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Author Topic: H1N1 - Swine Flu - Novel Flu - Information  (Read 101076 times)
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« Reply #360 on: October 20, 2009, 09:40:01 PM »

WHO - Weekly Update - Number 70

Pandemic (H1N1) 2009 - update 70
Weekly update


As of 11 October 2009, worldwide there have been more than 399232 laboratory confirmed cases of pandemic influenza H1N1 2009 and over 4735 deaths reported to WHO.

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

Influenza activity continues to increase in the northern temperate zones across the world. In North America, the United States is now experiencing nationwide rates of Influenza-Like Illness (ILI) well above seasonal baseline rates with high rates of pandemic H1N1 2009 virus detections in clinical laboratory specimens. Canada is reporting increases in ILI rates for the third straight week with some provinces now crossing the baseline. Mexico also reports high intensity and active transmission in some areas of the country. Western Europe and northern Asia are experiencing increased rates of ILI, well above baseline in some countries but activity is generally not as widespread as in North America. Of note, nearly half of the influenza viruses detected in China are seasonal influenza A (H3N2) viruses, which appeared prior to and is co-circulating with pandemic H1N1 2009 virus.

The tropical zones continue to have transmission that is mixed as some countries have now peaked and are declining, while others are experiencing increases. In the tropical region of the Americas, several Caribbean Island nations are now reporting increased rates of illness while Brazil, Costa Rica and other countries on the continent are declining. In South Asia, most countries now report a decline in rates of illness.

Influenza rates in the temperate zones of the Southern Hemisphere have all returned to below baseline levels and very few detections of pandemic H1N1 2009 virus are being reported.

Three articles of interest published this week in the peer reviewed literature reported three different series of seriously ill pandemic influenza patients in Canada, Mexico, Australia, and New Zealand. Several important observations were made including:

• A significant portion of patients with severe disease requiring intensive care had no predisposing conditions. The numbers are not directly comparable as the studies categorized conditions differently but nearly 1/3 of ICU patients in Australia and New Zealand had no predisposing conditions. 98% of ICU cases in Canada had a comorbid condition, which in this report included hypertension, smoking, and substance abuse, but only 30% had comorbid conditions that were considered "major". In Mexico, 84% of critical patients had an underlying condition, which in the report included hypertension, ever having smoked, and hyperlipidemia, conditions that are not considered risk factors for severe influenza outcomes. All three groups were impressed by the number of severe cases occurring in previously healthy individuals.
• The researchers in Australia and New Zealand reaffirmed that infants under the age of 1 year have the highest risk of developing severe illness. The average age of ICU patients was 32, 40, and 44 years in Canada, Australia/New Zealand, and Mexico respectively.
• The study from Australia and New Zealand estimated that the demand for ICU beds due to viral pneumonia during the pandemic was as much higher than in previous influenza seasons. The Canadian study reported that intensive care capacity in Winnipeg, Manitoba, was "seriously challenged" at the peak of the outbreak with full occupancy of all regional ICU beds.

All pandemic H1N1 2009 influenza viruses analyzed to date have been antigenically and genetically similar to A/California/7/2009-like pandemic H1N1 2009 virus.

Systematic surveillance conducted by the Global Influenza Surveillance Network (GISN), continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to the antiviral oseltamivir.

Weekly update (Virological surveillance data)

*Countries in temperate regions are defined as those north of the Tropic of Cancer or south of the Tropic of Capricorn, while countries in tropical regions are defined as those between these two latitudes.
Qualitative indicators (Week 29 to Week 40: 13 July - 4 October 2009)
The qualitative indicators monitor: the global geographic spread of influenza, trends in acute respiratory diseases, the intensity of respiratory disease activity, and the impact of the pandemic on health-care services.

Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance
A description of WHO pandemic monitoring and surveillance objectives and methods can be found in the updated interim WHO guidance for the surveillance of human infection with pandemic (H1N1) virus.


The maps below display information on the qualitative indicators reported. Information is available for approximately 60 countries each week. Implementation of this monitoring system is ongoing and completeness of reporting is expected to increase over time.

List of definitions of qualitative indicators
Geographic spread of influenza activity
Map timeline
Trend of respiratory diseases activity compared to the previous week
Map timeline
Intensity of acute respiratory diseases in the population
Map timeline
Impact on health care services
Map timeline
Laboratory-confirmed cases of pandemic (H1N1) 2009 as officially reported to WHO by States Parties to the IHR (2005) as of 11 October 2009
Map of affected countries and deaths
No new countries and overseas territories/communities have newly reported their first pandemic (H1N1) 2009 confirmed case(s) since the last web update (No. 69).

Region
 Cumulative total
 
as of 11 October 2009
 
 
 Cases*
 Deaths
 
WHO Regional Office for Africa (AFRO)
 12456
 70
 
WHO Regional Office for the Americas (AMRO)
 153697
 3406
 
WHO Regional Office for the Eastern Mediterranean (EMRO)
 13855
      90
 
WHO Regional Office for Europe (EURO)
 Over 61000
 At least 207
 
WHO Regional Office for South-East Asia (SEARO)
 39522
 530
 
WHO Regional Office for the Western Pacific (WPRO)
 118702
 432
 
 
   
   
 
Total
 Over 399232
 At least 4735
 


*Given that countries are no longer required to test and report individual cases, the number of cases reported actually understates the real number of cases.

 
 




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© WHO 2009 
 
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« Reply #361 on: October 20, 2009, 09:44:20 PM »

CDC - International Updates

2009 H1N1 Flu: International Situation Update
October 16, 2009, 3:00 PM ET


Map of International Activity Estimates
(Including 2009 H1N1 Flu)


This report provides an update to the international situation as of October 16, 2009. The World Health Organization (WHO) continues to report laboratory-confirmed 2009 H1N1 flu cases and deaths on its Web page. These laboratory-confirmed cases represent a substantial underestimation of total cases in the world, as many countries focus surveillance and laboratory testing only on people with severe illness. The 2009 H1N1 influenza virus continues to be the dominant influenza virus in circulation in the world. Since April 19, 2009, over half of all influenza positive specimens reported to WHO were 2009 H1N1. In temperate regions of the Southern Hemisphere, disease due to 2009 H1N1 has returned to below baseline. In tropical regions of the Americas and Asia, influenza activity due to 2009 H1N1 remains variable. In temperate regions of the Northern Hemisphere, there is increased influenza-like illness (ILI) activity due to 2009 H1N1 in many areas, including Western Europe and Northern Asia, most of the United States, and parts of Mexico and Canada.

Selected Highlights
The 2009 H1N1 influenza virus is the predominant influenza virus in circulation in most countries worldwide.
The epidemiology of disease caused by 2009 H1N1 influenza in the Southern Hemisphere is very similar to that described in the United States in the spring of 2009.
There have been no significant changes detected in the 2009 H1N1 influenza viruses isolated from persons in the Southern Hemisphere as compared to viruses isolated from persons in the Northern Hemisphere.
According to WHO, the majority of 2009 H1N1 influenza isolates tested worldwide remain sensitive to oseltamivir, an antiviral medicine used to treat influenza disease. Only 35 2009 H1N1 isolates tested worldwide have been found to be resistant to oseltamivir – 13 of these isolates were detected in the United States.
On September 17, 2009, several countries including the United States announced plans to donate 2009 H1N1 vaccine or funds to support vaccination campaigns in less developed countries.
International Resources for 2009 H1N1 Information
Health Organizations
World Health Organization (WHO)
ECDC (European Centre for Disease Prevention and Control)
H2P (Humanitarian Pandemic Preparedness)
Public Health Agency of Canada
World Health Organization (WHO) Regional Offices
AFRO (WHO Regional Office for Africa)
AMRO (WHO Regional Office for the Americas) / PAHO (Pan American Health Organization)
EMRO (WHO Regional Office for the Eastern Mediterranean)
EURO (WHO Regional Office for Europe)
SEARO (WHO Regional Office for South-East Asia)
WPRO (WHO Regional Office for the Western Pacific)
Travel and 2009 H1N1 Flu
Human cases of 2009 H1N1 flu virus infection have been identified in the United States and several countries around the world. For information on 2009 H1N1 flu and travel, see the CDC H1N1 Flu and Travel website.

Reports and Publications
White House Report on 2009 H1N1 in the Southern Hemisphere
Issued August 2009 – This White House report was prepared by the Department of Health and Human Services (HHS) in coordination with the Office of the Director for National Intelligence (ODNI) and the Department of State (Dos) and describes the characteristics and impact of 2009 H1N1 influenza A virus in the Southern Hemisphere.
ECDC Interim Risk Assessment Influenza A (H1N1) 2009 Pandemic
Issued July 30, 2009 - This document provides an interim risk assessment of novel H1N1 flu in Europe prepared by ECDC.
World Health Organization Weekly Epidemiological record  – Issued July 24, 2009
This document by WHO provides updates on the international novel H1N1 flu situation.
MMWR – Update: Novel Influenza A (H1N1) Virus Infection – Mexico, March-May, 2009 – Issued June 5, 2009 / Vol. 58 / No. 21.
This Morbidity and Mortality Weekly Report describes the novel influenza A (H1N1) outbreak in Mexico from March-May, 2009.
MMWR – Update: Novel Influenza A (H1N1) Virus Infections – Worldwide, May 6, 2009 – Issued May 8, 2009 / Vol. 58 / No. 17.
This Morbidity and Mortality Weekly Report describes worldwide novel influenza A (H1N1) infections as of May 6, 2009.


http://www.cdc.gov/h1n1flu/updates/international/
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« Reply #362 on: October 20, 2009, 09:49:01 PM »

WHO - Clinical - Features of Severe Cases

Clinical features of severe cases of pandemic influenza
Pandemic (H1N1) 2009 briefing note 13


16 OCTOBER 2009 | GENEVA -- To gather information about the clinical features and management of pandemic influenza, WHO hosted a three-day meeting at the headquarters of the Pan American Health Organization in Washington, DC on 14–16 October. Findings and experiences were presented by around 100 clinicians, scientists, and public health professionals from the Americas, Europe, Asia, Africa, the Middle East and Oceania.

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

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

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

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

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

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

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

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

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

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

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

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

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


http://www.who.int/csr/disease/swineflu/notes/h1n1_clinical_features_20091016/en/index.html
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« Reply #363 on: October 20, 2009, 09:53:09 PM »


Flu.gov - H1N1 Vaccine Supply Status

2009 H1N1 Influenza Vaccine Supply Status
October 16, 2009, 12:00 PM ET

Aggregate Totals
Posted October 16, 2009, 12:00 PM ET Doses Allocated as of 10/14/09*  11,422,900
Doses Ordered as of 10/14/09  7,971,800
Doses Shipped as of 10/14/09** 5,885,900
*Doses allocated to project areas for ordering are those that are at the distribution depots and ready for project areas to order.
Vaccine is allocated to each project area in proportion to its population (pro rata).

**There is a lag time between allocation, ordering, and shipment of doses as project areas place orders and those orders are processed and shipped.

Project areas reflect CDC Public Health Emergency Response (PHER) Grantees.

 

For Planners: Vaccine Allocation and Distribution Q&A

For the Public: 2009 H1N1 Influenza Vaccine Q&A, Supply and Distribution

Vaccine Shipment Status
by Project Area
Posted October 16, 2009, 12:00 PM ET
 Project Areas  Total Doses Shipped
as of 10/14/09
Alabama 102600
Alaska 25200
American Samoa 0
Arizona 180200
Arkansas 60100
California 836900
Chicago 71400
Colorado 88400
Connecticut 79900
Delaware 15700
District of Columbia 14500
Federal Worker Program* 13000
Florida 242700
Georgia 204700
Guam 2400
Hawaii 32600
Idaho 45600
Illinois 114000
Indiana 240800
Iowa 54000
Kansas 27400
Kentucky 73600
Louisiana 79400
Maine 33300
Marshall Islands 0
Maryland 130700
Massachusetts 189600
Michigan 151200
Micronesia 1700
Minnesota 48900
Mississippi 10000
Missouri 70500
Montana 17800
Nebraska 45500
Nevada 71600
New Hampshire 25600
New Jersey 158000
New Mexico 40000
New York 204800
New York City 151000
North Carolina 190100
North Dakota 13900
Northern Mariana Islands 2400
Ohio 203500
Oklahoma 65200
Oregon 59800
Pennsylvania 218100
Philadelphia 37500
Puerto Rico 42900
Republic of Palau 1300
Rhode Island 15800
South Carolina 74600
South Dakota 17300
Tennessee 160400
Texas 178300
Utah 64500
Vermont 14800
Virgin Islands 3000
Virginia 265100
Washington 75600
West Virginia 46500
Wisconsin 168600
Wyoming 11400
*For more information, please visit: http://www.opm.gov/pandemic/memos/h1n1_20090930.asp 



Read at link below.....

http://www.flu.gov/individualfamily/vaccination/supply.html
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« Reply #364 on: October 20, 2009, 09:57:16 PM »



U.S. Influenza and Pneumonia-Associated Hospitalizations
and Deaths from August 30 – October 10, 2009


 Posted October 16, 2009, 11:00 AM ET
Data reported to CDC by October 13, 2009, 12:00 AM ET 

Cases Defined by Hospitalizations Deaths

Influenza and Pneumonia Syndrome* 15,696 2,029
Influenza Laboratory-Tests** 4,958 292
*Reports can be based on syndromic, admission or discharge data, or a combination of data elements that could include laboratory-confirmed and influenza-like illness hospitalizations.

**Laboratory confirmation includes any positive influenza test (rapid influenza tests, RT-PCR, DFA, IFA, or culture), whether or not typing was done.

This table is based on data reported to CDC by U.S. states and territories from a new influenza and pneumonia hospitalizations and deaths web-based reporting system. This system will be used to monitor trends in activity for the 2009-10 influenza season. This is a cumulative count beginning August 30, 2009. The table shows aggregate reports of all influenza and pneumonia-associated hospitalizations and deaths (including 2009 H1N1 and seasonal flu) since August 30, 2009 received by CDC from U.S. states and territories. This table will be updated weekly each Friday at 11 a.m. For the 2009-2010 influenza season, states are reporting based on new case definitions for hospitalizations and deaths effective August 30, 2009.

CDC will continue to use its traditional surveillance systems to track the progress of the 2009-2010 influenza season. For more information about influenza surveillance, including reporting of influenza-associated hospitalizations and deaths, see Questions and Answers: Monitoring Influenza Activity, Including 2009 H1N1.

The number of 2009 H1N1 hospitalizations and deaths reported to CDC from April – August 2009 is available on the Past Situation Updates page.

For state level information, refer to state health departments.

International Human Cases of 2009 H1N1 Flu Infection
See: World Health Organization.
 
Read more here....in better format.....

http://www.cdc.gov/h1n1flu/updates/us/#totalcases
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« Reply #365 on: October 21, 2009, 10:03:49 AM »

USDA - Testing Swine Samples - Minnesota State Fair

 USDA CONDUCTING CONFIRMATORY TESTING ON POSSIBLE DETECTION OF 2009 PANDEMIC H1N1 INFLUENZA IN U.S. SWINE 
 
  WASHINGTON, Oct. 16, 2009 - Agriculture Secretary Tom Vilsack today announced that the U.S. Department of Agriculture (USDA) National Veterinary Services Laboratories will be conducting confirmatory testing on swine samples collected at the 2009 Minnesota State Fair between August 26 and September 1. The pigs sampled at the time showed no signs of illness and were apparently healthy. The samples collected were part of a University of Iowa and University of Minnesota cooperative agreement research project funded by the U.S. Centers for Disease Control and Prevention (CDC) which documents influenza viruses where humans and pigs interact at such as fairs.

"Like people, swine routinely get sick or contract influenza viruses. We currently are testing the Minnesota samples to determine if this is 2009 pandemic H1N1 influenza," said Vilsack. "We are working in partnership with CDC as well as our animal and public health colleagues and will continue to provide information as it becomes available."

USDA's National Veterinary Services Laboratories may have confirmatory results within the next few days.


"I want to remind people that they cannot get this flu from eating pork or pork products," said Vilsack.

An outbreak of 2009 pandemic H1N1 influenza occurred in a group of children housed in a dormitory at the fair at the same time samples were collected from the pigs, but no direct link to the pigs has been made. Information available at this time would suggest the children were not sickened by contact with the fair pigs.


USDA continues to remind U.S. swine producers about the need for good hygiene, biosecurity and other practices that will prevent the introduction and spread of influenza viruses in their herd and encourage them to participate in USDA's swine influenza virus surveillance program. Monitoring and studying these influenza viruses in swine, will help USDA learn about the virus, develop better tools to diagnose and develop new and improved vaccines to protect our U.S swine herds. USDA encourages commercial pork producers to intensify the biosecurity practices that they have in place, particularly during this flu season.

More information about USDA's 2009 pandemic H1N1 efforts is available at www.usda.gov/H1N1flu.



http://www.usda.gov/wps/portal/%21ut/p/_s.7_0_A/7_0_1OB?contentidonly=true&contentid=2009/10/0513.xml
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« Reply #366 on: October 21, 2009, 10:07:00 AM »

FDA - Warning Re Fraudulent Flu Supplements

FDA NEWS RELEASE
For Immediate Release: Oct. 19, 2009

Media Inquiries: Christopher Kelly, 301-796-4676 christopher.kelly@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA, FTC Issue Joint Warning Letter to Web Site Offering Fraudulent H1N1 Flu Supplements

Agencies continue effort to protect public health from illegal Web activity
On October 15, 2009, the U.S. Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) issued a joint warning letter to a Web site marketing fraudulent supplements that claim to help prevent the spread of the 2009 H1N1 influenza virus.

The warning letter, the first to be issued jointly by the agencies, advises the owners of the site that they must discontinue the fraudulent marketing of their product or face legal action. The letter further advises the owners of the site that they have 48 hours to give the agencies a plan to discontinue their fraudulent marketing.

The FDA and the FTC remind consumers to be cautious of promotions or Internet sites offering products for sale that claim to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus. Fraudulent H1N1 influenza products come in many varieties, including dietary supplements, as well as products purporting to be drugs, medical devices or vaccines. Since May 2009, the FDA has warned more than 75 Web sites to stop the sale of more than 135 products with fraudulent H1N1 influenza virus claims.

“Products that are offered for sale with claims to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus must be carefully evaluated,” said Commissioner of Food and Drugs Margaret A. Hamburg, M.D. “Unless these products are proven to be safe and effective for the claims that are made, it is not known whether they will prevent the transmission of the virus or offer effective remedies against infection. Furthermore, they can make matters worse by providing consumers with a false sense of protection.”

The FDA and the FTC also warn consumers to take extreme care when buying products over the Internet that claim to diagnose, prevent, treat or cure the H1N1 influenza virus because, in addition to being fraudulent, they could be dangerous.

In collaboration with the FTC, the FDA will continue to work aggressively to identify, investigate and take regulatory action against individuals or businesses that wrongfully promote purported 2009 H1N1 influenza products.

This will include taking joint action, when appropriate, such as the issuance of last Thursday's warning letter. Additional legal action could include an injunction or issuance of an administrative order by the FTC or seizure of products, an injunction or criminal prosecution by the FDA.

“The FDA continues to consider the sale and promotion of fraudulent H1N1 influenza products to be a possible threat to the public health and in violation of the Federal Food Drug and Cosmetic Act,” said Michael Chappell, acting associate commissioner for regulatory affairs. “The FDA has an aggressive surveillance program to detect fraudulent H1N1-related products and will take prompt action to stop the marketing of fraudulent H1N1 influenza products and will hold those who are responsible for doing so accountable.”

To view the warning letters, visit: http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2009/default.htm.

There are two antiviral drugs approved by the FDA for treatment and prophylaxis of the 2009 H1N1 influenza virus – Tamiflu (oseltamivir phosphate) and Relenza (zanamivir). Tamiflu and Relenza, in addition to their approved labeling, have been issued Emergency Use Authorizations by the FDA that describe specific authorized uses during this public health emergency.

H1N1 Flu Fraud Widget

This week, the FDA enhanced its efforts to warn the public about potentially deceptive H1N1 influenza products and to report suspected criminal activity with the release of an H1N1 flu fraud widget.

The portable application, embedded in a Web page that can be copied onto any other Web site or blog, will allow the public to play an active role in preventing flu fraud, and is available at http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm186340.htm

Consumers are urged to report any suspected fraudulent products or criminal activity relating to FDA-regulated products associated with H1N1 influenza virus, including the names of Web sites that may be offering these products for sale, to the FDA by visiting: http://www.accessdata.fda.gov/scripts/email/oc/oci/flucontact.cfm

Consumers are urged to purchase and consume only FDA-approved or authorized medical products to diagnose, treat, prevent, or cure infections caused by the H1N1 virus. Consumers also are urged to contact their health care provider if they have any questions or concerns about medical products or personal protective equipment.

For more information:

FDA 2009 H1N1 (Swine) Flu Page
http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm150305.htm

Centers for Disease Control and Prevention – 2009 H1N1 Flu (Swine Flu)
http://www.cdc.gov/h1n1flu/

Fraudulent 2009 H1N1 Influenza Products List
http://www.accessdata.fda.gov/scripts/h1n1flu/

Influenza Antiviral Drugs and Related Information
http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm100228.htm

The Federal Government’s Influenza Web site
http://www.flu.gov/

FTC Warns Internet Peddlers that Potentially Bogus H1N1 Influenza Products May Violate Federal Law—Press Release, May 5, 2009
http://www2.ftc.gov/opa/2009/05/swineflu2.shtm   
-

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm187142.htm
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« Reply #367 on: October 21, 2009, 10:11:48 AM »

FDA - Vaccine - Newly Approved for Pediatric Use - Seasonal Flu
FDA NEWS RELEASE
For Immediate Release: Oct. 19, 2009

Media Inquiries: Peper Long, 301-796-4671, mary.long@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA Approves Seasonal Influenza Vaccine Fluarix for Pediatric Use

The U.S. Food and Drug Administration today approved use of the seasonal influenza vaccine Fluarix for children ages 3 years to 17 years. Previously, this vaccine, which contains inactivated (killed) influenza A and B viruses, had been approved for use in adults, ages 18 years and older.

The safety and effectiveness of Fluarix for use in children ages 3 years and older is documented by  a U.S. study comparing 2,115 children who received Fluarix with 1,210 children who received Fluzone, a different influenza vaccine already licensed by the FDA for use in children ages 6 months and older. Study results showed that children 3 years and older vaccinated with Fluarix and Fluzone produced similar amounts of antibodies in the blood at levels considered likely to be protective against seasonal influenza.

Fluarix is a seasonal influenza vaccine not intended to protect against the 2009 H1N1 influenza virus.

"This approval of an additional seasonal influenza vaccine for children provides help in protecting them against influenza,” said Karen Midthun, M.D., acting director of the FDA’s Center for Biologics Evaluation and Research. “Children are very vulnerable to the influenza virus and are more likely to be hospitalized for associated problems.”

With today’s approval, there are now four companies approved by the FDA to manufacture seasonal influenza vaccine for use in children.

Influenza is far more dangerous than the common cold for children, who often require medical care, especially if they are younger than 5 years. It is best to vaccinate children each fall, but vaccination also can occur in the winter months when influenza season often peaks.

Common adverse events experienced after administration of Fluarix are typical of those for flu shots and include pain, redness, and swelling at the injection site as well as irritability, loss of appetite, and drowsiness.

Because Fluarix contains a small amount of egg protein, it should not be administered to anyone allergic to eggs or egg products.

Fluarix is manufactured by GlaxoSmithKline Biologicals of Dresden, Germany.

For more information:

FDA Web site on Influenza Virus Vaccine Safety and Availability
http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm110288.htm


http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm187156.htm
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« Reply #368 on: October 21, 2009, 10:15:15 AM »


CDC Podcast - Antiviral Drugs

Click on link..........

http://www2c.cdc.gov/podcasts/player.asp?f=175219
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« Reply #369 on: October 21, 2009, 10:20:38 AM »

CDC - Q&A Re Mixing Tamiflu Capsules with Liquid - Children

Questions & Answers

Opening and Mixing Tamiflu® Capsules with Liquids if Child Cannot Swallow Capsules
October 20, 2009 5:30 PM ET



Is there a shortage of oral suspension (liquid) Tamiflu®?
The Food and Drug Administration (FDA) and the maker of Tamiflu® (Roche ) have said that available supplies of liquid Tamiflu® for children are limited.

What is being done about this?
There are child doses of Tamiflu® in capsules (30 mg and 45 mg). It also is possible for a pharmacist to create a liquid children’s dose using adult doses of Tamiflu®. CDC is alerting pharmacists, doctors, and parents about these options. (Note: Children weighing more than 88 pounds would receive a 75 mg dose Tamiflu®, which is the adult dose.)

What can I do if my child cannot swallow capsules?
If your doctor prescribes Tamiflu® capsules for your child and your child cannot swallow capsules, the prescribed capsules may be opened and mixed with a sweetened liquid, which may be sugar-free, that the child will consume completely. 

What liquids can I use?
A thickened and sweet liquid that masks the flavor of the medicine can be mixed with the contents of the Tamiflu® capsule. Sugar-free sweetened liquids are available. The child should consume the liquid mixture entirely. Examples are:  applesauce, corn syrup, pudding, or chocolate/caramel/butterscotch syrup.  Honey may be used if the child is older than 1 year.

If my child can’t swallow capsules, how do I open Tamiflu capsules and mix the medicine?
Carefully open the Tamiflu® capsule and mix the powder inside the capsule with regular or sugar-free chocolate syrup. Use only the prescribed dose.

What will I need to do this?
You will need

The prescribed Tamiflu® capsule
A small bowl or cup and a spoon
1-2 Teaspoons of sweetened liquid
How do I mix the ingredients?
Holding one capsule over a small bowl, carefully pull the capsule open and pour the complete contents of the capsule into the bowl.
Add 1-2 teaspoons of the sweetened liquid that the child will consume completely.
Stir the mixture and give the entire dose to the child.

Should my child take all of the mixture?
Yes, make sure your child takes all of the medicine mixture.

http://www.cdc.gov/H1N1flu/antivirals/mixing_tamiflu_qa.htm
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« Reply #370 on: October 21, 2009, 10:54:43 AM »

RE Human to Animal Transmission

10/21/09.....I have read two articles this morning about animals with H1N1....with the article stating
that the flu was passed from human to animal.  The first was a ferret and the second was a turkey.
I am going to pass the information to you and will continue to look for verifying information which
should be available by the end of the day.

 
Worker gave H1N1 to turkeys

Officials reassure public; tell handlers to get flu shots

By ANTONELLA ARTUSO AND CHRISTINA SPENCER, SUN MEDIA

The Toronto Sun     


 Swine flu found in Ontario turkey farm
 

TORONTO -- Ontario's chief medical officer of health is advising poultry handlers and other livestock workers to get their flu shots after breeder turkeys at a Kitchener farm tested positive for the H1N1 virus.

Public health officials say the public can eat turkey with confidence as the affected birds did not end up on anyone's plate.

"I want to assure Ontarians that the risk to human health in this situation is minimal, but it is the clarion call to people who work with livestock to get both the seasonal and the H1N1 flu shot," Dr. Arlene King said yesterday.

'REDUCED IMMUNITY'

"We have to do all we can to stop the transmission of viruses between people and animals. The risk is the potential changes to the virus against which people could have reduced or no immunity."

The Canadian Food Inspection Agency confirmed on Friday that birds at an Ontario farm were infected with the H1N1 virus.

While provincial authorities refused to name the outfit, the Turkey Farmers of Canada website identified the operation as Hybrid Turkeys, a breeder based in Kitchener,

According to the company's website, Hybrid Turkeys is one of the two major turkey breeding companies worldwide and Canada's only primary turkey breeder.

Dr. Jim Clark, of the Canadian Food Inspection Agency, said there were about 3,500 birds at the farm and it's likely most were infected.

The CFIA's National Centre for Foreign Animal Disease in Winnipeg found "good evidence" of the virus in samples sent there, he said.

It's likely the illness passed from a human to the animals, Clark said.

"The poultry industry and the swine industry need to develop effective biosecurity measures to exclude any person ill with the disease from interaction with animals."

Dr. Deb Stark, Chief Veterinarian for Ontario, said it appears a worker at the farm, who experienced some signs of the flu, may have passed the virus to the birds.

"When it comes to influenza, we're all in this together," Stark said. "And that includes the animals."

The company voluntarily isolated the flock immediately after a drop in egg production was noted, Stark said.

Hybrid Turkeys issued a news statement last night that confirmed the H1N1 virus was found in one flock that is expected to fully recover.

'HUMAN TRANSMISSION'

"The most likely source of the virus is from human transmission," the statement says.

A limited number of employees prior to the egg production drop exhibited "cold-like" symptoms and one sought medical attention. Employee health is being monitored and some employees are now being tested for the virus.

"Influenza is not transmissible from hatching eggs nor through the consumption of turkey meat, which continues to be a safe, healthy product," the company says.

The affected turkeys produce eggs for breeding purposes and are not meant for the food supply.

The information on the ferret will be in the next post....Thank you.
 
 
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« Reply #371 on: October 21, 2009, 11:00:29 AM »


Is Your Ferret Sneezing? Pet Catches H1N1 Flu

October 20, 2009 05:21 PM ET | Nancy Shute | Permanent Link | Print

Kids aren’t the only critters getting sick with swine flu; a ferret has come down with it, too. The pet's owners took their ferret to a vet in Portland, Ore., on October 5, and the ferret’s nose mucus tested positive for genetic markers for H1N1 flu. Scientists have known for a long time that ferrets can get human flu; in fact, they use ferrets in the laboratory to test flu treatments. But ferrets are also popular pets. In this case, first reported in the Oregonian, it sounds like the ferret got the flu from its owner. And it appears to be the first reported case of H1N1 flu traveling from people to animals.

That’s not all the animal flu news today. A pig at the Minnesota State Fair also tested positive for H1N1. Human and pig influenza viruses are very similar and can infect both species, but there’s no indication that the state-fair pig has infected any humans. (Here’s the federal Department of Agriculture's press release on the swine with swine flu.)

The sick pig and ferret remind us that flu isn't just a human disease. Birds get it, too, and the avian flu that’s been causing deaths in Asia has been spread by migratory birds, domestic ducks, and chickens, though there have been no infections of birds with either H1N1 or avian flu in the United States. The nation’s hog farmers are understandably worried that people will stop eating pork if H1N1 is infecting pigs. But the Department of Agriculture says humans cannot contract H1N1 from eating pork. The infection of one show hog in St. Paul doesn’t pose much of a threat to anyone, except perhaps its handlers. (Full disclosure: Long ago my grandfather was a hog judge at the Minnesota State Fair, and I’m very fond of swine, so my heart goes out to that sick piggy.)

But enough of sick pigs; this blog’s about kids, and kid health. Many parents are nervous about giving their children the H1N1 vaccine. I went ahead and got my child vaccinated for H1N1 last week. So far, she’s had no side effects or other problems. But I understand parents’ fears of a new vaccine and the hope that there might be other alternatives out there to protect your children. If you’re looking for flu-fighting alternatives online, though, be skeptical. Many of them are scams. The Food and Drug Administration’s searchable list of fraudulent H1N1 flu cures includes bogus vaccines, body washes, and hand sanitizers. And the Federal Trade Commission, in a letter to the popular natural-products website drweil.com, said the site had better quit saying that its Immune Support Formula, which is listed as containing the astragalus plant and polypore mushrooms, including reishi, “can help ward off colds and flu.” (The Dr. Weil website has taken down the pages referring to Immune Support Formula.) Astragalus has been used in Chinese medicine for centuries, but there’s no evidence it works as a flu cure. Reishi has long been used as a tonic in Asia and has gotten a lot of attention from cancer patients and researchers in the United States. Studies have found that reishi has enough of an immune-modulating effect that it shouldn’t be used by patients taking immune-suppressing drugs. But again, there's no evidence that it will help ward off flu.

So, there’s no all-natural silver bullet for preventing the flu. Hand-washing helps, as does avoiding people who are sick. Not touching your face helps, since that transfers germs to the mouth and nose, but try telling that to a kid! Then there is the H1N1 flu vaccine. The vaccine sparked a strong immune response in children ages 10 to 17 when tested this summer, so children who get immunized once should be armed to fight off the virus. (The National Institute of Allergy and Infectious Diseases H1N1 website has lots of information on H1N1 flu vaccine trials, including new trials for people with asthma.) Children under age 10 responded less strongly to the vaccine in clinical trials, which is why two doses of vaccine a month apart are recommended for them. Supply has been slow getting into the pipeline, but almost 6 million H1N1 vaccines doses had been shipped as of last week. You know where I stand on this one: When it comes to protecting my child from a potentially fatal new flu, I’m going with the vaccine.



http://health.usnews.com/blogs/on-parenting/2009/10/20/is-your-ferret-sneezing-pet-catches-h1n1-flu.html
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« Reply #372 on: October 24, 2009, 03:22:17 PM »

PRESIDENT OBAMA DECLARES SWINE FLU (H1N1) EMERGENCY TODAY - 10/24/09

Emergency Use Authorization of Medical Products
Guidance - Emergency Use Authorization of Medical Products


For single copies of this guidance, please contact:

Office of Counterterrorism Policy and Planning (HF-29)
Office of the Commissioner
Food and Drug Administration
5600 Fishers Lane, Room 14C-26
Rockville, MD 20857
(Phone 301-827-4067)

U.S. Department of Health and Human Services
Food and Drug Administration
Office of the Commissioner
Office of Counterterrorism Policy and Planning

July 2007  (This is the date of this policy - not of the President's declaration)

 


--------------------------------------------------------------------------------

 

 

TABLE OF CONTENTS
I. INTRODUCTION

II. DECLARATION OF EMERGENCY

Publication

III. ELIGIBILITY FOR AN EMERGENCY USE AUTHORIZATION (EUA)

Categories of Products
Effectiveness
Risk-Benefit Analysis
Alternatives to the Product

IV. REQUEST FOR CONSIDERATION FOR AN EUA

Pre-Emergency Activities
Emergency Activities
Submission of a Request for Consideration
Summary of Recommended Data to Support a Request for Consideration
Recommended Safety Data
Recommended Effectiveness Data
Other Data Considerations
Discussion of Risks and Benefits
Format of Submissions

V. PROCESSING OF AN EUA

Prioritization of Pre-Emergency Activities
Review of Pre-Emergency Submissions
Prioritization of Requests for Consideration for an EUA During a Declared Emergency
Review Process for a Request for Consideration for an EUA
Timelines for Review

VI. CONDITIONS OF AUTHORIZATION

Conditions of Authorization for Emergency Use of an Unapproved Product
Conditions of Authorization for Emergency Use of an Approved Product for an Unapproved Use
Additional Conditions of Authorization
Summary of Conditions of Described in Section 564(e)
Option To Carry Out Authorized Activities
Rules of Statutory Construction

VII. REVOCATION OR TERMINATION OF AN EUA

Revocation
Termination
Continued use

VIII. PREEMPTION

IX. LIABILITY PROTECTION AND COMPENSATION UNDER OTHER STATUTES

APPENDIX A - Fact sheet for the Health Care Provider or Authorized Dispenser

APPENDIX B - FACT SHEET for the Recipient

APPENDIX C – CONTACT INFORMATION for Liability and Compensation Programs Under Other Statutes

 


--------------------------------------------------------------------------------

 

GUIDANCE1
Emergency Use Authorization of Medical Products
 

This guidance document represents the Food and Drug Administration's (FDA's) current thinking on this topic. It does not create or confer any rights for or on any person and does not operate to bind FDA or the public. You may use an alternative approach if the approach satisfies the requirements of the applicable statutes and regulations. If you want to discuss an alternative approach, please contact the appropriate FDA staff.

 

 

 I. INTRODUCTION
This guidance explains FDA's policies for authorizing the emergency use of medical products under section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) (21 U.S.C. 360bbb-3), which was amended by the Project BioShield Act of 2004 (Public Law 108-276).2 Section 564 permits the FDA Commissioner to authorize the use of an unapproved medical product or an unapproved use of an approved medical product during a declared emergency involving a heightened risk of attack on the public or U.S. military forces, or a significant potential to affect national security.

The Emergency Use Authorization (EUA) authority recently granted by Congress allows the FDA Commissioner to strengthen the public health protections against biological, chemical, radiological, and nuclear agents that may be used to attack the American people or the U.S. armed forces. Under section 564, the FDA Commissioner may allow medical countermeasures to be used in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions caused by such agents, when there are no adequate, approved, and available alternatives.

The document is intended to inform industry, government agencies, and FDA staff of the Agency's general recommendations and procedures for issuance of EUAs.3 FDA expects that requests for consideration for an EUA would be submitted by government agencies (e.g., the Department of Health and Human Services or the Department of Defense (DoD)) or private entities. FDA may seek additional data and information on a case-by-case basis to ensure that the statutory criteria for issuance of an EUA are met.

Additionally, the Secretary of Health and Human Services (the Secretary) will establish a permanent Emergency Use Authorization Working Group (EUA WG), headed by the Assistant Secretary for Preparedness and Response (ASPR), with representatives from FDA, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Department of Defense (DoD), the Department of Homeland Security (DHS), the Department of Veterans Affairs and, as appropriate, participants from other Federal agencies, to identify and provide expert consultation on potential EUA candidates prior to and during declared emergencies.

FDA's guidance documents, including this guidance, do not establish legally enforceable responsibilities. Instead, guidances describe the Agency's current thinking on a topic and should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited. The use of the word should in Agency guidances means that something is suggested or recommended, but not required.

 

 II. DECLARATION OF EMERGENCY
Section 564(b)(1) of the FD&C Act provides that, before an EUA may be issued, the Secretary must declare an emergency based on one of the following grounds:

a determination by the Secretary of Homeland Security that there is a domestic emergency, or a significant potential for a domestic emergency, involving a heightened risk of attack with a specified biological, chemical, radiological, or nuclear agent or agents;
a determination by the Secretary of Defense that there is a military emergency, or a significant potential for a military emergency, involving a heightened risk to United States military forces of attack with a specified biological, chemical, radiological, or nuclear agent or agents; or
a determination by the Secretary of a public health emergency under section 319 of the Public Health Service Act (PHS Act) that affects, or has the significant potential to affect, national security, and that involves a specified biological, chemical, radiological, or nuclear agent or agents, or a specified disease or condition that may be attributable to such agent or agents.
Once the Secretary has declared an emergency justifying an authorization under section 564 to use an unapproved medical product or an approved product for an unapproved use, the ASPR may convene the EUA Working Group to provide expert consultation to the FDA.4 Based on his review of the information and data submitted to the Agency and input from the EUA WG (if convened) and after consulting with the Director of NIH and the Director of CDC (to the extent feasible and appropriate given the circumstances of the emergency), the FDA Commissioner may authorize the emergency use of a particular product, assuming other statutory criteria and conditions are met.5

Section 564(b)(2) states that a declaration of emergency will terminate one year after issuance or earlier if the Secretary determines, in consultation (as appropriate) with the Secretary of Homeland Security or the Secretary of Defense, that the circumstances that precipitated the declaration have ceased. Before a declaration terminates, the Secretary must provide, under section 564(b)(3), advance notice that is sufficient to allow for disposition of unapproved product or any labeling or other information provided related to an unapproved use of an approved product. Section 564(b)(2)(B) also authorizes the Secretary to renew a declaration.

 Publication: The Secretary will promptly publish in the Federal Register notice of each determination of actual or potential emergency, the Secretary's declaration of emergency, advance notice of termination, and renewal of a declaration issued under section 564(b).6 The FDA Commissioner will promptly publish in the Federal Register a notice of each authorization, including an explanation of the reasons for issuance, a description of the intended use of the EUA product, and its indications and contraindications. The FDA Commissioner also will promptly publish in the Federal Register each termination or revocation of an authorization and an explanation of the reasons for the decision.7 In addition, FDA plans to provide notice of an emergency use authorization on the Agency's website, at www.fda.gov, and through announcements disseminated to the media.8

Much more information....click on link below...

http://www.fda.gov/RegulatoryInformation/Guidances/ucm125127.htm#declaration
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« Reply #373 on: October 24, 2009, 03:31:05 PM »

CDC - Emergency Use Authorization

Emergency Use Authorization (EUA) of Medical Products and Devices

What is EUA?
What are the products currently under EUA?
Why is EUA necessary?
FDA Related Information
Site last updated October 23, 2009 8:00 PM ET


What is EUA?
Questions & Answers

What are the products currently under EUA?
CDC-requested and FDA-issued EUA Products:

Antiviral Drugs:

Tamiflu (oseltamivir)
Relenza (zanamivir)
Peramivir IV
Devices:

N95 Respirators
rRT-PCR Flu Panel (NPS, NS, TS, NPS/TS, NA)
rRT-PCR Swine Flu Panel (also referred to as Swine Flu Test Kit)
For other medical products also currently FDA-authorized for use under EUAs (requested by non-CDC entities) in response to novel H1N1 flu (swine flu), please visit the FDA 2009 H1N1 Virus site and scroll down to the section entitled FDA Regulated Products.

Why is EUA necessary?
Reasons for Tamiflu EUA

Reasons for Relenza EUA

FDA Related Information
FDA News Release

EUA Guidance Document

FDA 2009 H1N1 Virus site

FDA Information for Healthcare Professionals - Authorization of Use of Expired Tamiflu for Oral Suspension

For questions regarding EUAs, contact: EUA.OCET@fda.hhs.gov

EUA Online Course
An EUA online course developed by the Food and Drug Administration and Centers for Disease Control and Prevention to provide public health officials, emergency managers, or SNS coordinators with an introduction to the Emergency Use Authorization of medical products.

Note: Continuing Education Units (CEUs) are not offered for the EUA course.

Links to non-federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the federal government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.

 

 
Contact Us:
Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333
800-CDC-INFO
(800-232-4636)
TTY: (888) 232-6348
24 Hours/Every Day
cdcinfo@cdc.gov

Lots of information at the link below.....

http://www.cdc.gov/H1N1flu/eua/
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« Reply #374 on: October 24, 2009, 03:39:03 PM »

Recommended Link for Information Throughout the World....

FluTrackers.com  -  take a look, click on oval red button "latest posts" - and see what is happening.

Lots of good information throughout this forum.  Find the United States and it's Regions to see what is happening in your State.
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« Reply #375 on: October 24, 2009, 03:42:04 PM »

Recommended Link for Information Throughout the World....

FluTrackers.com  -  take a look, click on oval red button "latest posts" - and see what is happening.

Lots of good information throughout this forum.  Find the United States and it's Regions to see what is happening in your State.

Try clicking on this link - http://www.flutrackers.com   
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« Reply #376 on: October 28, 2009, 11:57:19 AM »


CDC - Pneumococcal Infections - Prevention
 
Prevention Of Pneumococcal Infections Secondary To Seasonal And 2009 H1N1 Influenza Viruses Infection
October 23, 2009, 5:00 PM ET

Pneumococcal Disease Complicating Influenza

Influenza predisposes individuals to developing bacterial community-acquired pneumonia. During each of the influenza pandemics of the 20th century, secondary bacterial pneumonia was a frequent cause of illness and death and Streptococcus pneumoniae (pneumococcus) was reported as the most common etiology. These findings also apply to seasonal influenza.

S. pneumoniae remains a leading cause of vaccine-preventable illness and death in the United States. Recently, pneumococcal infections have been identified as an important complication in severe and fatal cases of 2009 H1N1 influenza virus infection. Importantly however, approximately 70 million persons with existing pneumococcal polysaccharide vaccine (PPSV) indications (Table) are unvaccinated (National Health Interview Survey, 2007).

 
Pneumococcal Vaccines

During the 2009-2010 influenza season, pneumococcal vaccines can be useful in preventing secondary pneumococcal infections and reducing illness and death among those infected with influenza viruses. Currently, a pneumococcal polysaccharide vaccine (PPSV) is available for prevention of pneumococcal disease among adults and children 2 through 64 years who are at increased risk for pneumococcal disease. All children less than 5 years of age should continue to receive pneumococcal conjugate vaccine (PCV7) according to existing recommendations. 

Use of PPSV during the 2009 H1N1 Influenza Pandemic

CDC’s Advisory Committee on Immunization Practices (ACIP) recommends a single dose of PPSV for all people 65 years of age and older and for persons 2 through 64 years of age with certain high-risk conditions (Table). Most people in these groups are at increased risk of pneumococcal disease as well as serious complications from influenza viruses infections. A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years. A single revaccination is also recommended as well as for people at highest risk of disease, such as those who have functional and anatomical asplenia, and those who have HIV infection, AIDS  or malignancy and have at least five years elapsed from receipt of first vaccination.

All people who have existing indications for PPSV should continue to be vaccinated according to current ACIP recommendations during the 2009 H1N1 influenza pandemic. Special emphasis should be placed on vaccinating people 2 through 64 years who have established high-risk conditions for pneumococcal disease; PPSV coverage among this group is low and this group may be more likely to develop secondary bacterial pneumonia after an influenza infection.

Use of PPSV among people without current indications for vaccination is not recommended at this time. 

Simultaneous Administration of Pneumococcal (PPSV) and Influenza Vaccines

Pneumococcal vaccine can be given at any time during the year and may be given at the same time as influenza vaccine. Visits for seasonal and 2009 H1N1 influenza vaccination provide a convenient time to evaluate patients for the need for pneumococcal vaccination. Persons who cannot remember if they’ve ever had pneumococcal vaccine should be still be vaccinated.

Table: U.S. ACIP Recommendations for use of Pneumococcal Polysaccacharide Vaccine 
 Pneumococcal polysaccharide vaccine (PPSV)
 


Universal vaccination
 All adults 65 years of age and older
 
 
Medical Indications
 Persons 2 through 64 years of age who have one or more of the following long-term health problems:
 
 
 chronic cardiovascular disease (congestive heart failure and cardiomyopathies)
chronic pulmonary disease (including chronic obstructive pulmonary disease and emphysema)
diabetes mellitus
alcoholism
chronic liver disease (including cirrhosis)
cerebrospinal fluid leaks, cochlear implant
functional or anatomic asplenia including sickle cell disease and splenectomy
immunocompromising conditions including HIV infection, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an organ or bone marrow transplant
residents of nursing homes or long-term care facilities
 
Adults 19 through 64 years of age who:
 
 smoke cigarettes
 have asthma
 

Related Links

Questions and Answers  for patients about prevention of pneumococcal infections secondary to influenza
Recommended adult immunization schedule - United States, 2009
Pneumococcal polysaccharide vaccine. Vaccine information statement (VIS) (PDF)
Interim guidance for use of 23-valent pneumococcal polysaccharide vaccine during novel influenza A (H1N1) outbreak 
ACIP Recommendations for Pneumococcal Vaccines
CDC's Morbidity and Mortality Weekly Report (MMWR):
Bacterial Coinfections in Lung Tissue Specimens from Fatal Cases of 2009 Pandemic Influenza A (H1N1) --- United States, May--August 2009; September 29, 2009 / 58(Early Release);1-4
CDC’s Clinician Outreach and Communication Activity (COCA)
September 28 - Bacterial Coinfections and the 2009 H1N1 Influenza Pandemic (Interim Transcript  (PDF), Audio )
 
Link to http://www.cdc.gov/h1n1flu/guidance/ppsv_h1n1.htm
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« Reply #377 on: October 28, 2009, 12:02:35 PM »

WHO - Update 71

Pandemic (H1N1) 2009 - update 71
Weekly update

As of 17 October 2009, worldwide there have been more than 414,000 laboratory confirmed cases of pandemic influenza H1N1 2009 and nearly 5000 deaths reported to WHO.

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

New Activity:

Mongolia, Rwanda, and Sao Tome and Principe have reported pandemic influenza cases for the first time this week.

Iceland, Sudan, and Trinidad and Tobago reported their first fatal cases.

Situation update:

In general, influenza activity in the northern hemisphere is much the same as in the last week, though respiratory disease activity continues to spread and increase in intensity. In North America, the U.S.A. is still reporting nationwide rates of Influenza-Like Illness (ILI) well above baseline rates with high rates of pandemic H1N1 2009 virus detections in clinical laboratory specimens (29% of all specimens tested are positive for influenza A and all of those subtyped are pandemic H1N1 2009 virus. Canada reports increases in ILI rates for the fourth straight week but the highest level of activity is in the western province of British Columbia. Mexico still reports active transmission in some areas of the country. Although influenza activity is low in most countries in Europe, in Belgium, Israel, the Netherlands, Norway, and parts of the United Kingdom consultation ILI/ARI rates are above baseline levels. Similarly the number of influenza virus detections relatively high, which may indicate the early start of an influenza season. Rates of respiratory illness in Eastern Europe and Northern Asia are increasing but are not yet at levels normally seen in an influenza season (baseline levels are not defined in many countries of the area). Of note, the proportion of cases in Asia that are related to seasonal influenza A(H3N2) continue to decline globally as the proportion related to pandemic H1N1 2009 virus increases. Currently, only East Asia is reporting any significant numbers of influenza A(H3N2) isolates.

In tropical areas of the world, rates of illness are generally declining, with a few exceptions. Cuba, Colombia, and El Salvador are reporting increases in the tropical region of the Americas. In tropical Asia, of the countries that are reporting this week, all report decreases in respiratory disease activity.

The temperate region of the southern hemisphere has no significant pandemic related activity in the past week.
 
....then link to the remainder of this article....
http://www.who.int/csr/don/2009_10_23/en/index.html
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« Reply #378 on: October 28, 2009, 12:06:33 PM »

CDC - NEJM Article - Study of Hospitalized Patients

Questions and Answers: NEJM article "Hospitalized Patients with 2009 H1N1 Influenza in the United States- April-June 2009"
October 23, 2009, 12:00 PM ET

What was the purpose of this study?
The purpose of this study published by the New England Journal of Medicine (NEJM) was to analyze the clinical characteristics of patients hospitalized with 2009 H1N1 flu virus infections in the United States during April through June 2009. This article is available online at NEJM.org.

How was this study conducted?
CDC researchers, in collaboration with state public health departments, analyzed the clinical characteristics of 272 patients hospitalized with 2009 H1N1 flu virus infections in the United States from April to mid-June 2009.
Cases were defined as any person hospitalized for 24 hours or more with influenza-like illness (ILI)* and who tested positive for 2009 H1N1 by real-time reverse transcriptase polymerase chain reaction (rRT-PCR)**.


Continue this article at link below:

http://www.cdc.gov/h1n1flu/njem_qa.htm
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« Reply #379 on: October 28, 2009, 12:12:47 PM »

CDC - Pneumococcal Infections - Prevention

Prevention Of Pneumococcal Infections Secondary To Seasonal And 2009 H1N1 Influenza
October 23, 2009, 4:30 PM ET


What is Pneumococcal Disease?
Pneumococcal disease is an infection caused by a type of bacteria called Streptococcus pneumoniae (pneumococcus). When these bacteria invade the lungs, they can cause pneumonia. They can also invade the bloodstream (bacteremia) and/or the tissues and fluids surrounding the brain and spinal cord (meningitis). Pneumococcal infection kills thousands of people in the United States each year, most of them 65 years of age or older.

What are the Symptoms of Pneumococcal Disease?
The symptoms of pneumococcal pneumonia include fever, cough, shortness of breath, and chest pain. The symptoms of pneumococcal meningitis include stiff neck, fever, mental confusion and disorientation, and visual sensitivity to light (photophobia). The symptoms of pneumococcal bacteremia may be similar to some of the symptoms of pneumonia and meningitis, along with joint pain and chills.

Why is Prevention of Pneumococcal Disease Important during Influenza Season?
Influenza infections can make people more likely to develop bacterial pneumonia.  Pneumococcus is the most common cause of bacterial pneumonia. Pneumococcal infections are a serious complication of seasonal and 2009 H1N1 influenza infections and can cause death.

How can High-Risk Individuals Protect Themselves from Pneumococcal Disease?
There is a vaccine to protect high-risk individuals 2 through 64 years of age against serious pneumococcal disease. The vaccine, pneumococcal polysaccharide vaccine (PPSV), is safe and effective. Most people need a single dose of the pneumococcal vaccine in a lifetime. All children less than 5 years of age should receive a different vaccine called pneumococcal conjugate vaccine (PCV7); high risk children 2 to 4 years of age need both pneumococcal vaccines. 

Who should get Pneumococcal Polysaccharide Vaccine (PPSV)?
Approximately 70 million people who should be receiving PPSV are not yet vaccinated (National Health Interview Survey, 2007). View chart showing who is not yet vaccinated.

PPSV is recommended for:

People who are 65 years of age and older
People 2 years of age and older who have a chronic illness such as:
cardiovascular or lung disease
sickle cell disease
diabetes
alcoholism
chronic liver disease
cerebrospinal fluid (CSF) leak
a cochlear implant
People 2 years of age and older with a weakened immune system
Due to illnesses such as:
HIV infection
AIDS
chronic renal failure
nephrotic syndrome
organ or bone marrow transplantation
Hodgkin’s disease
leukemia
lymphoma
multiple myeloma
generalized malignancy
Those receiving immunosuppressive therapy (e.g., steroids)
Those who have had their spleen removed or whose spleen is dysfunctional due to an illness such as sickle cell disease.
Residents of nursing homes or long-term care facilities
People 19 through 64 years of age who smoke cigarettes or have asthma.

During the 2009-2010 influenza season, vaccinating people 2 through 64 years of age who have the above risk conditions is most important because people in this group may be more likely to develop secondary bacterial pneumonia after an influenza infection.
Healthy persons less than 65 years of age are not recommended to receive PPSV. 

Can Adults get Pneumococcal (PPSV) and Influenza Vaccines at the Same Time?
Yes, pneumococcal vaccine may be given at the same time as influenza vaccine. Pneumococcal vaccine can be given at any time during the year. Because the adult groups for whom pneumococcal and seasonal influenza vaccines are recommended are similar, the need for pneumococcal vaccination should be evaluated at the time of annual influenza vaccination. The need for pneumococcal vaccination should also be evaluated at the time of 2009 H1N1 influenza vaccination. Persons who cannot remember if they’ve ever had pneumococcal vaccine should still be vaccinated.

During the 2009-2010 influenza season, work with your healthcare provider to determine when you can get your pneumococcal, seasonal influenza, and 2009 H1N1 influenza vaccines.

Is the Pneumococcal Vaccine (PPSV) Safe?
The pneumococcal vaccine is considered safe. Some people experience mild side effects, but these are usually minor and last only a short time. When side effects do occur, the most common include swelling and soreness at the injection site. A few people experience fever and muscle pain. Anyone who has a severe allergy to any component of the vaccine should not get that vaccine. As with any medicine, there are very small risks that serious problems could occur after getting the vaccine. However, the potential risks associated with pneumococcal disease are much greater than the potential risks associated with the pneumococcal vaccine. You cannot get pneumococcal disease from the vaccine. 

Ask your healthcare provider if you should delay receiving the pneumococcal vaccine if you have an illness with fever or other active infection. 


Related Links
Pneumococcal vaccine website
Pneumococcal Polysaccharide Vaccine: Vaccine Information Statement
Pneumococcal Conjugate Vaccine: Vaccine Information Statement
H1N1 Vaccination Resources


Entire article at this link:
http://www.cdc.gov/h1n1flu/vaccination/public/public_pneumococcal.htm
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