CDC: Flu activity picks up pace, hits summer camps

Lisa Schnirring * Staff Writer

Jun 26, 2009 (CIDRAP News) – An official from the US Centers for Disease Control and Prevention (CDC) said today that the nation just saw its largest weekly increase in cases since the beginning of the novel flu outbreak and that the virus has so far been detected at 34 summer camps in 16 states.

Anne Schuchat, MD, interim deputy director for the CDC's science and public health program, told reporters, "The key point is that this new infectious disease is not going away." Of the nearly 28,000 cases that have been confirmed in the United States, more than 6,000 were reported over the past week, according to the weekly update the CDC issued today.

She said influenza activity is widespread in 12 states, something very unusual for summer months, but not so unusual for an influenza pandemic. States reporting widespread activity are Arizona, Connecticut, Delaware, Hawaii, Maine, New Jersey, New York, Pennsylvania, Rhode Island, Utah, and Virginia. Nine others are reporting regional activity.

More than 99% of typed influenza isolates are the novel flu strain, Schuchat said. "So virtually all of the influenza that's circulating and getting a diagnosis is this new strain."

Clinical patterns in patients who are sick with the pandemic flu strain are staying constant, with the highest illness rates in people younger than age 25, she said, adding that the median age of those hospitalized with more severe illnesses is 19. However, the median age of people who are dying from novel H1N1 is somewhat older, 37.

Schuchat estimated that about three fourths of the patients who died from the disease had underlying health conditions, though the CDC doesn't have complete information on all 127 fatalities that have been reported.

She noted that though morbid obesity has been singled out as a risk factor that might be unique to the pandemic outbreak, the CDC wants to clarify that some severely obese patients have chronic lung disease that has developed from the burden of the extra weight. "So it's really not a new risk factor for influenza, it's just a repackaging of that chronic lung disease that we've always known was a risk for influenza," she said.

Members of the CDC's Advisory Committee on Immunization Practices (ACIP), which just wrapped up a meeting in Atlanta, discussed several pandemic flu issues, including how to plan for novel flu vaccine distribution, if federal officials decide to use it, Schuchat said. CDC officials are preparing different scenarios on reaching specific populations that states can use to help develop their vaccine distribution plans.

"We haven't finalized the plans, but states should be thinking about younger people, pregnant women, and people with chronic medical conditions," she said. "It's very important for planning to go on."

CDC

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jun 29
H1N1 Flu Breaking News

-World pandemic flu tally passes 70,000

The latest global number of new pandemic flu cases is 70,893 cases, including 311 deaths, the World Health Organization (WHO) reported today. The new total is an 11,079-case rise from the WHO's last update on Jun 26. The once-weekly update of US cases represents more than half of the new cases. The number of fatalities rose by 48 since the last report. The list includes four countries reporting their first cases: Iraq, Lithuania, Monaco, and Nepal. [WHO update 55]

-First Tamiflu-resistant novel flu case reported

A Danish patient confirmed as having novel H1N1 influenza exhibited resistance to the antiviral drug oseltamivir (Tamiflu), an official from Roche, the maker of the drug, said today. "While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche's pandemic task force leader, said on a conference call, according to Reuters. "This is the first report we have of it in H1N1," he said. [Jun 29 Reuters report]

-Experts: 2-shot novel flu vaccine likely to overwhelm system

The pandemic vaccine now being produced will require two shots 3 weeks apart to provide full immunity, which could overwhelm state agencies, officials said at a meeting last week at the Centers for Disease Control and Prevention. And children younger than 9 years old will need four shots, the CDC said, according to a Bloomberg News report. "Public health departments are underfunded and will get fatigued," said flu expert William Schaffner, adding that one shot will give at most 20% protection. [Jun 26 Bloomberg News report]

-Kenya, Myanmar report first novel flu cases

Kenya's health ministry today announced the country's first novel flu case, a 20-year-old British man visiting as a student, Agence France-Presse (AFP) reported. The man got sick 2 days after arriving in Kenya and is recovering in isolation at a hotel. In other developments, Myanmar's government on Jun 27 reporting the country's first pandemic flu case, a 13-year-old girl who became ill after visiting Singapore with her family, according to Irrawaddy, a Thai-based news service. [Jun 29 AFP article]

-Brazil reports first novel H1N1 death

Brazil has reported its first swine flu fatality, in an adult woman of unspecified age, according to a story in today's Hindustan Times. Brazil's health ministry said in a statement that the woman, who died Jun 28, was "from the state of Rio Grande do Sul who had spent 1 week in Argentina." The story said officials were investigating another suspected novel flu death in the same state. [Jun 29 Hindustan Times story]

-Tamiflu reduces flu complications in kids with chronic conditions

Children with chronic medical conditions have fewer flu-related complications when they receive oseltamivir (Tamiflu) within a day of flu diagnosis, researchers reported today in an early online edition of Pediatrics. The study covered six flu seasons between 2000 and 2006 and was based on a Reuters Thomson database. Compared with those who didn't receive the drug, children who received oseltamivir had fewer complications and hospitalizations 14 and 30 days after flu diagnosis. [Jun 29 Pediatrics abstract]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

June 30

H1N1 Flu Breaking News
-Spain, Uruguay report first pandemic flu death

Health officials in Spain and Uruguay today reported their first novel H1N1 deaths, Agence France-Presse (AFP) reported. The patient who died in Spain was a 20-year-old Moroccan woman who was 7 months pregnant and had asthma. Spain's health ministry said the baby was delivered by Caesarean section and, though premature, appears to be healthy. The Uruguayan was a 60-year-old woman who died of multiple organ failure before tests confirmed novel H1N1. [Jun 30 AFP article]

-Indonesia to ask foreign visitors to wear masks

Indonesia's health minister said yesterday that visitors arriving at the country's airports from nations hit by novel flu will be asked to wear a mask for 3 days, according to a report today from AFP. The masks are a precautionary measure to reduce human-to-human transmission, she said. The masks will be handed out to international visitors as soon as funding for them comes through; however, those who don't wear them will not be penalized. [Jun 30 AFP article]

-Argentine health minister resigns over pandemic handling

Argentina's health minister, Graciela Ocana, resigned yesterday, citing differences with the government on the handling of pandemic flu and a previous dengue fever outbreak, the New York Times reported yesterday. Meanwhile, a crisis committee will meet today to discuss raising the response level, according to a local media report, which could close schools and other public places and curb mass gatherings. Argentina has 1,488 confirmed novel flu cases, many of them around Buenos Aires. [Jun 29 New York Times article]

-Saudi Arabia asks high-risk groups to skip hajj

Saudi Arabian health officials who just concluded a 4-day meeting with international health experts to discuss pandemic flu risks related to the hajj today advised that children, pregnant women, elderly people, and those with chronic health conditions avoid the annual pilgrimage, the Associated Press reported. The 4-day hajj starts in late November this year and is expected to attract about 3 million pilgrims. The health ministry said the crowded setting could pose a flu transmission risk. [Jun 30 AP story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 1
H1N1 Flu Breaking News

- World pandemic flu cases top 77,000

The world's number of pandemic flu cases rose to 77,201 today, including 332 deaths, the World Health Organization (WHO) reported. Today's numbers represent 6,308 more cases and 21 more deaths than the last report on Jun 29. Countries included for the first time are the French overseas territory of New Caledonia, Kenya, Mauritius, Myanmar, and Saint Lucia. About a third of the new cases are from the United Kingdom. South American countries and Thailand also reported large increases. [WHO update 56]

-Argentina capital declares flu health emergency

Health officials in Argentina's Buenos Aires city and province yesterday, amid quickly rising numbers of pandemic flu cases, declared a health emergency, extending school vacations and giving the mayor the power to suspend sports and other entertainment gatherings, the Associated Press reported today. Public places remain open. Buenos Aires is the fifth province to declare a health emergency. Argentina has South America's highest number of pandemic flu cases, with 1,587, including 26 deaths. [Jul 1 AP story]

-Roche unveils Tamiflu discount program for poor nations

Roche, the maker of Tamiflu (oseltamivir), today launched a program to help developing countries buy the drug at a discount for their national stockpiles. The company will produce and store the drug at a significantly reduced price, with the cost spread over the drug's shelf life. Roche will ship the supplies whenever the country requests them. The price will depend on the length of storage time that the country requests. An international health group will likely coordinate the orders. [Jul 1 Roche press release]

-Bosnia, Guam report first novel flu cases

Bosnia's health ministry today announced the nation's first pandemic flu case, a 24-year-old woman who recently arrived from a South American country, the AP reported. She is recovering in isolation at the home of relatives. Meanwhile, the US territory of Guam confirmed its first pandemic flu case today, a woman in her 40s who just returned from Texas, KUAM, Guam's broadcast network, reported. [Jul 1 AP story]

- Flu cluster of pregnant women reported in San Francisco

San Francisco officials reported what they believe may be the first publicized cluster of novel H1N1 infections in pregnant women, KPIX, a northern California television station, reported on Jun 29. All five remain hospitalized, two of them still in intensive care. A doctor who consulted on the cases said all are or were in their third trimester and that some required intubation. Some had underlying conditions. Pregnant women are among those at high risk for flu complications. [Jun 29 KPIX story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 2
H1N1 Flu Breaking News

-US cases rise to almost 34,000

The United States' number of pandemic flu cases climbed to 33,902, with 170 deaths, the US Centers for Disease Control and Prevention (CDC) reported today. The new totals reflect 6,185 more cases and 43 more deaths than last week. In its new surveillance report today for the week ending Jun 27, the CDC said flu activity decreased but is still higher than normal for this time of year. The New York/New Jersey area is still reporting elevated activity, as is the Pacific Northwest. [Current CDC numbers]

-Malta, Uganda report first novel flu cases

Authorities in Malta today confirmed the country's first two pandemic flu cases, two 26-year-old men who had recently traveled with a group to Spain, Deutsche Presse-Agentur reported. Others from the group also have flu symptoms. Before today's confirmation, Malta was the only European Union country that had not reported a novel flu case. Elsewhere, Uganda today reported its first case, a 40-year-old British man who had recently arrived from Kenya, Xinhua, China's state news agency, reported. [Jul 2 DPA article]

-Paraguay, China report first pandemic flu deaths

Paraguay's health ministry today reported the nation's first novel flu death, a man in his 60s, Agence France-Presse (AFP) reported. No details were available about any preexisting conditions. Meanwhile, China's state media said a woman who was hospitalized with a novel H1N1 infection was found dead yesterday in a hospital bathroom, according to the Associated Press. She was reportedly recovering and her death is under investigation. [Jul 2 AFP story]

-UK moves away from flu containment measures

The United Kingdom is moving from a novel flu containment strategy to focus more of its resources on more vulnerable patients, AFP reported yesterday. Prime Minister Gordon Brown announced the change yesterday, noting that case numbers spiked by 2,000 over the past week and that a "more flexible and local approach" will be used in hard-hit areas. Media reports say hot spots include London, the West Midlands, and Glasgow. [Jul 1 AFP story]

-Argentina authorities criticize government's flu response

Some health officials in Argentina are criticizing the government for rejecting calls to postpone the nation's recent election, a move they say could have avoided the virus's spread at crowded polling places and focused the public's attention on pandemic issues, the New York Times reported yesterday. The officials said the health minister who just resigned was among those who recommended postponing the election. Increased flu cases prompted an emergency declaration in Buenos Aires. [Jul 1 New York Times article]

-Obama convenes flu summit for next week

President Obama has called a "flu summit" on Jul 9 to discuss the nation's pandemic flu preparedness plans for the fall, CNN reported yesterday. The meeting will be held at the National Institutes of Health and be led by Department of Homeland Security Secretary Janet Napolitano and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. On Jul 30 Obama met with federal officials who helped manage the 1976 influenza outbreak to discuss lessons learned from their experience. [Jul 1 CNN story]

-US to supply Tamiflu to Latin America, Caribbean

HHS Secretary Kathleen Sebelius announced today that the country will supply 420,000 treatment courses of oseltamavir (Tamiflu) to the Pan-American Health Organization to fight novel H1N1 flu in Latin America and Caribbean countries. She announced the effort while attending a series of meetings in Cancun, Mexico, for health ministers throughout the Americas. [Jul 2 HHS statement]

-Japan reports its first antiviral resistant novel flu case

Japan's health ministry today confirmed the country's first instance of oseltamivir (Tamiflu) resistance in a novel flu virus, Reuters reported. The patient, from Osaka prefecture, was sick with the new H1N1 virus in mid May and has since recovered. A health ministry spokesman said the patient's sensitivity to the drug has not been tested yet. Danish officials reported the world's first oseltamivir-resistant novel flu case Jun 29 [Jul 2 Reuters article]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 6

H1N1 Flu Breaking News
-Global novel flu total passes 94,000

The world's pandemic flu total reached 94,512 cases, 429 of them fatal, the World Health Organization (WHO) reported today. The number is 4,591 more cases and 47 more deaths than the last report on Jul 3. Countries reporting their first cases include Cook Island, Croatia, the French overseas territories Guadaloupe and St Martin, Guyana, Libya, and Macedonia. Countries reporting the highest numbers of new cases are Argentina (898), Australia (730), and Thailand (662). [WHO update 58]

-Hong Kong finds antiviral-resistant novel flu strain

Public health officials in Hong Kong said they have detected their first oseltamivir (Tamiflu)-resistant novel H1N1 strain, which was isolated from a 16-year-old girl after she arrived from San Francisco, the health ministry said in a Jul 3 press release. Similar cases were recently reported in Denmark and Japan. The girl was isolated and treated at a hospital where she refused antiviral treatment. She was released on Jun 18. The sample was sensitive to zanamivir (Relenza). [Jul 3 Hong Kong Department of Health statement]

-UN director: $1 billion needed to help poor nations fight flu

United Nations Secretary-General Ban Ki Moon today estimated that $1 billion is needed by the end of the year to help developing countries respond to pandemic influenza, the Associated Press (AP) reported. Speaking at a press conference in Geneva after a donor's conference, Moon said funding isn't coming in as expected. Margaret Chan, the WHO's director-general, said donor assistance is needed to help 49 developing countries stockpile antivirals and other drugs. [Jul 6 AP story]

-Study: Credible flu info linked to behavior changes

A British survey on the public's perceptions and behavior changes related to the novel flu outbreak revealed that just over a third had followed any advice to reduce their risk, the British Medical Journal reported on Jul 2. The survey of 997 adults showed that changes were associated with beliefs that the outbreak is severe, that good information is available, and that people can control their risk. Belief that outbreak reports are exaggerated was linked to less behavior change. [Jul 2 BMJ report]

-Traveler is Syria's first novel H1N1 case

Syria's health ministry confirmed the country's first novel flu case, a Syrian woman living in Australia who had flown back for a visit, the AP reported on Jul 4. The woman's family was tested, and all of the passengers on her flight were slated for testing. The woman had flown through Dubai on her way to Syria. [Jul 4 AP story]

-Three countries report first pandemic flu deaths

Peru, New Zealand, and El Salvador recently reported their first pandemic flu deaths, according to several media reports. Peru's fatalities include a 38-year-old woman and a 4-year-old girl, both of whom had underlying conditions and died last week, the AP reported yesterday. New Zealand reported three deaths: two men, ages 19 and 42, and a young girl. One of the men and the girl had underlying conditions. El Salvador's fatal case was a 9-year-old boy who died in the country's capital. [Jun 5 AP story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 7


H1N1 Flu Breaking News
-Jamaica reports first pandemic flu death

Jamaica's health ministry yesterday reported its first novel flu death, a patient who had an underlying medical condition who died at the University Hospital of the West Indies in Kingston, the Jamaica Observer reported. The ministry has asked a medical team to investigate the death. Jamaica reported its first novel flu cases in late May, and on Jun 24 announced the virus was spreading in the community. So far 33 cases have been reported, including the recent fatality. [Jul 7 Observer story]

-Chile officials cancel religious festival to curb flu spread

Chile's health ministry recently cancelled a large religious festival, set to converge on a small town in the southern part of the country, in an effort to slow the spread of pandemic flu, the Santiago Times reported on Jul 3. The dance and music celebration typically brings 200,000 visitors to the town of La Tirana. The event was last cancelled in 1991 during a cholera outbreak. The World Health Organization said yesterday Chile has confirmed 7,376 novel H1N1 cases. [Jul 3 Times report]

-Military flu data boosts global influenza surveillance

A profile of US military flu surveillance efforts, to appear in the September issue of the American Journal of Preventive Medicine, illustrates the importance of global influenza surveillance and quick access to epidemiologic data, the journal said in a press release today. Military surveillance efforts began in the 1970s and have made notable contributions, such as detecting the first novel H1N1 cases in the United States. Military disease surveillance is active in 56 countries. [Jul 7 Am J Prev Med press release]

-CDC issues flu advisory for OB settings

The Centers for Disease Control and Prevention (CDC) yesterday released interim guidance for preventing and managing novel H1N1 infections in obstetric settings. Severe illnesses in pregnant women and infants have been a feature of the flu pandemic, though experts don't have a firm grasp on the epidemiology and illness spectrum. The new guidance says areas where prenatal care and labor and delivery services are delivered should be separated from areas where the sick are handled. [Jul 6 CDC guidance]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 8

H1N1 Flu Breaking News
-CDC releases pandemic H1N1 vaccine guidance

The Centers for Disease Control and Prevention (CDC) issued recommendations today to help state and local health officials decide who should get novel H1N1 vaccine when supplies are initially limited. Target groups include schoolchildren and staff, children in daycare and staff, pregnant women and contacts of newborns, those with medical underling conditions, and health workers. The report also discusses weighing the needs of other nations and military personnel, but it focuses on US civilians. [Jul 8 CDC recommendations]

-Novel strain may dominate Australia's flu season

The novel flu virus seems poised to dominate Australia's flu season, the country's health minister, Nicola Roxon, said today, according to the Adelaide Advertiser. Flu surveillance for the week ending Jun 20 revealed that almost two thirds of the infections were from the pandemic H1N1 virus. Roxon said the new virus will likely replace seasonal flu, rather than circulate alongside it. [Jul 9 Advertiser story]

- Tamiflu-resistant strain found in US traveler

Federal and state health departments are increasing their testing of novel flu viruses for oseltamivir (Tamiflu) resistance, the Associated Press (AP) reported today. The measures were prompted by a report of a resistant strain isolated from a San Francisco resident who had arrived in Hong Kong in June. The girl had had not taken osteltamivir. The CDC has asked states to send more samples for resistance testing, and California said it has stepped up its testing. [Jul 8 AP story]

-Paraguay lawmakers pass emergency measures

Paraguay's government passed emergency legislation yesterday aimed at curbing the spread of pandemic flu, the AP reported today. The law gives the country's president expanded powers to respond to the flu outbreak and allows health officials to use $19.2 million from the treasury to fund programs to boost healthcare capacity. [Jul 8 AP story]

-Live feeds from tomorrow's White House flu summit

The two plenary sessions of tomorrow's White House pandemic H1N1 flu preparedness summit--a substantial portion of the event--will be broadcast over the Web via flu.gov, according to the Department of Health and Human Services. In addition, David Hale, a biomedical informatics and social media expert, will be providing live Twitter updates during the entire event. His Twitter name is lostonroute66. The day-long event starts at 8:30 a.m. Eastern time. [David Hale's Twitter home page

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 9
H1N1 Flu Breaking News

-HHS to fund $350 million for state preparedness

The Department of Health and Human Services (HHS) plans to rapidly distribute $350 million that Congress recently provided for pandemic efforts by states, HHS Secretary Kathleen Sebelius said today. Speaking at a federal "flu summit," Sebelius said HHS will announce the funding tomorrow. She said $260 million will go to state health departments for general and vaccine efforts and $90 million will go to hospitals for surge capacity. "We hope to push the money out the door by July 31," she said. [HHS pandemic flu Web site]

-Thailand, Argentina launch community mitigation measures

Thailand's government has ordered more than 1,000 schools to close for 15 days starting Jul 13 and has asked Internet cafes, popular with youth, to close during the time to curb the spread of pandemic flu, the Australian Broadcasting Corporation reported today. Elsewhere, Argentina will close financial markets and banks tomorrow to slow the spread of the virus, Reuters reported yesterday. It encouraged private businesses to do the same. Today is a national holiday in Argentina. [Jul 9 ABC story]

-Tanzania, Zimbabwe confirm first novel flu cases

Tanzania's health ministry today confirmed the country's first novel H1N1 case, a British student who arrived in the country about a week ago and told immigration officials he felt sick, the Associated Press (AP) reported. Also, Zimbabwe's state media today reported the country's first two cases, an Asian man who had recently arrived from London and a squash player hospitalized in South Africa, the Kenya-based Daily Nation reported. It's unclear where the player was infected. [Jul 9 AP story]

-New Zealand: flu season eclipses 12-year high

An official with New Zealand's influenza center said today that flu activity has reached a 12-year high point and predicted the season hasn't peaked yet, Bloomberg News reported. A flu surveillance report released today for the week ending Jul 5 notes that novel H1N1 makes up 80% of circulating flu strains in New Zealand, an increase from the 48% reported in the previous week's report. [Jul 9 Bloomberg News story]

-Japan quarantines American university student group

Japanese health officials quarantined 20 American university students Jul 3 after two of their Japanese instructors were diagnosed as having novel flu, the AP reported yesterday. Authorities are monitoring the students' health, but so far none have shown any flu symptoms. The students are from California colleges, and the quarantine is scheduled to end tomorrow. [Jul 8 AP story]

-CDC updates home care guidance

The Centers for Disease Control and Prevention (CDC) yesterday updated its guidance on caring for people who are sick with novel H1N1 flu at home. The revision incorporates interim guidance on facemask and respirator use that the CDC updated in late May. The updated home care guidance suggests that all caregivers, not just those in high-risk groups, who must have close contact with a sick person try to use a facemask or N-95 disposable respirator. The update also lists where to buy the items. [Jul 8 CDC home care guidance]

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Roscoe and Miss Priss 

July 9, 2009
H1N1 - Threat Has Not Passed
At a conference outside Washington, 500 State and local health officials traded lessons from the swine flu outbreak this Spring, and got warning from the federal government that we haven't dodged a bullet just because outbreak wasn't as serious as was feared. Officials say it may come back with a vengeance during regular flu season this Fall. Health Secretary Kathleen Sebelius says it's still not certain there will be a vaccine for the H1N1 strain. It's being tested next month to make sure there's no repeat of the 1976 debacle when the government urged people to take a swine flu vaccine and reactions to it left two dozen people dead, and hundreds more with a neurological disorder.

Sebelius told reporters that scientists are trying to determine "if we have an effective...and a safe vaccine...and what the side effects are." If there is a vaccine, she says, it may need to be distributed in non conventional ways; through schools and day care centers, since the H1N1 strain tends to target young people more than seniors.

Sebelius says the good news is that the H1N1 strain seems to be easily treated with the medications tamiflu and rolenza, and there's plenty of that. And production of this Fall's seasonal flu vaccine is complete, so those production lines can be used for H1N1 vaccine. The bad news is we don't know, yet, if swine flu has mutated this year's seasonal flu and made it more virulent or less susceptible to treatment.

Dr. Thomas Frieden, the head of the Centers for Disease Control, says the flu virus changes "from season to season and from year to year," and he says it rarely becomes less severe. He says vaccination and response plans will depend on how severe both the H1N1 and seasonal flu strains are this Fall.

State and local health officials say the Mexico City outbreak this Spring made an excellent preparatory drill. A Texas school superintendant said the most important thing the federal government can do, is help local officials know when they need to close the schools. Education Secretary Arne Duncan said local school officials should concentrate most on how to keep the kids learning if they do have to shut their doors. In rural communities, where high speed internet may not be widely available, officials say local television stations may need to help, if kids can't go to school.

There were stories of ingenuity, like the New York City school nurse with 100 sick students, one phone line and no medical assistants. Mary Pappas, of St. Francis Preparatory School, said she had to send 102 kids home one day and she was the only health official in the school. Pappas enlisted a security guard as a medical assistant. "I said please just go down the line take their temperature, and I gave him a post it pack and said throw the temperature on their chest." She then had "every child pull out their cell phone...because what child doesn't know where their mother is." Pappas was able to go from child to child and talk to the parents of those with high fevers.

http://whitehouse.blogs.foxnews.com...has-not-passed/

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Being happy doesn't mean everything is perfect.
It means you decide to see beyond the imperfections.
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Live each day as if there is World enough and Time~
Arubi 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 10

H1N1 Flu Breaking News

-US warns that China may quarantine children traveling alone

The US State Department yesterday said parents planning to send unaccompanied children to China should consider postponing such trips until China changes its quarantine policies or the H1N1 flu pandemic subsides. The agency said some unaccompanied minors, including some under 10 years old, have been quarantined on arrival in China. It is nearly impossible to predict which travelers might be quarantined, and the US continues to receive reports of poor quarantine conditions, officials said. [State Department warning]

-H1N1 case count in US tops 37,000

The US tally of pandemic H1N1 flu cases has risen to 37,246, with 211 deaths, the CDC reported today. The numbers are up by 3,344 cases and 41 deaths since the last CDC report on Jul 2. Wisconsin led the list with 6,031 cases and 4 deaths, followed by Texas (4,463 and 21), Illinois (3,259 and 14), New York (2,582 and 52), and California (2,461 and 31). [Current CDC numbers]

-US flu activity down, but still above normal

US influenza activity decreased last week but stayed above normal for this time of year, the CDC said in its weekly flu surveillance report today. More than 97% of the influenza A viruses that were subtyped were the novel H1N1. Nine states still reported widespread flu activity, while 10 states and Puerto Rico reported regional activity. Five novel H1N1-related pediatric deaths were reported. The proportion of medical outpatient visits due to flu-like illness was below the national baseline. [CDC flu report for Jun 28 to Jul 4]

-Pigs vulnerable to novel H1N1 flu

Piglets experimentally infected with the novel H1N1 flu develop symptoms and measurable immune responses, excrete virus, and can infect other pigs (but not chickens), researchers from Germany's Friedrich Loeffler Institute report today in the Journal of General Virology. The findings echo USDA Agricultural Research Service data. The authors voice concern that the virus will become endemic in farmed pigs and ask whether human access to them should be controlled. [J Gen Virol full text]

-HHS details preparedness grants for states

The Department of Health and Human Services (HHS) today announced state-by-state details of the $350 million it will grant states and territories to prepare for H1N1 pandemic and seasonal flu. State public health departments will receive $260 million, and hospitals $90 million. States receiving the most funds were (in millions): California ($22.7), Texas ($20.1), Florida ($15.5), Pennsylvania ($10.6), Ohio ($9.8), New York ($9.5), Michigan ($8.6), Illinois ($8.6), and Georgia ($8.0). [Jul 10 HHS press release]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 13

H1N1 Flu Breaking News

-US to spend another $1 billion on H1N1 vaccines

The United States will order another $1 billion worth of pandemic H1N1 influenza vaccine, Health and Human Services (HHS) Secretary Kathleen Sebelius said yesterday, according to Reuters. "There'll be another $1 billion worth of orders placed to get the bulk ingredients for an H1N1 vaccination," Sebelius told CNN, without naming the suppliers. Sebelius had announced on May 22 that HHS would spend about $1 billion to buy vaccine antigen and adjuvant and fund clinical studies. [Jul 12 Reuters story]

-Lurie OK'd as new HHS preparedness head

HHS Secretary Kathleen Sebelius announced today that the US Senate unanimously confirmed Nicole Lurie, MD, MSPH, as assistant secretary for preparedness and response. Lurie most recently worked for the Rand Corporation and with federal officials and state and local health departments on pandemic preparedness and other public health issues. Sebelius said in today's release that Lurie's "knowledge and expertise will be essential" as the country coordinates its national response to the H1N1 virus. [Jul 13 HHS news release]

-Botswana confirms first novel flu case

Botswana's health ministry on Jul 10 confirmed the country's first novel flu case, Mmegi, a Botswana newspaper, reported today. Confirmatory tests were conducted in South Africa. The patient, who is one of three people with suspected cases, has been isolated at a clinic, and the ministry is tracing his contacts. The health minister said oseltamivir (Tamiflu) will be available to those in high-risk groups and those who have respiratory infections. [Jul 13 Mmegi story]

-CSL set to launch human trial of H1N1 vaccine

Australia-based flu vaccine maker CSL Ltd said today that it expects to launch a human trial of its novel H1N1 vaccine Jul 22, Bloomberg News reported. In a Jun 29 press release, CSL said it would undertake the trial with a research group in Adelaide and was seeking healthy adults aged 18 to 64 to enroll in the study to compare two injections of a standard dose, administered 3 weeks apart, with a higher dosage. The Australian government has ordered enough vaccine to immunize 10 million people. [Jul 13 Bloomberg News story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Jul 14
H1N1 Flu Breaking News

-Novel flu hits dozens at Air Force Academy

The US Air Force Academy in Colorado Springs has confirmed that 67 incoming cadets have tested positive for pandemic H1N1 influenza and that a total of 121 incoming freshmen with flulike symptoms are being quarantined in a separate dorm, the Associated Press (AP) reported yesterday. The students are among about 1,300 who recently reported to the academy for their first weeks of military training. [Jul 13 AP story]

-Nurses file complaint against hospital over protective gear

Nurses at a hospital in Vallejo, Ca., filed a complaint today with the state's Division of Occupational Safety and Health alleging that their facility hasn't supplied them with adequate masks for caring for patients with pandemic H1N1 influenza, the AP reported. Ten nurses reportedly got sick after treating three patients with novel flu infections. [Jul 14 AP story]

-Oregon beefs up pig biosecurity at fairs

Oregon's Department of Agriculture is asking fairgoers this year to help protect pigs from the pandemic H1N1 virus. In two instances, in Canada and Argentina, pig herds apparently contracted the virus from infected workers. Officials are asking people to keep at least 6 feet away from pigs and are recommending that fairs keep an adequate number of hand washing stations stocked with disinfectant nearby. They ask people with flu symptoms to stay away from pigs for at least 7 days. [Oregon Department of Agriculture press release]

- Pandemic forces postponement of surgeries in Chile

Five thousand surgeries were postponed in Chile last week to free up hospital beds for patients with H1N1 flu, according to the Santiago Times. The story said the number of delayed procedures could rise to 20,000 over the next few weeks as the country continues to battle the pandemic. As of the last World Health Organization update on Jul 6, Chile had 7,376 H1N1 cases and 14 deaths. [Santiago Times story]

-Bangkok to close schools for 5 days to fight H1N1

Officials in Bangkok said they will close 435 city schools for 5 days to fight the flu pandemic, Reuters reported today. The schools will be thoroughly cleaned during the interval. Also, Thailand's cabinet decided today to order 2 million doses of an H1N1 vaccine, with delivery expected by December, the story said. It said Thailand has had 4,057 H1N1 cases with 24 deaths. [Jul 14 Reuters story]

-HHS to spend $884 million for H1N1 vaccine ingredients

The US government will commit $884 million to buy additional pandemic H1N1 vaccine antigen and adjuvants, Health and Human Services (HHS) Secretary Kathleen Sebelius announced yesterday. The products will be additional orders under existing contracts with Sanofi Pasteur, MedImmune, GlaxoSmithKline, and Novartis, an HHS news release said. The announcement is an apparent follow-up to Sebelius's comment on CNN 2 days ago that the agency would spend another billion dollars on H1N1 vaccines. [Jul 13 HHS announcement]

-Inovio reports preclinical findings for DNA vaccine

Inovio, a biotechnology company based in San Diego, yesterday announced promising results in a preclinical trial of its DNA vaccine against pandemic H1N1 influenza. All pigs immunized with a two-dose regimen showed an antibody response, the company reported. The firm said it is conducting other animal studies to determine if the seasonal and pandemic H1N1 vaccines it is developing provide cross-protection against other circulating influenza strains. [Jul 13 Inovio press release]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 15
H1N1 Flu Breaking News

-American Lung Association recommends closing affiliated summer camps

The American Lung Association (ALA) has asked about 50 summer camps with which it is affiliated to close, after four children who attended one of the camps were diagnosed with H1N1 flu, the Associated Press (AP) reported yesterday. An ALA spokeswoman said she wasn't sure how many ALA camps would follow the advice. Patients who have asthma and other chronic conditions are at greater risk for flu complications. In June the Muscular Dystrophy Association canceled its camps for similar reasons. [Jul 14 AP story]

-California nurses detail complaint about masks

The California Nurses Association yesterday detailed the complaints of nurses at a Vallejo hospital about inadequate respiratory protection to care for patients with novel flu. They said the hospital had too few N95 masks, and the masks were not properly fitted. Also, they said they were asked to reuse masks repeatedly and to wear surgical masks over the N95s. A hospital official told the Associated Press that only one employee had confirmed H1N1 flu and that the masks could be safely reused. [Jul 14 California Nurses Association press release]

-Australia and Chile each exceed 10,000 H1N1 cases

Australia and Chile have both counted more than 10,000 H1N1 flu cases, according to reports today from Agence France-Presse (AFP) and Reuters. In Australia, which has had 22 deaths, patients' average age is 19, and authorities are worried about a growing number of serious cases in young, otherwise healthy people, according to AFP. Chile has had 33 deaths, and its case count is the highest in South America, according to Reuters. [Jul 15 AFP report]

-Tonga reports first H1N1 cases

The South Pacific archipelago of Tonga has reported its first two cases of novel H1N1 flu, according to a report today from Radio Australia News. Blood tests conducted in Australia confirmed the illness in two women, one a resident and the other a visitor from Brisbane, Australia, the report said. [Radio Australia report]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 16
H1N1 Flu Breaking News

-Britain prepares to launch phone service to supply antivirals

Following a surge of flu-like illnesses, a British system that will allow people to report symptoms by phone and obtain antiviral drugs will be launched very soon, The Times reported today. Data from general practitioners indicated that the rate of people reporting flu-like illnesses rose to 73 per 100,000 last week, from 50 per 100,000 the week before, the newspaper said. Using the phone service, people will get reference numbers that friends can use to collect antivirals for them. [Jul 16 Times report]

-South American health ministers meet to coordinate pandemic response

Health ministers from six South American countries met yesterday in Buenos Aires, Argentina, to coordinate responses to the H1N1 pandemic, according to a report from TerraDaily, a business and technology news Web site. Besides Argentina, the meeting included Bolivia, Brazil, Chile, Paraguay, and Uruguay. Ministers said the countries need to share medicine and supplies, and they voiced concern about access to vaccines. Argentina has had 137 deaths, second highest toll after the United States. [TerraDaily report]

-Vaccine contracts might prove worthless in severe pandemic, experts say

Experts warn that if the H1N1 flu pandemic turns severe, countries that have vaccine factories might seize vaccine supplies, rendering contracts that promise doses to other countries meaningless, the Associated Press reports. Many vaccine contracts that countries have signed involve doses made outside their borders. In a severe pandemic, countries with vaccine plants might decide to seize all doses and ban their export, said David Fidler, a law professor at Indiana University, and other experts. [Jul 16 AP story]

-Haiti reports its first pandemic H1N1 cases

Haiti has confirmed its first three novel H1N1 flu cases, according to a Xinhua report published yesterday. Two cases are in Chilean soldiers serving in the United Nations Stabilization Mission for Haiti, and the third involves a 23-year-old Haitian who has not been outside the country. The two soldiers entered Haiti early this month. All three patients were in stable condition. Samples from 61 people are being tested in foreign laboratories, Health Minister Alex Larsen said. [Jul 15 Xinhua report]

-National Biodefense Science Board to hold teleconference

The National Biodefense Science Board will host a public teleconference tomorrow to allow the public to participate and comment in a session on findings from an H1N1 countermeasures and decision-making forum held last month by the board's pandemic influenza working group. Members of the public are invited to call in to listen to and comment on the board's deliberations. Call-in information is listed on the board's Web site (see link). [NBSB teleconference information]

-NIAID seeking H1N1 patients for study

The National Institute of Allergy and Infectious Diseases (NIAID) said today that it is seeking patients with pandemic H1N1 influenza to participate in a study of how the disease affects those with chronic illnesses and impaired immune systems. The study is taking place at the NIH Clinical Center in Bethesda, Md. Findings will be used to develop new prevention and treatment strategies against the new flu strain. [NIAID flu study information]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...update_mws.html

CDC braces for back-to-school flu spike, addresses vaccine worries
Lisa Schnirring Staff Writer


Jul 17 2009 (CIDRAP News) – Novel flu activity is still going strong but dropped for the third week in a row, the US Centers for Disease Control and Prevention (CDC) said today during a media briefing that also sought to calm fears about vaccine availability.

Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said the CDC will probably follow the World Health Organization's (WHO's) lead and phase out weekly reports of lab-confirmed cases, which grossly underestimate the true disease burden and divert resources from other pandemic response activities. She said over the next several weeks the agency will start adding new data and other enhancements to its weekly flu report to provide a more detailed profile of the nation's activity.

The CDC's update today, however, reports that the country's number of lab-confirmed cases has reached 40,617, of which 263 were fatal.

In its flu surveillance report for the week ending Jun 11, the CDC said nine states reported widespread activity: California, Delaware, Georgia, Hawaii, Maine, Maryland, Nebraska, New Jersey, and New York. Twelve states and Puerto Rico reported regional influenza activity.

More than 99% of flu isolates that have been subtyped are the novel H1N1 virus, the CDC reported. One of three cases of oseltamivir-resistant viruses detected worldwide was from a child who got sick in California and traveled to Hong Kong. Enhanced antiviral-resistance testing in California has not revealed any oseltamivir-resistant novel H1N1 viruses, the CDC said.

One pediatric death from the new virus was reported during the past week, in a child from Massachusetts. Of the 90 fatal pediatric flu cases that have been reported to the CDC so far this season, 23 were novel H1N1 infections.

Schuchat said the virus might be persisting through the summer, despite the heat and humidity, because of the US population's low immunity to the novel virus rather than because the virus has mechanisms for coping with the conditions. However, she said the CDC doesn't have the data to flesh out its theory about the summer spread.

The CDC expects flu activity to start rising again in September, ahead of the regular flu season, which would coincide with kids congregating in greater numbers as school resumes, she said. The CDC and its partners are in the active stage of planning for a spike in pandemic H1N1 flu activity in early fall, she added.

The CDC's Advisory Committee on Immunization Practices (ACIP) will hold an emergency meeting on Jul 29 to discuss recommendations for which populations should be targeted for novel H1N1 flu vaccination and whether tiering the vaccine prioritization would be appropriate, Schuchat told reporters.

Two federal officials who are involved in high-level vaccine decisions were on hand at the press conference to address recent questions that have cropped up about disappointingly low novel flu vaccine yield and potential international squabbles over vaccine supplies. The officials were Jesse Goodman, MD, the Food and Drug Administration's acting chief scientist and deputy commissioner for scientific and medical programs, and Bruce Gellin, MD, director of the National Vaccine Program, Department of Health and Human Services.

Gellin said federal officials have stockpiled antigen and adjuvant and that National Institutes of Health investigators, as well as researchers at vaccine companies, are starting to test both adjuvanted and nonadjuvanted versions of the novel flu vaccine. Stockpiling the bulk ingredients gives US officials greater flexibility in pulling together a safe and effective vaccine for its citizens, he said.

Schuchat said the CDC has heard concerns about vaccine manufacturers in foreign countries diverting vaccine orders to their own populations. "From our own planning, this is not one of our current concerns," she said. "We haven't received any information that makes us question the supply of what's been promised."

As for poor antigen yields that some manufacturers are reporting for the new virus, Schuchat said the CDC is not surprised and has already incorporated such yields into its planning and vaccine production expectations. "It's within the range of our planning assumptions, but of course there could always be some surprises," she said.

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 17

H1N1 Flu Breaking News

-Australian ob-gyn group urges pregnant women to wear masks

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists urged pregnant women to wear masks in public and "wash themselves scrupulously" after coming into contact with others, the Australian newspaper The Age reported today. Ted Weaver, president of the group, said pregnant women should work at home if possible. "If it's not essential to go out, stay home," he said. The story said six pregnant women were fighting for their lives in intensive care units in Sydney. [Jul 17 The Age report]

-Baxter stops taking H1N1 vaccine orders

The vaccine maker Baxter International said it has orders for 80 million doses of H1N1 flu vaccine and can take no more, according to a Reuters report published yesterday. The Illinois-based company has orders from five countries, including Britain, Ireland, and New Zealand, said spokesman Chris Bona. Though the company is taking no more orders, it has agreed to reserve some doses for the World Health Organization, Bona said. The firm does not have an order from the United States. [Jul 16 Reuters story]

-Germany to offer vaccine to 22.5 million people

Germany plans to provide H1N1 flu vaccine to 22.5 million people, including healthcare workers, police, and people with chronic ailments, according to a Bloomberg News story citing a report in the newspaper Die Welt. The target groups make up slightly less than a quarter of Germany's population, the story said. The nation's compulsory health insurance program will pay for the immunizations and notify those eligible for the vaccine. [Jul 17 Bloomberg News story]

-Canada says it can meet its own vaccine needs

When vaccination against the novel H1N1 virus begins, Canada will be able to fill all of its vaccine needs within its borders, the Canadian Press reported yesterday. In 2001, Canada signed a contract with a vaccine maker that is now owned by GlaxoSmithKline that requires the company to be able to make pandemic vaccine for Canadians whenever needed. The contract was prompted by an incident during the 1976 swine flu outbreak, when Canada never got the vaccine it ordered from the United States. [Jul 16 Canadian Press story]

-Sudan reports first novel flu cases

Sudan's health ministry yesterday reported the country's first pandemic H1N1 influenza cases, Reuters reported. The patients are two Sudanese men who arrived on a flight from Britain on Jul 13. They are reportedly recovering from their illnesses. [Jul 16 Reuters story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 20
H1N1 Flu Breaking News

-NIAID to study simultaneous seasonal-flu, pandemic vaccination

The head of the US National Institute of Allergy and Infectious Diseases (NIAID) said the agency will approve a study of whether vaccines for the pandemic H1N1 virus and seasonal flu can be given at the same time, the Canadian Press reported today. Meanwhile, Canada has plans to test whether people who have egg allergies can be given flu vaccines produced in eggs, a step now considered too risky. The studies are among a number planned in preparation for a likely H1N1 vaccination drive this fall. [Jul 20 Canadian Press story]

-Advice to pregnant women sows confusion in UK

Messages from two health groups in Britain yesterday caused confusion about the dangers posed by the novel H1N1virus to women who are pregnant or may become pregnant, according to a TimesOnline report. The Royal College of Midwives said pregnant women should not use public transport, while the National Childbirth Trust suggested that women delay pregnancy until the pandemic ends. Government health officials described the groups' advice as extreme and said their advice to women had not changed. [Jul 20 TimesOnline report]

-ECDC assesses pandemic risks

In a risk assessment published today, the European Centre for Disease Prevention and Control (ECDC) said to expect 20% to 30% of the population to be affected during the next wave of pandemic H1N1, with the attack rate highest in children and young adults. Though it admits uncertainty, the ECDC says a "reasonable" assumption is a hospitalization rate of 1% to 2%. It also estimates a case-fatality rate of 0.1% to 0.2% and says, "this pandemic can severely stress healthcare systems." [Jul 20 ECDC report]

-Security guards to protect Tamiflu depots in Britain

Security guards will be used to protect oseltamivir (Tamiflu) supplies when more than 100 distribution centers are set up in the United Kingdom this week, according to a report by Metro, a free British newspaper. The location of the centers will be kept secret until they are set to open. Richard Hampton of the National Health Service said there is concern about theft and the safety of workers at the centers. Plans call for giving the drug to patients who describe symptoms over the phone. [Jul 20 Metro story]

-Canada sees decline in flu-like illness

Canada saw a decrease in people with flu-like symptoms last week, suggesting that community transmission of the H1N1 virus is decreasing, Canwest News Service reported today. Most cases have been mild, but there were still "pockets of more severe disease" in some communities, Health Minister Leona Aglukkaq said at a Jul 17 press conference, according to the story. [Jul 20 Canwest story]

-Egypt reports its first H1N1 fatality

Egypt reported its first death from the novel H1N1 virus, involving a young woman who fell ill while on a Muslim pilgrimage to Saudi Arabia, Reuters reported yesterday. The woman, who had a heart condition due to rheumatic fever, was hospitalized after she returned to Egypt and died Jul 18, the health ministry said. Other reports listed the woman's age as 25. Egypt has had confirmed 130 H1N1 cases, including 10 new ones reported yesterday, the state news agency said. [Jul 19 Reuters report]

-Air carriers list restrictions on suspected H1N1 patients

Two British air carriers, British Airways and Virgin Atlantic, announced they would increase restrictions on passengers with suspected H1N1 infections, according to an Agence France-Presse (AFP) report. If a customer looks sick, the airport staff can call in a medical team for advice, the story said. If the medical team is concerned, the customer will be asked to produce a "fit-to-fly" certificate from a doctor or hospital. [Jul 20 AFP story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 21

H1N1 Flu Breaking News

-US Coast Guard Academy has 37 H1N1 cases

Thirty-seven confirmed cases of H1N1 flu have been reported at the US Coast Guard Academy in New London, Conn., according to the Connecticut newspaper The Day. The outbreak includes 31 incoming freshmen, or "swabs," more than 10% of the class. Also among the sick are two clinic staff members and four cadets who were training the freshmen. The academy is awaiting test results for 13 more patients. An official said it was not known how the virus was introduced to the campus. [Jul 21 The Day report]

-WHO says H1N1 death toll tops 700

A World Health Organization (WHO) official told reporters the H1N1 virus has killed more than 700 people, well above the 429 deaths listed in the WHO's last official update on Jul 6, Reuters reported today. The official, Alphaluck Bhatiasevi, said confirmed cases have reached 125,000, far above the 94,000 mentioned in the Jul 6 update. The WHO last week stopped reporting global case counts, because case testing is expensive and confirmed cases are only a small fraction of total cases. [Jul 21 Reuters report]

-Namibia reports first H1N1 cases

Namibia has reported its first two cases of novel H1N1 infection, both in young people who traveled abroad, a Jul 20 Agence France-Presse (AFP) report said. One case was in a 13-year-old boy who went on a rugby trip to South Africa with 20 other students; the other involved a "young student" who was treated at a hospital after returning from Europe, the story said. Two neighboring countries, South Africa and Botswana, had their first cases in June and last week, respectively. [Jul 20 AFP report]

-FDA advisory committee to discuss H1N1 vaccines Jul 23

The Food and Drug Administration's (FDA's) vaccine advisory committee will meet Jul 23 to discuss clinical trials of vaccines for the H1N1 virus and related FDA regulatory activities. The meeting of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) will be held in Gaithersburg, Md. [VRBPAC meeting announcement]

-ACIP sets special meeting Jul 29 on H1N1 issues

A special meeting of the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) will be held Jul 29 in Atlanta to discuss novel H1N1 flu issues, the CDC announced yesterday. The group will discuss epidemiology, vaccine development and formulations, and communications, and will hear a report from the FDA's Vaccines and Related Biological Products Advisory Committee, which meets Jul 23 (see above item). [CDC ACIP announcement]

-Malicious software poses as H1N1 update from CDC

A piece of malicious computer software that's disguised as H1N1 information from the Centers for Disease Control and Prevention (CDC) is circulating, according to the Internet security firm F-Secure. The file, called Novel H1N1 Flu Situation Update.exe, has an icon that makes it look like a Microsoft Word document. When opened, the file creates several new files that contain "backdoor functionality" and a key logger, or program that records keystrokes. [Jul 21 F-Secure report]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 22

H1N1 Flu Breaking News

-Australia, China launch novel H1N1 vaccine trials

Two Australian pharmaceutical companies said they began human trials this week of their pandemic H1N1 vaccines, the Associated Press (AP) reported today. CSL, based in Melbourne, said it hoped that results will allow release of the government-contracted vaccine in October, and Vaxine said it hoped to have results in 6 to 8 weeks. Meanwhile, two Chinese companies said they launched clinical trials of novel H1N1 vaccines, Xinhua reported today. They are Hualan Biological Engineering and Sinovac. [Jul 22 AP story]

-Glaxo issues vaccine update, triples Relenza production

In an update on its pandemic activities, GlaxoSmithKline (GSK) said in a press release today that it is talking with regulatory agencies about testing its pandemic H1N1 vaccine, which consists of antigen and its AS03 adjuvant, to be combined before administration. The firm said its first orders will be delivered to countries in September, but the delivery pace will depend on production yield. GSK also said it tripled production of its antiviral drug, zanamivir (Relenza). [Jul 22 GSK press release]

-Sanofi set to launch human vaccine trials

An official from Sanofi Pasteur today said the company would begin human trials of its pandemic H1N1 vaccine in early August and expects to have a vaccine ready by November or December, Bloomberg News reported today. The clinical trials, which could last about 2? months, will take place in the United States, France, and one other European country. The company said it doesn't know yet how much antigen will be needed for each dose. [Jul 22 Bloomberg News story]

-Canadian inspectors got sick after exposure to infected pigs

The Canadian Food Inspection Agency said yesterday that two of its employees contracted the novel H1N1 virus during their investigation earlier this spring of an Alberta pig herd that had the virus, the Calgary Herald reported yesterday. The employees reportedly removed their protective masks, contrary to recommended procedures, in the hog barn after their equipment fogged up. They got sick within days of their exposure to the virus in the barn. [Jul 21 Calgary Herald story]

-Canada, Japan find new oseltamivir-resistant cases

Canada reported its first and Japan its second case of oseltamivir (Tamiflu)-resistant pandemic H1N1 flu, the Canadian Press reported today. The Canadian patient is a 60-year-old Quebec man who was treated with the drug, and public health officials said it appears to be an isolated incident. The Japanese patient is from Yamaguchi and received the drug as postexposure prophylaxis. The patient's virus was sensitive to zanamivir, and officials said there was no sign of additional spread. [Jul 22 Canadian Press story]

-Hungary reports first pandemic H1N1 death

Hungary today reported its first novel H1N1 death, in a 41-year-old man who had underlying heart and lung problems, Reuters reported. The country has so far confirmed 37 cases, and two patients are hospitalized with mild illnesses. [Jul 22 Reuters story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/index.html

Jul 23

H1N1 Flu Breaking News

-Neurologic complications arise in children with H1N1

The US CDC reported today on four children who had neurologic complications of novel H1N1 flu. The four, aged 7 to 17, were hospitalized with flu-like illness and seizures or altered mental status, according to Morbidity and Mortality Weekly Report. All recovered fully. The complications were less severe than those described in two recent reports of cases related to seasonal flu. The CDC advises clinicians to be alert for such cases and use appropriate tests and antiviral treatment. [Jul 24 MMWR article]

-Muslim countries bar high-risk groups from hajj

Health ministers from Middle Eastern countries who met yesterday to discuss pandemic flu risks decided to ban children, the elderly, and those with chronic health conditions from attending the hajj pilgrimage in Saudi Arabia in late November, the Associated Press (AP) reported. The ban applies to children under 12 and adults over 65. Some Muslim clerics have opposed pilgrimage travel bans and have said flu risks are exaggerated. [Jul 23 AP story]

-Britain launches flu phone line

Britain launched its national influenza phone hotline today, staffed by more than 1,500 people, the London Telegraph reported. The system is designed to relieve pressure on England's National Health Service. Patients experiencing novel H1N1 flu symptoms can call in to have their illness diagnosed and receive a code number that allows them to obtain oseltamivir (Tamiflu). Patients from high-risk groups will be referred to doctors. [Jul 23 Telegraph story]

-British businesses lag on preparedness

Absenteeism in British workplaces is three times normal for this time of year, a consultant group told the British government this week, leading to fears that businesses will struggle when the H1N1 influenza pandemic peaks, the Financial Times reported today. Many companies have instituted hygiene steps, but an expert said most haven't planned for absences, such as making telecommuting plans, boosting customer self-service systems, and identifying key workers. [Jul 23 Financial Times story]

-Southern hemisphere sees H3N2 seasonal flu variant

Laboratory experts in the southern hemisphere are reporting the circulation of a drifted strain of the seasonal H3N2 flu virus, raising the threat of a vaccine mismatch for the northern hemisphere's upcoming flu season, the Canadian Press reported today. Officials, overwhelmed by handling a deluge of pandemic H1N1 samples, aren't sure how common the variant is. It was first identified in March by researchers in British Columbia. [Jul 23 Canadian Press story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...dateflu-jw.html

Novel H1N1 flu activity continues at unusual levels
Lisa Schnirring Staff Writer


Jul 24, 2009 (CIDRAP News) – Pandemic H1N1 influenza activity decreased for the fourth consecutive week, though the percentage of deaths from pneumonia and influenza rose a bit above the epidemic threshold, the US Centers for Disease Control and Prevention (CDC) said today.

The nation's number of lab-confirmed novel flu cases rose to 43,771, including 302 deaths, the CDC said. Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said at a press conference today that this would be the last national case count update, though the CDC will still provide regular updates on hospitalizations and deaths.

Many public health officials say keeping case counts in countries that have had ongoing widespread transmission isn't useful, because it dramatically underestimates the true burden of the disease and can be a waste of public health resources.

On Jul 16 the World Health Organization (WHO) announced it would no longer provide a regular global case count, but would instead issue periodic surveillance updates and will still issue case counts for areas in which the virus is just beginning to circulate.

Unusual activity for summer
In a statement today, the WHO said the number of pandemic H1N1 cases is still increasing substantially in many countries, even in those that were first affected. Most countries are reporting that most cases continue to occur in younger people, with a median age of 12 to 17 based on information from Canada, Chile, Japan, the United Kingdom, and the United States.

Despite the dip in lab-confirmed cases in the United States, Schuchat said the level of flu circulation is still very unusual for the summer months. She added that the CDC has gotten reports of outbreaks at summer camps and military academies where people from different parts of the country come together. "Unfortunately, it's been a challenging summer," she said.

Seven states are reporting widespread activity, including California, Delaware, Georgia, Hawaii, Maine, Maryland, and New Jersey, the CDC said in its flu surveillance report for the week ending Jul 17. Thirteen states and Puerto Rico are experiencing regional activity. Many of the states reporting regional activity are on the East coast.

Five pediatric flu deaths were reported during the past flu surveillance week, though some occurred as far back as February. Four of the deaths were from novel H1N1, and one was associated with an influenza B virus. Of the 95 pediatric deaths that have been reported during the current flu season, 27 were related to the new flu virus.

More than 99% of all subtyped influenza A viruses reported to the CDC were the novel flu strain.

Pneumonia and influenza deaths, tracked through the 122-Cities Mortality Reporting System, were at 6.7%, which is slightly above the 6.5% baseline.

Seasonal flu vaccine recommendations
In other developments, the CDC today issued its recommendation for the seasonal flu vaccine, which appeared in an early edition of Morbidity and Mortality Weekly Report (MMWR). For the first time, the CDC recommends, rather than encourages when feasible, the shot for children aged 6 months to 18 years. Today's appeal is part of a gradual phase-in of the Advisory Committee for Immunization Practices (ACIP) recommendation for kids, Schuchat said.

The CDC now recommends the seasonal flu vaccine for about 83% of the population or for anyone who wants to reduce their risk, she said. However, only 40% of the recommended groups received their flu vaccine last year, she added.

The 2009-10 vaccine contains a different influenza B strain from last year's version but the same seasonal H1N1 and H3N2 strains.

Seasonal flu vaccine immunization campaigns should begin as soon as the vaccine is available to make way for another possible round of vaccination against the pandemic H1N1 virus, she said.

See also:

CDC weekly flu surveillance report

Jul 24 WHO statement

Jul 24 MMWR report

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 24

H1N1 Flu Breaking News

-Britain's H1N1 cases soared last week

The United Kingdom's Health Protection Agency (HPA) estimated yesterday that the nation had 100,000 new cases of H1N1 flu in the past week, up from 55,000 the week before. The estimate is based on medical-visit rates for flu-like illness. Children up to age 14 were the age-group most affected, with people older than 65 showing much lower rates, the HPA said. Most cases continued to be mild. [HPA pandemic flu update]

-UK flu line hits glitch on first day

The Web component of Britain's national flu line, which launched yesterday alongside a telephone service, crashed yesterday after receiving about 9.3 million hits per hour, the London Telegraph reported today. The system was reportedly back online a short time later. The system is designed to relieve pressure on doctors' offices by diagnosing novel flu cases over the phone and issuing patients code numbers that allow them to obtain oseltamivir (Tamiflu). [Jul 24 Telegraph story]

-Canada clears Tamiflu use for infants

Canada's health ministry yesterday approved an interim order authorizing the use of oseltamivir (Tamiflu) in children younger than 1 year, despite limited safety data, Canwest News Service reported yesterday. As in the United States, the drug previously had been approved only for use in patients older than 1. The Public Health Agency of Canada requested the action because infants seem to be at higher risk for novel H1N1 flu complications. [Jul 23 Canwest News Service story]

- FDA issues emergency authorization for H1N1 diagnostic test

The Food and Drug Administration (FDA) today issued an emergency use authorization (EUA) for another unlicensed diagnostic test for novel H1N1 flu. The test, made by Focus Diagnostics of Cypress, Calif., is the third H1N1 test to receive an EUA. The EUA allows the company to distribute the test to labs certified under the Clinical Laboratory Improvement Amendments to run highly complex tests. The test amplifies viral genetic material from nose or throat swabs or nasal discharges. [Jul 24 FDA news release]

-Kazakhstan reports first H1N1 cases

Kazakhstan yesterday reported its first three novel H1N1 cases, involving three students who were diagnosed after returning from London, according to a Reuters report based on an Interfax news service story. [Jul 23 Reuters report]

-Baby girl had Mexico's first known novel flu case

Mexico's first known H1N1 flu case was in a 6-month-old baby girl from San Luis Potosi in the northern part of the country, Agence France-Presse (AFP) reported today. Previously the country's first patient was thought to be a 5-year-old boy who lived near a pig farm in eastern Mexico or a woman from Oaxaca in the southeast. The baby girl first showed symptoms in late February, a Mexican lab official told AFP. [Jul 24 AFP story]

-Canadian employers see high H1N1-related absenteeism

Canadian employers are reporting "huge increases" in absenteeism tied to concerns about the H1N1 virus, according to Karen Seward of Shepell-fgi, a Canadian firm that provides health and productivity services to businesses. Seward said her company is getting many questions from employers about handling absences, according to a story in the Hamilton, Ont., Spectator. She said employers and public health officials are giving conflicting advice about when sick workers should see a doctor. [Jul 23 Spectator story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Jul 27
H1N1 Flu Breaking News

-Europe plans to streamline H1N1 flu vaccine approval

Europe's drug regulators are fast-tracking the approval process for novel H1N1 vaccines, which could mean they would be used before much human testing is done, the Associated Press reported yesterday. Though flu vaccines in the EU usually get thorough testing, authorities plan to evaluate H1N1 vaccines largely based on previous data for H5N1 avian flu vaccines, since both types have the same basic ingredients, the AP said. Regular safety monitoring will be required as the vaccines are used. [Jul 26 AP story]

-H1N1 flu cases surge in Mexico's Chiapas state

The number of novel H1H1 cases in the Mexican state of Chiapas is soaring, with up to 130 new infections reported each day, Agence France-Presse reported today. However, Mexican health officials say the virus is under control in the rest of the country. Located in the country's southeast, Chiapas has a poor indigenous population, tourist sites, and heavy traffic from Central American immigrants. The state has the country's highest case count and has reported 8 of the last 10 deaths. [Jul 27 AFP story]

-Canada to test idea that vitamin D boosts flu protection

To see if high vitamin D levels help protect against novel H1N1 flu, the Public Health Agency of Canada is launching a trial to compare blood levels of the vitamin in those with mild and severe cases, the Toronto-based Globe and Mail reported today. Scientists speculate that the winter spike in flu infections is related to lower vitamin D levels associated with reduced exposure to sunlight. Higher vitamin D levels in mildly infected people might suggest a low-cost flu prevention measure. [Jul 27 Globe and Mail story]

-South American nations ask WTO to ease flu drug patent rules

A trade bloc of seven South American nations on Jul 24 demanded exemptions from paying patent fees for vaccines and drugs against the pandemic H1N1 virus, Agence France-Presse reported. They urged the application of a World Trade Organization intellectual property provision to relax patent rules to protect public health. Argentine President Cristina Kirchner said that though suspending patents could save millions of lives, she wasn't suggesting that the vaccines should be produced for free. [Jul 24 AFP story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Jul 28


H1N1 Flu Breaking News

-Pregnant women bear disproportionate share of flu deaths

About 6% of pandemic H1N1 deaths in the United States have occurred in pregnant women, though they make up just 1% of the population, the Associated Press reported today. The numbers are based on 266 detailed death reports that the Centers for Disease Control and Prevention (CDC) has received. Fifteen deaths occurred in pregnant women. The CDC's vaccine advisory committee meets tomorrow and is expected to list pregnant women among the high-priority groups to receive the pandemic H1N1 vaccine. [Jul 28 AP story]

-Poll shows parents likely to seek H1N1 flu shots for kids

An Associated Press-GfK Roper poll suggests that about 63% of American parents are likely to allow their children to receive the pandemic H1N1 vaccine, but only 51% of adults would probably receive the immunization themselves. Only 43% said they were concerned that they or a family member might contract the new flu virus. The telephone poll, conducted in mid July and released yesterday, included 1,006 adults, of whom 296 were parents. [AP-GfK flu poll report]

-Chinese officials say their policy of quarantining foreigners is working

Chinese authorities assert that their aggressive quarantine policy to prevent foreign visitors from spreading H1N1 flu has worked well, according to a New York Times report. Officials say China has had few cases and proudly note that no deaths have been reported. But the newspaper tells the story of an American woman who said her surgery for appendicitis was delayed because of the quarantine policy. More than 1,800 Americans have been quarantined in China since the start of the pandemic. [Jul 28 New York Times story]

-El Salvador extends school vacation to battle pandemic

El Salvador announced it will extend a scheduled school vacation to 2 weeks to fight the spread of the H1N1 flu, the Associated Press reported yesterday. School vacations that began yesterday and last from 2 days to a week, depending on the region, will be extended until Aug 10. The action will affect nearly 2 million students. The country has had 545 confirmed cases of H1N1 flu, including seven fatal ones, the story said. [Jul 27 AP story]

-Canadian cities group says national pandemic plan is lacking

The head of the Federation of Canadian Cities has charged that Canada has no national plan for protecting critical frontline workers such as police, firefighters, and transit workers, the Toronto Globe and Mail reported. In an open letter to federal Health Minister Leona Aglukkaq, Basil Stewart said Canada's pandemic plan does not say who will have priority access to vaccines and antivirals. A spokesman for Aglukkaq said ongoing epidemiologic studies will guide vaccine allocation. [Jul 28 Globe and Mail report]

-WHO to probe antiviral use patterns

A World Health Organization (WHO) spokeswoman said today that the agency will host a technical teleconference soon to discuss antiviral use during the H1N1 pandemic and the risks of antiviral resistance, Agence France-Presse reported. Countries vary in their use of oseltamivir (Tamiflu). Some use it widely for prevention and treatment of mild cases, while others are reserving it for infections in high-risk groups and for severe cases. So far, five antiviral-resistant cases have been identified. [Jul 28 AFP story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Jul 29

H1N1 Flu Breaking News

-Canada to use adjuvanted H1N1 vaccine

Canadian health officials anticipate using an adjuvant to address the possible need to stretch supplies of an H1N1 influenza vaccine this fall, according to a Canadian Press story. Neither Canada nor the United States have licensed flu vaccines with adjuvants before. Health Canada has worked with GlaxoSmithKline on safety studies of the AS03 adjuvant for H5N1 vaccine and is urging the company to do a small trial with an H1N1 vaccine. US officials have been more circumspect on the subject. [Jul 29 Canadian Press story]

-Japan finds two more Tamiflu-resistant H1N1 cases

Japan has detected two more cases of Tamiflu-resistant pandemic H1N1 flu, Alexander Klimov, PhD, of the CDC's flu surveillance branch, revealed at the CDC's vaccine advisory committee today. He also said that Chinese officials revealed during a World Health Organization conference call that they may have one more antiviral-resistant case. Klimov said all cases so far have been linked to Tamiflu prophylaxis or treatment, except for one involving an American girl who was diagnosed in Hong Kong. [Jul 29 ACIP meeting agenda]

-Latin America has lion's share of H1N1 deaths

Although novel H1N1 flu strain is spreading worldwide, Latin America, currently in its winter season, is being disproportionately hit right now, according to WA Today.com, an Australian news service. Of the 816 deaths the World Health Organization has so far confirmed, two thirds have occurred in Latin America, the report said. [Jul 29 WAtoday article]

-UK advises nurseries to remove soft toys

Britain's Department of Children, Schools and Families has come under fire for issuing recommendations that nurseries and "childminders" remove communal soft toys from care settings to help contain the spread of H1N1 flu, saying the toys cannot be cleaned adequately. The agency also recommend that crayons and pencils not be shared and large assemblies be suspended. Defenders of the guidance say it is sensible but should be administered sensitively so as not to upset children. [Jul 29 The Times article]

- Military may assist with US H1N1 response

US military personnel may work alongside civilian authorities during any significant outbreaks of the H1N1 influenza virus this fall, according a CNN report. Unnamed Department of Defense officials said the proposal is awaiting approval by Secretary Robert Gates. Personnel from all branches of the military may be involved, and it has not been determined whether the troops would be pulled from active duty or from the National Guard and/or reserves. [Jul 29 CNN article]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Jul 31
H1N1 Flu Breaking News

-CDC says H1N1 hospitalizations total 5,514

The US Centers for Disease Control and Prevention (CDC) today said it is aware of a total of 5,514 H1N1 flu hospitalizations and 353 deaths from 47 states and territories. The agency said last week it would no longer list national H1N1 case counts. Meanwhile, the CDC's flu surveillance report for last week says that novel H1N1 activity continued to drop for the fifth consecutive week, with only four states and Puerto Rico reporting widespread activity, down from seven states the week before. [CDC novel flu hospitalization and death count]

-UK surveys find side effects in children given preventive oseltamivir

Two survey studies in the Jul 30 issue of Eurosurveillance report side effects in British schoolchildren who received prophylactic oseltamivir treatment. In an online survey of three London schools, 53% of the children reported side effects, including gastrointestinal (40%) and mild neuropsychiatric (18%) problems. In the other study, 51% of students from one school reported symptoms such as feeling sick, headache, or stomachache. Compliance was higher in the single-school study. [Jul 30 issue of Eurosurveillance]

-Two nurses die of novel flu infections

A 51-year-old California nurse who worked on a cancer unit at a hospital in Carmichael died of a novel H1N1 flu infection, the Sacramento Bee reported today. A hospital spokesman said authorities don't know if she was exposed to the virus at the hospital or elsewhere. Her death certificate said she also had pneumonia and was infected with methicillin-resistant Staphylococcus aureus. Meanwhile, a pediatric nurse in New Zealand recently died of a novel H1N1 infection, local media reported. [Jul 31 Sacramento Bee story]

-Wal-Mart may help feds with vaccine campaign

Wal-Mart officials met with US health officials on Jul 29 to discuss what role the retail chain might play in helping to distribute the pandemic H1N1 vaccine this fall, Reuters reported yesterday. Dr. John Agwunobi, the company's president of health and wellness, in an address at the annual meeting of the National Association of County and City Health Officials yesterday, said options might include giving flu shots in stores and helping federal officials with logistic and supply-chain issues. [Jul 30 Reuters story]

-Switzerland to be among first to get Glaxo pandemic vaccine shipments

A GlaxoSmithKline spokesman said Switzerland will be one of 10 countries to receive the "first wave" of the company's pandemic H1N1 vaccine, though he did not name the other nine countries, Bloomberg News reported today. He said first-wave-countries will get their supplies in September or October and that countries in the second wave will receive theirs "a bit later." The spokesman said Switzerland signed an agreement with Glaxo in 2006 to receive priority delivery of pandemic vaccine. [Jul 31 Bloomberg News story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Aug 3
H1N1 Flu Breaking News

-Argentina's novel flu pace slows

Argentina's pandemic H1N1 cases have peaked, and so far the death rate from the disease seems to be less than for seasonal flu, said public health experts quoted in a Jul 31 Associated Press (AP) report. However, one official said the disease has had its greatest impact on young people. With more than a month left of the country's flu season, scientists report that viruses isolated in Argentina are nearly identical to those circulating in North America. [Jul 31 AP story]

- UK sees spurt in reports of reactions to oseltamivir

Britain has seen a spurt in reported negative side effects from oseltamivir (Tamiflu) use since the National Pandemic Flu Service was launched Jul 23, the Daily Mail newspaper reported today. The service allows people to get the drug over the phone without seeing a doctor. The story said 293 reports have come in since early April, of which 143 were in the past week. The reported effects include vomiting, diarrhea, and psychiatric and nervous system problems. [Aug 3 Daily Mail report]

-Solomon Islands reports first novel H1N1 case

The country of the Solomon Islands has reported its first case of novel H1N1 flu, in a member of a multinational assistance team that arrived in the islands from Brisbane, Australia, Jul 30, according to an Australian Broadcasting Corp. (ABC) report. The patient and 12 other team members who traveled with him to Honiara, the capital, are in quarantine. Authorities are urging passengers who were on Pacific Blue flight DJ-169 to contact them. [Aug 3 ABC News report]

- CDC issues call-center resource

The US Centers for Disease Control and Prevention (CDC) on Jul 30 issued a tool to help communities develop and manage call centers as a way of relieving pressure on 911 systems and healthcare systems during the H1N1 flu pandemic. The guidance, developed for the CDC by a Department of Energy facility, acknowledges that each community's needs and capabilities vary. Communities are urged to identify key partners and build on systems that are already in place. [CDC call center guidance]

-Feds launch school-closure monitoring system

The CDC and the US Department of Education have set up a system for monitoring school dismissals related to the novel H1N1 pandemic. The CDC has posted a page for the system on its Web site. School districts have the option of filling out and submitting the report online or printing out a form that can be submitted by e-mail or fax. [CDC/DOE school dismissal monitoring portal]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Aug 5

H1N1 Flu Breaking News

-India flu death spurs crowds, tussles at hospital

India's announcement of its first novel flu death 2 days ago sparked panic at a hospital in the town where the 14-year-old girl died, the Associated Press (AP) reported today. Hundreds of people gathered outside a hospital in Pune hoping to be tested for the virus. Several fights broke out while people were waiting in long lines. Local authorities are testing all students who attended the girl's school, the Press Trust of India reported. [Aug 5 AP story]

-Novartis novel flu vaccine trials under way

Novartis has launched human trials of its novel H1N1 vaccine, according to a company spokesman quoted in an AP story today. The company, like other vaccine makers, is seeing antigen yields that are only 30% to 50% of seasonal flu vaccine, but is still working with the original seed strains. The spokesman said Novartis is testing an unadjuvanted vaccine for the US market and an adjuvanted version for use in Europe and expects to begin shipping in the last quarter of 2009. [Aug 5 AP story]

-North Carolina strives to protect pigs at fairs

North Carolina's agriculture department yesterday said fairgoers will be asked to wash their hands at hand washing stations to protect pigs from the novel H1N1 flu virus. The department is advising people to avoid fairs or at least avoid animal exhibits if they have flulike symptoms. Veterinary officials have recommended that fair managers add 6-foot-high barriers around swine exhibits to separate animals from people [Aug 4 North Carolina Department of Agriculture press release]

-Flu strikes summer camps in 40 states

The pandemic H1N1 virus has been detected at 80 summer camps in 40 states so far this summer, according to Anne Schuchat, MD, an official from the US Centers for Disease Control and Prevention (CDC). She made the comment yesterday during a webcast during which federal officials shared updates on novel flu and the status of planning efforts. Health officials have said they expect flu activity to rise when school starts again, and students in some parts of the country are already returning. [Readout of Aug 4 federal flu webcast]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Aug 6

H1N1 Flu Breaking News

-British lab finds better-yielding seed strain of H1N1

Britain's National Institute for Biological Standards and Control (NIBSC) has produced a seed strain of novel H1N1 virus that grows much better than strains currently used, the Canadian Press reported yesterday. John Wood of the NIBSC said the strain grows about as well as typical seasonal flu seed strains, but the results must be confirmed by manufacturers. Vaccine makers welcomed the news. Yields from the seed strains now in use have been 50% below those with seasonal flu vaccines or worse. [Aug 5 Canadian Press story]

-Argentina flu deaths double in latest count

The number of novel H1N1 flu deaths in Argentina has risen to 337, according to the health ministry's latest report, suggesting that Argentina could soon pass United States as the country with the most fatalities, The Guardian, a British newspaper, reported yesterday. The number was more than double the deaths reported in the ministry's last report 2 weeks ago. Though Argentina has more fatalities than any South American country, officials believe novel flu cases have peaked. [Aug 5 Guardian story]

-Iran bars pilgrims from attending the Hajj

To slow the spread of the pandemic H1N1 virus, Iran's health ministry has banned the country's citizens from attending the annual Hajj pilgrimage in December in Saudi Arabia, the Associated Press (AP) reported today. The health minister said through state media that the event draws 3 million pilgrims from all over the world, presenting a heightened risk of flu transmission. Iran has confirmed 145 cases so far, but no fatalities. [Aug 6 AP story]

-California nurses protest inadequate safety equipment

California nurses protested outside the University of California-San Francisco (UCSF) medical center yesterday to demand better equipment to protect them against the pandemic virus, according to an Aug 4 press release from the California Nurses Association. An ABC News report yesterday showed the nurses protesting in scrubs and masks. Nurses also protested the alleged firing of a UCSF nurse for complaining about inadequate safety gear. The California Hospital Association has denied the claims. [Aug 4 California Nurses Association statement]

-Baxter finishes first batches of cell-based pandemic H1N1 vaccine

Baxter International Inc. yesterday announced completion of the first commercial batches of its cell-based pandemic H1N1 vaccine, called Celvapan A/H1N1. The company said the vaccine was developed and produced within 12 weeks of receiving the H1N1 virus strain. In making the vaccine, Baxter applied the same processes used in gaining earlier European licensure of a mock-up pandemic vaccine, officials said. Clinical trials are scheduled to start this month. [Aug 5 Baxter news release]

-CDC reports low sensitivity for rapid flu tests

The CDC reported today that it assessed several rapid influenza diagnostic tests and found they had low sensitivity, ranging from 40% to 69%. Sensitivity declined substantially when the clinical samples had lower levels of virus, the agency said in Morbidity and Mortality Weekly Report. Thus a positive result can guide treatment, but a negative result does not exclude a novel H1N1 infection. The agency evaluated the tests using 65 samples known to contain novel H1N1 or seasonal viruses. [Aug 7 MMWR article]

-Large insurer to cover novel H1N1 vaccine

WellPoint, the nation's largest health insurance company in terms of membership, says it will cover administration of the novel H1N1 vaccine as it becomes publicly available, according to a story today from IFAwebnews. WellPoint operates as Anthem Blue Cross in Virginia and as Empire Blue Cross in New York. Members whose plans already provide coverage for vaccines will qualify for the added coverage. [Aug 6 IFAwebnews article]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Aug 7
H1N1 Flu Breaking News

-Canada orders 50.4 million doses of H1N1 vaccine

The Canadian government announced plans yesterday to buy 50.4 million doses of novel H1N1 flu vaccine, enough for all Canadians who "want and need" to be immunized. Officials said immunizations will begin by November. Canada has a longstanding contract with GlaxoSmithKline to maintain vaccine production capacity in Canada to meet the country's pandemic vaccine needs. The federal government will cover 60% of the vaccine cost, with provinces and territories paying the rest. [Aug 6 Canadian government news release]

-US death toll from novel H1N1 reaches 436

The US death toll due to novel H1N1 flu has risen to 436, up from 353 a week ago, the CDC said in today's weekly flu surveillance report. The agency said flu activity continued its decline last week but still remained above normal for this time of year. Four states and Puerto Rico reported widespread flu activity, the same number as the week before. More than 98% of all subtyped flu viruses were the novel H1N1. The CDC said 6,506 hospitalizations related to the virus have been reported. [CDC flu surveillance report for Jul 26 to Aug 1]

-Prospect of three flu shots raises questions

People in groups targeted for both seasonal flu and H1N1 flu immunizations will likely need three separate vaccine doses this fall, according to the Associated Press. Experts believe that two doses will be necessary for the new H1N1 virus. Because giving seasonal and H1N1 vaccinations at the same time would complicate safety monitoring, government experts prefer the idea of giving the three shots in three separate visits. But that's expecting a lot from the public, said one vaccine expert. [Aug 6 AP story]

-Sanofi files for H1N1 vaccine license, launches clinical trial

Sanofi Pasteur announced today that it has launched a clinical trial of its novel H1N1 influenza vaccine and applied to the US Food and Drug Administration for licensure of the vaccine. The company is testing the vaccine, including a version that contains an adjuvant, for immunogenicity and safety in about 2,000 volunteers. In line with recent FDA recommendations, the company has asked the FDA to evaluate the vaccine the same way it reviews seasonal flu vaccine strain changes. [Aug 7 Sanofi news release]

-Hanoi closes all schools in bid to stop pandemic

Hanoi today closed all of its schools until further notice in an effort to contain the novel H1N1 outbreak, according to an Agence France-Presse report. The city's education department said three schools have had cases among their students. Schools just began opening this week, though the new school year doesn't begin until Aug 17, the story said. Vietnam has had 1,043 H1N1 cases since May, but only one death, which occurred Aug 3 and involved a 29-year-old woman in Khanh Hoa province. [Aug 7 AFP story]

-H1N1 enters Ghana

Ghana's Deputy Health Minister, Benjamin Kumbour, said yesterday that the country had recorded its first two cases of novel H1N1 flu, according to Independent Online, a South African news service. One case is in a 19-year-old woman from Accra, the capital, who may have been infected by a relative who had visited Britain. The other case involves a woman from the Western Region. Kumbour said Ghana, in collaboration with the World Health Organization, has procured drugs for H1N1 treatment. [Aug 6 Independent Online article]

-Healthcare retirees may be called up in UK pandemic efforts

Some of the UK's National Health Service (NHS) trusts (organizations that provide services on behalf of the NHS) have begun contacting retired doctors, nurses, and other staff to see if they are willing to help if the H1N1 pandemic worsens. Depending on the trust involved, retirees up to 3 years out have been approached, according to Nursing Times, a British weekly. Some trusts are not enlisting retirees but are cross-training staff and may stop elective services and transfer staff as needed. [Aug 7 Nursing Times online article]

-US, Mexican, Canadian leaders to discuss H1N1

President Barack Obama, Mexican President Felipe Calderon, and Canadian Prime Minister Stephen Harper will include the flu pandemic on their agenda when they meet Sunday and Monday in Guadalajara, Mexico. The leaders will confer about vaccine development for the H1N1 flu wave expected this fall and discuss mitigation measures, according to a Reuters story. A joint statement from the three leaders will be issued after the summit. [Aug 6 Reuters article]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Aug 10

H1N1 Flu Breaking News

-Review finds little benefit from antiviral use in children

An analysis of studies of the effects of oseltamivir and zanamivir for seasonal flu treatment and prophylaxis in children aged 12 and younger showed a small benefit, according to a study in today's British Medical Journal. The authors, who looked at seven studies, found that the drugs provided a small benefit by shortening illness duration and reducing household transmission, but they had little effect on asthma or antibiotic use. Vomiting was reported in children who took oseltamivir. [Aug 10 BMJ abstract]

-Pakistan confirms first novel flu case

Pakistan's health ministry today reported the country's first novel H1N1 case, according to Xinhua, China's state news agency. The patient is 1 of 25 people with suspected cases undergoing treatment. No other details were available. The health minister revealed the case in a speech to Pakistan's parliament. [Aug 10 Xinhua story]

-Iraq sees flu threat from US troops

As the US military reported yesterday that 51 American soldiers in Iraq have novel H1N1 flu and 71 others may have the illness, Iraqi health officials expressed concern that the US troops could spread the disease, the New York Times reported yesterday. Members of the Iraqi parliament said Iraqi soldiers serving alongside US troops could spread the virus into Iraq. A health official claimed US soldiers aren't screened for the virus and that their 2-week visits home pose disease risks. [Aug 9 New York Times story]

-Canada promotes 'flu buddy' preparedness

Health officials in Canada are urging citizens to find "flu buddies" to help care for them during the novel H1N1 pandemic, Canwest News Service reported on Aug 7. The Public Health Agency of Canada is urging people to check in on people who live alone or are vulnerable and help care for them or seek medical care if they are sick. The measure may help take some pressure off the health system and is among the general preparedness tactics that the agency will promote in the fall. [Aug 7 Canwest News Service story]

-Trials of long-acting antiviral show promise

The Australian drug company Biota today reported positive phase 3 study results from Asian countries of its new antiviral medication laninamivir, a long-acting neuraminidase inhibitor. In adults, a single inhaled dose of the new drug was as effective as oseltamivir taken twice a day for 5 days. Similar trials in children showed the drug was safe and effective. Preclinical studies suggested that the new antiviral is effective against seasonal H5N1 and pandemic H1N1 viruses. [Aug 10 Biota press release]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Aug 11
H1N1 Flu Breaking News

-Flu picks up in Asia with monsoon season

Novel H1N1 influenza is spreading in India, Thailand, and Vietnam with the onset of Asia's monsoon season, the World Health Organization (WHO) said today, according to Reuters. The regular flu season has started in those countries, and both H1N1 and seasonal flu are being detected, said WHO spokeswoman Aphaluck Bhatiasevi. But the spread of pandemic H1N1 appears to have peaked in parts of the southern hemisphere, including Argentina, Chile, Australia, and New Zealand. [Aug 11 Reuters article]

-Disease expert notes fever-free flu cases

In his clinical observation of novel flu cases in the United States and South America, Richard P. Wenzel, MD, former president of the Infectious Diseases Society of America, has noted that some patients are afebrile, even some with serious infections, and lack of fever might underestimate case totals, the New York Times reported yesterday. He said diarrhea seen in a portion of patients suggests a need for stool testing to assess transmission and the role of better hand hygiene. [Aug 10 New York Times article]

- School nurse shortage could slow ID of sick kids

School nurses are expected to be at the frontlines of detecting and fighting novel flu when schools resume this fall, but the ratio of nurses to students in many states falls well below the levels suggested by the US Centers for Disease Control and Prevention (CDC), USA Today reported yesterday. The CDC recommends a workload of 1 nurse per 750 students, but the newspaper's analysis of census data puts the national average at 1 per 971 students. [Aug 10 USA Today story]

-IOM holds meeting on protective equipment for novel flu

The Institutes of Medicine's (IOM's) Board on Health Sciences Policy is convening a meeting today through Aug 13 on pandemic influenza and personal protective equipment (PPE) for healthcare workers. Today's agenda includes a call to the committee, with panel discussions starting tomorrow. Topics include the science and clinical experience with novel H1N1, infection control guidelines, risk assessment in health workers, and data on the effectiveness of PPE. [IOM meeting home page]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Aug 12
H1N1 Flu Breaking News

-Officials close schools in Bombay

Government officials in India's Maharashtra state have ordered all schools and colleges in Bombay to close for a week to slow the spread of novel flu, Agence France-Presse (AFP) reported today. The state has the country's highest number of confirmed pandemic H1N1 cases and has reported four deaths over the past 10 days. India's cable news channels are reportedly devoting hours to novel flu coverage, but the health minister told reporters this week other diseases are more serious and costly. [Aug 12 AFP story]

-Costa Rica's president has novel flu

Costa Rica's president, Oscar Arias, said in a statement yesterday that he was sick with the pandemic H1N1 flu, AFP reported today. He is the first world leader known to have been sickened by the virus. His brother said the 67-year-old president has asthma and had flulike symptoms for days. Tests yesterday confirmed that he had the novel flu virus. Arias is in home isolation but has not delegated power. [Aug 12 AFP story]

-France prepares TV lessons for school shutdowns

France's education minister said officials have prepared lessons that can be broadcast on state television and radio if novel flu outbreaks spark flu closures after classes resume this fall, the Associated Press (AP) reported today. Schools in France resume in late August and September. The minister said the country's national distance learning agency developed the lessons. He said school-closure decisions will be made on a case-by-case basis. [Aug 12 AP story]

-Researchers question predictive value of past pandemic waves

Health officials are being prudent to plan for a more severe second pandemic wave, but a historical review of previous pandemics offers confusing clues about patterns with no evidence that virus mutations led to increased transmissibility, two federal researchers wrote today in a commentary appearing in the Journal of the American Medical Association (JAMA). The authors are Dr David Morens and Dr Jeffrey Taubenberger from the National Institute of Allergy and Infectious Diseases. [Aug 12 JAMA commentary extract]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Aug 13
H1N1 Flu Breaking News

-Canada develops business preparedness tools

Canada's health minister Leona Aglukkaq yesterday urged businesses to prepare for another novel flu surge, Agence France-Presse (AFP) reported. She said small- and medium-size firms lag behind larger corporations that have more resource for continuity planning. To help smaller companies prepare, the country's public health agency has contracted with two groups to develop tools to assist with such tasks as flu-related communications and staffing issues. [Aug 12 AFP story]

-EU issues school and travel pandemic recommendations

The European Union (EU) today issued two pandemic H1N1 policy statements, one on school closures and one on travel. The EU's health security committee said it doesn't see a need for mass preemptive school closures, but said that local closures when large numbers of staff and students are infected may help delay virus transmission. The travel advisory urges sick people to stay home but does not support restriction of individual travelers or movement of people across borders. [Aug 13 EU school closure and travel statements]

-WHO: pandemic H1N1 reported in 170 global sites

In an update on the novel flu pandemic yesterday, the World Health Organization (WHO) said the virus has now been confirmed in 170 countries and territories. Newly confirming first cases are Timor-Leste, Pakistan, Kirabati, Maldives, French Guiana, Falkland Islands, and Wallis and Futuna. Global deaths, as of Aug 6, rose to 1,462. Flu activity is waning in many southern hemisphere countries and is picking up in tropical regions. [Aug 12 WHO situation update 61]

-India urges restraint in media flu coverage

India's broadcast ministry has asked media organizations to avoid creating panic over the pandemic H1N1 virus that is quickly spreading in the country, Indo Asian News Service (IANS) reported today. The ministry, however, said it supports efforts to raise flu awareness. In other developments, Delhi province officials have ordered private hospitals with 200 or more beds to help diagnose and treat flu patients as a means of reducing burden on government facilities. [Aug 13 IANS story]

-China, Singapore report Tamiflu-resistant H1N1

The WHO said yesterday that China and Singapore have found osteltamivir (Tamiflu)-resistant novel H1N1 viruses, according to a report from the Canadian Press. The story also said the WHO has informal information on a small, unspecified number of other oseltamivir-resistant viruses. The WHO has received formal notification of seven oseltamivir-resistant cases from Japan, Canada, Denmark, Hong Kong, and now Singapore. China has yet to file a formal report on its case. [Aug 12 Canadian Press report]

-Seven novel flu cases found in Peruvian tribe

Seven members of the native Amazonian Matsigenka tribe tested positive for pandemic H1N1 and have recovered, Peruvian health officials said yesterday, according to Reuters. But because the tribe lives near a reserve set aside for tribes that have limited contact with modern society, human rights groups fear the virus could spread to the more isolated native people who lack immunity to the disease. [Aug 12 Reuters story]

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Roscoe and Miss Priss 

I hope this isnt worse for these isolated native people, but except for older people, no one has immunity to this virus.

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html


Aug 14
H1N1 Flu Breaking News

-CDC reports 41 more US flu deaths

The number of novel H1N1 deaths in the United States has risen to 477, up from 436 last week, the US Centers for Disease Control and Prevention said today in its weekly update. Hospitalizations rose to 7,511, up from 6,506. Dan Jernigan, MD, MPH, with the CDC's Influenza Division, said during a teleconference today that flu continues to decline, with widespread activity reported in four states. Officials are looking into reports of increased flu activity in Florida and North Carolina. [Aug 14 CDC novel flu situation update]

-Hong Kong reports second Tamiflu-resistant case

Health officials in Hong Kong today announced the detection of a second case of novel flu resistant to oseltamivir (Tamiflu). They found the virus in a 40-year-old woman who is a resident of a home for disabled people. She was prescribed the drug prophylactically after other residents of the home became ill. She developed flu-like symptoms about a week later. The Tamiflu-resistant strain wasn't found in any other of the 20 novel flu cases at the home. [Aug 14 Hong Kong Centre for Health Protection news release]

-Researchers suggest osteoporosis drugs may have antiviral benefits

Researchers from Hong Kong have found that two osteoporosis drugs, pamidronate and zoledronate, might have potential as treatment for influenza, including the novel H1N1 and the H5N1 viruses, Reuters reported today. They found that the two drugs triggered yd-T cells that killed flu-infected human cells. The next steps are to test the drugs in animals and conduct clinical trials in humans. The findings were released by the University of Hong Kong, Xinhua reported today. [Aug 14 Reuters story]

-Massachusetts deputizes more healthcare workers to give vaccine

The Massachusetts Public Health Council on Aug 12 voted to enable such healthcare professionals as dentists, pharmacists, and paramedics to administer the novel flu vaccine in this fall's vaccination campaigns, the Boston Globe reported yesterday. The move would open the possibility of volunteering to about 12,000 additional workers. The regulators also directed hospitals and clinics to provide vaccine to all their workers, although the workers will not be forced to receive the vaccine. [Aug 13 Boston Globe story]

-UK releases vaccine priority plan

Government officials in the United Kingdom released details of the country's pandemic H1N1 vaccination priority plan today, which places pregnant women, healthcare workers, and people aged 6 months to 65 years with underlying chronic medical conditions first in line to get the vaccine, reported the Guardian, a British newspaper. The plan also prioritizes people who live in households that include individuals with certain underlying conditions, such as cancer or immune system compromise. [Aug 14 Guardian story]

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Roscoe and Miss Priss 

Just a repeat, but seems important enough.

Snip from CIDRAP , august 14; studies saying about 50% of the hospitalised cases in USA and Mexico were previously healthy.

Clinical findings

From April 15 through May 5, 642 confirmed cases of novel H1N1 infection were identified in the United States (see References: Novel swine-Origin Influenza A [H1N1] Virus Investigation Team.

In patients for whom clinical information was available, the most common presenting symptoms were fever (371 of 394 [94%]), cough (365 of 397 [92%]), and sore throat (242 of 367 [66%]). Diarrhea was present in 82 of 323 patients (25%) and vomiting in 74 of 295 patients (25%). Of the 399 patients for whom hospitalization status was known, 36 (9%) required hospitalization. Two patients died; one was a 23-month-old child and one was a pregnant 33-year-old woman.

In a report from the WHO dated May 22, 2009, key clinical features of laboratory-confirmed cases for which data are available include the following (see References: WHO 2009: Human infection with new influenza A [H1N1] virus: clinical observations from Mexico and other affected countries, May 2009):

Most patients appear to have uncomplicated, typical influenza-like illness and recover spontaneously. The most commonly reported symptoms include cough, fever, sore throat, malaise, and headache. Fever has been absent in some patients.

Almost one half of cases in the United States requiring hospitalization as well as 21 (46%) of 45 fatal cases in Mexico for which data are available involved underlying conditions, including pregnancy, asthma, other lung diseases, diabetes, morbid obesity, autoimmune disorders and associated immunosuppressive therapies, neurologic disorders, and cardiovascular disease.

Among 20 pregnant women with H1N1 in the United States, three required hospitalization and one of these died.

Among 45 fatal cases in Mexico, 54% of patients were previously healthy and most were 20 to 59 years of age. The median time from symptom onset to death was 10 days (range, 2 to 33 days).

The clinical course for fatal cases in Mexico has been characterized by:

Severe pneumonia with multifocal infiltrates (including nodular alveolar and, less frequently, basilar opacities) on chest x-ray (bacterial coinfections were documented in three fatal cases)

Rapid progression to acute respiratory distress syndrome (ARDS) and renal or multiorgan failure (24% of fatal cases)

Another study from Mexico found a significant increase in the rate of severe pneumonia between March 24 and April 29, 2009 (during the time of peak novel H1N1 influenza activity), with a shift in the age distribution to a younger segment of the population.

The age-group 5 to 59 represented 87% of deaths from severe pneumonia compared to approximately 17% on average during other influenza epidemic periods (see References: Chowell 2009).

A case series of 18 patients with pneumonia caused by H1N1 influenza who were hospitalized in the Mexico City area during March and April 2009 reported that 12 patients required mechanical ventilation and seven died (see References: Perez-Padilla 2009); most patients were previously healthy adults.

These findings clearly demonstrate that novel H1N1 can cause severe disease and death in otherwise healthy persons.

http://www.cidrap.umn.edu/cidrap/co...luoverview.html

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Aug 17
H1N1 Flu Breaking News

-Oseltamivir resistance seen in two immunosuppressed H1N1 patients

Oseltamivir (Tamiflu) resistance developed in two immunosuppressed patients in Seattle who were treated with the drug for novel H1N1 flu, the CDC reported recently. Both patients, a teenage boy and a woman in her 40s, were receiving immunosuppressive therapy for leukemia, and both had prolonged viral shedding. The cases were not epidemiologically linked. The CDC said clinicians caring for such patients should be aware of the potential for antiviral resistance and prolonged viral shedding. [Aug 14 MMWR Dispatch]

-UK expert panel urged against prescribing Tamiflu by phone

In launching its system to diagnose H1N1 flu and prescribe oseltamivir by phone, the British government rejected an advisory committee's advice that the practice might engender growing resistance to the drug, according to the Guardian newspaper. A member of the committee said officials judged that the public would not tolerate being told that the national stockpile could not be used, the story said. The advisory panel said the drug should be reserved for people in high-risk group. [Aug 16 Guardian report]

-British health officials ask neurologists to track GBS cases

England's Health Protection Agency has sent a letter to neurologists asking them to be alert for any increase in Guillain-Barre syndrome (GBS) cases after the public starts receiving the novel H1N1 vaccine, the London Daily Mail reported on Aug 15. The letter, obtained by the newspaper, warns of GBS cases that occurred in the wake of the 1976 US swine flu vaccine campaign. Britain's neurologist association told its members in July that it would launch a 9-month GBS survey on Aug 1. [Aug 15 Daily Mail story]

-Democratic Republic of Congo reports first pandemic flu case

The Democratic Republic of Congo reported its first novel flu case, in a South African mining official employed by a US firm in Katanga province, Agence France-Presse (AFP) reported today. The man, who is recovering, had recently returned from a vacation in South Africa, and so far none of his family contacts have had flu-like symptoms. [Aug 17 AFP story]

-China rolls out tough school flu-prevention measures

China's state media said yesterday that the country's education and health ministries have ordered strong measures to curb the spread of the novel flu virus when schools reopen, AFP reported yesterday. Schools in flu-stricken areas can postpone the start of the school year and have been advised not to hold large gatherings and to reduce class sizes. Students are being asked to stay home for 7 days if they have close contact with a sick person and, if they are sick, to stay home until recovered. [Aug 16 AFP story]

-Egyptian pilgrims protest travel ban

About 300 people staged a protest at Cairo's airport yesterday to oppose an Egyptian government restriction that bars them from traveling to Mecca on pilgrimage, the Associated Press reported. Airport security dispersed the crowd. The travel ban is intended to slow the spread of the pandemic H1N1 virus. The new restriction took effect yesterday. Only travelers between ages 25 and 65, a group thought to be at lower risk for flu, are allowed to make the trip to Mecca. [Aug 16 AP story]

-Quebec districts to keep pregnant teachers home this fall

Two school districts in Quebec will keep pregnant teachers at home this fall to reduce their risk of severe complications if they get sick with pandemic H1N1 flu, the Toronto Star reported on Aug 15. An official from the Toronto district school board said keeping pregnant teachers home is an idea worthy of consideration, but quantifying the risks is difficult. Pregnant women are listed as a priority group for novel flu vaccines by the United States and the United Kingdom. [Aug 15 Toronto Star story]

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Roscoe and Miss Priss 

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

Auug 19

H1N1 Flu Breaking News

-New York state requires health workers to get flu immunizations

The New York State Department of Health has adopted an emergency rule requiring healthcare workers who have direct contact with patients to be vaccinated against seasonal and novel H1N1 influenza, the New York Times reported yesterday. The rule affects hospitals, home health agencies, and hospices but not nursing homes. The state's largest healthcare union protested the rule, saying the policy could become punitive for workers who shun vaccination for religious or cultural reasons. [Aug 18 New York Times story]

- NIAID to launch trials of H1N1 vaccine in children

Following approval from a safety monitoring panel, the National Institute of Allergy and Infectious Diseases said it would launch two trials of novel H1N1 vaccines in children. Plans for the trials were announced in July. The safety committee reviewed data from two adult trials that started Aug 7 and found no problems that would preclude the tests in children. One trial will test two different doses of an H1N1 vaccine, and the other will involve giving an H1N1 vaccine with seasonal flu vaccine. [Aug 18 NIAID announcement]

-H1N1 vaccine orders in northern hemisphere top 1 billion doses

A World Health Organization (WHO) official said yesterday that northern hemisphere countries have ordered more than 1 billion doses of H1N1 vaccines, Agence France-Presse reported. The WHO's Melinda Henry said a few countries, such as Greece, Canada, and Israel, have ordered enough doses to cover their whole populations, while others, including the United States, have ordered less. [Aug 18 AFP story]

-Australian government expects first H1N1 vaccine doses next week

The Australian government expects to receive its first 2 million doses of H1N1 vaccine by the end of next week, the Adelaide Advertiser reported today. Pregnant women, health workers, and chronically ill people will be first in line for the vaccine. It is expected that immunizations could begin Sep 7, pending approval from national health authorities. They are awaiting safety data from the vaccine manufacturer, CSL, which is also making vaccine for the US government. [Adelaide Advertiser report]

-British agency says Tamiflu plus warfarin may increase stroke risk

Britain's Medicine and Healthcare Products Regulatory Agency (MHRA) is concerned that oseltamivir (Tamiflu) may interact with the anticoagulant warfarin to increase the risk of uncontrolled bleeding and stroke, according to a report by the Daily Mail newspaper. The agency has advised health professionals to be alert for such cases. The story said the MHRA has received reports of 12 suspected adverse reactions to oseltamivir that involved interactions with warfarin. [Aug 19 Daily Mail report]

-Australian survives near-fatal H1N1 case with help of IV zanamivir

A 20-year-old Australian who has asthma survived a nearly fatal case of H1N1 flu after he was treated with an experimental intravenous form of zanamivir (Relenza), the Adelaide Advertiser reported today. The man's lungs had filled with mucus and his stomach had shut down, ruling out treatment with oral oseltamivir, the report said. So his doctors decided to try IV zanamivir, which had to be flown in from the United States. The drug is normally taken with an inhaler. [Aug 19 Adelaide Advertiser report]

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Roscoe and Miss Priss