6 MILLION CASES REPORTED

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.

6 MILLION CASES REPORTED

HOW DO YOU FEEL?

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

HOW DO YOU FEEL?

CARE FOR SICK PERSON - IN HOUSE

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

CARE FOR SICK PERSON - IN HOUSE

PUBLIC VACCINE INTEREST

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%

PUBLIC VACCINE INTEREST

H1N1 NATIONAL EMERGENCY

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

H1N1 NATIONAL EMERGENCY

VIRUS INVASION VIDEO

VIRUS INVASION VIDEO

VACCINE SUPPLY ISSUES

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

VACCINE SUPPLY ISSUES

FLU FORECAST

FLU FORECAST

VACCINE ALERT - IMPORTANT

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.

VACCINE ALERT - IMPORTANT

GOOGLE FLU TRENDS

Google has been monitoring numerous sources of data, and has compiled an algorithm that very closely maps out the effect and spread of the Swine FLU in real time.  Check it out.

CLICK HERE TO LINK

SMALL BUSINESS CONCERNS

Business managers should draft a plan outlining how to work around employee absenteeism and how they can maintain adequate inventory in the event of supply chain interruptions resulting from absenteeism among product distributors.

According to the Department of Homeland Security, small businesses are especially susceptible to the negative economic impacts of a flu pandemic. An estimated 25 percent of businesses do not reopen following a major disaster, the department says, citing research by the Institute for Business and Home Safety.

Planning from the outset can help offset business losses and protect businesses and employees if and when the flu hits. Benefits of planning include: minimizing disruption to business activities; protecting employees’ health and safety; and limiting the negative impact to the community, economy and society.
Additional details are available on the Homeland Security Web site here.

Employers everywhere should be bracing for the events to come.
Here are some suggestions to better prepare your workplace.

• Provide plenty of hand wipes or sanitizer.
• Make sure employees are aware of situation, and act appropriately.
• Provide lessons on cleanliness, sneezing, and disposal of waste.
• Make sure your employment area has good ventilation.
• Make sure employees stay home if they are feeling infected.
• Provide a list of local doctors and areas where vaccinations occur.
  
• Provide breathing mask, or ask employees to bring them - use them.
• Keep employee contact to a minimum.

GOOGLE FLU TRENDS

THE LATEST STUDY - WHO

16 OCTOBER 2009 |

GENEVA -- To gather information about the clinical features and management of pandemic influenza, WHO hosted a three-day meeting at the headquarters of the Pan American Health Organization in Washington, DC on 14–16 October. Findings and experiences were presented by around 100 clinicians, scientists, and public health professionals from the Americas, Europe, Asia, Africa, the Middle East and Oceania.

The meeting confirmed that the overwhelming majority of persons worldwide infected with the new H1N1 virus continue to experience uncomplicated influenza-like illness, with full recovery within a week, even without medical treatment.

Need for intensive care

However, concern is now focused on the clinical course and management of small subsets of patients who rapidly develop very severe progressive pneumonia. In these patients, severe pneumonia is often associated with failure of other organs, or marked worsening of underlying asthma or chronic obstructive airway disease.

Treatment of these patients is difficult and demanding, strongly suggesting that emergency rooms and intensive care units will experience the heaviest burden of patient care during the pandemic.

Primary viral pneumonia is the most common finding in severe cases and a frequent cause of death. Secondary bacterial infections have been found in approximately 30% of fatal cases. Respiratory failure and refractory shock have been the most common causes of death.

Presentations during the meeting explored the pathology of severe disease in detail, with findings supported by work in experimental animals. These findings confirm the ability of the new H1N1 virus to directly cause severe pneumonia.

Clinical picture different from seasonal influenza

Participants who have managed such cases agreed that the clinical picture in severe cases is strikingly different from the disease pattern seen during epidemics of seasonal influenza. While people with certain underlying medical conditions, including pregnancy, are known to be at increased risk, many severe cases occur in previously healthy young people. In these patients, predisposing factors that increase the risk of severe illness are not presently understood, though research is under way.

In severe cases, patients generally begin to deteriorate around 3 to 5 days after symptom onset. Deterioration is rapid, with many patients progressing to respiratory failure within 24 hours, requiring immediate admission to an intensive care unit. Upon admission, most patients need immediate respiratory support with mechanical ventilation. However, some patients do not respond well to conventional ventilatory support, further complicating the treatment.

On the positive side, findings presented during the meeting add to a growing body of evidence that prompt treatment with the antiviral drugs, oseltamivir or zanamivir, reduces the severity of illness and improves the chances of survival. These findings strengthen previous WHO recommendations for early treatment with these drugs for patients who meet treatment criteria, even in the absence of a positive confirmatory test.

In addition to pneumonia directly caused by replication of the virus, evidence shows that pneumonia caused by co-infection with bacteria can also contribute to a severe, rapidly progressive illness. Bacteria frequently reported include Streptococcus pneumoniae and Staphylococcus aureus, including methicillin-resistant strains in some cases. As these bacterial co-infections are more frequent than initially recognized, clinicians stressed the need to consider empiric antimicrobial therapy for community acquired pneumonia as an early treatment.

Groups at greatest risk

Participants agreed that the risk of severe or fatal illness is highest in three groups: pregnant women, especially during the third trimester of pregnancy, children younger than 2 years of age, and people with chronic lung disease, including asthma. Neurological disorders can increase the risk of severe disease in children.

Evidence presented during the meeting further shows that disadvantaged populations, such as minority groups and indigenous populations, are disproportionately affected by severe disease. Although the reasons for this heightened risk are not yet fully understood, theories being explored include the greater frequency of co-morbidities, such as diabetes and asthma, often seen in these groups, and lack of access to care.

Although the exact role of obesity is poorly understood at present, obesity and especially morbid obesity have been present in a large portion of severe and fatal cases. Obesity has not been recognized as a risk factor in either past pandemics or seasonal influenza.

WHO and its partners are providing technical guidance and practical support to help developing countries better detect and treat illness caused by the pandemic virus. Patient care advice that can be applied in resource-limited settings is being rapidly compiled.

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THE LATEST STUDY - WHO

As of 4 October 2009, worldwide there have been more than 375,000 laboratory confirmed cases of pandemic influenza H1N1 2009 and over 4500 deaths reported to WHO.

As many countries have stopped counting individual cases, particularly of milder illness, the case count is significantly lower than the actually number of cases that have occurred. WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data.

In the temperate regions of the Northern Hemisphere, transmission of influenza virus and rates of influenza-like-illness (ILI) continue to increase marking an unusually early start to fall and winter influenza season in many countries. Geographically widespread influenza is being reported throughout North America, with the United States reporting ILI levels elevated above the seasonal baseline for the past month and Mexico reporting a high intensity of respiratory diseases for the past three weeks. In Canada, although overall ILI activity remains low, focal increases have been reported in the western part of Canada. In Europe and Central and Western Asia, early transmission of influenza virus continues to increase in many countries, with more intense focal activity being reported in a few. National or regional ILI levels remained elevated above the baseline in parts of the United Kingdom (Northern Ireland and Scotland), Ireland, and Israel. In Ireland, a high intensity of respiratory diseases has been reported for the past two weeks, with the highest rates of ILI reported among children aged 5-14 years old. In addition to Ireland and Israel, widespread geographic spread of influenza virus is also now being reported in Belgium, the Netherlands, and Cyprus. At least 10 countries in the region are also reporting an increasing trend in respiratory diseases activity. In Japan, influenza activity continues to be elevated above the seasonal epidemic threshold since week 33, most recently in the large population centers.

In the tropical regions of the Americas and Asia, influenza virus transmission persists, however influenza activity remained variable. Geographically widespread to regional influenza activity continues to be reported throughout the tropical region of the Americas without a consistent overall trend (and increasing trend in parts of the Caribbean, and decreasing in much of tropical Central and South America). High intensity respiratory diseases activity was reported in Columbia, Cuba, and El Salvador, and moderate health-care impact was experienced in many countries; two countries, Barbados and St. Lucia, reported severe health-care impact. As influenza transmission slowly declines in many parts of South and Southeast Asia, several countries are reporting geographically regional spread (India, Bangladesh, and Thailand) or localized spread (Sri Lanka and Myanmar) of influenza activity; and most countries in the region have reported experiencing a low health care impact since late September.

In the temperate regions of the southern hemisphere, influenza transmission has largely subsided (Chile, Argentina, and New Zealand) or continues to decline substantially (South Africa and Australia).

All pandemic H1N1 2009 influenza viruses analyzed to date have been antigenically and genetically similar to A/California/7/2009-like pandemic H1N1 2009 virus. See below for a detailed laboratory surveillance update.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN), supported by WHO Collaborating Centers and other laboratories, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir. To date, 31 resistant pandemic H1N1 influenza viruses have been detected and characterized worldwide. All of these viruses show the same H275Y mutation that confers resistance to the antiviral oseltamivir, but not to the antiviral zanamivir. Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.

*Countries in temperate regions are defined as those north of the Tropic of Cancer or south of the Tropic of Capricorn, while countries in tropical regions are defined as those between these two latitudes.

TO VACCINATE OR NOT TO VACCINATE?

Swine flu is here, and there's a new challenge: getting people to take the vaccine.

A consumer reports poll recently reported that 75% of parents plan to delay or skip getting their children the H1N1 vaccine shot.

Government officials say that the vaccine is safe, and that there is no need to worry about facts like – it being rushed to quickly into production, and if it was tested adequately before release. Those concerns are not rational, and there is a large body of evidence to show that the vaccine is both safe and effective. Children world wide have been hit particularly hard by the virus, and all governments are advising parents very strongly to do what's best for their kids and get them vaccinated.

“I think many of the concerns by parents are based on the perception that this vaccine has been rushed into production and may not be safe, and we understand parents' concerns — they want what is best for their children. We often tell people the best antidote for fear is information. And we ask them to really seek out sound and reliable information from sources they trust.” Said the spokesman for the U.S. Centers for Disease Control and Prevention, Tom Skinner.

Health and Human Services Secretary Kathleen Sebelius made appeals to all Americans about the safety of the vaccine, and urged them to act immediately in safeguarding themselves from this pandemic. She made extensive rounds Tuesday and Wednesday morning preaching her message of vaccination, but it is yet unclear just how well she was heard. Vouching for the safety of the vaccine, and saying it “has been made exactly the same way the seasonal vaccine has been made, year in and year out”, Sebelius was hoping to persuade parents everywhere to take action and to stay informed about the current escalating pandemic situation.

The flu shot does not give people the flu. Side effects are generally mild — soreness and swelling at the injection site, headache, occasional fever and body aches. Less common side effects include coughing, runny nose and nausea, especially in young children. These are all normal and appropriate responses by your immune system, you should not be afraid of these shall possible side effects, as it is necessary to introduce a small sample of the virus into your system in order to better combat it when faced full on. The incidence of more severe side effects is extremely low.

Infectious disease specialists in many countries say it is imperative that people trust the H1N1 shots; they are the best source of protection from a virus that has already claimed the lives of thousands.

We strongly urge parents to take precautionary steps. Flu kills many kids every year, however, there is hope and we’ve got a great vaccine to deal with it. This is especially important because this flu virus strain is highly contagious, and we all know how deadly it can be in the school systems and daycare facilities.

Skinner said 1,300 people have died from the flu since the beginning of September, and most of those deaths have been linked to the H1N1 strain of the virus.

“I think what concerns us most is that more children may die this year because they weren’t vaccinated, and that would be tragic and we don’t want that to happen, we really implore any parent to seek out information that’s reliable and can help them make a decision that’s best for their child.” said Skinner.

TO VACCINATE OR NOT TO VACCINATE?

PROTECTION MEASURES FOR BUSINESS

Afraid of swine flu? Well then, wear this suit.

If the new swine flu vaccine doesn't give you the right dose of inner peace, there's another layer of protection at your disposal. It comes from Japan, which means it looks good, too.

The new anti-H1N1 suit doesn't just make you look good, but it supposedly also helps keep you disease-free.

According to the U.K. Telegraph, Japanese menswear company Haruyama Trading has developed a suit that it claims can protect wearers from the H1N1 virus.

The suit is coated with titanium dioxide--a chemical commonly used in toothpaste and cosmetics--that breaks down when reacting with light and supposedly kills the virus upon contact. (If you read Japanese, here is the company's press release.)

Despite the new layer of protection, the suit seems pretty much like other suits commonly worn by Japanese white-collar workers. Each suit costs about $580, about how much a decent suit at Men's Wearhouse costs. The suits go on sale Thursday and in four colors and styles, including medium gray, charcoal, navy, and a gray pinstripe. The company says the suit will retain its protective capability even after being washed multiple times.

Japan, like many other places in Asia, has been gripped by the swine flu since its outbreak a year ago. According to the World Health Organization, more than 340,000 people have been infected with H1N1 worldwide; the disease is responsible for 4,100 deaths.

Generally, most of the new cases were reported to take place in urban areas, where population density increases the risk of transmission. It's unclear if there will be a female version of the suit; it's also unknown when or if the suit will be on sale in the U.S.

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How Business Travelers Can Avoid Swine Flu

Experts say businesses and their employees must take precautions against the seasonal flu and the H1N1 virus on the road.

With flu season just around the corner, workers and employers need to make plenty of preparations in order to stay safe on planes, trains, and buses. Fears that a second wave of the H1N1 virus, or swine flu, will hit during the upcoming flu season are already prompting airlines to be cautious.

Some airlines including Southwest are saying they will keep passengers from flying if they appear to be very ill with a communicable disease, but it can be hard even for medical professionals to attribute a lone sneeze to flu, as opposed to some other condition. Other airlines, such as Virgin America, are gearing up for the resurgence by keeping sanitizing wipes and gels, and surgical masks on board. The airline is also removing pillows and blankets from daytime flights.

Travelers can take some of these precautions themselves, during their morning commute as well as on a business trip. Commuters and passengers should make sure that they are "doing the sensible, common sense things like washing their hands frequently, and covering their coughs and sneezes," advises Lisa Koonin, the Centers for Disease Control's (CDC) lead for pandemic planning for the private sector and businesses. And of course, she adds, "sick people really do not need to travel."

In addition to skipping your flight if you're under the weather, Koonin says business travelers can beef up their immune systems by eating, drinking, and sleeping well before a flight. "The healthier they are going into it, the more resilient they'll be," she says. Also, in highly-trafficked public places, commuters and flyers should avoid touching their eyes, nose and mouth, and use alcohol-based hand sanitizers if they cannot access soap and running water.

Koonin also says that despite the close quarters, being on a plane is no more or less dangerous than punching in at the office. "Flu is going to be everywhere," she says, the only area of increased risk is, ironically, in a health care environment because of the higher concentration of sick people.

What about wearing a mask? "The surgical masks that you see some people wear were created to prevent splashes of fluid into the nose and mouth during surgery," Koonin says. They are not going to prevent virus particles from penetrating the body's defenses, although they could be useful in blocking the sneezes of a person who is already sick but has to leave the house.

A lot of the responsibility also falls to business owners. In addition to following World Health Organization and CDC directives they need to educate their employees about which demographics are the most at risk, gather information from their local health department and nearby businesses, provide vaccines—which are available for seasonal flu now, but won't be out for H1N1 until mid-October—and perhaps most importantly, have a clear leave policy.

"People don't want to jeopardize their job, they don't want to jeopardize their sick leave, they don't want to be unpaid," says Al Berman, executive director of DRII, The Institute for Continuity Management, an organization that certifies businesses in contingency planning. "So you want to make it conducive to them to stay home if they are ill. I'm not sure that the personnel policies of a lot of organizations have done that."

According to CDC officials, here's a list of precautions that business owners should share with employees:


* Always wash your hands especially after touching common surfaces.

* Cough and sneeze into your sleeves and not into hands.

* If your airplane seat comes with a pillow or blanket, ask a member of the crew if they could remove it. Bring your own pillow and blanket.

* Avoid traveling and stay home from work if you are sick.

* Wait until you have been fever-free for 48 hours without the help of medicine before resuming work and commuting. If you must travel, wear a mask.

* Eat well, drink lots of water, and get a good night's rest before flying.

* If you won't have access to soap and water, carry an alcohol-based hand sanitizer.
sourced from www.inc.com

PROTECTION MEASURES FOR BUSINESS

VACCINE ARRIVES - FLU KEEPS SPREADING

Most of the USA (over 50%) reported widespread flu cases today, as the vaccine became available.

"The level of activity we're seeing for this time of year is really unusual," said Tom Skinner, a spokesman for the CDC. "We just really don't see the level of activity we're seeing." The high number of cases, however, is not a predictor of how severe this flu season will be, he said. "Flu is unpredictable, and unfortunately we can't say one way or the other that what we are seeing now is a harbinger of what's to come," Skinner said.

According to the CDC's latest report there are widespread cases coming from every area of the country, and more to come as the spreading virus continues to be passed from person to person.

Joy Alexiou, a public information officer for the Santa Clara Public Health Department in San Jose (CA) said that there have been 9 deaths and 159 hospitalizations relating to the swine flu.

"Last week, our board of supervisors declared a local state of emergency," Alexiou said. The action allows additional local money to funnel toward containing H1N1.

"In September, we're already seeing greater rates of influenza than we've seen in November and December in previous years. Certainly our hope is that it will peak sooner and dip sooner,"

The CDC's Skinner said there was no indication that the H1N1 virus has hit its peak, and no predictions were offered up to estimate the total impact. A total of 600,000 doses of nasal FluMist were being shipped this week, and 250 million will be used throughout the season (in both mist and injection formats).

The doctors across the country are bracing for impact, as hoards of people are expected to rush for the vaccines, but everyone is still unsure just how successful the treatment will be. Everyone is hoping for the best and praying that the virus does not mutate into another more dangerous form.

Thousands of doctors, hospitals, clinics and health departments across the USA have reregistered to receive the vaccine. Some states are asking their residents to be patient, everyone will be taken care of they say.

"We've been told that we'll have about 15 million doses for Texas after all is said and done, but it won't be available all at once," David Lakey, commissioner of the Department of State Health Services, said in a press statement. Will it be too late to get the vaccine if your doctor's office doesn't receive supplies for weeks to come?

"I don't think so, It's coming out at the right time." The flu season will be several months long; the first release is here on time.

Contact your local doctor's office for details, if possible we recommend making an appointment to visit promptly, demand for the vaccines is very high and as more people come into contact with the flu more people will need to be immunized. In the end it is most important to stay calm, keep your hands clean, boost your immune system and health, and to avoid crowded places (at least until the pandemic slows its pace).

VACCINE ARRIVES - FLU KEEPS SPREADING

TRACKING THE VIRUS MAP (US)

The latest on the US spread and containment efforts.







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TRACKING THE VIRUS MAP (US)