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


Aug 20
H1N1 Flu Breaking News

-Australian doctors question country's vaccination plans

Australia's major infectious disease society is questioning the safety of the country's novel H1N1 vaccination plans, the Australian Broadcasting Corp. reported today. In a letter to the government, the Australasian Society for Infectious Diseases cited a risk of cross-contamination when using multidose vials and said the flu epidemic has subsided, so the campaign needn't be rushed. A spokeswoman for vaccine maker CSL countered that the single-dose approach would be slower and more expensive. [Aug 20 Australian Broadcasting Corp. News story]

-Novel H1N1 deaths in Latin America exceed 1,300

Deaths from H1N1 flu in Latin America, the world's hardest-hit region, have reached 1,303, more than 70% of the global total of 1,799 listed by the World Health Organization, Agence France-Presse reported yesterday. Argentina has had 404 deaths, the second-highest toll after the United States' 477, and Brazil has 368, the story said. Trailing Brazil are Mexico, with 164 deaths; Chile, 105; and Peru, 62. [Aug 19 AFP report]

-Americans not worried about H1N1 but will get vaccine

More than 60% of Americans say they are not worried about the novel H1N1 flu, but 55% plan to get the H1N1 vaccine for themselves or someone in their household, according to a Washington Post-ABC News Poll. The poll indicates that about one in eight Americans is very worried that the pandemic will affect his or her family, while twice as many are not at all worried, the Post reported. Nearly 75% were confident that the government will be able to cope effectively with the epidemic. [Aug 19 Washington Post story]

-Canada expects November vaccination launch, adequate supply

Canadian officials hope to license the country's novel flu vaccine and begin immunizing people in November, the Canadian Press reported yesterday. Canada's vaccine supplier, GlaxoSmithKline, will ship about 10 to 15 million doses and will be able to quickly replenish supplies as healthcare workers administer the vaccine to patients. Officials project that GSK's antigen production will outpace its fill-and-finish capacity, but said finishing the vaccine elsewhere would cause delays. [Aug 19 Canadian Press story]

-Zimbabwe, Belarus report first novel flu cases

Zimbabwe's health ministry today announced the confirmation of the country's first novel H1N1 cases, in five private-school children who got sick in early August, Agence France-Presse reported. Doctors at Zimbabwe's state hospitals are on strike over wage and allowance issues, but the health minister said the medical system is coping. Meanwhile, Belarus confirmed its first novel flu case yesterday, in a Chinese man who had recently returned from visiting China, the Interfax news agency reported. [Aug 20 AFP story]

-Many British firms have had H1N1-related absences

In a survey of 429 small and medium-size British companies, 72% said they had weathered staff absenteeism because of the H1N1 flu and 38% expected that their sales would suffer, Reuters reported yesterday. The survey by the law firm Eversheds also found that one in five businesses said they expected to have to close or partially close premises, and 87% said they had introduced new sanitation measures to combat the virus. [Aug 19 Reuters report]

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Roscoe and Miss Priss

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


Aug 21
H1N1 Flu Breaking News

-Chile finds novel flu virus in turkeys

Chile's agriculture ministry yesterday reported an outbreak of novel H1N1 flu at two turkey farms west of Santiago, the first such report in birds, Reuters reported. The farms were quarantined on Aug 13 after a change in egg production prompted testing. So far officials have found no further spread. Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said at a press conference today that the finding was interesting but not surprising or worrisome. [Aug 21 Reuters story]

-WHO official predicts 'explosion' of H1N1 cases this fall

A World Health Organization (WHO) official speaking in Beijing today said he expects to see an "explosion in case numbers" this fall when novel H1N1 virus activity picks up again in the northern hemisphere, the Associated Press reported. Shin Young-soo, the WHO's Western Pacific director, said cases in many countries could double every 3 to 4 days. But a US CDC official said that while vigilance is needed, fall outbreaks might resemble only a bad flu season. [Aug 21 AP story]

- US death toll from H1N1 virus rises to 522

The Centers for Disease Control and Prevention (CDC) recorded 7,963 hospitalizations and 522 deaths attributed to novel H1N1 flu as of the end of last week, up from 7,511 hospital cases and 477 deaths a week earlier, Dr. Jay Butler of the CDC reported at a news conference today. Butler said the overall level of flu activity was low, but two states, Alaska and Maine, still had widespread activity. Those two states plus Hawaii and South Carolina had widespread activity a week earlier. [CDC flu surveillance page]

-WHO says cases declining in temperate parts of southern hemisphere

H1N1 flu cases in temperate areas of the southern hemisphere are declining, except South Africa, the WHO reported in a revised situation update today. But cases are increasing in tropical parts of Asia that are entering their monsoon season, such as India. The WHO expects the new strain to dominate the early part of the northern hemisphere's flu season. Twelve oseltamivir-resistant cases have been reported. The global H1N1 death toll has reached 1,799, with 177 countries confirming cases. [Aug 21 WHO revised situation update]

-Flu fatality study finds half of patients had underlying conditions

A review by French researchers of 574 novel flu deaths reported globally through mid July found that about half involved people with underlying conditions, most notably pregnancy and obesity. Reporting in the latest issue of Eurosurveillance, they said more research is needed to explore if other conditions contribute to higher death rates in obese patients. Though older people seem to have some immunity, the group found that elderly patients who had novel flu infections were more likely to die. [Aug 20 Eurosurveillance study]

-Study says flu vaccination should target kids and their parents

A modeling study to assess flu vaccine allocation strategies found that immunizing school children and adults their parents' age, 30 to 39, might be optimal, researchers reported in Science Express yesterday. Their rationale is that school children are responsible for most flu transmission and that their parents spread the virus to the wider community. The authors wrote that CDC recommendations for seasonal and novel flu vaccination don't fully address those transmission factors. [Aug 20 Science Express abstract]

-Another large insurer vows to cover H1N1 vaccine administration

Minneapolis-based UnitedHealth Group (UNH), one of the largest US health insurance companies, announced yesterday it would cover administration of the novel H1N1 vaccine for all its members, even if their benefit plans do not usually cover immunizations. Earlier this month, a trade association of health insurance companies told the CDC that insurers would generally cover administration of the vaccine for their members. [Aug 20 UHC announcement]

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Roscoe and Miss Priss

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

Aug 24

H1N1 Flu Breaking News

-WHO urges vaccine support for poor nations

The World Health Organization's (WHO's) flu chief urged wealthy nations and drug makers to donate more novel H1N1 vaccines to the world's poorest countries, according to an Aug 22 Associated Press (AP) story. Dr. Keiji Fukuda said, "It is clear that the poorest countries in general are just the most vulnerable to any number of diseases." Two drug companies have already agreed to donate 150 million doses to developing countries, while a third is looking at reduced pricing. [Aug 22 AP article]

-HHS tallies US ventilator capacity

The US Department of Health and Human Services (HHS) has enlisted the help of the American Association for Respiratory Care to gauge the supply of mechanical ventilators in the nation's hospitals, according to the respiratory therapy journal RT. The HHS requested the inventory, due Sep 10, to help assess how to boost ventilator capacity in advance of an expected fall wave of pandemic H1N1 flu. The report will be confidential and will not be used to relocate machines. [Aug 21 RT story]

- PLoS launches preliminary flu research findings site

Public Library of Science, a nonprofit, open-access scientific publisher, recently introduced a new portal for rapidly disseminating preliminary influenza-related research findings. Articles on the Web site, called PLoS Currents: Influenza, are screened by a board of moderators but are not thoroughly peer reviewed. The site currently contains 10 articles, including one on pandemic H1N1 virulence and another on the outbreak and intensive care capacity. [PLoS Currents: Influenza Web site]

-South Korea delays school openings over flu

Because of the rapid spread of H1N1 flu, some South Korean schools are delaying their semester start, scheduled for yesterday, to slow the spread of the virus, the Korea Herald reported. The schools include 3 middle schools, 12 high schools, and 1 international school that reported a total of 38 confirmed H1N1 infections. The number of South Korean cases reached 3,113 yesterday with 188 new cases in that day alone. [Aug 25 Korea Herald story]

-Kyrgyzstan reports first novel flu cases

Public health officials in Kyrgyzstan today confirmed the country's first novel H1N1 cases, a 24-year-old man and his wife who had traveled to Dubai in mid August, Trend News Agency reported. The two were admitted to an infectious disease hospital on Aug 18 with flu symptoms. Lab tests in Moscow confirmed the diagnosis. [Aug 24 Trend News Agency story]

-CSL launching H1N1 vaccine trials

CSL Biotherapies, one of five companies making novel H1N1 vaccine for the US government, today announced the launch of clinical trials of the vaccine in adults and children. Plans call for enrolling 1,300 adults and 450 children (aged 3 months to 9 years) in the trials. The subjects will receive two doses 3 weeks apart; three different doses will be tested in the adult trial and two doses in the children's. The children's vaccine will be in a thimerosal-free formulation. [Aug 24 CSL news release]

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Roscoe and Miss Priss

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

Aug 25

H1N1 Flu Breaking News

--Full H1N1 immunity may not come till Thanksgiving

Health and Human Services Secretary Kathleen Sebelius said yesterday it will probably be Thanksgiving before many Americans are fully immunized against the novel H1N1 flu virus, the Associated Press (AP) reported. Sebelius, speaking to reporters in Atlanta, said immunization will probably require two doses 3 weeks apart, and full immunity won't develop until a week or two after the second dose. The first doses are expected to become available in mid-October. [Aug 25 AP report]

-As demand drops, UK closes 2 pandemic flu call centers

Because of declining demand, Britain's National Pandemic Flu Service will close two of its telephone call centers this week, the Guardian newspaper reported. The story said infection rates have dropped and calls to the help lines have fallen since late July. The centers prescribe antiviral drugs over the phone to people with flu-like illnesses, a practice that has stirred controversy. More than 500,000 packs of oseltamivir were prescribed in the first 2 weeks after the centers opened. [Aug 25 Guardian story]

-Smokers may be susceptible to severe H1N1 illness

A Hong Kong health official said smokers may be prone to suffering life-threatening complications from novel H1N1 flu, Bloomberg News reported yesterday. At a medical meeting, Thomas Tsang of Hong Kong's Centre for Health Protection said 12 of 27 patients who suffered pneumonia and other serous complications were current or former smokers, and some had no other known risk factors. About 1 in 200 people in Hong Kong who tested positive for H1N1 experienced severe disease, the story said. [Aug 24 Bloomberg News story]

-Asia predicted to fall far short on H1N1 vaccine

Asian countries will far markedly short of novel H1N1 vaccine this fall, a spokesman for the World Health Organization (WHO) said, according to a Reuters story today. Australia and China are scheduled to start vaccine production in September, but their vaccine is unlikely to benefit the rest of the region. "There is going to be massive underproduction of vaccines as compared to the needs and demand," said Manila-based WHO spokesman Peter Cordingley. [Aug 25 Reuters article]

- Sweden targets entire population for vaccine

Sweden has set aside $142 million to pay for the vaccination of its entire population against pandemic flu, an official said yesterday, according to an Agence France-Press (AFP) story today. The country has signed an agreement with British vaccine maker GlaxoSmithKline for 18 million vaccine doses enough to cover its population of about 9.3 million with two doses each. Sweden's vaccination program will be voluntary. [Aug 25 AFP story]

- All Maryland hospitals e-linked for flu tracking

Maryland officials announced Monday that all of the state's hospitals will be linked via computer to better track pandemic influenza this fall and winter, according to a Baltimore Sun report. Maryland is the first state to enroll all its hospitals in the surveillance program, which also can be used to combat bioterror. Forty-six hospitals will share data on patients admitted, diagnoses, and treatments. In addition, state drugstores will log sales of flu and cold medications. [Aug 25 Baltimore Sun report]

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Roscoe and Miss Priss

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

Aug 26
H1N1 Flu Breaking News

-CDC reports 2 more antiviral-resistant H1N1 cases

Two more oseltamivir (Tamiflu)-resistant cases of novel H1N1 flu have been identified in the United States, bringing the US total to four, Dr. Scott Epperson of the CDC reported today during a teleconference sponsored by the National Influenza Vaccine Summit. "These two new cases as well as the first two reported 2 weeks ago were associated with treatment or prophylaxis with Tamiflu," Epperson said. The two latest cases were included in the CDC's weekly surveillance update issued Aug 21. [CDC's most recent weekly flu surveillance report]

-Pandemic H1N1 picks up pace at schools, colleges

Officials at Carnegie Mellon University in Pittsburgh have confirmed novel H1N1 in 24 students, many of whom are being treated in isolation units, the Pittsburgh Post-Gazette reported today. Penn State has also confirmed several cases. Meanwhile, schools near Lee County, Alabama, including the cities of Opelika and Auburn, are reporting hundreds of students sick with flu-like illnesses, and dozens of illnesses have been reported in Los Alamos, NM, schools, according to other reports. [Aug 26 Pittsburgh Post-Gazette story]

-Novel flu suspected in another Australian pig herd

Another pig herd in Australia has been quarantined because of a suspected novel H1N1 flu outbreak, the Australian Associated Press (AAP) reported. Veterinarians took samples from the pigs after several in a shed of 450 showed flu-like symptoms. The farm is located west of Brisbane in Queensland. Initial results were positive for influenza A, and further tests are under way to confirm the pandemic H1N1 virus. An outbreak was reported in Victoria last week and New South Wales in July. [Aug 25 AAP story]

-Australia's H1N1 epidemic still going strong

Australia's H1N1 flu epidemic has not yet passed its peak, Health Minister Nicola Roxon said today, according to the AAP. Roxon said there have been signs of a decline in cases in some areas, but cases are still increasing in others. The country has had 138 deaths from the virus, and about 80% of people tested for flu-like illness have had it. Australia currently has 440 people hospitalized with the illness, including 100 in intensive care units, the story said. [Aug 26 AAP story]

-Angola reports first novel flu cases

Angola's health ministry yesterday reported the country's first four pandemic H1N1 cases, Angola Press reported. The patients include two Brazilians and two Angolans from the same family, both of whom traveled internationally. All of the patients are in isolation and are reportedly in stable condition. [Aug 25 Angola Press story]

-EU puts chronically ill, pregnant women, health workers first for vaccine

The European Union's (EU's) health authorities yesterday recommended that people ages 6 months and older who have chronic health conditions, pregnant women, and healthcare workers be first in line for novel H1N1 flu vaccine. The EU statement said it will be up to member states to develop their own vaccination strategies. Unlike the US priority group list, the EU list does not include the general population of children aged 6 months through 4 years. [Aug 25 EU statement]

-FDA issues emergency authorization for H1N1 test in military

The US Food and Drug Administration (FDA) yesterday issued an emergency use authorization (EUA) for a novel H1N1 flu diagnostic test in US troops overseas. The Centers for Disease Control and Prevention developed the test, called the CDC swH1N1 Influenza Real-Time RT-PCR. FDA Commissioner Margaret A. Hamburg said the test will permit faster diagnosis of H1N1 in troops so that treatment can start sooner. [Aug 25 FDA statement]

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Roscoe and Miss Priss

(Reminder, if you want to read more on any of these subjects, go to CIDRAP and click on the link at the end of each little update. M.)

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

Aug 27

H1N1 Flu Breaking News

-Judge rejects bid to ban use of some H1N1 vaccines in pregnant women

A federal judge yesterday rejected an advocacy group's request to bar the government from using thimerosal-containing H1N1 flu vaccines in pregnant women, the Washington Post said. The group argued that thimerosal could harm fetuses. But a judge in Washington said the group couldn't prove that pregnant women would get shots containing thimerosal. Most flu vaccines contain it, but the CDC has said it plans to supply enough thimersoal-free H1N1 vaccine for pregnant women and young children. [Aug 26 Washington Post story]

-Chicago H1N1 study shows children far more susceptible than older adults

A study of the first 3 months of the H1N1 flu epidemic in Chicago shows that children aged 5 to 14 were 14 times more susceptible to the virus than adults aged 60 and older, according to Morbidity and Mortality Weekly Report (MMWR). Chicago had 1,557 confirmed cases during the 3 months, and the attack rate for children was 147 per 100,000 population. The hospitalization rate was highest for children 0 to 4 years old (25 per 100,000), followed by those aged 5 to 14 (11 per 100,000). [Aug 29 MMWR article]

-New Zealand's medical visit rate for flu-like illness tripled this year

Flu surveillance in New Zealand from early May to early August showed that the peak in weekly visits to general practitioners for flu-like illness was the highest since 1997 and three times as high as in 2008, according to MMWR. Surveillance also showed that as the season progressed, the number of 2009 H1N1 isolates rapidly exceeded the number of seasonal flu isolates, with the new strain making up 80% of all weekly isolates by early July. [Aug 29 MMWR article]

- Brazil reports world's highest H1N1 flu death toll at 557

Brazil has displaced the United States as the country with the most 2009 H1N1 flu deaths, at 557, Agence France-Presse reported yesterday. The latest official death toll for the United States was 522 as reported by the CDC last week. Brazil's health ministry said the country's H1N1 epidemic appears to be declining. The ministry has allocated $1 billion to buy 73 million doses of H1N1 vaccine, along with oseltamivir, hospital equipment, and diagnostic tests. [Aug 26 AFP story]

-Federal workers may be allowed to use sick leave to care for ailing relatives

Under a new proposal, federal employees could use accumulated sick leave to care for family members sick with H1N1 flu or other infectious diseases, the Washington Post reported. The proposal, published yesterday, would allow workers to use up to 13 days of sick leave to care for a relative before getting a doctor's determination that the relative had an infectious disease. With the doctor's determination, the employee could use up to 12 weeks of sick leave a year. [Aug 27 Washington Post story]

- Liability, insurance coverage threaten Australia's vaccine program

Australia's pandemic H1N1 vaccine campaign is in peril because the government has refused to indemnify physicians who administer the vaccine and insurance companies seem unwilling to pay doctors to deliver the vaccines, the Sydney Morning Herald reported today. Insurance companies have also raised concerns about multidose vial safety and a lack of vaccine safety data. The country's vaccine campaign is slated to start in mid September, with enough vaccine to cover half of the population. [Aug 27 Sydney Morning Herald story]

-Defense Department secures its own vaccine supply

The US Department of Defense has purchased a 2.7-million-dose supply of novel H1N1 vaccine for active military members through the federal government and will launch immunization campaigns in October, starting with high-risk groups and those who live in close quarters at sea, Government Executive reported yesterday. All service members are slated to receive the vaccine, though their dependents will receive theirs though civilian channels. [Aug 26 Government Executive story]

-South Korea rolls out strict school flu measures

South Korea's education ministry yesterday announced strict measures to curb the spread of the pandemic H1N1 virus, including checking all students' temperatures each day, sterilizing classrooms daily, and refraining from group activities, Agence France-Presse reported today. So far 46 schools have closed or delayed the start of fall classes. The government expects to place school children on its vaccine priority list. [Aug 27 AFP story]

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Roscoe and Miss Priss

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

H1N1 Flu Breaking News

-Poll suggests rising flu concern in US public

A new USA Today/Gallup poll suggests Americans are becoming more concerned about getting sick with the pandemic flu virus, USA Today reported yesterday. Of 1,007 adults who were polled, 1 in 3 believe they or a family member will get sick with the virus, up from 1 in 5 in May. Compared with the earlier poll, slightly more accept the government's risk assessment, and 55%, up from 46%, now say they will get the vaccine. The poll's margin of error is 4 percentage points. [Aug 27 USA Today story]

-Expert warns about next year's pandemic flu wave

The fall wave of pandemic H1N1 flu in the northern hemisphere will likely resemble the spring spread of the virus, but a more deadly outbreak could strike next year because of natural selection pressure, virologist John Oxford told Agence France-Presse (AFP) yesterday. Once the virus infects a third of the population, it will find fewer susceptible individuals, which may give mutant viruses a selective advantage, he said. He urged governments not to let down their guard after the next wave. [Aug 27 AFP story]

-Manitoba finds novel flu virus on pig farms

Manitoba's chief veterinary officer recently announced that the novel H1N1 virus has been detected on various pig farms in the province, according to a post today on ProMED-mail, the Internet-based reporting system of the International Society for Infectious Diseases. No deaths were reported, but the animals showed mild flu-like symptoms. Movement of the pigs was limited to curb transmission, and veterinarians have been asked to help identify and report further outbreaks. [Aug 28 ProMED-mail post]

-Britain, France get first H1N1 vaccine shipments

Britain and France have received their first novel flu vaccine shipments, but they await regulatory approval and likely won't be administered to patients until October, AFP reported today. British officials said they received 100,000 doses of a vaccine made by US-based Baxter, but French officials didn't specify the number of doses they received or the manufacturer. [Aug 28 AFP story]

-Several factors tipped US decision for 2 separate flu vaccines

In response to reader questions about why US officials didn't combine the novel flu vaccine with the seasonal flu vaccine, Columbia University virologist Vincent Rancaniello, who authors a virology blog, posed the question to the Centers for Disease Control and Prevention. The agency responded that factors weighing against inclusion were lack of clinical trials for tetravalent vaccines, different high-risk populations for seasonal and pandemic flu, production timing, and ease of safety tracking. [Aug 26 Virology Blog post]

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Roscoe and Miss Priss

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

Aug 31
H1N1 Flu Breaking News

-H1N1 cases may strain ICUs this winter

Experience to date suggests that the novel H1N1 flu may put a heavy burden on intensive care units (ICUs) in coming months, said critical care specialists quoted in a Canadian Press report today. ICUs in some of the hospitals hit hardest by virus nearly ran out of specialized equipment and skilled staff. The Public Health Agency of Canada has scheduled a meeting this week in Winnipeg to discuss the problem. [Aug 31 Canadian Press story]

-Mexico predicts 1 million cases in next flu wave

Mexico's government projects that 1 million of its citizens will become ill this winter with the novel H1N1 virus, the Latin American Herald Tribune reported today. The country's health secretary, Jose Angel Cordova, said on Aug 28 that the number of cases is stable for now, with about 80 to 100 infections reported each day. He said the government is working on emergency plans on school closures, social distancing measures, and hospital preparations. [Aug 31 Latin American Herald Tribune story]

-WHO chief: H1N1 spreads at 'unbelievable' speed

Dr. Margaret Chan, head of the World Health Organization, told France's Le Monde newspaper that the novel H1N1 virus "spreads at an unbelievable, almost unheard-of speed," according to an Aug 29 Agence France-Presse (AFP) story. She said the virus can travel as far in 6 weeks as other viruses travel in 6 months and estimated that up to 30% of people in densely populated countries are at risk for infection. Chan also noted that about 40% of deaths are in previously healthy young adults. [Aug 29 AFP story]

-Colombia's president ill with pandemic flu

Colombian President Alvaro Uribe became ill with flulike symptoms on Aug 28 while addressing South American leaders at a summit in Argentina and was diagnosed yesterday as having the pandemic H1N1 virus, The Guardian reported today. He has continued working in partial isolation via phone and internet. So far no illnesses have been reported in other leaders or in Uribe's travel group. [Aug 31 Guardian story]

-HHS opens public vote for flu-prevention video

The US Department of Health and Human Services (HHS) has invited the public to help pick the best video in its Flu Prevention Public Service Announcement (PSA) Contest. The top 10 videos, chosen from among 240 entries, have been posted on YouTube, and the public is invited to view the 30-second spots and vote their choice. The winner will receive $2,500 and see the video broadcast on national television. [Aug 31 HHS news release with link to PSAs]

-Kuwait postpones kindergarten start

Kuwait's education ministry said yesterday that the country will delay opening kindergartens for 2 months to curb the spread of the novel H1N1 virus, AFP reported today. The measure will also apply to nurseries and schools that serve students with special needs. Other schools will reopen at the usual time, the last week of September. [Aug 31 AFP story]

-CVS stores to offer seasonal flu vaccine

The CVS pharmacy chain today announced that seasonal flu vaccine will be available starting tomorrow at 500 of its stores, according to a company press release. Vaccine will be available to adults and children over 18 months without an appointment. The chain said it will host about 9,000 flu clinic events starting Sep 15. With novel H1N1 vaccine expected to reach providers in October, the US CDC has said that people should receive the seasonal vaccine as soon as it's available. [Aug 31 CVS/Caremark press release]

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Roscoe and Miss Priss

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html
Sep 1
H1N1 Flu Breaking News

-Neurologists to help with vaccine safety surveillance

The American Academy of Neurology has joined with the CDC to ask neurologists to report any potential new cases of Guillain-Barre syndrome (GBS) after the pandemic H1N1 vaccine campaign begins. The organizations are asking neurologists to report through the federal Vaccine Adverse Event Reporting System. The groups don't anticipate that the vaccine will pose a GBS risk, but they are acting with caution because some GBS cases were linked to the 1976 swine flu vaccine. [Aug 31 American Academy of Neurology press release]

-Canadian expert urges using non-adjuvanted vaccine

Dr. Paul Hebert, editor of the Canadian Medical Association Journal, said in an editorial that approving an adjuvanted version of Canada's H1N1 vaccine will cause delays and urged using a non-adjuvanted version to begin vaccinating high-risk groups, according to the Toronto Star. But a spokeswoman for the Public Health Agency of Canada said the government has a "highly flexible regulatory plan" and will not need extra time to approve the adjuvanted vaccine, the story said. [Sep 1 Toronto Star story]

-Openness was Mexico's most effective tactic against H1N1

Mexican health officials who are examining what worked and what didn't in fighting the first wave of H1N1 flu say that rapid notification of the public about the virus was the most effective step, though it cost the economy billions of tourist dollars, the Associated Press (AP) reported today. Rapid diagnosis, treatment, and quarantine, along with hand-washing, also were helpful. Ineffective steps included travel bans, school closures, and widespread use of surgical masks, the story said. [Sep 1 AP report]

-Mexico City offers travelers free insurance

To boost travel business in the wake of the novel H1N1 epidemic, Mexico City last month began offering free insurance to anyone who registers to stay at one of the city's hotels, the Toronto Star reported today. The coverage, provided by Spain-based Mapfre, covers medical problems, trip cancellations, and document losses. It costs the hotels $30 per visitor. Enrollment is automatic when travelers book a Mexico City hotel room. [Sep 1 Toronto Star story]

-Walgreens' seasonal flu vaccine program includes some free doses

The Walgreens drugstore chain announced yesterday that it will begin offering the seasonal flu vaccine today in its stores. Walgreens also announced a $1 million program to provide free flu vaccine to uninsured adults, who will receive vouchers to use at wellness tour bus locations in nine cities. The Centers for Disease Control and Prevention has called for early seasonal flu vaccine campaigns to make way for novel H1N1 vaccination efforts, expected to start in mid October. [Aug 31 Walgreens press release]

-Federal agencies launch 'Sesame Street' PSAs

Three federal agencies, including the Department of Health and Human Services (HHS), have teamed with Sesame Workshop, the educational group linked to television's "Sesame Street," to launch a new series of public service announcements to teach families and children how to prevent pandemic H1N1 flu. The four videos, available on the Flu.gov Web site, address hand-washing and proper coughing and sneezing techniques. The groups produced a similar series at the start of the spring flu outbreak. [Sep 1 HHS press release]

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Roscoe and Miss Priss

http://www.cidrap.umn.edu/cidrap/co...eflu/index.html
Sept 2

H1N1 Flu Breaking News

-New York City to offer kids free pandemic flu shots

New York City's school district said yesterday it will offer free novel H1N1 flu vaccine to all its students, according to the Associated Press (AP). Hundreds of US school districts will provide vaccinations in schools as the vaccine becomes available, projected to occur next month. Brenda Greene, director of school health programs for the National School Boards Association, said New York, with its more than 1 million schoolchildren, could be "a great role model." [Sep 1 AP story]

-Other large US cities detail their plans

In addition to New York's immunization plan, other large US cities are announcing steps, according to Bloomberg News. Los Angeles will administer vaccine at its fairgrounds, Boston is allowing city employees to leave work for 2 hours for vaccine, and Chicago's schools for the first time plan to track real-time attendance to pinpoint trends. Los Angeles and Boston are also setting up swine flu centers to administer vaccinations. [Sep 1 Bloomberg report]

-Egyptian H5N1-H1N1 coinfection report debunked

A story out of Egypt about a man infected with both the novel H1N1 virus and the deadly H5N1 avian flu is not accurate, according to an official with the Centers for Disease Control and Prevention (CDC). The story by an Egyptian newspaper was picked up yesterday by the widely read electronic surveillance system ProMED mail. However, Nancy Cox, head of the CDC's influenza division, told the blog ScienceInsider, "Our reliable sources indicate that this report is incorrect." [Sep 2 ScienceInsider blog entry]

-China nears decision on one-dose vaccine

China is close to approving domestic novel flu vaccines that manufacturers claim can protect people with just a single dose instead of the two doses that most officials believe will be necessary, according to the AP today. China's vaccines could boost global health efforts if the one-dose administration proves effective. China's State Food and Drug Administration said at least two pandemic vaccines are near approval and another four are under review. [Sep 2 AP report]

- WHO expert: Mutations no obstacle for H1N1 vaccine

Novel H1N1 vaccines should offer effective protection even if the pandemic flu virus mutates as it spreads, a World Health Organization (WHO) official said today, according to Reuters. Marie-Paule Kieny, director of the WHO vaccine research program, said, "Based on the extensive knowledge available on seasonal vaccines and the results obtained through evaluation of H5N1 avian influenza vaccines, there is no doubt that it will be possible to make effective H1N1 pandemic vaccines." [Sep 2 Reuters article]

-Novel flu may cause deaths in heart patients

Physicians have raised concerns that pandemic flu may hit heart patients hard, according to the AP. Thus, some specialists at a European cardiology meeting said that such patients should receive vaccine priority. Although most heart patients are 60 or older and therefore may have some immunity to novel H1N1, "It's almost a given that any influenza exposure is going to cause more mortality in heart patients," said Alfred Bove, president of the American College of Cardiology. [Sep 2 AP story]

-iPhone app may help track flu near you

A new iPhone application, created by researchers at Children's Hospital Boston, is said to enable users to track and report outbreaks of infectious diseases, such as H1N1 pandemic flu, in real time. The application, "Outbreaks Near Me," employs the online resource HealthMap, which collects, filters, and maps information about emerging infectious diseases and pinpoints outbreaks near the user. [Sep 1 Children's Hospital Boston press release]

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Roscoe and Miss Priss

Sept 4

H1N1 Flu Breaking News

-Britain scales back flu death projection

The British government scaled back its projection of how many novel H1N1 deaths could occur, The Times of London reported today. In July it predicted 65,000 fatalities in a worst-case-scenario, but now the National Health Service (NHS) says fatalities could range between 3,000 and 19,000. Officials lowered the estimate because symptoms of the virus are mild for most patients. The NHS's chief medical officer said case numbers have not risen in Scotland, where school resumed 3 weeks ago. [Sep 4 Times story]

-Tiered epidemic plans could improve response

Responses to the novel H1N1 virus outbreak might be seen as alarmist, because many pandemic plans accounted for only a worst-case scenario, Peter Doshi, a doctoral student at Massachusetts Institute of Technology wrote in the British Medical Journal yesterday. Calibrated responses based on four types of risk assessments that take into account disease distribution and severity could build public trust and engage the public's attention to warning messages, he wrote. [Sep 3 British Medical Journal press release]

- Uninsured New Jersey residents to get free pandemic flu vaccine

In announcing new measures to curb the fall wave of pandemic flu, New Jersey officials said yesterday that the state will provide free novel H1N1 vaccine to the 1.3 million uninsured people. The free vaccines will be offered though public health clinics located in all New Jersey counties. Other response measures include a public education campaign, working with school districts to keep schools open, and partnering with districts to establish a voluntary vaccination program. [Sep 3 New Jersey governor's office press release]

-Lung tissue in some fatal cases resembles H5N1 infection

Pathologic investigation of lung tissue from patients who have died of pandemic H1N1 infections resembles that in those dying from H5N1 avian influenza, a scientist who has studied about 70 fatal cases told the Canadian Press. Dr Sherif Zaki, a pathologist at the US Centers for Disease Control and Prevention said the level of lung damage makes it difficult to oxygenate patients. About a third of the patients had bacterial coinfections, and about 90% had underlying conditions such as obesity. [Sep 3 Canadian Press story]

-Doctors reverse severe infection with experimental IV antiviral

A 22-year-old woman with pandemic H1N1 infection and chemotherapy-induced immune compromise recovered from a severe infection after treatment with an experimental intravenous version of zanamivir, her doctors reported today in The Lancet. She had not responded to oseltamivir or nebulized zanamivir alongside antibiotics, hydrocortisone, and mechanical ventilation. Her doctors combined IV zanamivir with corticosteroids, which is controversial but is used in some respiratory distress cases. [Sep 4 Lancet report]

-WHO: flu activity increasing in many tropical regions

In its weekly pandemic update today, the World Health Organization (WHO) said flu activity is widespread and increasing in many tropical regions of South and Southeast Asia as well as South America. Though flu activity is past its seasonal peak in some parts of the southern hemisphere, parts of Australia and South America are seeing sustained circulation. Japan is experiencing an early start to its flu season. The global number of deaths is at least 2,837, mostly from WHO's Americas-region count [WHO pandemic update 64]

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Roscoe and Miss Priss

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

sept 8

H1N1 Flu Breaking News

-China reports flu rise, predicts vaccine shortage

China's health minister Chen Zhu today called the country's pandemic flu situation "grim," due to a surge in cases and clusters in the wake of schools resuming, Agence France-Presse (AFP) reported. Chen cited worries over a national holiday next month, which will prompt gatherings and travel, and the limited ability of China's flu vaccine company to supply enough pandemic H1N1 vaccine to meet demand. China has confirmed 5,592 cases, but has reported no deaths. [Sep 8 AFP story]

-Pandemic puts damper on French cheek kiss

To help curb the spread of the pandemic H1N1 virus, French health officials, as well as some companies and schools, are advising people to avoid greeting other with "la bise," the country's traditional cheek-to-cheek kiss, the Associated Press (AP) reported yesterday. The health ministry's phone hotline recommends avoiding close contact, such as shaking hands or kissing. [Sep 7 AP story]

-Report says job questions among top pandemic-related legal issues

Questions related to employment are among the most significant legal issues raised by an influenza pandemic, the Congressional Research Service (CRS) said in a recent report on pandemic-related legal issues. Compliance with public health measures such as isolation and quarantine are likely to suffer if workers fear pay cuts or firing, the report says. It says workers may have some protection under the Family and Medical Leave Act. [Full text of CRS report]

-Singapore finds pandemic H1N1 virus in Indonesian pigs

Singapore's Agri-Food and Veterinary Authority has detected the pandemic H1N1 virus in pigs imported from Indonesia, according to a recent report by Channel NewsAsia. While saying that pork sold in Singapore is safe to eat, the agency vowed to step up its inspections of pork products and to work with Indonesian authorities to identify and isolate affected pig houses on farms. [Sep 3 Channel NewsAsia report]

-New York nurses group advocates N95 respirators

In an open letter, the New York State Nurses Association (NYSNA) called on the state health department to recommend the use of fit-tested N95 respirators to protect nurses who care for pandemic H1N1 flu patients. The Sep 4 letter said the state's current guidelines, which call for the use of surgical masks, are not adequate. A health department spokeswoman defended the current guidelines and said nurses would be protected by mandatory vaccinations, the New York Daily News reported. [Sep 4 NYSNA open letter]

-Production delay slows vaccine delivery to Holland

The Dutch health ministry said today a delivery of 18 million doses of pandemic H1N1 vaccine from Novartis slated for the end of October will be late, Dow Jones news reported today. Novartis attributed the delay to "disappointing production result." The country, now expecting 6 to 10 million doses from the company by the end of next month, expects 2 million more from GlaxoSmithKline. Novartis said it hopes to boost yield by using a new seed strain it received from the World Health Organization. [Sep 8 Dow Jones story]

-Flu fatal for Ecuador's security chief

Ecuador's presidential security chief, John Merino, died on Sep 6 from a pandemic H1N1 infection, AFP reported today. He was first diagnosed with the novel flu strain on Aug 10. The virus has struck a host of other South American government officials over the past few weeks, including the presidents of Costa Rica and Colombia. [Sep 7 AFP story]

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Roscoe and Miss Priss

I just overheard a conversation in a coffee shop between a guy from our county Public Health department and a representative from the Fire Department. The Fire guy was saying his people would abuse any policy that allowed for extra absence due to the flu, and the Public Health guy kept restating the CDC recommendations. It sounded like they had to make a presentation the next day and weren't agreeing on policy.

I can see where these policy decisions get messy, and maybe even more so since the virus is mild for most people.


MomCares

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"I don't want to make money. I just want to be wonderful." - Marilyn Monroe

Don't anthropomorphize viruses. They hate that.

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

sept 9


H1N1 Flu Breaking News

-Harvard survey finds business preparedness gaps

Only one third of businesses responding to a national survey said they could sustain operations if half their employees were absent for 2 weeks because of pandemic H1N1 flu, researchers from the Harvard School of Public Health reported today. Though 74% offer sick leave, only 35% of businesses allow paid leave for taking care of sick family members. The report's lead author advised businesses to start making continuity and disease-prevention plans now. [Sep 9 Harvard School of Public Health press release]

-Alabama reports rising school absence rates

Alabama's school absence rates have doubled over the past few weeks, though officials aren't able to determine how much of the rise is related to novel flu, the Associated Press (AP) reported. Dr Don Williamson, the state's health officer, said emergency departments are reporting that 20% of patients have flu-like illnesses. He attributes the rise in pandemic flu cases to schools resuming and said the virus has been detected at most of Alabama's colleges. [Sep 8 AP story]

-WHO urges Southeast Asian countries to prepare

A World Health Organization (WHO) official speaking to health ministers from 11 Southeast Asian nations today urged the region to prepare for another wave of pandemic flu cases as the northern hemisphere moves closer to its winter season, Agence France-Presse (AFP) reported. The WHO told the group meeting in Kathmandu that although the virus has yet to take a big toll in Asia, hospitals should prepare for a surge of severe cases. [Sep 9 AFP story]

- Egypt orders 5 million vaccine doses

Egypt's health ministry said in a Saudi News Agency report that the country has ordered 5 million doses of the pandemic H1N1 vaccine and expects to receive the first delivery in October, Dow Jones news reported yesterday. The story did not say what company was under contract to produce vaccine for Egypt. According to a Sep 5 update from the WHO's eastern Mediterranean office, Egypt has confirmed 727 novel H1N1 cases, including 1 death. [Sep 8 Dow Jones story]

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Roscoe and Miss Priss

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


Sep 10

H1N1 Flu Breaking News

-CDC says H1N1 virus has claimed 47 children's lives

Forty-seven children died of confirmed 2009 H1N1 flu between Apr 26 and Aug 29, the CDC reported in an MMWR early release today, up from 43 such deaths the CDC reported in a weekly update last week. Today's report, an overview of flu activity from April through August, notes that cases declined in July and early August but picked up in the Southeast in the last 2 weeks of August, reaching levels usually seen during winter peaks. This may signal an early start to the 2009-10 flu season. [Sep 10 MMWR early release]

-Resistant H1N1 strain found in summer camp cabin mates

A report in the Sep 11 MMWR describes the first known instance of oseltamivir-resistant H1N1 infection in patients with epidemiologic links. The virus was found in two girls who shared a cabin at summer camp and had received prophylactic doses. Respiratory specimens revealed two mutations, including I223V, which had not been seen before. Elsewhere, two other resistant cases were noted in media reports today, one in Hong Kong and the other in Israel. [Sep 11 MMWR report]

-Colleges report big increase in flu-like illness cases

The American College Health Association, in its surveillance report for the week ended Sep 4, reported 4,974 flu-like illness cases at 236 participating schools, a 105% increase from the week before. The report doesn't list the flu subtype, but federal officials have said the pandemic virus makes up 97% of circulating strains. Schools in the South had the most cases, but Washington and Kansas also reported big increases. About 96% of the new cases occurred in the 17- to 24-year-old age-group. [Sep 8 American College Health Association surveillance report]

-EU official says early H1N1 vaccine trial results promising

The head of the European Union's drug regulatory agency said early clinical trial results for pandemic H1N1 vaccines in Europe look promising, Reuters reported today. "The immune response to all these vaccines is very promising, whatever type of vaccine it is, whether it is adjuvanted or non-adjuvanted," said Thomas Lonngren, executive director of the European Medicines Agency. He said the first vaccines could be licensed by the EU in early October if all goes well. [Sep 10 Reuters report]

-NIAID launches trial of pandemic vaccine in pregnant women

Federal officials yesterday announced the start of the first clinical trial of a pandemic H1N1 vaccine in pregnant women, who face an increased risk of complications from the virus. The trial is to enroll up to 120 women in the second or third trimester of pregnancy, the National Institute of Allergy and Infectious Diseases (NIAID) said. The women will receive two doses, 21 days apart, of a Sanofi Pasteur vaccine. NIAID Director Anthony Fauci said interest in the trial has been "extraordinary." [Sep 9 NIAID news release]

-Flu absences shutter special-needs school

Officials at an Atlanta public high school for students with severe cognitive disabilities suspended classes yesterday after about half of its 50 students were out sick, 15 of them with confirmed flu-like symptoms, the Atlanta Journal-Constitution reported. Five of the school's teachers were also sick. One student was hospitalized. Officials will sanitize the building before classes resume Sep 14. [Sep 9 Atlanta Journal-Constitution story]

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Roscoe and Miss Priss

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

sept 11


H1N1 Flu Breaking News

- H1N1 activity rises in parts of Asia, Europe, US

Novel flu activity is declining in the Southern Hemisphere and in parts of Central America and the Caribbean but increasing in tropical areas of Asia and the Americas and in some parts of the United States and Eastern Europe, the World Health Organization reported today. Oseltamivir-resistant strains have been identified in 21 patients, 12 linked to postexposure prophylaxis and 4 linked to treatment. At least 3,205 deaths have been reported. The WHO also issued school closure guidance today. [WHO pandemic H1N1 update 65]

-Baxter behind on UK pandemic vaccine order

British officials recently said one of the companies it ordered pandemic H1N1 vaccine from, US-based Baxter, is behind on delivering doses, the Financial Times reported. The government placed about one-third of its order with Baxter for its cell-based product. Baxter had promised 400,000 doses by the end of August, but has delivered only about half that amount. Britain ordered the rest of its vaccine supply from GlaxoSmithKline, which is reportedly on schedule. [Sep 9 Financial Times story]

- Inhaled H1N1 vaccine may ship within days

An official from MedImmune, which is making an inhaled vaccine against pandemic H1N1 influenza, said the company would begin shipping orders to the US government by the end of September, Reuters reported yesterday. The company official, Raburn Mallory, said MedImmune said there are no "red flags" in the safety data submitted to the Food and Drug Administration and that 5 million doses will likely be delivered by the end of the month, about 2 weeks ahead of other pandemic vaccine makers. [Sep 10 Reuters story]

-Egypt delays school start to curb flu

A state-run paper in Egypt carried an announcement from the country's prime minister today that the start of school and universities will be delayed to slow the spread of the pandemic H1N1 virus, the Canadian Press (CP) reported. The school year will begin Oct 3, a week later than planned, to allow those returning from Mecca Ramadan pilgrimages to show illness signs. [Sep 11 CP story]

-Poll: Pandemic vaccine interest highest in seniors

A new Associated Press-Gallup poll shows seniors are the group most interested in getting the pandemic H1N1 vaccine, and more people in the 18- to 29-year-old age- group are now saying they'll get the shot, the AP reported today. Younger people are bearing the greatest pandemic flu burden, so they are at the front of the line to receive the vaccine. During a normal flu season, seniors are at the front of the line for vaccine because they are among the hardest hit groups. [Sep 11 AP story]

-Efforts to extend shelf life of oseltamivir urged

British scientists writing in Emerging Infectious Diseases call for a systematic effort to extend the shelf life of oseltamivir (Tamiflu), as it is one of just two drugs active against the H1N1 virus and is scarce globally. Oseltamivir's chemical profile suggests it should be feasible to extend its shelf life to more than 20 years, the writers say. In May, they note, European authorities said new batches of the drug would have a shelf life of 7 years instead of the previous 5 years. [EID article posted Sep 10]

- Study shows little cross-protection from seasonal flu vaccines

A New England Journal of Medicine study of children and adults published yesterday showed that receiving recent seasonal flu vaccines produced little or no immune response to this year's novel H1N1 in any age-group. However, 34% of adults older than 60 had cross-reactive antibodies to novel H1N1. Also, vaccination with the 1976 swine flu vaccine substantially boosted cross-reactive antibodies to novel H1N1 in adults. [NEJM study posted Sep 10]

Study: Novel H1N1 can infect deep-lung cells

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Roscoe and Miss Priss

Mosaic,

Thanks for all the research and hard work that you do. It is greatly appreciated!

Yarrow

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(\__/)
(='.'=) This is Bunny. Copy and paste bunny into your
(")_(") signature to help her gain world domination

You're welcome, Yarrow.

CIDRAP does a very good job. It's one of my favorite sites for what I consider reliable flu information.

Mo.

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Roscoe and Miss Priss

H1N1 Flu Breaking News
http://www.cidrap.umn.edu/cidrap/co...eflu/index.html

sept 14

-Glaxo study supports single dose for adjuvanted pan flu vaccine

GlaxoSmithKline today announced that the first results from clinical trials of its adjuvanted pandemic H1N1 vaccine show a strong immune response from one dose, 3 weeks after immunization. The study involved 130 German adults, aged 18 to 60. The antigen content was 5.25 micrograms. Glaxo, the fourth company to report evidence of one-dose efficacy, said it is conducting 15 more studies in healthy adults, elderly people, and children, including infants. [Sep 14 Glaxo press release]

-Sebelius predicts early October arrival of first vaccine doses

The nation's first doses of the pandemic H1N1 vaccine could be available the first week of October, about a week earlier than expected, US Health Secretary Kathleen Sebelius said yesterday, the Associated Press (AP) reported. Appearing on ABC's "This Week" news show, she said the first doses are earmarked for healthcare workers and high-priority groups. She predicted ample supplies will be available by mid October and said vaccine will be sent to states as soon as it is produced. [Sep 13 AP story]

-G-7 nations vow to help developing nations with pandemic response

Members of the Group of Seven (G-7) leading economies plus Mexico at a Sep 11 meeting to discuss pandemic flu measures in Brussels agreed to prioritize pregnant women, healthcare workers, and people with underlying conditions for H1N1 vaccination, the AP reported. The seven nations?Canada, Japan, Germany, France, Britain, Italy, and the US?also agreed to share data, coordinate vaccine actions, and help poorer nations fight the virus. [Sep 11 AP story]

-ICU study: Half of flu patients were previously healthy

A review of the first 32 patients with severe pandemic H1N1 infections treated in Spain's intensive care units found that only half had preexisting medical conditions, though about a third were obese. Most required mechanical ventilation. About 90% of patients had viral pneumonia with severe lung damage, while only one had secondary bacterial pneumonia. [Sep 11 Critical Care study]

-GISAID re-launches flu database

A widely used database for influenza gene sequences is available again at the Global Initiative on Sharing Avian Influenza Data (GISAID) Web portal, according to a press release today. In July GISAID's database administrator, the Swiss Institute of Bioinformatics, removed access after a legal conflict. The Max Planck Institute and A3 Systems developed the new version with the world science community. WHO researchers are using it to select strains for the southern hemisphere's 2010 flu vaccine. [GISAID EpiFlu database platform]

-Feds launch novel H1N1 guidance for small businesses

Federal officials today released guidance to help small businesses prepare for the next surge of pandemic H1N1 illnesses. Homeland Security Secretary Janet Napolitano emphasized that the most important element is to have a written plan, and the guidance lists steps for doing that. The resource also includes tips for keeping employees healthy, such as encouraging sick workers to stay home, providing for telework, and supplying resources for personal hygiene. [Federal pandemic flu guidance for small businesses]

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Roscoe and Miss Priss

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

Sept 15

H1N1 Flu Breaking News

-Study finds no protection from surgical masks

Surgical masks don't protect healthcare workers, but N95 respirators do, according to a 5-week trial at 24 Chinese hospitals. Results of the trial, headed by researchers from Australia, were presented today at the Interscience Conference on Antimicrobial Agents and Chemotherapy. The study involved 1,936 healthcare workers and also showed that fit-testing did not appear to boost N95 efficacy. A federal group recently said that workers caring for H1N1 patients should use fit-tested N95s. [Sep 15 Bloomberg News story]

-Business travel group advises curbing handshakes

The Association of Corporate Travel Executives (ACTE) yesterday urged its members to temporarily suspend business handshakes until the threat of the pandemic H1N1 virus subsides. The group said business travelers might be less willing to soil their business suits covering coughs and sneezes with their sleeves and cuffs and that eliminating the handshake could reduce person-to-person spread. The group also recommends that business travelers carry hand sanitizer and get vaccinated. [Sep 14 ACTE press release]

-CDC issues new vaccine safety resources

Yesterday the US Centers for Disease Control and Prevention (CDC) issued documents addressing pandemic H1N1 vaccine safety, Guillain-Barre syndrome (GBS), thimerosal, and general immunization issues. The CDC notes that each year 1 to 2 people per 100,000 develop GBS, whether or not they are vaccinated. Though research has found no evidence that thimerosal preservative is unsafe, two versions of the vaccine won't need to contain it: single-use and inhaled units. [CDC Q&A on Guillain-Barre syndrome]

-Tamiflu-resistant H1N1 said to be less transmissible

The same genetic mutation that makes the pandemic H1N1 virus resistant to oseltamivir (Tamiflu) also reduces its ability to spread to others, said David Mercer, acting head of the communicable disease unit in the World Health Organization's European regional office, as reported by Bloomberg News today. He noted that 23 oseltamivir-resistant H1N1 cases have been identified. Public health officials are concerned that overuse of the drug may lead to widespread resistance. [Sep 15 Bloomberg News report]

-Restaurant carves out flu-control niche

A restaurant in a Spanish suburb of Madrid has specialized in preventing pandemic H1N1 flu and other infectious diseases by adopting measures such as taking employee temperatures at the start of each shift, washing menus after each use, and placing tables farther apart, the Associated Press (AP) reported. The eatery is designed so that customers don't need to touch doorknobs, faucets, or light switches. [Sep 14 AP story]

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Roscoe and Miss Priss

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

News Scan



Sep 16
H1N1 said to kill at same rate as seasonal flu The H1N1 flu death rate is lower than previously estimated and comparable to what is seen in a moderate flu season, a Harvard University expert said at a meeting in Washington, DC. Dr. Mark Lipsitch estimated the case-fatality rate is between .007% and .045%, Reuters reported. That would qualify as a category 1 pandemic (the lowest level) on the US government's pandemic severity index. Lipsitch based his estimate on global reports of flu-like illness, hospitalizations, and deaths. [Sep 16 Reuters report]

Saudi Arabia dismisses hajj flu risk Health officials in Saudi Arabia yesterday downplayed the risk of pandemic H1N1 flu transmission at the upcoming hajj pilgrimage in Mecca, Agence France-Presse (AFP) reported today. They said they are reassured because no flu deaths have been linked to the smaller Umrah pilgrimage, which began Aug 22 with the month-long Islam Ramadan observance. Other countries, such as Egypt, have considered barring pilgrim travel, and others have advised that high-risk groups not make the trip. [Sep 16 AFP story]

Experts say hand washing science shaky for flu Some infectious disease experts are questioning the science behind hand washing as a measure to curb the spread of the pandemic H1N1 virus, Newsweek reported. Though hand washing can prevent the spread of cold and other respiratory viruses, there is no evidence that it helps stop influenza, said Arthur Reingold, an epidemiologist at the University of California Berkeley. He says that flu transmits through airborne routes and that hand washing could provide a false sense of security. [Sep 15 Newsweek story]

Microsoft offers Web tools for teachers, sick students Microsoft today launched a Web portal with free tools to help teachers and students manage class assignments during novel H1N1 outbreaks. The Microsoft Office Live Workspace H1N1 flu site enables teachers to post assignments, share handouts, and conduct group projects. The tools are accessible with any Internet connection and don't require Microsoft Office on the students' computers. A Microsoft official said the tools could help schools handle flu-related disruptions. [Sep 16 Microsoft press release]

WHO director: Pandemic may devastate poor nations In a speech yesterday in Copenhagen, World Health Organization director-general Margaret Chan said the H1N1 pandemic is causing "manageable disruptions" in affluent countries but will likely have a "devastating impact" on developing countries that have few health resources. She predicted the pandemic will be a "watershed event" that will test the world on fairness issues. On the same day the European Commission urged members to share vaccine with developing nations. [Sep 15 Margaret Chan speech]

China licenses third novel flu vaccine China has licensed its third pandemic H1N1 vaccine, made by the government-affiliated Shanghai Institute of Biological Sciences, the United Kingdom Press Association reported today. The state-run paper Shanghai Daily reported that the institute has plans to produce 3 million doses by Oct 1 and up to 10 million by the end of the year. Sinovac and Hualan Biological Engineering produce the other two approved vaccines. China hopes to vaccinate 5% of its population by the end of 2009. [Sep 16 Press Association story]

Glaxo awaits US approval for H1N1 vaccine A spokeswoman from GlaxoSmithKline, the only one of five producers that didn't received Food and Drug Administration approval for its pandemic H1N1vaccine yesterday, said the company earlier this month submitted a request for approval for its nonadjuvanted vaccine, Bloomberg News reported. She said the company initially concentrated on developing a vaccine with an adjuvant, but US health officials have favored a nonadjuvanted vaccine approach to speed and simplify the approval process. [Sep 15 Bloomberg News story]

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Roscoe and Miss Priss

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

News Scan



Sep 17
Flu cases up 21% on campuses In its surveillance of flu-like illnesses for the week ending Sep 11, the American College Health Association (ACHA) reported 6,432 cases at 253 schools, a 21% increase from the previous week. Though the report doesn't include flu subtype, federal officials have said 98% of circulating flu viruses are the pandemic strain. Cases slowed in the southeast but increased elsewhere, particularly in Mid Atlantic and Midwestern states. [Sep 16 ACHA surveillance report]

US, others donate pandemic vaccine The Obama administration today announced that the nation will donate 10% of its pandemic vaccine supply as supplies become available to help stop the global spread of the virus. The news follows reports that most people may need only one dose of the vaccine, which will greatly boost the nation's stockpile. Australia, Brazil, France, Italy, New Zealand, Norway, Switzerland, and the United Kingdom have also joined the donation program, which will go through the World Health Organization. [Sep 17 White House press release]

Similar H1N1 strain may explain 1-dose effectiveness The unexpectedly robust response to just one dose of pandemic H1N1 vaccine in research subjects might suggest that the vaccine boosts preexisting immunity to a similar strain that has circulated since 1977, New Scientist reported today. Experts say other factors could also play a role, such as a slight priming effect from seasonal flu vaccination or a priming effect on the cell-mediated immune system from previous seasonal flu infections. [Sep 17 New Scientist story]

Canada sets pandemic vaccine priorities The Public Health Agency of Canada (PHAC) yesterday announced priority groups to receive the country's first pandemic H1N1 vaccine doses. They include those under age 65 with underlying health conditions, pregnant women, children ages 6 months to younger than 5 years, people in remote or isolated communities, frontline healthcare workers, and household contacts of high-risk groups. The government is urging provinces to use the guidance based on local conditions. [Sep 16 PHAC press release]

UK sees signs of 2nd pandemic wave British health officials said today that surveillance data show a slight increase in pandemic H1N1 cases, which might herald the start of a second wave of infections, the London Telegraph reported. Suspected outbreaks have been reported at six schools, though there are no closure plans. Scottish officials also reported a rise in novel flu cases. [Sep 17 London Telegraph story]

Lab clue led researchers to immune therapy A Melbourne scientist who recently presented a study on the use of immunoglobulin in severely ill H1N1 patients said a colleague first considered the therapy when evaluating the lab work of a rapidly declining hospitalized patient, the Canadian Press reported. Doctors noticed the patient had low IgG2 antibody levels after ordering tests on all H1N1 patients in the intensive care unit. They said IgG2 deficiency might explain why some patients become severely ill. [Sep 16 Canadian Press story]

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Roscoe and Miss Priss

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

Sep 18
WHO praises pandemic vaccine donations The World Health Organization (WHO) today applauded the donation of the United States and eight other developed countries of pandemic H1N1 vaccine to poorer nations. The donation announcement yesterday shows a commitment to fairness, the WHO said in a statement. Given that demand will exceed the global supply of vaccine, the WHO noted that the country donations, plus those previously announced by some manufacturers, will ensure vaccine for nations that lack resources for their own stockpiles. [Sep 18 WHO statement]

WHO lowers pandemic vaccine estimate The WHO has scaled back its projection of how much pandemic H1N1 vaccine that will be produced globally, spokesman Gregory Hartl told the media today, according to the Associated Press (AP). Output will be "substantially less" than the WHO's previous forecast of 94 million doses a week and 4.9 billion doses in the next year, Hartl said. Estimates are lower because some companies are still making seasonal vaccine, and some have experienced production problems. [Sep 18 AP story]

Piglets in Northern Ireland test positive for H1N1 Some piglets in Northern Ireland have tested positive for the novel H1N1 virus, the jurisdiction's Department of Agriculture and Rural Affairs announced yesterday. A BBC News report said the finding is the first such case in Europe. "Given that this virus is currently circulating in humans this finding is not unexpected," the department said in a news release. Officials did not list the location of the affected farm. [Sep 17 Northern Ireland Department of Agriculture statement]

Australia approves CSL's H1N1 vaccine The Australian government has approved a pandemic H1N1 vaccine made by CSL Ltd. for use in adults, the Australian Associated Press (AAP) reported today. The government has bought 21 million doses, which Health Minister Nicola Roxon said will be enough for all adults, and doses are expected to be available starting Sep 30. The government is awaiting clinical trial results before approving the vaccine for use in children. The virus has killed 172 people in Australia. [Sep 18 AAP story]

Minnesota says to keep ill preschoolers home longer The Minnesota Department of Health (MDH) says that children up to age 5 who have flu should be kept home from day care and school for 7 days after they get sick or 24 hours after symptoms resolve, a more cautious approach than the federal one, the Star Tribune reported. The CDC recommended in August that children be kept home until they are fever-free for 24 hours without the help of medication. Minnesota, which now has widespread flu activity, still uses that advice for older children. [Sep 17 Star Tribune story]

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Roscoe and Miss Priss

News Scan
http://www.cidrap.umn.edu/cidrap/co...scan/index.html


Sep 21
Poll: Many workers feel pressure to work when ill

More than 80% of workers feel pressure to come to work when sick, and 69% have received little direction from employers on pandemic H1N1, according to a survey released today. The poll of 1,028 employees by Mansfield Communications found that 84% of workers believe the recession creates more pressure to show up for work, even when they're feeling sick. Mansfield's Rob Ireland said that employers need to communicate clearly about extended sick-leave policies and how to minimize disease spread. [Sep 21 Reuters story]


US orders 27.3 million more doses of Sanofi vaccine

The US Department of Health and Human Services (HHS) has ordered another 27.3 million 15-microgram doses of pandemic H1N1 vaccine from Sanofi Pasteur, bringing the total government order of Sanofi vaccine to 75.3 million doses, the company announced today. HHS had previously ordered a total of about 195 million doses from five companies. Sanofi's H1N1 vaccine and versions made by Novartis, CSL Ltd., and MedImmune were licensed by the Food and Drug Administration last week. [Sep 21 Sanofi press release]


Sanofi projects mid October for US vaccine delivery

An official from Sanofi said today that the company would begin delivering pandemic H1N1 flu vaccine to the United States by mid October, the Associated Press (AP) reported. Chris Viehbacher, head of the France-based company, said Sanofi would be able to produce at least 800 million doses of pandemic flu vaccine per year. [Sep 21 AP story]


WHO's Chan says severe cases could overwhelm ICUs

Margaret Chan, director general of the World Health Organization (WHO), told a WHO Western Pacific regional meeting today that the overall clinical picture of the pandemic H1N1 virus is reassuring, but health officials are increasingly concerned about a small group of patients who rapidly become severely ill. Though numbers have been small, they could burden intensive care units as infections spread. She said the second wave of the pandemic appears to be beginning. [Sep 21 Margaret Chan speech]


China begins immunizing students

China today became the first country to start administering the pandemic H1N1 vaccine, Agence France-Presse (AFP) reported. Medical workers are vaccinating students who will take part in National Day celebrations. Health workers, border inspectors, and transportation workers will also be among the first to receive vaccine, followed by the military, police, children and their teachers, and those with chronic conditions. [Sep 21 AFP story]


Canadian experts applaud deliberate vaccine process

Some of Canada's infectious disease experts are applauding the country's decision to put its pandemic vaccine through the full approval process, rather than speeding it through with an emergency use authorization, the Canadian Press reported. One expert said the vaccine uses an adjuvant that hasn't been used before, and a more thorough and deliberate review could avoid future problems and build public trust in the new vaccine. [Sep 20 Canadian Press story]


Health departments' job losses accelerate

Budget cuts forced public health departments to cut 8,000 positions between January and June, according to a new survey from the National Association of County and City Health Officials (NACCHO). The trends reflects a big increase in the continuing erosion of the health department workforce, which lost more jobs in the first 6 months of 2009 than all of 2008. The news comes as departments prepare to launch two immunization campaigns, one for seasonal flu and the other for the pandemic H1N1. [Sep 21 NACCHO press

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Sep 22
BioCryst nets federal funding to further peramivir development BioCryst said it has received $77.2 million from the US government to continue late-stage development of its intravenous antiviral medication peramivir, Reuters reported yesterday. The company said it has also received a request for proposal to supply the government with between 1,000 and 40,000 courses of the experimental drug, which, if an emergency use authorization is granted, could be used to treat critically ill flu patients. [Sep 21 Reuters story]

Hospital sets up tents to handle flu surge Authorities at Dell Children's Medical Center in Austin, Tex., set up tents outside its emergency department to start triaging some patients with less severe flu-like illnesses today, the Austin Statesman reported. The hospital has seen a steady increase in flu patients, and daily numbers over some of the past few days have exceeded 300. The hospital made the decision on Sep 20 to open the tents after 343 patients swamped the hospital. [Sep 22 Austin Statesman story]

Survey finds businesses see flu risk but have planning gaps A survey of 400 companies by the British law firm DLA Piper revealed that about half of them believe they are at high or very high risk for disruptions caused by the next wave of pandemic flu, the Financial Times reported yesterday. About 80% said they were reviewing their continuity plans, but only slightly more than half had communicated the strategies to employees, customers, or suppliers. About 75% said they had no plans to modify employee policies. [Sep 21 Financial Times story]

New York doctor wins H1N1 video message contest Dr. John Clarke of Baldwin, N.Y., won the Department of Health and Human Services (HHS) 2009 H1N1 public service announcement contest, HHS said today. More than 50,000 YouTube viewers voted for Clarke's video. He will receive a $2,500, and the video will be broadcast on national television. "I want to congratulate Dr. Clarke, the 'hip hop doc,' for producing his creative and engaging video. His work will reach millions of Americans this flu season," said HHS Secretary Kathleen Sebelius. [Sep 22 HHS press release]

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Sep 23
US orders 29 million more doses of H1N1 spray vaccine The US government has ordered another 29 million doses of nasal-spray pandemic H1N1 flu vaccine from MedImmune, the company announced this week. The government had previously ordered about 13 million doses. The government has now ordered a total of about 251 million doses of H1N1 vaccine from five firms. MedImmune said it has already made enough vaccine to fill its orders, and the Food and Drug Administration has released 3.4 million doses, which are expected to reach providers in early October. [Sep 21 MedImmune news release]

Quebec may delay or cancel seasonal flu shots Quebec may delay or shelve its seasonal flu vaccination campaign and concentrate on vaccinating people against pandemic H1N1 instead, CBC News reported today. For now, seasonal flu shots are "on hold," said Karine White, a spokeswoman for the provincial health ministry. She said officials are considering delaying seasonal flu shots until after the pandemic vaccine is delivered, narrowing the effort to focus on those at highest risk, such as seniors, or even canceling the drive altogether. [Sep 23 CBC News story]

Scientist: Russia underreporting pandemic flu cases One of Russia's leading virologists claims that the country is underestimating its number of pandemic H1N1 cases, the Wall Street Journal reported today. Dr Dmitry Lvov made the claims in a state TV interview on Sep 21 and said Russia had also confirmed its first novel flu death. The country's health ministry has disputed both of Lvov's claims. [Sep 23 Wall Street Journal article]

Review suggests non-drug measures can curb flu A meta-analysis of nonpharmaceutical interventions such as hand washing, masks, gloves, and gowns shows they can curb the spread of flu and should be pursued more vigorously, the British Medical Journal (BMJ) reported yesterday. The review included 58 papers, which varied in quality. N-95 respirators were generally superior to surgical masks, but the N-95s caused skin irritation. The authors said more studies are needed to gauge the efficacy of individual interventions. [Sep 22 BMJ report]

Meta-analysis supports link between flu and heart attack A meta-analysis of 39 studies supports the idea that influenza (including flu-like illness) increases the risk of myocardial infarction, according to a report by British researchers in Lancet Infectious Diseases. Many observational studies showed consistent links between flu and acute myocardial infarction. One small randomized trial showed that flu vaccination reduced the risk of cardiac death in people with cardiovascular disease, but another randomized trial was inconclusive. [Lancet Infectious Diseases article summary]

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Sep 24
Forecast for early-October vaccine deliveries doubles Between 6 million and 7 million doses of H1N1 flu vaccine will arrive the first week of October, about double the previous estimate of 3.4 million doses, according to an Associated Press (AP) report today quoting Health and Human Services (HHS) Secretary Kathleen Sebelius. Most of the doses will be the nasal-spray vaccine, Sebelius said. Previous reports said the initial 3.4 million doses would all be the nasal-spray vaccine, which is approved only for healthy people aged 2 to 49 years. [Sep 24 AP story]

Toronto group pens pandemic-ethics reports The University of Toronto Centre for Bioethics has nine articles covering ethical issues likely to arise in the second wave of the H1N1 flu pandemic. Topics include the duty of healthcare workers to work during a pandemic, limits on individual freedom, government responsibilities in vaccination programs, allocation of limited medical resources; and rich countries' obligation to share resources with poor countries. The authors drew on academic and public opinion research. [Sep 23 EurekAlert press release]

HHS offers pandemic guidance for community, faith groups HHS today released "H1N1 Flu: A Guide for Community and Faith-Based Organizations." The guide describes how the leaders of organizations can help fight the pandemic by communicating health information effectively, supporting vaccination efforts, linking vulnerable and hard-to-reach populations to information and resources, and adjusting organizational activities to help people stay healthy. [Sep 24 HHS guide]

AHRQ offers guide to mass medical care The HHS Agency for Healthcare Research and Quality (AHRQ) today released a guide titled "Mass Medical Care with Scarce Resources: The Essentials," which is an abbreviated version of a 2007 AHRQ publication. Topics covered are community-wide planning, ethical and legal considerations, prehospital, acute, and palliative care, and alternative care sites during public health emergencies. A special section on influenza pandemic preparedness is included. [Hyperlinked table of contents and pdf document]

CDC launches mobile texting tool A 3-month pilot text-messaging service has been launched by the Centers for Disease Control and Prevention (CDC) to deliver important CDC information on H1N1 flu and other topics directly to users' mobile phones. A subscription is required, but there is no cost. The CDC anticipates delivery of about three messages a week, and it is possible to opt out at any time. Feedback is sought during the pilot period. [CDC Web page with instructions]

US campus flu cases rise 15% Flu-like illnesses at the nation's colleges rose by 15% from the previous week, according to a surveillance report for the week ending Sep 18 from the American College Health Association (ACHA). The report was based on 7,696 cases at 243 schools. It doesn't specify flu subtype, but federal officials have said 98% of all circulating strains are pandemic H1N1. The number of new infections was highest in New England and some western states, and the pace seemed to slow in some southern states. [Sep 24 ACHA surveillance report]

Trial confirms CDC wariness about rapid flu tests A field trial at two schools at the start of the novel H1N1 outbreak showed that the rapid influenza A and B test worked well for confirming the new virus, but not for ruling it out, according to the latest issue of Morbidity and Mortality Weekly Report. The researchers compared the rapid test with real-time reverse transcription-polymerase chain reaction assay. The findings confirm recent CDC advice to be cautious about using negative rapid test results to guide treatment. [Sep 25 MMWR report]

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Sep 25
WHO: Flu activity up in Northern Hemisphere In a global pandemic flu update today the World Health Organization (WHO) said flu activity is increasing in temperate parts of the Northern Hemisphere such as the US and parts of the UK. Activity in tropical regions varies. It is increasing in some parts of Peru and Mexico but decreasing in temperate parts of the Southern Hemisphere such as South Africa. So far the WHO has logged 3,971 deaths. [WHO pandemic update 67]

Europe approves two pandemic vaccines Europe's drug regulatory agency today approved two pandemic H1N1 vaccines, one made by GlaxoSmithKline and the other by Novartis. The two vaccines were developed through a "mock up" process that moved forward during preparation for the H5N1 avian influenza virus. Both vaccines contain adjuvants, with Novartis's having been in use since 1997. The agency is recommending a two-dose schedule but said it expects further data that may confirm one-dose efficacy. [Sep 25 European Medicines Agency release]

Mexico unveils measures against next wave Mexico's health minister announced measures yesterday to address renewed novel H1N1 outbreaks in the country, Xinhua, China's state news agency, reported. Public hospitals will delay nonessential surgeries and reserve 12% of their beds for flu patients. The new measures also establish special areas in hospitals to isolate patients who have the virus. Officials expect 8,000 to 10,000 hospitalizations over the coming flu season. [Sep 24 Xinhua story]

Survey finds tepid interest in kids' H1N1 vaccine Researchers from the University of Michigan reported yesterday that only 40% of 1,679 parents indicate they will get their children vaccinated against pandemic flu. However, 54% said they would have their kids receive the seasonal flu vaccine. Among racial groups, support for the vaccine was highest in Hispanics. Of those who answered no or were unsure, half said they worried about side effects. [Sep 24 University of Michigan press release]

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Sep 28
Zambian district bans social gatherings Health authorities in Zambia's Luanshya district have banned weddings and other social gatherings to curb the spread of the pandemic H1N1 virus, according to a Sep 26 Times of Zambia report that was picked up by Xinhua, China's state news agency. Over the past 4 days the district has reported more than 630 suspected pandemic flu cases. Flu cases are reportedly on the rise elsewhere in Zambia, as well. [Sep 26 Xinhua story]

British Columbia pares back seasonal flu efforts British Columbia said today it would delay promoting seasonal flu shots until early in 2010, except for those in high-risk groups such as older people, the Vancouver Sun reported. Quebec, Alberta, Saskatchewan, Ontario, and Nova Scotia announced similar steps in the past few days. The moves follow reports of an unpublished Canadian study that suggests seasonal flu vaccination may double the risk of pandemic H1N1 infection, a finding not confirmed by WHO and CDC data. [Sep 28 Vancouver Sun story]

High antiviral dosage may have saved H1N1 patients Doubling the dosage of oseltamivir (Tamiflu) in patients with severe H1N1 flu cases has helped Prince of Wales Hospital in Hong Kong avoid any deaths from the disease so far, according to the Hong Kong newspaper The Standard. The hospital has treated at least 60 severely ill patients without loss of life, said Dr. David Hui Sui-cheong, a respiratory disease specialist. The hospital has focused on early treatment along with doubling the dose. [Sep 28 Standard report]

Pandemic chokes flow of pilgrims to Mecca Worries about the H1N1 pandemic have kept many Muslims from traveling to Mecca for the minor pilgrimage called umra, which can be done any time of year, according to the Herald, a Scottish newspaper. The drop in visitors has hurt business for shops, hotels, and tour operators in Mecca, with hotel occupancy rates in the last 10 days of Ramadan down by more than a third from last year. Saudi Arabia had urged the elderly and people with chronic diseases to postpone trips. [Sep 28 Herald story]

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Sep 29
CDC addresses liquid Tamiflu supply, dosing concerns The US Centers for Disease Control and Prevention (CDC) yesterday posted a notice about possible shortages of the pediatric liquid suspension oseltamivir (Tamiflu) as more states report widespread activity. The CDC said pharmacists may need to compound Tamiflu capsules into a liquid syrup to help fill the demand. Also, the CDC warned that the units on the liquid dosing dispenser have led to some confusion, and doctors and pharmacists need to ensure that their dosing instructions match. [Sep 25 CDC Health Alert Network notice]

IOM issues report on standards of care for disasters The Institute of Medicine (IOM) has released a report titled "Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations." As the name indicates, the 150-page report is designed to help public health officials and other healthcare personnel devise standards of care for use in disaster situations in which resources are scarce. The report uses two scenarios to illustrate the principles it presents: a gradual-onset flu pandemic and an earthquake. [IOM page with linked table of contents and general information]

Report offers lessons from school closures in 1918 pandemic Researchers who combed the records of 43 cities that closed schools during the 1918 flu pandemic found that closures worked best when there were clear lines of authority between agencies and good communication between school officials and the public, according to a report in Health Affairs. Usually, school closures were linked to community-wide steps such as quarantine, isolation, and public-meeting bans. The authors say that preparedness and dialogue are the key to smooth implementation. [Health Affairs article]

Flu threat prompts suspension of school attendance incentive School officials in Bismarck, N.D., have suspended an attendance incentive at the city's two public high schools to encourage students to stay home if they are sick, the Associated Press reported yesterday. The pandemic H1N1 virus is hitting schools in most states, though North Dakota is reporting localized flu activity, according to the latest national surveillance report. The incentive allows students to skip most final exams if they have no more than two excused absences and two tardies. [Sep 28 AP story]

Ho Chi Minh City reports success with field hospital for H1N1 patients Ho Chi Minh City's health department said an H1N1 field hospital that was set up in August has proved "immensely effective," according to the Vietnamese newspaper Thanh Nien. The 11-room hospital has treated 200 patients, some in critical condition. The health department is seeking permission to set up similar field hospitals in other parts of the city to relieve hospital overcrowding. Meanwhile, Vietnam's official H1N1 case count has reached 8,065, with 14 deaths, the story said. [Sep 29 Thanh Nien report]

Hungary approves H1N1 vaccine Hungary's drug regulatory agency has approved the country's pandemic H1N1 vaccine, Dow Jones Newswires reported yesterday. Officials cleared the vaccine after clinical trials showed promising efficacy and safety results. The vaccine is made by Omninvest Kft, Hungary's only vaccine manufacturer. Based on the company's H5N1 avian flu vaccine, the pandemic H1N1 shot will be available within 2 weeks. The Hungarian government has ordered 4 million doses. [Sep 28 Dow Jones Newswires story]

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Roscoe and Miss Priss

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Sep 30
3 H1N1 vaccine makers ship first doses Three H1N1 vaccine manufacturers have begun shipping vaccine doses, according to CNN. Sanofi Pasteur said it shipped its first batch yesterday, several days ahead of schedule. More shipments will follow, according to a company spokesperson, with a total of 75.3 million doses expected by year's end. MedImmune sent its first batch of 5 million doses to distribution centers last Tuesday, and Novartis began shipments on Sunday. [Sep 29 CNN report]

Researchers find mutation in novel H1N1 Virologists in the Netherlands have detected a pandemic H1N1 virus mutation that has been linked to enhanced replication and possible virulence changes. In a Sep 28 ProMed e-mail list post, they said they found the mutation in the basic polymerase 2 protein in samples from two patients who had links to an island in northern Holland. Both patients recovered. In a Canadian Press report yesterday, experts said it's not clear how clinically significant the mutation is, but it bears watching. [Sep 28 ProMed mail post]

CDC updates advice on flu testing The CDC yesterday released updated recommendations on diagnostic testing for flu during the coming season. The agency recommends considering testing for hospital patients with suspected flu; those for whom a flu diagnosis will affect decisions about care, infection control, or management of contacts; and those who died of suspected flu. The advisory includes information about rapid testing and issues related to antiviral treatment. [Updated CDC recommendations]

Australia begins vaccination campaign Australia began nationwide vaccinations against H1N1 influenza today, administering the first shots in what is intended to be a 21-million-dose campaign. The initial allotment of 5.5 million doses from Australian manufacturer CSL Ltd. will be given to pregnant women, healthcare workers, and the chronically ill. Authorities are concerned the vaccine will face low uptake because the flu season is waning after 35,000 confirmed cases and 178 deaths. [Sep 30 Sky News article]

Military flu shots to provide data Active-duty members of the US armed forces will begin receiving 1.4 million doses of H1N1 flu vaccine in the next 10 days, part of a 2.7-million-dose vaccine purchase by the Pentagon. The shots, which are mandatory, will go first to troops preparing to deploy, followed by troops on hold for domestic disasters. Planners hope the early shot campaign will provide needed data on efficacy and side effects. [Sep 29 Associated Press report]

Nationwide school closure would prove costly Closing all US schools for 4 weeks to curb the spread of pandemic flu would cost between $10 billion and $47 billion in lost workforce productivity and temporarily shrink the pool of healthcare workers by 6% to 19%, according to a report today from economists at the Brookings Institution. The group estimated that about 14% of households with kids would have a sick worker during the pandemic. Federal guidance discourages school closure but allows local officials to make their own determinations. [Sep 30 Brookings report abstract]

Biggest business flu concern is vaccine When it comes to pandemic flu, US businesses are most concerned about the availability of a vaccine for employees, according to a survey released today by the Business Roundtable. The organization also found that "nearly 90%" of businesses surveyed have activated or updated their preparedness plans since novel H1N1 flu first appeared. About 35% of respondents said they need more information about the severity of pandemic H1N1 flu compared with seasonal flu. [Sep 30 CNBC story]

Irish pigs infected with novel H1N1 Forty pigs have contracted pandemic H1N1 flu, apparently from an infected worker, on a swine farm in County Cork, Ireland, according to a report filed yesterday with the World Organization for Animal Health (OIE). The worker tended pigs on the farm Sep 15 through 18 while sick, and on Sep 22 was confirmed to have novel H1N1. Forty of the farm's 650 sows began showing clinical flu symptoms Sep 25 and are being monitored. The farm, near Kilworth, also contains 2,400 young pigs. [Sep 29 OIE report]

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Roscoe and Miss Priss

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Oct 1
Poll: Americans iffy on pandemic flu shot Americans are uncertain about getting the pandemic H1N1 vaccine, according to a poll conducted in early September by the Consumer Reports Health Ratings Center. Only 34% said they would definitely get the vaccine when it's available, while 21% said they would decline. Forty-three percent said they will wait and see what happens with flu developments. The nation survey of 1,502 adults found that 35% will have their children vaccinated, 50% are unsure, and 14% will not. [Consumer Reports poll results]

US Army records H1N1 death An apparently healthy 23-year-old soldier may be the US military's first fatality from the novel strain. Spec. Christopher Hogg of Deltona, Fla., serving at Fort Jackson, S.C., died of flu-related pneumonia Sep 10, 10 days after falling ill. The fort's commanding general told media that autopsy data confirmed Spec. Hogg had no underlying conditions that would have made him vulnerable. More than 50 soldiers at the 10,000-member base, the Army's largest training center, currently have flu. [Oct 1 The State (Columbia, S.C.) article]

Flu sidelines 1 in 14 on US Navy ship An outbreak of H1N1 flu aboard the USS Boxer, a Navy amphibious assault ship holding more than 2,200 sailors and Marines, put 166 personnel into isolation for an average of 3.6 days each, according to military medical surveillance. Epidemiologists described the illness, which struck 7.3% of personnel, as mild and brief, with cough, aches, sore throat and fevers less than 102 degrees. The month-long outbreak began after the ship completed a 5-day "liberty port" in Phuket, Thailand. [Sep Medical Surveillance Monthly Report]

Sanofi warns of delay in seasonal flu shots A spokeswoman from Sanofi said today that the company is behind on its shipments of seasonal flu vaccine because of pressure to quickly produce the pandemic flu vaccine, the Associated Press (AP) reported today. Sanofi said it has shipped more than half of the 50.5 million doses ordered by US providers, who may face delays into November. Some clinics have had to turn patients away, despite advice to get seasonal flu shots early to make way for the pandemic H1N1 shot. [Oct 1 AP story]

Navy awards $1.25 million for DNA flu vaccine San Diego biotech company Vical Inc. said Thursday it has received $1.25 million from the US Navy to support a phase 1 human clinical trial of its DNA-based vaccine against H1N1 flu. The company received earlier grants from the National Institute of Allergy and Infectious Diseases for the technology, which has shown early positive results using strains of H5N1 avian flu. [Oct 1 AP story]

Sanofi study confirms H1N1 vaccine 1-dose efficacy Sanofi today announced the results of additional trials that confirm the company's pandemic H1N1 vaccine is effective with just one dose, similar to initial findings from a National Institutes of Health study. Results of the latest trial of 849 adults show that a single 15-microgram dose is protective after 21 days, even in seniors. US regulators approved Sanofi's vaccine on Sep 15. [Oct 1 Sanofi press release]

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Roscoe and Miss Priss

(Reminder: if you want to read any of these stories in greater depth, follow the CIDRAP link
and click on the link in brackets at the end of each snippet. M.)

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

Oct 2
Pandemic flu widespread in 27 states The US Centers for Disease Control and Prevention (CDC) said today that 27 states reported geographically widespread influenza activity for the week that ended Sep 26, up 1 state from the previous week. In addition, 11 children died from pandemic H1N1 flu, compared with 3 the week before. There have been 60 confirmed pediatric deaths from the virus since the outbreak began. [Oct 2 CDC update]

Flu cases drop at US colleges The number of flu-like illnesses at colleges dropped 19% from the previous week, according to a report for the week ending Sep 25 from the American College Health Association (ACHA). The report showed 6,527 new cases at 248 schools. Though the report doesn't include flu subtype, federal authorities have said about 99% of circulating strains are pandemic H1N1. Colleges in New England and some western states reported increases, but other parts of the country saw cases decline. [Oct 1 ACHA surveillance report]

WHO: Flu continues climb in Northern Hemisphere Pandemic H1N1 flu is widespread in the Northern Hemisphere, particularly in the United States and northern and northwestern Mexico, the World Health Organization (WHO) said today. Activity is starting to increase in Europe and parts of Asia but is slowing in most of South America and Australia. So far the WHO has recorded more than 4,100 deaths, an increase of at least 130 from the previous week. About 85% of reported specimens were the pandemic strain. [WHO pandemic update 68]

Poll finds limited interest in vaccine, growing H1N1 worry Another poll has found lukewarm interest in getting the pandemic H1N1 vaccine. A Harvard survey found that 40% of adults were certain they'd get the shot and 51% were sure they'd get their kids vaccinated, slightly higher than in a recent Consumer Reports poll. The Harvard survey, conducted in mid September, indicated demand would surge if the virus caused local sickness and death. Seventy-six percent said they were concerned about more outbreaks, up from 59% in the summer. [Oct 2 Harvard School of Public Health press release]

Taiwanese flu case reports reveal viral pneumonia A review of the medical records from the first 100 severe H1N1 cases in Taiwan, initially posted to an international listserv, reveals that complex illness tends to strike children and young adults who are obese or have other underlying conditions, including pregnancy. Twenty-three of the 100 patients required mechanical ventilation, 9 went on extra-corporeal membrane oxygenation (ECMO), and 9 died. In contrast to US data, 89 of the 100 had primary viral pneumonia. [Oct 1 ProMED-mail report]

Researchers name severe flu syndrome: FLAARDS Australian and New Zealand researchers have dubbed the direst manifestation of H1N1 flu "FLAARDS," for "flu A-associated acute respiratory disease syndrome," according to Bloomberg News. In a medical journal editorial, intensive-care specialists Drs. Steven Webb and Ian Seppelt describe inflamed, flooded lungs requiring mechanical ventilation or ECMO, sometimes leading to multi-organ failure and death. Bacterial pneumonias and underlying chronic conditions also play a role, they said. [Sep 29 Bloomberg News report]

European agency endorses Baxter's cell-based vaccine The European Medicines Agency (EMEA) today recommended approval of Baxter's cell culture-based H1N1 vaccine, Celvapan, for use in the European Union. The move follows similar verdicts last week on H1N1 vaccines from Novartis and GlaxoSmithKline. EMEA recommendations are usually adopted by the European Commission. Baxter said Celvapan is the first cell-based, non-adjuvanted H1N1 vaccine to get the EMEA's endorsement. The EMEA is recommending two doses of the vaccine for both adults and children. [Oct 2 EMEA press release]

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Roscoe and Miss Priss

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Oct 5
UN officials call for more donated vaccine Though some vaccine companies and affluent nations have already donated supplies of pandemic flu vaccine to developing nations, more is needed, officials from the World Health Organization (WHO) and the United Nations said yesterday, according to a Reuters report. Julie Hall, an infectious disease expert at the WHO, said more readiness is needed in developing countries, especially if a different pattern is seen when big outbreaks hit poorer countries. [Oct 4 Reuters report]

NYC's schools hold pandemic vaccine drill New York City health and education department will hold vaccination clinics at five of the city's schools next week to prepare for school based pandemic H1N1 vaccine clinics. Parents will start receive consent forms to sign if they want their children to receive the vaccine. The city said it will begin an 8-week school-based vaccination effort in late October at the elementary schools. In November and December vaccine clinics will be held at middle schools and high schools on weekends. [Oct 3 NYC Department of Health news release]

Researchers derive formula for closing schools For optimal social distancing in a flu outbreak, schools should consider closing when they reach 5% absenteeism on a single day, 4% on 2 consecutive days or 3% on each of 3 days, researchers in Boston and Niigata, Japan, say in an Emerging Infectious Diseases (EID) article. The group based its recommendation on absentee data gathered over four flu seasons from one 54-school district in Japan. [EID article]

WHO will not act on unpublished Canadian data A teleconference convened Friday by the WHO to assess the validity of unpublished data linking seasonal flu vaccine and development of H1N1 flu did not find the association persuasive, according to the Canadian Press. The data by Canadian researchers, contained in an article that is in press at an unnamed medical journal but apparently has circulated widely, has led to almost universal scaling back of seasonal flu shot campaigns in Canada. [Oct 4 Canadian Press report]

CDC issues treatment algorithm for flu-like illness The Centers for Disease Control and Prevention (CDC) and Emory University School of Medicine have developed a treatment algorithm to guide healthcare professionals and their surrogates on when and how quickly to steer adult flu patients to care. The algorithm, on the CDC's flu Web site, progressively assesses patients by age, vital signs, symptoms of severe disease, presence of underlying conditions, and membership in a high-risk group. [CDC/Emory treatment algorithm]

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Oct 6
US, Canada, Mexico discuss flu coordination Officials of the US, Mexican, and Canadian governments met in Mexico City Monday to map out cross-border communication and immigrations issues raised by the continuing spread of H1N1 flu, according to the Department of Homeland Security (DHS). The United States was represented by officials from DHS, the Departments of State and Agriculture, the Transportation Security Administration, and Customs and Border Protection. [Oct 5 DHS press release]

Cuba asks international help getting vaccine The Cuban government has asked the World Health Organization (WHO) and the Pan American Health Organization to help the country acquire H1N1 vaccine, saying the formula is too expensive for it to afford on its own. The island nation has officially recorded 468 cases of H1N1 flu but no deaths since the pandemic began. [Oct 5 Agence France-Presse report]

Tunisia prohibits hajj pilgrimages Though some Muslim countries have taken measures to limit the number of people making the hajj pilgrimage to curb the spread of pandemic flu, Tunisia today became the first to bar its citizens from making the trip, Reuters reported today. The country's religious affairs ministry said a vaccine would not arrive in time to vaccinate pilgrims for November travel. About 10,000 Tunisians typically make the trip every year. [Oct 6 Reuters story]

China reports first pandemic flu death China's health ministry has confirmed the nation's first pandemic H1N1 death today, an 18-year-old woman from Tibet's capital, Lhasa. The ministry said it has confirmed 21,453 cases of pandemic flu and that 78.7% of the patients have fully recovered. On Sep 21 China became the first nation to start vaccinating its people against the novel H1N1 virus. [Oct 6 Associated Press story]

Study shows regional variance in pandemic response In the first several days after the WHO declared pandemic level 5 on Apr 29, Malaysians showed greater concern than their European counterparts but also more preparedness steps, according to a study released today. Forty-two percent of Malaysians and only 5% of Europeans said they were "very concerned" about the outbreak. Malaysians also ranked higher in reduced public transport use (48% to 22%), flight cancellations (56 % to 17%), and intent to buy protective equipment (41% to 15%). [BMC Infect Dis study abstract]

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News Scan

Oct 7
Study: Seasonal vaccine may help fight H1N1 Contrary to most other evidence, a study from Mexico suggests that seasonal flu vaccine may offer some protection against the novel H1N1 virus. Researchers compared the vaccination status of 60 H1N1 case-patients and 180 control patients at a specialty hospital. The H1N1 patients were less likely to have had a seasonal flu shot. But the authors say the study is limited by its small size, retrospective design, and the high prevalence of vaccination and chronic conditions in the control group. [Oct 6 British Medical Journal study]

Microsoft offers online flu self-assessment Microsoft launched a new Web site today, H1N1 Swine Flu Response Center, to help patients assess flu-like symptoms and decide their next step. The self-assessment is licensed from experts at Emory University. Dr Arthur Kellermann, professor of emergency medicine at Emory, said in a Microsoft release that the tool "can encourage those who are severely ill or at risk for serious illness to contact their doctor, and reassure everyone else that it is safe and prudent to recover at home." [Oct 7 Microsoft news release]

EU approves Baxter's cell-based vaccine The European Commission today approved Baxter International's pandemic H1N1 vaccine, Celvapan, for use in the European Union, the company announced. It is the first cell culture-based H1N1 vaccine as well as the first non-adjuvanted product to win European approval. The EU authorization calls for using two doses of the vaccine in adults and children; the company is awaiting trial results to determine if one dose will be sufficient in adults. [Oct 7 Baxter news release]

Novartis ships seasonal, H1N1 vaccines to US Vaccine manufacturer Novartis said yesterday it has completed shipments of its seasonal flu vaccine, Fluvirin, to the United States after delivering 27 million doses. The Swiss company originally had said it planned to supply about 30 million doses to the US market. Yesterday the firm also said it started shipping swine flu vaccine on Sept. 27, 2 weeks after the formulation received approval from the US Food and Drug Administration. [Oct 6 Novartis press release]

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Oct 8
H1N1 Flu Breaking News

Spring wave may have given NYC some protection

New York City and a few other cities that had big H1N1 outbreaks in the spring are seeing little activity now, leading to suggestions that the spring wave spawned a significant level of population immunity, the New York Times reported today. City health officials believe that perhaps 20% to 40% of the population were exposed to the virus in the spring and gained immunity. But city officials and other experts agreed it would be unwise to assume that New Yorkers don't need the H1N1 vaccine. [Oct 8 New York Times story]

Lack of paid sick leave could spread flu

A lack of paid sick leave could force working parents either to report to work sick with flu or to send their children to school sick, at the risk of sacrificing either income or their jobs, ABC News reports. Up to 54 million Americans, many of them self-employed or employees of small businesses, have little or no paid sick leave, an issue that advocates hope to bring before Congress. [Oct 7 ABC News report]

Third of parents may say no to kids' vaccine

Concerned over the new H1N1 vaccine, or unconcerned about the seriousness of the disease, 38% of parents say they are unlikely to permit their children to be vaccinated during school programs planned by many states, according to an Associated Press (AP)-GfK poll. Federal health officials vouched for the vaccine's safety, urging widespread inoculation. Among concerns are the newness of the vaccine and potential side-effects. [Oct 7 AP story]

New Web resources for individuals, families

The federal government's www.flu.gov Web site has two new features, the Department of Health and Human Services (HHS) announced yesterday. A self-evaluation section for adults offers a click-through assessment aimed at determining whether flu is or is not present, followed by guidance on self-care, preventing transmission, and warning signs of serious disease. "Flu Myths and Facts" provides accurate refutations of common misconceptions about vaccinations and the disease itself. [Oct 7 HHS news release]

CDC unveils system to gather data on flu-like illness

The CDC today announced the launch of a system to gather data about influenza-like illness (ILI) from syndromic surveillance systems run by health departments in cooperation with hospital emergency departments. The system, called Distribute, enhances existing flu surveillance by providing more details on geographic- and age-specific trends. The system involves a partnership of the CDC with the International Society for Disease Surveillance and the Public Health Informatics Institute. [CDC announcement in Oct 9 MMWR]

Canadian H1N1 vaccination to lag US by weeks

Canada's national campaign to vaccinate residents against the H1N1 flu is likely to begin in early November because attempts to move up the shots' delivery have not been successful, according to the Canadian Press. The US campaign uses multiple suppliers and began with a roll-out of aerosol vaccine; Canada uses only one manufacturer, and aerosol vaccine is not approved for sale there. [Oct 6 Canadian Press report]

Michigan man recounts 7-week H1N1 battle

A Michigan man who barely survived a battle with the H1N1 virus is expressing support for the vaccination campaign, according to ABC News. Jim Shrode, 53, was in excellent health before he fell ill with the virus in May. He was hospitalized for 7 weeks, required mechanical ventilation, and lost 37 pounds. "People need to know that the risks of the vaccine are minimal compared to the risks if you get ill with it," he said. [Oct 8 ABC News report

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Roscoe and Miss Priss

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

Oct 9

H1N1 Flu Breaking News

Pandemic flu still on rise in Northern Hemisphere

The spread of pandemic influenza and rates of flu-like illness continue to climb in many regions of the Northern Hemisphere, according to today's World Health Organization (WHO) weekly update. Early flu transmission continues to increase in many European and Asian countries, while the Southern Hemisphere continues to see a substantial decline. The WHO reports little change with the virus, which has caused at least 4,525 global deaths, up more than 400 from the week before. [WHO H1N1 update 69]

Lack of case counts blunts assessment of flu impact

The fact that US and other countries' officials have stopped keeping close track of novel H1N1 cases and deaths means the government doesn't have a clear grasp of how hard the pandemic is affecting various groups, said flu expert Andrew Pekosz of Johns Hopkins University, according to the Associated Press (AP). H1N1 appears to be more dangerous for children, young adults, pregnant women, and the obese, but just how dangerous is hard to discern because of this lack of comprehensive data. [Oct 9 AP story]

UK H1N1 cases fewer than feared

Britain reported about 18,000 new pandemic H1N1 cases last week, up from 14,000 the previous week and 9,000 the week before that, according to the Nursing Times. However, flu spread is nowhere near the doubling that some had predicted. Sir Liam Donaldson, the UK's chief medical officer, said, "We may be able to get the vaccine out there before our flu season really gets under way." [Oct 9 Nursing Times article]

Vaccine for public to trickle in to Minnesota

H1N1 flu shots for the general public are scheduled to arrive in Minnesota next week, but not enough to meet demand, according to the Minneapolis Star Tribune.The state health department will distribute the 30,000 doses and the following week's supply randomly to clinics that care for the state's sickest children. An official said shipments should grow to 100,000 to 150,000 doses by late October, but the slow supply may mean many high-risk patients might not get vaccine till mid November. [Oct 9 Star Tribune report]

Hospital gives workers two choices: shot or mask

An Arkansas hospital has devised an alternative to mandating pandemic vaccine for its employees: It gives them a choice between vaccine and wearing a mask. And nearly all 3,200 St. Vincent Health System workers opted for the vaccine; only six chose the mask. A spokesperson said the hospital devised the policy to protect both the public's and its employees' health. [Oct 7 AP story]

Most Canadians unconcerned about H1N1

Only a third of Canadians plan to get vaccinated against novel H1N1 flu, and few seem concerned about the pandemic, a recent poll indicated. The Canadian Press Harris-Decima poll, conducted Oct 1 to 5, found that 36% of respondents were either very concerned or somewhat concerned about the virus, while nearly two thirds were not very or not at all concerned. In the same poll in late August, 45% had planned to get an H1N1 flu shot. [Oct 8 Canadian Press report]

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Roscoe and Miss Priss

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

Oct 12
WHO sees November vaccine delivery to poor nations An official from the World Health Organization said today that the group hopes to start shipping 60 million H1N1 vaccine doses to poor countries in November, the Associated Press (AP) reported. Marie-Paule Kieny said the first doses of the donated vaccine from drug companies and other countries will go to doctors and nurses and maybe high-risk patients in about 100 nations. She added that more donations are needed. [Oct 12 AP story]

Flu illnesses drop slightly at US colleges The number of flu-like illnesses at the nation's colleges decreased 6% from last week's report, the American College Health Association (ACHA) said in its surveillance for the week ending Oct 2. The report listed 6,326 new influenza-like illness cases at 250 schools. Nine hospitalizations were reported. The highest levels of flu activity were seen in the mid Atlantic region, as well as in New Hampshire, Rhode Island, Montana, Wyoming, Oregon, and Alaska. [Oct 8 ACHA surveillance report]

NY nurse sues over mandatory flu shots A registered nurse in Dutchess County, New York, not far from New York City, has sued to prevent New York State from requiring heathcare workers to take the H1N1 flu vaccine. Newsday reports that attorneys for nurse Suzanne Field filed for a temporary restraining order last week on behalf of New York State's 60,000 healthcare workers and expect to appear in court Wednesday. New York is the only state to require the vaccine, though individual healthcare organizations do as well. [Oct 9 Newsday report]

Pregnant women are Cuba's first H1N1 deaths The Cuban government says that 2,100 pregnant women on the island have been treated for symptoms of H1N1 flu, 110 are seriously ill, and 3 have died, according to a report by state-sponsored media that was carried by the AP. While the first wave of illness was among tourists, Cuban residents are now contracting the flu, with 621 cases confirmed, including 177 children, the deputy health minister said. [Oct 10 AP report]

Sweden starts vaccinating health workers Sweden began vaccinating health workers in the southern part of the country today, with clinics slated to begin immunizing people as soon as they receive the vaccine, Swedish-based TT News Agency reported today. Authorities noted a lot of interest in the vaccine a month ago when a few fatalities were reported, but the demand for the vaccine has leveled since. Sweden becomes the fourth country to launch novel H1N1 vaccination, after China, Australia, and the United States. [Oct 12 TT News story]

UK fears its health workers will shun vaccine The United Kingdom's Department of Health has ordered regional chiefs of the National Health Service (NHS) to make sure doctors and nurses take the H1N1 vaccine amid fears that uptake will be only 10% to 20%, The Guardian reports. NHS executives say healthcare staff will shun the vaccine because the disease appears mild, but fear high absenteeism if unvaccinated staff contract the flu. [Oct 11 Guardian article]

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Roscoe and Miss Priss

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

Oct 13
NIAID launches vaccine trials in HIV-infected groups The National Institute of Allergy and Infectious Diseases (NIAID) recently announced the launch of H1N1 vaccine trials in HIV-infected pregnant women and HIV-infected children and young adults. The trials are important because HIV infection and pregnancy increase the risk of a poor immune response to vaccines and because these groups have an increased risk of severe H1N1 illness, the NIAID said. Plans call for enrolling 130 pregnant women and 140 people aged 4 to 24 years in the two studies. [Oct 9 NIAID announcement]

NBA prepares defense against pandemic flu The National Basketball Association (NBA) has deployed several measures to respond to the pandemic flu threat, including hiring an infectious disease expert advisor, the Orlando Sentinel reported today. The NBA has contingency plans for when games are canceled or when many players get sick. Players are urged to report illnesses immediately so team doctors can prescribe antiviral medication, and teams have installed hand sanitizer dispensers throughout their facilities. [Oct 13 Orlando Sentinel story]

EU works out vaccine-sharing proposals European Union health ministers met yesterday to discuss how to make sure all member states have the tools to manage a surge of pandemic flu cases, EUobserver.com reported today. Some countries, such as Bulgaria and Malta, have few resources in their stockpiles. The officials asked the European Commission to develop a vaccine-sharing mechanism and draft a stance on sharing vaccine with needy countries outside the EU. [Oct 13 EUobserver.com story]

H1N1 spreads from farmer to pig in Norway A pig on a farm in Norway apparently caught the pandemic H1N1 virus from the farmer, according to a report that Norwegian veterinary authorities filed with the World Organization for Animal Health (OIE) yesterday. The farmer tested positive for the virus Oct 7, and the pig tested positive 3 days later, the report said. No other pigs in the herd of 850 were reported ill. [Oct 12 OIE report]

Emergency docs concerned about pandemic impact Nearly 90% of emergency physicians who responded to a poll by the American College of Emergency Physicians (ACEP) voiced concern about their ability to take care of extra patients generated by the H1N1 pandemic, the ACEP reported. ACEP President Dr. Angela Gardner said emergency departments need more resources to help them prepare for the pandemic and other health crises. The online poll was sent to 20,464 emergency physicians, 1,043 of whom responded. [Oct 13 ACEP news release]

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Roscoe and Miss Priss