Swine Flu - Indian Perspective

 

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Swine flu shadow on Janmashtami

With swine. People suffering from flu or showing flu-like symptoms have been advised to stay home and temples will put up medical camps with doctors and nurses on duty to screen devotees at the entry point.
A day before the festival, some temples will be taking out tableaux on swine flu to spread awareness about the disease. And while some are even arranging for masks, most others have only beefed up security.
At Birla Mandir, which expects a crowd of around 2 lakh people, it could be a low-key affair this year because of the swine flu fear. V K Mishra, administrator, Birla Mandir, said, "There will be some impact on the number of people coming to temple. I would advise all those with symptoms of swine flu like a cold and fever to not come. There will be two medical camps in the temple. Devotees showing any signs of swine flu will be taken inside through a different route. We have not arranged for masks as yet, but might order for some.''
About the two tableaux on swine flu, Mishra added, "A doctor and nurse on the Jhanki would be wearing masks. And posters would carry information about the symptoms of swine flu to educate people. We will also list the dos and don'ts for people infected with the H1N1 virus. While ambulances will be stationed, our only request to those infected is to stay home.''
At Chhattarpur Mandir, arrangements for the midnight prayer and bhajans are on. "We cannot predict how many people will come and nobody can be stopped from visiting the temple. All necessary arrangements have been made for Janmashtami. We have a diagnostic centre inside the temple,'' said a spokesperson.
While Surendra Nath, a priest at Kalkaji temple, said they were burning neem leaves to burn all impurities, Jhandewalan temple has not made any special arrangements in view of the swine flu. "We haven't had a meeting about it yet. The management will on Thursday decide what precautions will be taken. As far as security is concerned, there will be heavy police deployment on Janmashtami.''
Meanwhile, since Iskon temple in Pune has cancelled pandal and cultural programmes on account of swine flu, programmes in Delhi have also been called off. "We are not having any gathering in Delhi either. We will ensure the crowd that comes for darshan does not collect at one place. While last year around 10 lakh devotees visited the temple, the number may go down by a few lakhs this year. Around 450 personnel from Delhi Police and 500 private security will be deployed on Friday,'' said Vrajendra Nandan Das, national communication director, Iskon.

Pune overflow by swine flu cases

Of the 13 suspected cases who have been quarantined in various government hospitals across the state, five are students from Pune who have come home with flu symptoms. Friends of atleast three of these students have also been diagnosed positive for the disease. One of the suspects, quarantined at Jodhpur has ran away from the hospital.
"The laxity on part of the health machinery in Pune has created a menace at our end, they must make some arrangements to control the outflow of suspected cases," a senior health official said.
The state health department is apprehensive as not only the risk of these cases being positive runs high, if left unattended they would spread the disease in the state. Earlier too, a couple of students who had returned from Pune had shown flu symptoms, but none of them tested positive. 
On Wednesday, eight suspected cases of swine flu were quarantined at the SMS hospital isolation ward in Jaipur. They are an 18-year-old youth from Dholpur who had recently been on a trip to Madhya Pradesh, a 16 year old boy from Kotputali, a woman from Ajmer, other four suspected patients are from Jaipur, which includes two Pune-returned students.
In Kota, three students have been quarantined, while in Ajmer one person has been admitted at the isolation ward, after he returned from a foreign trip. The samples collected from these patients have been sent to National Institute of Communicable Disease (NICD) for tests.
Till date 52 samples have been collected across state, five of which tested positive and four treated at SMS Hospital. Reports of nearly 20 suspected patients are yet to arrive. The health department has also increased its preparations and has acquired more supplies of drugs and protection kit. "We have received additional stock of the antiviral drugs and protection kit for the infected patients as well as their kins," Dr B R Meena, additional director health department, said. 

Swine flu suspect tests positive for HIV

The first suspected swine flu case of Balasore district was tested HIV positive on Wednesday. Upendra Rana (47) of Sundhira village
within Khaira police station limits, who had returned from Thane three days ago, was admitted to SCB Medical College and Hospital with suspected swine flu symptoms.
"But doctors, who conducted several tests on him, later confirmed that he had contracted the fatal virus. Rana admitted that he had been tested positive for the same virus. But he had kept quiet, fearing social stigma," said his brother Manoranjan Rana.
Members of his family said Rana, a bachelor, who was working at a Thane hotel returned home after 35 years. The hotel owner sent him home after conducting a few tests on him at a hospital there.
However, Rana's homecoming with a suspected deadly virus has shaken his family. His mother, Sabitri, who was waiting for her elder son since last more than three decades is taken aback.
"He had left home in search of job at the age of 12. During the past 35 years, he had never visited his home and didn't even make a phone call until he appeared at our doorstep with this deadly disease. We thought he had gone missing. Though I was happy to see him again, the news that he has contracted such a disease broke my heart," she said.
Apart from Hindi, Rana does not know any other language, not even his mother tongue Oriya. "He told us that he first went to Kolkata and then proceeded to Maharastra. He was working at a hotel in Thane as a cook where he fell sick. He returned home after the hotel owner sent him home with some money," Manoranjan Rana said.

Indian swine flu vaccine- take time

The clinical trials of vaccines against the pandemic strain of swine flu have started in Australia, China, Germany, the U.K. and the U.S., according to the World Health Organisation (WHO). Some of these vaccines could complete the process for regulatory approval and be ready for public use by next month.
India has hitherto not been producing flu vaccines. But now three leading manufacturers - Serum Institute of India in Pune, Bharat Biotech in Hyderabad and Panacea Biotec in Delhi - are seeking to make the swine flu vaccine within the country. But it looks like the indigenous vaccine will not be ready for several months more, and even subsequently it may be available only in limited quantities.
The Serum Institute of India was one of six manufacturers in developing countries chosen by the WHO for a programme to expand global pandemic vaccine production beyond a few wealthy countries that possess such capacity.
The company has received the seed strain and started making the swine flu vaccine, its executive director Suresh Jadhav told The Hindu. He also spoke about the long procedure that had to be completed to get the vaccine to the public. This included putting in place a production process that gave the best possible yield, scaling up of the process, quality-testing, pre-clinical tests for toxicity in animals and clinical trials in humans. Then regulatory approval had to be secured before the vaccine could be made commercially available. Phase-I clinical trials was likely to start in the first quarter of 2010.
The company currently had the capacity to produce only limited quantities of the vaccine, Dr. Jadhav said. Large-scale production would require the establishment of a new facility with appropriate levels of bio-safety. The Serum Institute would be able to make such an investment only if there was an assured demand for flu vaccines, he said.
Moreover, under the WHO scheme, the Serum Institute is committed to providing at least 10 per cent of its swine flu vaccine production for use in other countries, according to a report that has appeared in the latest issue of the Indian edition of the magazine Technology Review.
Bharat Biotech too has received the seed strain and begun the process of making a pandemic vaccine, said Krishna Ella, its chairman and managing director. Instead of the conventional eggbased method, the company intended to make the vaccine by growing the virus in cell culture. A vaccine that could be used for clinical trials was expected to be ready in fourfive months, Dr. Ella told this correspondent.
Bharat Biotech would be able to make only limited quantities of the vaccine. However, Dr. Ella said the Bangalore veterinary vaccine unit of Biovet, another company promoted by him, could be used. The veterinary vaccine production could be shut down if required, and the unit switched to large-scale production of the swine flu vaccine.
But "we need more encouragement from the government," he said. "If I produce the vaccine, who is going to buy?" There had to be either a purchase commitment from the government to buy the vaccine or grants to support the company in its efforts. International vaccine manufacturers were given such purchase commitments by governments, he said.
A spokesperson for Panacea Biotec said the company was not at present making any statement on its pandemic vaccine.

Swine flu vaccine tests underway

The University of Maryland kicked off its tests of the H1N1 vaccine this morning with 67 adult volunteers. It's one nine centers nationwide testing whether the shot is safe and effective. The trial is the first step in what could be a mass vaccination campaign to start in mid-October, as infectious disease experts anticipate a resurgence of the new flu.
I'm spending the morning with volunteers and researchers over at the university and will be certain to keep you all updated as things get going. For now, here's the nuts and bolts:
Volunteers started arriving at 7 a.m. for an orientation session, briefing on consent forms and a medicalassessment. (Volunteers must be healthy to take part). Those who make the cut will get stuck and will remain on site for about 20-30 minutes in case of any allergic reactions, before they may go home.
Researchers will follow up with them in eight days for blood tests. Then, volunteers will return after two weeks later for another injection. If all goes well in adults, the vaccine will be tested in children as soon as the end of next week, said Dr. Karen Kotloff, the study's lead investigator.
Kotloff told me last week that she's been impressed by the response from volunteers. While researchers are still seeking people 65 and over to take part, they have had an easy time getting adults and even children -- especially those with doctors for parents.
"To me, that is very comforting," she said. "These are people who have a very good understanding of influenza and influenza vaccine, they have weighed, in a very personal way, what the risk and benefits are and have decided to volunteer their children. That says a lot."

Fight against swine flu

The Ministry of Health announced on Sunday that it would set up an electronic network to connect all its 20 health regions in the Kingdom to monitor the movement of swine flu, according to Health Minister Dr. Abdullah Al-Rabeeah.“We are making use of advance communications technology to counter the rapid spread of the swine flu, which has already killed four people in the Kingdom,” Al-Rabeeah told the health directors of the 20 regions in the Kingdom on Sunday. He also called upon participants of Sunday’s meeting to intensify their preventive measures in their respective regions.
Initially, 500 mobile surveillance machines will be distributed to health officials and prominent community leaders in all parts of the Kingdom. The minister explained that there would be a Central Command Office (CCO) that would monitor the movement of the influenza through this network. The users of the machine will communicate with the CCO in the event of any incidence of the disease in any part of the country. The ministry will gear its emergency activities according to the report from the CCO, the minister said.
“We must provide the best of preventive and curative services to citizens as well as expatriates who come for treatment in government and private hospitals,” he told the directors, insisting that patients’ safety is the top priority of his ministry. He also said the four main laboratories (Jeddah, Madinah, Riyadh and Dammam) are open for emergency services throughout the day and night.
He said the regional strategies adopted by the regional directors should be in accordance with the guidelines set out by the National Committee To Combat Swine Flu, which is in line with the standards of the World Health Organization.
While concentrating on the control and treatment of the infection, the minister said that the directors should organize effective public awareness programs to enable the members of the public to know the nature and the hazards of the virus. He said the ministry would communicate from time to time on swine flu developments in the Kingdom in accordance with the regular report submitted by the National Scientific Committee that coordinates with the WHO and the US Centers for Disease Control.
On Sunday, while seeking the cooperation of the newsmen to the ministry’s counter move against the spread of the virus, Al-Rabeeah said it would be transparent in all its activities regarding the control, spread and treatment of swine flu in the Kingdom.
Since May 27, there have been 595 cases of swine flu and the ministry reported 95 percent recovery among them.
Ziad Al-Memish, assistant deputy minister of health for preventive medicine, told Arab News that the ministry would start training the people who are using the mobile surveillance machines from Saturday.
“We have handpicked health officials from all 20 regions for necessary training,” he said, pointing out that those who are trained under the program are expected to teach the other users in the respective regions. “Initially, it’s going to be a train-the-trainer program.”
The official said that a major number of the machines would be distributed to Makkah, Madinah and Jeddah regions in view of the forthcoming Umrah season.
“We are making every effort to make the Umrah a flu-free season,” Memish said.

Death in US reaches 353

Fifty-one more swine flu-related US deaths were reported in the United States over the previous week, bringing the toll to 353 in the country worst affected by the global pandemic.
The US Centers for Disease Control and Prevention (CDC) reported the new figures in its weekly surveillance update Friday, which also said that 5,514 people have required hospitalization for the A(H1N1) virus.
The CDC also announced in its Friday report that it was no longer publishing the individual confirmed and probable cases, or its aggregate total of cases from the 5O US states, its territories and the capital Washington.
"CDC will report the total number of hospitalizations and deaths weekly, and continue to use its traditional surveillance systems to track the progress of the novel H1N1 flu outbreak," the center said on its website.
As of Monday, some 816 people infected with swine flu had died, according to the World Health Organization.
With the new US figures, plus recent updates to death tolls in Latin America, the region in the midst of winter that has been hardest hit by the virus, the global toll is closer to 950.
Unlike seasonal flu, which usually hits elderly people the hardest, the A(H1N1) virus has mostly infected the young.

8 steps to boost health,by swine flu

However, Dr. Jane Horton, director of student health and counseling at Washington and Lee University, says that the keys for students to stay healthy are not really different despite the swine flu’s presence.

Here are eight measures that Horton thinks students and families should consider as they prepare for the opening of classes.

1. Have a physical exam before starting college. Washington and Lee requires all students to have a physical, and Dr. Horton believes it’s an important part of preparing for college.

2. Talk to your doctor about recommended immunizations for adolescents and young adults and make sure all of your vaccinations are up to date. Make plans to get a flu shot in the fall. Dr. Horton cautions that this will be the year when student health centers will be doing more outreach than ever to see that students get vaccinated against the flu — both the normal seasonal shot and the H1N1 vaccine when it becomes available.

3. Have a parents-student conversation about expectations regarding alcohol, other drugs and sexual activity.

4. Check your health insurance. Families need to be aware, says Horton, of what kind of coverage the student will have on campus, including whether or not the prescription drug plan will be honored at pharmacies in the area.

5. Bring a first aid kit with common, over-the-counter medications.

6. Do what your mom always told you. Wash your hands, cover your cough, dispose of used tissues.

7. Watch your diet. Unhealthy eating habits are easy to pick up when no one is there to make sure you eat your veggies.

8. Get plenty of sleep. “For some reason, students get to college and their clock seems to shift, and they stay up too late, and they still have 8 o’clock classes,” said Horton. “They stay up talking to friends in the hall, and they don’t start their work until 11 or 12, and they’re up half the night doing their homework. Sleep deprivation among students is a very unhealthy habit.”

Side-effects of Swine flu drug

More than half of children taking Tamiflu suffer side-effects such as nausea, insomnia and nightmares, researchers said.
Two studies from experts at the Health Protection Agency (HPA) showed a "high proportion" of British schoolchildren reporting problems after taking the anti-viral drug.
Data was gathered from children at three schools in London and one in the South West who were given Tamiflu earlier this year after classmates became infected.
The researchers behind one study said that, although children may have attributed symptoms that were due to other illnesses to the use of Tamiflu, "this is unlikely to account for all the symptoms experienced".
Their research, published in Eurosurveillance, looked at side-effects reported by 11 and 12-year-old pupils in one school year in a secondary school in South West England.
The school was closed for 10 days in response to a pupil being confirmed with swine flu on return from a holiday in Cancun, Mexico.
A total of 248 pupils took part in the study and were given Tamiflu prophylactically. Compliance with prophylaxis was high, with 77% of children taking the full course, the researchers said. But they added: "Fifty-one per cent experienced symptoms such as feeling sick (31.2%), headaches (24.3%) and stomach ache (21.1%).
The researchers said "likely side-effects were common" and the "burden of side-effects needs to be considered" when deciding on giving Tamiflu to children prophylactically. The researchers concluded that a "high proportion of school children may experience side-effects of oseltamivir (Tamiflu) medication".
A spokesman from the Medicines and Healthcare products Regulatory Agency (MHRA) said it was monitoring reported side-effects by GPs and the public. Between April 1 and July 23, the MHRA received a total of 150 reports of 241 suspected side-effects for Tamiflu and five reports for another anti-viral, Relenza.
A spokeswoman for the Department of Health said: "As is the case with many medicines, nausea is a known side-effect of Tamiflu, in a small number of cases. Symptoms may lessen over the course of the treatment, and it may help to take Tamiflu either with or immediately after food, and drinking some of water may also lessen any feeling of nausea."

Pregnant womens more infected by swine flu

 Pregnant women are four times more likely to be hospitalised for swine flu and face a much higher risk of severe illness and death, according to
health experts.
US researchers have revealed that the H1N1 virus is taking an “exceptionally heavy toll” on expectant mothers – accounting for at least 13 per cent of deaths worldwide.
And now, they have recommended that pregnant women with the illness should be given antivirals.
Also they have said that expectant mothers must also be given the vaccine as soon as one is ready.
When pregnant, women are always at a higher risk of infection, particularly in the later stages of pregnancy,

Swine Flu in india reached 371

Twenty nine new cases of swine flu were reported in the country on Thursday, taking the tally to 371.
'Twenty-nine new laboratory confirmed cases have been reported on Thursday. Seven in Delhi, six in Bangalore, four in Chennai, four in Pune, three in Hyderabad, two in Thiruvananthapuram, two in Goa and one in Coimbatore,' said a health ministry statement.
'Of the 371 positive cases, 237 have been discharged. Rest of them remain admitted to the identified health facilities. The situation is being monitored,' it added.

Meanwhile, Delhi Health Minister Kiran Walia on Thursday asked parents not to send their children to school if they show symptoms of swine flu, but at the same time advised students that there was no need for panic.
On a visit to St. Thomas School, where 11 students were diagnosed with Influenza A(H1N1), Walia said the government is fully prepared to treat swine flu if there is an outbreak.
'Swine flu has not taken a virulent form and there is no need to worry about the disease. It is curable and can be controlled,' Walia said. Of the 11 students of the school who were diagnosed with the virus, six have been fully cured, while the rest are being treated in the Ram Manohar Lohia, Bhimrao Ambedkar and Loknayak Jai Prakash hospitals.
Special: Swine flu
'There is no need to close the schools. We only need to be careful and take precautions about the disease. The preventive measures have been sent to the schools and principals have been asked to tell the students about the dos and don'ts to avoid the infection,' Walia said.

Fight against swine flu

Copper is quite effective in inhibiting the influenza A H1N1 virus commonly known as Swine flu, according to the latest study.
Copper appears to have a broad spectrum in antiviral activity due to its effectiveness against RNA (Ribonucleic acid)-based influenza and DNA (Deoxyribonucleic acid)-based adenovirus 40/41, which causes gastrointestinal infections.
Bill Keevil, professor at the University of Southampton’s School of Biological Sciences, said that he believed copper could be used to reduce the spread of flu in public places.
"With the ongoing threat of contamination by influenza A virus, such as H1N1, there is a real and pressing need to utilise all appropriate and effective measures with proven antimicrobial qualities," said Keevil.
"It is recognised that many infectious diseases are contagious and studies have now shown that the use of copper as a surface material in key public places such as hospitals and food preparation areas offers the potential to substantially restrict and reduce the spread of harmful infections."
The influenza aspect of the study involved a series of experiments testing incubation of influenza A on copper and stainless steel surfaces.
Results showed that after incubation for one hour on copper, 75 percent of the virus was eradicated. Similar inactivation rates have now been observed for adenovirus 40/41.
The study has contributed further to the understanding of copper's antimicrobial qualities, which actively inhibit the growth of bacteria, fungi and viruses, said a University of Southampton release.
These findings were presented at the BIT Life Sciences' Second Annual World Summit on Anti-virals in Beijing this week.

Swine flu test positive in city

Four persons from the city have been tested positive for H1N1 influenza (swine flu), health officials said on Saturday, in the first reported case of the deadly virus in Rajasthan.
The patients -- two women and two children -- are from one family residing at Vishwakarma Industrial Area in the city. They are currently undergoing treatment at the isolation ward of SMS Hospital.
According to the health department, a relative of the patients from London had stayed with the family from July 12 to 14 with his two children. The relative's children were tested positive for flu in Hyderabad on July 16.
"The report of National Institute of Communicable Diseases (NICD) has confirmed positive for A(H1N1) infection," said a senior health official.
Meanwhile, the health department held an emergency meeting to discuss the issue and initiate measures to contain the disease. According to officials, relatives, neighbours, colleagues and visitors of the family were being provided precautionary medication.
In fact, it was due to the vigilance of the family which led to early diagnosis of the case. "After the relative was tested positive in Hyderabad, the family reported to the health department about his stay in Jaipur. Those with symptoms were subsequently admitted to the hospital," said a health official.
Meanwhile, health minister Aimaduddin Ahmad Khan said 20 beds have been arranged in the SMS isolation ward for swine flu, besides masks, caps, gowns and drugs. Rapid response teams had been deployed at all district headquartersto contain the disease, he said.

Younger People at Greater Risk by swine flu

Younger people are at greater risk of catching swine flu, with most cases occurring in teenagers, the World Health Organization said.
The median age of those infected with the pandemic H1N1 virus is 12 to 17 years, WHO said in a statement yesterday, citing data from Canada, Chile, Japan, U.K. and U.S. Patients requiring hospitalization and those with fatal cases may be slightly older, the Geneva-based United Nations agency said.
“As the disease expands broadly into communities, the average age of the cases is appearing to increase slightly,” WHO said. “This may reflect the situation in many countries where the earliest cases often occurred as school outbreaks but later cases were occurring in the community.”
World health officials are trying to determine which groups are most likely to get severely ill so measures to best protect them can be taken. Drugmakers are developing vaccines to fight the scourge, which WHO says may result in 2 billion infections.
Cardiovascular and respiratory diseases, diabetes and cancer put people infected with the new H1N1 virus at greater risk of developing severe complications, the UN agency said. Asthma and other forms of respiratory disease have been consistently reported as underlying conditions associated with more severe illness in several countries, it said.
Obesity has also been reported as a risk factor, and there is mounting evidence that pregnant women are at higher risk for more severe symptoms, WHO said. Some minority populations may also be more vulnerable, “but the potential contributions of cultural, economic and social risk factors are not clear.”
Vaccine Supply
Humans trials of a pandemic vaccine began in Australia this week, helping regulators gauge the safety and efficacy of shots.
The most common way to make flu vaccine is by growing the virus in fertilizer chicken eggs. The virus is then extracted, purified and killed for injection into humans, prompting the immune system to generate antibodies that fend off any infection.
WHO said yesterday that the yields for pandemic vaccine viruses are 25 percent to 50 percent of those of normal seasonal flu viruses for some manufacturers.
A network of WHO collaborators is trying to develop higher- yielding vaccine virus candidates, the agency said, adding that it will be able to revise its estimate of pandemic vaccine supply once it has the new yield information.

Help by Factory against swien flu

Workers at the GlaxoSmithKline (GSK) factory in Montrose are getting ready to restart production of an essential component of a drug to treat swine flu.

The plant will restart manufacturing zanamivir, the active ingredient in Relenza, in the next few weeks.
Production will last about six months and is designed to replace supplies which are currently being used up because of the swine flu scare.
GSK has said it plans to increase production levels of Relenza.
By the end of the year, it expects to raise its annual production capacity to 190 million treatment courses.
The previous maximum capacity was 60 million treatment courses.
Relenza, which has previously been used in the treatment of bird flu, is an alternative to Tamiflu.
Tamiflu is the drug which has been most widely used in the UK when treating swine flu.

Swine Flu reaches everywhere

he swine flu virus has reached 160 countries and could infect two billion people within the next two years, the World Health Organization has said.
A senior WHO official, Keiji Fukuda, said the virus was still in its early stages and would continue to spread for some time.
Mr Fukuda said work on a vaccine was intensifying but safety could not be compromised by rushing the process.
The virus is thought to have killed almost 800 people in recent months.
Mr Fukuda, the WHO's Assistant Director General for Health Security, said the agency had been reporting only laboratory-confirmed cases, but that this was always going to be "only a subset of the total number of cases".
"Even if we have hundreds of thousands of cases or a few millions of cases, we're relatively early in the pandemic," he told the Associated Press news agency.

"One of the things that is relatively clear is that we will continue to see spread of the virus; even though we are now three to four months into the pandemic, this is still pretty early into the overall period," he said.
Mr Fukuda said the WHO estimates two billion people, one third of the global population, could eventually be infected.
He said the figure was a reasonable prediction, based on analysis of previous pandemics, but that it was "really impossible to predict what the future will hold".
Pregnancy risk
Mr Fukuda said officials and drug manufacturers were investigating how to speed up the process of developing a vaccine against the H1N1 swine flu strain.
But he said there could be no doubt over the safety and efficacy of the drug before it was publicly distributed.
"There is always a balance in this sort of situation. You of course want to get out vaccine and as much vaccine as possible, as quickly as possible. On the other hand there are certain things which cannot be compromised," he said.
"There are certain areas where you can make economies, perhaps, but certain areas where you simply do not try to make any economies."
The WHO says that in most affected countries, the majority of cases appear to be occurring in young people, around the ages of 12 to 17, although some reports suggest it is mainly older people who have required hospital treatment.
The organisation also said there was "accumulating evidence suggesting pregnant women are at higher risk of more severe disease".

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