Why You Should Still Be Worried: Swine flu

Swine flu is spreading faster than ever — so much so that the World Health Organization has decided to stop tracking cases.
In the U.S., the H1N1 virus has sickened tens of thousands and closed summer camps at a time when there should be little or no flu activity.
Even as the WHO and the U.S. Centers for Disease Control and Prevention continue to raise awareness of this potentially deadly disease, which appears to be killing both sick and healthy individuals, the topic has virtually disappeared from the headlines.
“Complacency is a major concern,” said Dr. Anne Schuchat, director for National Center for Immunization and Respiratory Diseases at the CDC.
“This virus is a new one, and on top of that, we really still don’t know how it’s going to behave,” Schuchat said during a media conference call Friday. “There are special efforts that have been undertaken by health agencies, but individuals also need to be ready, to be thinking ahead and have steps in place should a family member get sick or a workplace close down or a situation arise that requires working from home.”
Over the next six to 12 weeks, there are several concerns that national health officials are preparing for:
1. Figuring out how the virus will react and spread once students return to schools, especially inner city schools, which typically struggle with overcrowding issues.
2. Overseeing the completion of a vaccine and getting it to the individuals who need it most.
3. Determining how the virus will behave as it spreads and mutates.
Schools
School districts across the U.S. struggle every fall with outbreaks of typically non-flu respiratory viruses, which are easily spread through germs on surfaces and doorknobs, as well as passed from student to student through sneezing, coughing, and sharing drinks and food.
Seasonal influenza usually begins to spread through schools in the late fall and early winter, but this probably will not be the case with swine flu, which behaves differently than seasonal influenza – by oddly thriving in warm and humid conditions.
“This year we’re seeing the H1N1 virus circulating through summer camps and military units, so I’m expecting we may see an increase in cases once school starts, but we don’t definitely know that,” Schuchat said. “We are concerned that there will be challenges in the fall. It is the kind of thing we want to be ready for and not surprised by.”
Schuchat said national and state health officials are working closely together on updating their guidance for schools and similar institutions with regard to swine flu outbreaks.
“We still believe that the best place for kids is in schools, where they can be nourished receiving a healthy breakfast and lunch and learning,” she said. “But we also believe the best place for a sick kid is at home being cared for. So we’re working on putting strong plans in place on communication and preparedness on the local and state levels.”
Vaccine
Companies such as Baxter, GlaxoSmithKline and Novartis are working to ready a swine flu vaccine for October. Earlier this week, concerns were raised that the U.S. may not receive all the vaccine it needs because it only manufactures about 20 percent of its own supply. The other 80 percent is produced in foreign countries, which will also need ample supplies of the vaccine.
But Schuchat downplayed those concerns, saying the U.S. has contracts in place with manufacturers around the world that guarantee it will receive adequate vaccine.
But, will the vaccine be effective?
In a typical year, the seasonal flu vaccine is about 70 to 90 percent effective, depending on how closely the vaccine matches the strains circulating and on the population the vaccine is used in. In other words, a vaccine is not going to be as effective in a person with a compromised immune system or someone who is considered at high risk for the virus.
Scientists typically spend months researching the strains of seasonal flu virus that are circulating the globe in order to pick out the three strains that it puts into the annual vaccine.
Because swine flu is new and mutating – for example, in Argentina the virus appears to have mutated to where it can now easily spread from humans to pigs – scientists have their work cut out for them when it comes to determining what strains of the H1N1 swine flu virus to include in the vaccine.
“Unfortunately, right now, we do not know how effective it will be in different populations,” Schuchat said. “We will be looking back at how well it worked, taking into account whether it worked as well as expected, better than expected or worse than expected. Unfortunately, that’s something we’re not able to do until after the fact.”
Virus Behavior
World and U.S. health officials have already determined that swine flu behaves differently than seasonal flu in a number of ways. First, it’s able to spread in hot and humid weather, which is not usually the case for the seasonal flu virus.
Second, the infection appears to be more severe in young people and less severe in the elderly than the typical seasonal flu. Schuchat said in some countries, elderly people, usually at high-risk for influenza, appear to be immune to swine flu – possibly because of the similarities between swine flu and the 1918 flu pandemic, which some of the world’s elderly survived and may be resistant to.
“We are particularly concerned about pregnant women; we’re seeing fatalities and life-threatening illnesses that have occurred in pregnant women in the Southern Hemisphere,” Schuchat said. “We are expecting pregnant women to get a recommendation to get the H1N1 vaccine to reduce the risk of complications from influenza. We know many pregnant women don’t like to take any drugs, but this is one instance where you need to be much more concerned about your health than the baby’s health.”
“We’re in a very active stage of preparing for the [coming months],” she continued. “We’re working with the private sector. We want individuals and families to be preparing. Influenza in general is unpredictable, and we don’t know what to expect in the weeks and months ahead.”

Swine-Flu Vaccination UK plans

The medical establishment in Britain, the nation hardest hit by swine flu outside North America, is scrambling to roll out a large-scale vaccination program in an effort to protect its population against a virus that threatens to spread rapidly here in coming weeks.
The state-run health system is deciding whether to hire private contractors to help doctors carry out the massive vaccination job, said Peter Holden, a general practitioner who represents the British Medical Association in pandemic-flu planning with the government. Doctors would rather handle the shots themselves, he said, but as phone calls and office visits related to swine flu have jumped, they are concerned the extra work will overwhelm them unless they suspend some other routine care.

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A postman delivers a leaflets giving information about swine flu to a home in Scotland. The leaflets were delivered to every household in the U.K.

In his own practice in the Peak District in central England, Dr. Holden is making plans for each doctor or nurse to vaccinate between 30 and 40 people an hour. "There'll be no chitchat. It will be, 'Are you allergic to anything? Bang, in, out,'" he said.
It isn't yet clear how many doses will be needed per person, but many flu experts believe it will be two.
Since the spring, 17 Britons have died after being infected with the H1N1 virus that is causing the swine-flu pandemic, according to U.K. officials. The U.K. recently recorded its first swine-flu death in an otherwise healthy patient, an event that set off further concern, even as other deaths, including that of a 6-year-old girl last week, have gained attention.
As of July 6, the U.K. had 7,447 confirmed cases, ranking the country fourth in the world, behind the U.S., Mexico and Canada, according to the World Health Organization's most recent figures. World-wide, 429 people have died from swine flu and 94,512 have been infected, according to the WHO.

swine flu deaths in London

Four more people in London have died after contracting swine flu, including a baby less than six months old.

The other casualties are a 70-year-old man, a 39-year-old woman and another adult. All of the victims had underlying health problems.
Three other possible swine flu deaths are also being investigated.
NHS London said the latest fatalities, which happened in the past two weeks, bring the total number of swine flu-related deaths in the capital to 10.
The baby died at Royal Free Hospital last week.
Dr Simon Tanner, regional director of public health at NHS London, said: "We would like to extend our deepest sympathies to each of the families affected at this very difficult time.
"It is also important that these deaths be kept in perspective.
"All four had underlying health conditions and these upsetting cases should be kept in context with the many people who have had swine flu and recovered just a few days after experiencing a mild illness."
Andy Wapling, head of emergency preparedness at NHS London, said: "We would like to reassure people that NHS London is well-prepared - all NHS organisations have plans which have been practised and checked regularly.
"NHS London has put in place recently audited plans on how to prepare for flu pandemic and ensure that anyone who needs help will receive it."
Twenty-nine people have now died in the UK after contracting swine flu and the number of new cases hit 55,000 last week.
The NHS has seen a surge in calls and consultations.
Ministers in England have responded by promising the National Flu Service will go live at the end of next week to relieve pressure on hospitals and GPs.
The government has also warned that deaths from swine flu this winter could be between 19,000 and 65,000 in the UK.

Symptoms Of Swine Flu?

Swine flu has affected thousands around the world - 29 people in the UK have died after contracting it and there are predictions that the worst is still to come.

Test kits for swine flu

Symptoms of the H1N1 virus are similar to those of seasonal flu. Sufferers will usually have a fever (temperature above 38C or 100.4F), sudden cough and some or all of the following:

• sore throat
• headache
• runny nose
• sneezing
• muscle ache
• vomiting
• diarrhoea or upset stomach
• tiredness
• chills
• loss of appetite

Do you think you have symptoms of swine flu?

Some areas in the UK have been identified as having sustained person to person spread.
These areas are Greater Glasgow, Birmingham and London.
The vast majority of cases reported so far in this country have been mild.
Most people who have contracted swine flu recover within a week and do not suffer complications, even without being given antiviral medication.
Only a small number have led to serious illness, and these have mainly been where patients have had underlying health problems.
The Government have decided to offer the antiviral, Tamiflu, to everyone with swine flu, at their doctor's discretion.

High-risk groups
People with:

• chronic lung disease
• chronic heart disease
• chronic kidney disease
• chronic liver disease
• chronic neurological disease (neurological disorders include motor neurone disease, multiple sclerosis and Parkinson's disease)
• immunosuppression (whether caused by disease or treatment) and diabetes mellitus, patients who have had drug treatment for asthma within the past three years
• pregnant women
• people aged 65 years and older
• young children under five years old.

Health Secretary Andy Burnham has confirmed a formal move from a "containment phase" to a "treatment phase" for swine flu.
This means that school closures will no longer be automatic, and cases will be confirmed by doctors rather than through lab testing.
The National Pandemic Flu Service will also be put into place by the end of next week.

6000 could die with Swine flu

A "worst case scenario" could see around 6,000 people die from swine flu across the country this season, Health Minister Nicola Roxon says.

Over 10,000 Australians have contracted the virus, 22 have died and almost 60 are in intensive care.
There were predictions yesterday that between 10,000 and 20,000 people could die from swine flu, but the Health Minister was quick to dismiss those numbers as "ludicrous".
Ms Roxon has told Radio National that projections show that if no action was taken against the disease, such as use of a vaccine and anti-virals, around 6,000 deaths would be expected.
"The 6,000 figure was agreed between all jurisdictions and advising health professionals," she said.
Yesterday infectious diseases expert Professor Raina MacIntyre, who is part of the influenza advisory group to Australia's chief medical officer Jim Bishop, said there could be up to 20,000 deaths from the disease.
But Ms Roxon says this is not correct.
"That simply is not based on the current information that we have about this particular disease," she said.
On average there are around 1,000 flu deaths in Australia each season.
On Tuesday Professor Jim Bishop said swine flu cases were expected to peak in August.
Pharmaceutical CSL will begin human tests next week of a vaccine it has developed after which it is expected over 20 million doses will be distributed in October.
In the UK it is likely a vaccine will be available in around a month but Ms Roxon says this is because they are not conducting human tests.
"I think we should be confident that we want to make sure the vaccine is safe and effective before we distribute it to a very big chunk of the population," she said.
However, Ms Roxon said if the virus "took a turn for the worse" the Government would consider fast-tracking the vaccine if appropriate advice was given.
She also said treating those with swine flu make take precedence over elective surgery as hospitals deal with the extra demand.
"It may well mean that some elective surgery or other procedures do have to be delayed for urgent attention to be provided to those who are having a severe impact from this flu," she said.

NRI family positive for Swine flu

Four members of a Non-Resident Indian family, whose swab samples were sent to the National Institute of Communicable Diseases (NICD), New Delhi, on Tuesday have tested positive for A (H1N1).
Suspected swine flu patients were quarantined in the local civil hospital on Monday, after symptoms of the H1N1 virus were noticed among them, T.P. Singh, district epidemiologist, told reporters revealing that the family belonged to the United States and had recently visited Jalandhar to meet their relatives.
Family quarantined All the four patients were kept in the Isolation Ward of the civil hospital and efforts were on to identify the persons, who came into contact with the family in the recent days and accordingly each and every identified person would be medically examined, Dr. Singh added.
He said that family recently visited other districts also and accordingly authorities concerned of such districts were being informed to undertake the identification of the persons, who came into close contact with the affected NRIs.
13 positive cases With the detection of four more H1N1-affected persons, the number of swine flu positive cases reached 13, including a couple who returned from Thailand recently and seven students, who came back from an educational trip from NASA.

Swine flu vaccine

With about 100 million doses of swine flu vaccine slated for distribution by October, public worries about the disease should lessen, said Patti Bull, infection prevention coordinator with Hendrick Health System.
“People should take some comfort in the fact that they’ve been able to make a vaccine so quickly,” she said. “At this point in time, they’re saying that the severity will be unchanged, but whether it’s worse or less severe, we’ll have a vaccine.”
Officials met at the National Institute of Health at a “flu summit” in Maryland Thursday to discuss the new vaccine. Clinical trials are scheduled for next month. The Institute warned that states should prepare for another wave of swine flu in the fall.
But Bull said people should not panic just yet.
“If there are adequate supplies, it will be distributed just like other vaccine seasons,” she said. “If there is an inadequate supply, they will first go to protecting the most vulnerable.”
High-risk persons include children, those dealing with children, the sick and elderly.
Bell said it is too early to determine how many immunization doses the Hendrick Health System will be allotted.
Five U.S. pharmaceutical companies are working on the vaccine, which has affected roughly 1 million people nationwide and killed 170. Globally, the virus has killed at least 420 people.
Last month the World Health Organization(WHO) declared a swine flu pandemic, meaning the disease spread in two world regions. WHO estimates more than 100 countries have been exposed to the disease.
Experts say the H1N1 virus more severely affects people between the ages of 5 and 24.
As of June, only 14 cases of the swine flu were confirmed in Taylor County.
“I think it’s just a matter of continuing to recognize that we need to observe this organism,” Bull said. “They are advocating judicious use of anti-viral resistant, meaning they don’t want people to get crazy and take a lot of anti-virals.

Swine Flu Outbreak at Airforce Base

The Air Force Academy in Colorado Springs, Colorado is dealing with the state's largest outbreak of the H-1-N-1 virus, or swine flu.

The Academy says initial tests show 15 cadets with the virus.
Nearly 90 cadets have been isolated because of flu-like symptoms.
The Academy says most of the sick cadets are members of the incoming freshman class.
They began training on June 25th.
Others in the 13-hundred member class are having to wash their hands with an alcohol-based sanitizer.

New Cases of Swine Flu Continue Nationwide

 The government is spending $1 billion on a new vaccine. Nearly 100,000 people have been infected worldwide - 37,000 of those in the use and 429 people worldwide have died from complications of the virus, including 211 in this country.
"The potential for a significant outbreak in the fall is looming," President Barack Obama said recently - so the government is now putting big money into finding a vaccine, fast.
"There'll be another $1 billion worth of orders placed to get the bulk ingredients for an H1N1 vaccination," Health and Human Services Secretary Kathleen Sebelius said today. "Congress has agreed with the president that this is the number one priority, keeping Americans safe and secure."
According to the Centers for Disease Control, 211 Americans have died after contracting H1N1. A CDC map shows some H1N1 activity in almost every state, with widespread illness in more than 20 states.
Hawaii saw 100 new cases in just the past week, and in Colorado, the Air Force Academy says more than 80 cadets are being tested for H1N1 after coming down with flu-like symptoms.
Some summer camps are closing early after 50 outbreaks among campers. In Britain, the actor Rupert Grint, who plays Harry Potter's friend in the movies, is now recovering.
U.S. health officials are watching countries in the southern hemisphere where it's winter and flu season now, to see what effect H1N1 might have here in the fall. Bolivia announced its first two swine flu deaths today.
"When exactly the flu season starts, we can't predict, but we will have a vaccination ready by mid-October, assuming we have a safe, effective strain that's been identified," Sebelius said.

H1N1 Swine Flu Cases in Brazil

he dreaded H1N1 swine flu continues unabated in Brazil as the number of new cases rose by 72 to 977 confirmed cases of the disease, the Health Ministry said late Wednesday.
Brazil first reported the H1N1 flu on May 8, and the numbers have increased quickly since then. One patient died after a return trip from Argentina, where the situation has deteriorated over the last several weeks.
Argentine authorities have confirmed 2,800 cases, with 70 patients dying of the respiratory disease.
In Brazil, 57% of the infections were caught during international travel, with the vast majority of them coming from Argentina.
According to the World Health Organization, there are 94,512 cases of the new flu in 122 countries as of July 6. Around 430 people have died.

Fort Gordon's Swine flu Cases

It’s a pandemic that has caused a global panic, and now the swine flu has found its way into the CSRA. The recent cases were confirmed by doctors at the Eisenhower Army Medical Center (EAMC), Wednesday night, At Fort Gordon.
Dr. Edward Boland, EAMC: “Of those eight cases, only two of them had a travel history like you would accept, according to the CDC.“
Doctor Edward Boland Is The Chief of Preventive Medicine on post. He says most of the patients got the flu from outside Fort Gordon.
Dr. Boland: “We know the flu is out in the community. That is were most of our folks were getting the H1N1 flu. They are members of the community, so they did not have a travel history, and we suspect that they are getting it here in Georgia.“
Dr. Boland says the patients got better and were released. He says, despite the widespread panic, many of them were not really concerned.
Dr. Boland: “The experience in the United States was not like it was in Mexico. Patients have sort of calmed down. At this point, it’s not the death threat that we thought it was going to be, in this country.“
Dr. Boland says, at this point, there are measures in place to make sure all their soldiers are safe and healthy before they leave the country.
Dr. boland: “You have to have your temperature taken to make sure you’re not running a fever, and you answer a questionnaire looking for flu-like symptoms. If you answer yes to any of those questions, you’re pulled to the side, then you don’t get to deploy until we know, for sure, that you are not sick.“
On friday, the Obama administration warned the states that swine flu promises to create a real mess this fall. The federal government called together health officials from every state to check their preparations for mass vaccinations, and how they’ll handle flu-riddled schools this fall.

Vaccine for Kids

he U.S. is planning a vaccination campaign that could start in October, with school-age children among the first to be offered a shot, Dow Jones Newswires reports. The new vaccine still has to be developed and tested. But if it works, the government will purchase much of the vaccine. Unlike seasonal flu, which disproportionately affects the elderly, the swine flu has hit particularly hard among school children.

Officials have documented three cases of Tamiflu-resistant swine flu, but they appear to be isolated cases and not evidence of widespread resistance, the WHO said. In one case, testing revealed that a teenage girl who flew from San Francisco to Hong Kong was infected with a Tamiflu-reistant strain, despite the fact that she hadn’t been treated with Tamiflu — suggesting a resistant strain that has the ability to spread from person to person, the New York Times reports. There is no evidence that the resistant strain is widespread, and Tamiflu-resistant flu is susceptible to Relenza, another drug.
The French government is planning to spend nearly $1 billion to buy 100 million doses of vaccine from Sanofi-Aventis, GlaxoSmithKline, Novartis and Baxter, reports the French newspaper Le Parisien.

Swine Flu 140 Cases in Maine

Maine's swine flu tally now stands at 141.  The Maine Center for Disease Control says 140 of those cases have been confirmed and one is considered probable.  Forty-seven of the cases have turned up in out-of-state residents who are visiting Maine. 

The cases are concentrated in southern Maine, in Cumberland and York Counties, but swine flu has been confirmed in 11 of the state's 16 counties.  Counties with no identified cases so far include Aroostook, Franklin, Piscataquis, Waldo and Washington.

But state health authorities say the official numbers don't tell the whole story because a lot of people who get sick don't get tested.  The Maine CDC says H1N1 is now widespread in Maine and tests are being conducted less frequently. 

Among those identified with the disease, seven have been hospitalized, but all have been discharged.

First women died by swine flu

The H1N1 virus, commonly known as the swine flu, claimed its first victim in Stanislaus County last week, a 21-year-old woman with prior health problems.
County health officials would not release the woman’s identity or location, but they said she had been hospitalized with severe pneumonia and died July 1. The Modesto Bee reported this week the woman was Rosario Rivera of Ceres.
It was the fourth confirmed case of the flu in Stanislaus County. County Public Health Officer Dr. John Walker said the other three cases were also relatively young adults, which follows the trend of the global pandemic that has sickened nearly 100,000 and killed more than 400 according to the World Health Organization.
Of the 187 swine flu-related deaths in the United States so far, 24 have come in California. While the flu is believed to have originated in Mexico and spread through travel there, Walker said it’s more likely the virus will now act like the typical seasonal flu that appears later in the year.
“We genuinely believe that H1N1 is active in all parts of our county,” Walker said. “As we monitor this outbreak in our county and in California, it’s very clear that it’s no longer related to travel but that it is spread within a community, person to person.”
The county confirmed its first case of swine flu on June 15, a 22-year-old woman who was not hospitalized and fully recovered. Since then, there have been two other confirmed cases, but Walker said both recovered and neither required hospitalization.
According to the state Department of Public Health Web site, Stanislaus is one of only 13 counties in California with a swine flu-related death. San Joaquin County, though it has had 14 confirmed cases, has had no deaths. Merced County has had two confirmed cases and no deaths.
The county is generally advocating standard hygiene like it would during the normal flu season — washing hands regularly, covering your mouth when you cough or sneeze, etc. Walker said the county is trying to walk a fine line by emphasizing the seriousness of the swine flu while not causing any unnecessary panic.
“What we’re trying to do is to alert people that it may be summer, but we have influenza,” Walker said. “We don’t want to alarm them … it’s very similar to seasonal influenza. But we don’t want it to be taken lightly, either, because influenza carries the risk of serious complications.”

2 new swine flu deaths in Minnesota and LA

Health officials say two more people in Los Angeles County have died of swine flu, bringing the total death toll in the county to three. The county's health officer, Dr. Jonathan Fielding, said Wednesday that the latest victims had underlying medical conditions.
One of the recent victims was a pregnant woman. Her baby survived.
Overall, 23 swine flu deaths have been recorded in California as of July 2, the latest statewide tally available.

became infected. The first, a 5-year-old girl from Minneapolis, had been fragile since infancy. The two announced Wednesday -- one a child; one an elderly hospital patient -- also had underlying complications.
That might be reassuring to healthy people, but it's one reason why health officials have been monitoring the new flu so carefully: A broader outbreak could quickly kill dozens of people with conditions as common as asthma, diabetes and heart disease.
That's what happens every winter when the seasonal flu bug strikes. People with common but compromising health problems are the ones most at risk when they also contract the flu.
In fact, the most common health problem among Minnesotans hospitalized with swine flu is asthma, state health officials said Wednesday.
"This novel virus is affecting the same groups" as regular seasonal flu, said Dr. Aaron DeVries, an epidemiologist with the Minnesota Department of Health.
Only at this point there is no vaccine to protect the medically vulnerable from the new flu.
It's largely for the sake of those vulnerable people, primarily sick children and the elderly, that health officials keep repeating the wash-your-hands, cover-your-cough mantra to stop the flu's spread.
Those with heart and lung disease, for example, have a 100-fold increase in the risk of death from flu, said Dr. Greg Poland a flu expert with the Mayo Clinic in Rochester.
Nationally, each winter about 36,000 people die and 200,000 are hospitalized from standard seasonal flu, and the vast majority had some kind of underlying health condition.

Swine Flu Returns

Even though the panic seems to have faded, the number of swine flu cases has just jumped dramatically.
The Centers for Disease Control and Prevention says the most significant increase in reported U.S. activity came at the end of June, months after the initial scare. U.S. deaths jumped 34 percent to 170 in just the past week.
"We don't have any evidence that it's mutated yet, but I'm concerned the mutation may be taking place. The children seem to me to be getting much more sicker than they used to be one or two months ago," said Dr. Norris Payne, a Houston pediatrician.
He's seeing three or four new cases of swine flu each day.
Dr. Payne is the pediatrician for FOX 26 anchor Melissa Wilson's two year old son. Melissa's son has been diagnosed with swine flu.
Over the weekend, she says, "He was belligerent. He would not stop crying." His fever had soared to 105 degrees.
"Flu season is over, but this is the first time in 30 years I've seen flu in the summer," said Dr. Payne.
For now, the antiviral tamiflu still seems to be working.
Melissa says, "If you have a child with a fever in the middle of summer, that's odd. I would get help immediately."
Dr. Payne believes the cases he's seeing could be just the tip of the iceberg. The CDC estimates more than a million Americans have been infected with the virus, though many probably had a mild illness.
A vaccine is still being developed but could become available sometime in the fall.