DOSES

Sanofi Pasteur produces these vials of H1N1 vaccine in France, but the U.S. version is made in Pennsylvania
 
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

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    11.12.09

    NATURAL WAYS TO AVOID FLU

    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.


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    8.12.09

    HYGIENE - WASHING HANDS VIDEO


    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

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    2.12.09

    BEWARE FRAUDULENT PRODUCTS

    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

        AirFree

        AllerAir

        Cleanaer

        Eliminator

        Sanuvox

        UV Aire

        Verilux


    Antiseptic Products

        Silver Soft


    Body Wash Products

    Device Products

    Drug Products

        Zeolite


    Gel Products

    Gloves Products

    Hand Sanitizer Products

        Silver Soft

        SkinWear

        Soapopular

        Viraban

        staSAFE


    Herbal Extract Products

        Amrita

        TCM Help Me


    Immunization Products

        Buy Best

        Swine Flu


    Inhaler Products

        Flu Away

    Kit Products

        911 Water

        Boss Safety

        Duram

        Life Secure

        Quake Kare

        SilverCure


    Mask Products

        Noveko

        Safe Life

        Triosyn


    Shampoo Products

        SilverCure


    Spray Products

        Nozin

    Supplement Products

        Acai Burn

        Allera

        BioSET

        CeraFlu

        Defend-Rx

        Dr. Weil

        Fitura

        Flucinex

        GlycoMeds

        Guardian

        NZYMES

        Natren

        Perelandra

        Royal Camu

        Vitacroft

    Tea Products

        TCM Help Me


    Test Products

        BD

        LightMix

        Luminex

        Prodesse


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    28.11.09

    SURGICAL MASK vs. RESPIRATOR

     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

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    NEW VACCINE AND UPDATE

    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


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    19.11.09

    CURRENT FLU FORECAST AND TRENDS


    United States

    National

    2009-2010




    Intense
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    Mexico 

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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.

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