H1N1 - Swine Flu - Novel Flu - Information

[Mere]

FTC - Internet Scam Warnings

FTC Warns Internet Peddlers that Marketing Unproven H1N1 Flu Products May Be Illegal

The Federal Trade Commission last week sent 10 warning letters to Web site operators who made questionable claims that their products can prevent, treat, or cure the H1N1 flu, commonly known as swine flu.

In an ongoing effort that began during the spring, the FTC told the companies – whose products include dietary supplements, air filtration devices, homeopathic remedies, items containing silver, and cleaning agents – that unless they have scientific proof for their claims, they are violating federal law and must drop the claims or face further action.

The FTC conducted its swine flu surf as part of the International Consumer Protection Enforcement Network’s 11th Internet sweep, which took place from September 21 to 25, 2009.

 As part of this sweep, consumer protection agencies around the world targeted rapidly growing fraudulent and deceptive conduct on the Internet, with special emphasis on conduct exploiting financial crises or natural disasters such as the H1N1 pandemic.

Besides sending warning letters to 10 operators, the FTC referred 14 other Web site operators – which it suspects are located outside the United States – to foreign law enforcement authorities.

“As consumers grow increasingly anxious about obtaining the H1N1vaccine for their children and other vulnerable family members, scam artists take advantage by selling them bogus remedies online,” said David Vladeck, Director of the FTC’s Bureau of Consumer Protection.

In collaboration with other enforcement agencies, including the U.S. Food and Drug Administration, the FTC will continue to work aggressively to identify, investigate, and take additional regulatory and law enforcement action against individuals or businesses that deceptively promote purported H1N1 products.

The FTC reminds consumers that the only products recommended for treatment of H1N1 flu are prescription antiviral drugs, including oseltamivir (brand name Tamiflu) and zanamivir (brand name Relenza).

The FTC’s Consumer Alert, Rx for Products That Claim to Prevent H1N1? A Healthy Dose of Skepticism, warns the public to be skeptical of claims that products like pills, air filtration devices, and cleaning agents can kill or eliminate the virus. The alert advises consumers to:

Know the facts: The H1N1 virus is thought to spread from person to person in the same way that seasonal flu spreads – mainly coughing or sneezing by people with the flu.

Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth, nose, or eyes.

Keep your hands clean: Public health authorities advise that basic personal hygiene is the best protection against infection. Wash your hands thoroughly. When soap and water are not available, health authorities suggest using alcohol-based disposable hand wipes or gel sanitizers. These products are available in most supermarkets and drugstores.
 
Check travel advisories for affected areas: To lower your risk of infection, the Centers for Disease Control and Prevention (CDC) suggests avoiding travel to affected regions.
 
Seek medical attention: If you think either you may have influenza symptoms, or you may have been in direct contact with someone who has the flu, consult a health care professional immediately.
 
Stay informed: For more information from the federal government about the H1N1 flu, check out flu.gov or visit the CDC at http://www.cdc.gov/h1n1flu/.

To learn more, go to http://www.ftc.gov/bcp/edu/pubs/consumer/alerts/alt083.shtm.
 
Entire article here....
http://www.ftc.gov/opa/2009/11/h1n1.shtm

[Mere]

CDC - Update

2009 H1N1 Flu
Site last updated November 17, 12:00 PM ET

Situation Update

During the week of November 1-7, 2009, influenza activity remained high in the United States, with some key indicators decreasing slightly and others continuing to climb as reported in FluView.

Flu activity is widespread in 46 states.

Nationally, visits to doctors for influenza-like-illness declined slightly from last week, but are still very high. Flu-related hospitalizations and deaths continue to increase and are very high nation-wide compared to what is expected for this time of year.

See More On Key Flu Indicators »

Continue reading here.....
http://www.cdc.gov/h1n1flu/

[seahorse]

CDC - Update

2009 H1N1 Flu
Site last updated November 17, 12:00 PM ET

Situation Update

During the week of November 1-7, 2009, influenza activity remained high in the United States, with some key indicators decreasing slightly and others continuing to climb as reported in FluView.

Flu activity is widespread in 46 states.

Nationally, visits to doctors for influenza-like-illness declined slightly from last week, but are still very high. Flu-related hospitalizations and deaths continue to increase and are very high nation-wide compared to what is expected for this time of year.

See More On Key Flu Indicators »

Continue reading here.....
http://www.cdc.gov/h1n1flu/

Thank-you for the update.

[seahorse]

http://**/lifestyles/ci_9236533


Consumer Reports analyzes probiotics
By The Denver Post

Consumer Reports test:
snip:

(bottom of article)

Know your bugs
Bacteria: Single-celled microorganisms. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria play an important role in maintaining a healthy body.

Bifidobacterium: A genus of "friendly" bacteria that lives in our large intestine and helps to beneficially modulate the Immune system. Commonly used genus for probiotic applications.

Inflammatory bowel disease (IBD): Two types of disease, Crohn's disease and ulcerative colitis. Both are a chronic inflammation of the intestine. Ulcerative colitis is limited to the colon, while Crohn's can be anywhere between the stomach and anus. Not to be confused with irritable bowel syndrome (IBS).


snip...

[Mere]

Good Morning.....the following article was published in the DesMoines Register although I read it initially at FluTrackers.com.....

Families shocked by how fast flu can hit
Posted In: Life Sciences

By REID FORGRAVEAssociated Press
Sunday, November 15, 2009

     
     
Email
Print
Eighty-year-old Lucy McKenzie led her family down Westminster Presbyterian Church's aisle this week, walking past hundreds who gathered at the Des Moines church to remember her son.

The pastor stood at the pulpit and asked the question haunting the minds of many: How could Doug McKenzie, a 54-year-old computer analyst from Clive, with a big belly, a big laugh and a big heart, be gone so soon? How could a man who loved to camp and canoe with his son be healthy one week and dead the next?

"Most of us come here startled," the Rev. Ken Arentson began. "Death seems to have come like the biblical thief in the night, stolen Doug away from all who love him. We wonder at it all, at all the medical explanations about viral pneumonia, and H1N1 and the effect on the body."

The pastor paused. Even doctors struggle to explain why H1N1 influenza strikes a fraction of its victims so hard and so fast.

All the explanations "don't change the fact that death has come crashing in upon us," he said.

Most flu victims recover after a week, but some don't even survive that long. In Iowa, 19 deaths have been confirmed as being caused by H1N1, and more than 500 Iowans have been hospitalized with the virus, according to the state health department.

The thief that stole Lucy McKenzie's son was the virus that has concerned public health officials in Iowa and nationwide. The H1N1 flu has hospitalized nearly 100,000 Americans and killed about 4,000.

For many of us, the virus is just a small worry in our daily lives: Wash your hands, or you'll be stuck in bed for a week with a bad cough and a weak body. We post signs at the workplace, we stand in line for a vaccine, we shrug, we hope for the best.

For Lucy McKenzie, the fast-moving virus took her son before he could say goodbye.

The day before the funeral, McKenzie sat at the Des Moines home where she raised her five sons. She pulled out a photograph of Doug. He was smiling broadly, sipping wine at her surprise birthday party a couple of months ago. He was a man who loved jigsaw puzzles and baking bread, fiddling with computers and writing poetry. He often took his mother to dinner and a movie, and he loved making steak and potatoes for his only son, a 21-year-old Iowa State University student.

"He wasn't afraid of death," Cameron McKenzie said of his father. "He wouldn't have minded having a heart attack over a giant steak. He would have been happy with that."

Ten days ago, Doug McKenzie called his mother. He was having trouble breathing and was heading to the hospital. He asked his mother to call his son. Tell him to take out the dog, Doug McKenzie said.

The next day, a tube was placed in his throat. He was put on sedatives. A machine helped him breathe. Soon, his lungs collapsed, his kidneys failed, his heart gave out.

And one week later, Doug McKenzie was dead.

We all know the early signs of the H1N1 virus. They're not much different from the seasonal flu: a fever, a cough, a sore throat, a runny or stuffy nose, an achy body and head, chills and fatigue. Sometimes there is diarrhea and vomiting. For most, it's a week of pure misery.

We all know the best ways to avoid infection. It's not much different from avoiding any seasonal flu: Wash your hands, cover your cough with a tissue or a sleeve, get vaccinated, stay home if you are sick.

But less publicized are instances like Doug McKenzie's. For people like him, the signs are more dire: difficulty breathing, chest pain, lips turning purple or blue, dizziness, an inability to keep down liquids, an inability to urinate.

These patients, the vast majority of whom are between the ages of 18 and 64, are put on a ventilator, some for weeks. Sedatives relax the body and aid the ventilator.

H1N1 was first diagnosed in Mexico in April and quickly spread to more than 70 countries.

One in 14 Americans are estimated to have been infected with the virus, a total of more than 22 million cases since spring, according to the U.S. Centers for Disease Control and Prevention. That's more cases than in any other country, although most infected people have recovered without medical treatment.

"They're just estimates," said Dan Diekema, an epidemiologist and professor of infectious diseases at the University of Iowa. "We have to live with the fact we don't really know how many people have been infected with H1N1 because we don't have the ability to test everybody."

Meanwhile, seasonal flu activity is considered widespread in 46 states, including Iowa, according to the CDC.

That's important, because about 36,000 Americans a year die from seasonal flu and associated infections.

"People say, 'Oh well, it's just the flu,' " said Sandy Peno, a nurse epidemiologist at Iowa Methodist Medical Center. "But it's not just the flu. People can become very, very ill with just flu."

The last pandemic came through 50 years ago. That means people over the age of 65 tend to have an immunity to H1N1, said Daniel Gervich, medical director of infection control at Mercy Medical Center.

The problem isn't that this strain is particularly virulent; it's that the immune systems of people under 65 tend to respond slowly because they don't have an immunity. That lets the virus gain a foothold.

Another wave or two of H1N1 through the winter, combined with the onset of seasonal flu, will likely make this one of the worst flu seasons in 50 years, Gervich said. Most victims will be bedridden a few days. Some will be hospitalized. A few will be like Doug McKenzie.

McKenzie was overweight but had no major health problems. At the end of October, he began struggling to breathe. After that, the virus moved fast.

"The way they look at the end is terrible," said Lucy McKenzie. "All these machines beeping and buzzing, him slowly sedated. It's very hard to think of your son that way."

And if you're Jessica Johnson, the problem is multiplied.

When the 29-year-old Monroe woman was admitted to the hospital on Halloween with a severe shortness of breath, she was 28 weeks pregnant.

Dr. Roger Harvey walked into the eighth-floor room at Iowa Methodist Medical Center last week. When he saw the young woman sitting in the chair, the infectious disease doctor took a double-take.

Jessica Johnson — on a ventilator less than a week ago, on the verge of death because of H1N1 — smiled at him. She pointed at her face: no tubes pumping oxygen into her body.

The doctor couldn't believe it.

"They took it off yesterday," she said, laughing.

"Wow," Harvey exclaimed. "You coughing any at all? Short of breath at all?"

"Not too bad."

"How are you doing with walking?"

"Good," she said. "They told me to slow down."

For the doctor, seeing Johnson's recovery was the best part of his week.

On Halloween, Johnson found herself severely short of breath. Her oxygen level was at about 70 percent of what it should have been. Chest X-rays showed her lungs full of fluid.

By the next morning, Johnson was breathing with an oxygen mask in Methodist's critical-care unit, where the worst H1N1 patients come. Soon she needed a ventilator, a feeding tube, an IV in her neck. Doctors said Johnson's chances at survival were a tossup, and they constantly monitored her baby.

Her husband, Adam Johnson, saw distraught families in the hospital whose loved one died from H1N1. Johnson's family and friends prayed her body would keep fighting.

"All you want to do is go in there, pull those tubes out of her mouth, put her in your arms and carry her out of here," said Johnson's father, Gary Grier.

Then, a week ago, something happened. Her family walked into the room, and she was sitting up in her hospital bed, only two tubes in her nose. The family was shocked at how fast the virus knocked her down, then how fast she improved. So were doctors. By Wednesday she was off oxygen.

Doctors are used to the average flu season. But this year they're seeing younger patients on ventilators who were healthy just days before. They're not used to seeing these young, relatively healthy patients struggling so mightily.

"That's what made Jessica so good," her doctor said, "because we had several patients dying at the same time."

On Friday afternoon, Johnson was discharged. Her baby is due in January. Her doctor told her to stay home a week before returning to her job as a first-grade teacher in Newton. But Johnson wasn't thinking of that. She was thinking of finally going home and seeing her dog, a puggle named Harlie.

Her family tried to think why they were put through this, and why Johnson survived while others in similar situations didn't.

"My biggest thing I see is how easy it is to lose somebody," Johnson's father said.

"You expect when you're sick, you go the doctor, then you're OK. But seeing how helpless she was, how helpless we were, how helpless the doctors were. There's some things you can't do."

___

Information from: The Des Moines Register, http://www.desmoinesregister.com

[Mere]

Hi....I am again reading at the website www.FluTrackers.com and would like to remind you of the wealth of information that is available.  If you scroll to the United States forum, you can locate your State and see what is occurring at this time.  If you click on the red oval "latest posts" you can read all that is happening worldwide.
Mere

Re: Ohio - Novel H1N1 Vaccine Availability


Doctors finally getting some H1N1 vaccine


Tuesday, November 17, 2009 8:56 PM
By Misti Crane
THE COLUMBUS DISPATCH


After a couple of months of fielding nonstop phone calls from sometimes-frantic parents and pregnant women seeking H1N1 vaccine, doctors' offices are finally receiving some doses.

The Ohio Department of Health gave a small amount to some practices early on. But after that, little vaccine made its way into the hands of doctors.

Because of an unexpectedly low supply, the state opted to send only to hospitals and health departments under the premise that they could best vaccinate large groups of people and could disseminate vaccine as needed.


Recently, Columbus Public Health and the Franklin County Board of Health began sharing some of what they had with high-volume practices. And this week, shipments have started to arrive at practices throughout the state, direct from the vaccine supplier.

That means it might be worth a call to your doctor before you head to a public-health clinic.


Some practices won't ever have vaccine because they didn't register with the state to receive it. In Franklin County, 46 private obstetrics and pediatrics practices were included on the list when the state ordered 182,700 more doses on Friday, bringing the state total to more than 1.6 million.


At Rainbow Pediatrics, they're working overtime but happy to finally be able to schedule clinics for their patients, said Kim Justus-Davis, the clinical manager, and Billie Jo Taylor, the office manager.

Rainbow has offices in New Albany and Dublin, and last week vaccinated more than 800 patients at two clinics after Franklin County shared some of its supply.


Justus-Davis said it was frustrating to not be able to offer vaccine earlier.


"It's a fantastic opportunity to be able to provide this to the community," Taylor said.


Providers are allowed to charge an administrative fee for the vaccine, which has been free at public-health clinics. Rainbow, which has planned another clinic for Thursday, has charged $15 to cover employee wages, Justus-Davis said.


"It's been crazy ever since this whole flu season hit," said Dr. Jennifer White of Riverside Pediatrics, which has now received about 4,000 doses, most of it from Columbus Public Health.


"We're just thrilled to have something to offer patients."


White said patients should be vaccinated even if they've already been sick and suspect it was the H1N1 virus, also known as swine flu.


Jose Rodriguez, spokesman for Columbus Public Health, said department leaders have been happy to share vaccine with doctors and welcome news that supplies have begun to arrive at physician practices.


"It really opens up our ability to serve people in a greater way," he said.


Originally, public-health leaders expected that retail outlets and doctors' offices would vaccinate more people and they'd serve as a safety net for those who couldn't be vaccinated elsewhere.


All vaccine at all providers is supposed to be reserved for members of the priority groups outlined by the Centers for Disease Control and Prevention.

So far, neither Franklin County nor the city has opened clinics to at-risk adults, who are on the CDC's list, but that could happen next week.


The state has stepped in a couple of times because health departments elsewhere were either offering vaccine to people outside the priority groups or were planning to, said Ohio Department of Health spokesman Kristopher Weiss.



http://www.dispatch.com/live/content...s&cat=&sid=101
__________________

[Mere]

 Pennsylvania: 13 Flu Associated Deaths--Week 45


Influenza trends in Pennsylvania during week 44 (November 8 to 14)

"13 flu-associated deaths were reported during week 45, up from 8 deaths the previous week. Two deaths during week 45 were in children under 18 years."

"There was a 20 to 40% decline in flu cases in all regions of the state."

"4.3% of all flu cases reported during week 45 were hospitalizations, up from 3.9% hospitalizations reported the previous week."

"441 (97%) of all positive flu specimens were the 2009 Pandemic strain."

http://www.dsf.health.state.pa.us/he...a=171&q=246529

[Mere]

Note - above post read at FluTrackers.com. Sub-Forum United States....

[Mere]

FluTrackers Forum - Oregon - Cat with H1N1 has Died   

More from the OVMA

http://oregonvma.org/news/h1n1

Oregon Cat Positive for H1N1 Virus Has Died

On November 4, 2009, a 10-year-old male cat was brought to a veterinarian in Lebanon, Oregon with labored breathing. A member of the family had been sick with influenza-like illness approximately one week earlier.

On intial examination, the cat's temperature was 101.7 F. There was no coughing or sneezing and its respiration was rapid and shallow. Radiographs were taken and revealed results consistent with pneumonia.

On November 5, 2009, the cat's respiratory rate worsened. The cat was admitted and treated with oxygen and medication.

On November 7, 2009, the cat died. Samples were collected and later were confirmed to be positive for pandemic H1N1 by Oregon State University Veterinary Diagnostic Laboratory and the National Veterinary Diagnostic Laboratory. It is believed that this is the first fatality of a cat with the H1N1 virus.

The three other cats in the same household also became ill with different degrees of sneezing and coughing. None of them had an elevated temperature. Nasal swab samples were collected from all of the cats in the household and yielded no other positive results for H1N1.

In additional to this case, there have been two other cases of confirmed H1N1 infection in cats in Iowa and Utah. Both cats recovered.

Transmission

In these cases it is believed that the cats caught the virus from humans in their households who were sick with influenza-like symptoms. If you or other members of your household are ill with influenza-like symptoms, wash your hands, use alcohol-based hand cleaners, cover your mouth and nose with a tissue when you sneeze, and avoiding touching your cat's eyes, nose and mouth.

Dr. Emilio DeBess, Oregon State Public Health Veterinarian, cautions owners and veterinarians that it may be possible for cats to transmit this virus to humans. Coughing and sneezing can spread the virus which can remain infectious for about a week outside the body. Thoroughly wash your hands when handling sick pets or when you are sick.

Symptoms

Cat owners should not panic. The number of confirmed cases of H1N1 infection in cats is quite small compared to the US cat population.

Watch for symptoms and seek veterinary care for cats that show signs of respiratory illness when there has also been recent influenza-like illness in humans in the same household.

Symptoms include coughing, sneezing, lethargy, or conjunctivitis (swelling and redness of the membranes around the eyes). In these instances, the cat should be examined by your veterinarian, especially if there is a recent history of influenza-like illness in the household.

Treatment

As with people, treatment is supportive, which means treating the symptoms and letting the virus run its course. If a diagnosis of respiratory illness is made, your veterinarian can suggest medications and treatment to make your cat more comfortable.

4 Oregon Ferrets Confirmed Positive for H1N1 Virus

In late October 2009, a client presented three of nine owned ferrets who had become ill with an influenza-like illness to a veterinarian in the Roseburg area. The family had human patients with influenza-like illness about a week prior to onset of illness in the ferrets.

Two of the three ferrets presented with fevers (temperature above 103 F), sneezing, coughing and had nasal discharge. Not all ferrets became ill at the same time, but 2 - 3 days after the initial 2 cases. Nasal discharge samples were collected on October 27, 2009 and were later reported as positive for Influenza A.

Further testing at the National Veterinary Diagnostic Laboratory confirmed the isolates as pandemic influenza H1N1. The other ferrets were not tested, but it is believed they may have had the virus as well. All nine ferrets have recovered.

The first documented case of the H1N1 virus in a ferret was in a Portland, Oregon ferret early October.

On October 5, 2009, a client brought a ferret to a Portland, Oregon veterinary hospital. The ferret had been exhibiting weakness followed by sneezing, coughing, and an elevated temperature.

Because the client and her children previously had symptoms compatible with influenza, the attending veterinarian consulted with Dr. Emilio DeBess, Oregon State Public Health Veterinarian, and both agreed to test the ferret's nasal secretions for influenza.

On October 8, 2009, Oregon State University's Veterinary Diagnostic Laboratory presumptively diagnosed pandemic influenza H1N1 by PCR from the nasal secretions of the ferret.

On October 9, 2009, pandemic influenza H1N1 was confirmed at the National Veterinary Diagnostic Laboratory.

Contrary to published media reports, which stated that this Oregon ferret had died, it has, in fact, recovered.

Other ferrets in the US have now also tested positive for the H1N1 virus. One ferret in Nebraska died.

Transmission

Pet owners should be cautious as we enter this year's flu season. Ferrets are generally susceptible to influenza A viruses under which H1N1 is classified.

In these cases, it is believed that the human owners transmitted the virus to their ferrets.

Dr. Emilio DeBess, Oregon State Public Health Veterinarian, cautions owners and veterinarians that it may be possible for ferrets or cats to transmit this virus to humans. Coughing and sneezing can spread the virus which can remain infectious for about a week outside the body. Thoroughly wash your hands when handling sick pets or when you are sick.

Symptoms

If your ferret starts to exhibit signs of a respiratory illness or lethargy, the animal should be examined by your veterinarian.

Because of the immunosuppressive effects of influenza, bacterial infection may be of concern. If discharge from the nose or eyes becomes discolored (yellow or green), or if your ferret is coughing, contact your veterinarian.

Treatment

Once a diagnosis is made, your veterinarian may be able to suggest medications to make the ferret more comfortable. You must also ensure that your ferret remains hydrated. If your ferret is very lethargic or off food and water (monitor closely), treatment with fluids and/or force feeding may be necessary.

H1N1 and Other Animals

Dogs

At this time, it is unknown as to whether dogs are considered to be susceptible to pandemic H1N1.

Canine influenza (H3N8) is a different influenza strain which is not known to be transmissible to humans.

Birds & Poultry

In August 2009, the pandemic H1N1 virus was detected in turkeys in two farms near the seaport of Valparaiso, Chile. The detection followed a decrease in both the laying rate and the egg shell quality in the flocks without noticeable mortality. Some birds had been in contact with persons with respiratory disease. Backyard poultry could potentially be at risk of H1N1 transmission from humans.
 
Pet Birds

Pet birds can also be susceptible to H1N1. Testing is recommended if the bird and owner both develop an influenza-like illness compatible with H1N1.

Swine

At least six pigs from Minnesota have tested positive for the H1N1 virus, the first confirmed case in the US swine population. This confirms a preliminary diagnosis of H1N1 pandemic influenza virus in swine samples collected during the 2009 Minnesota State Fair between August 26 and September 1.

According to a report from the USDA on November 2, the virus has been found for the first time in a commercial swine herd in Indiana. All animals and caretakers have recovered. USDA said the Indiana facility has continued its routine processing practices because it is safe for swine that recover from influenza viruses to be slaughtered.

Consumers are reminded that they cannot catch the influenza virus from eating pork.

Pet Pigs

Because swine are susceptible to this virus, follow standard flu prevention protocols when handling your pet pig. If you are concerned about your pet pig's health, please contact your veterinarian.

Key Points for Pet Owners

Prevention

Pet owners should not panic. The number of confirmed cases of H1N1 infection in domestic animals is tiny compared to the overall US pet population.

Standard techniques to prevent the spread of influenza are recommended. These include hand-washing and using alcohol-based hand cleaners, covering your mouth and nose with a tissue when you sneeze, and avoiding touching your eyes, nose and mouth. Try to avoid close contact with sick people and stay home from work or school if you are sick. If you are sick, you may want to limit contact with your domestic pet, bird or backyard poultry until you are well.

Vaccines

A human vaccine is now available. Refer to the CDC Web site for the most current official information on human cases. Pet owners may wish to consult with their physicians to see if they are a candidate to receive the H1N1 vaccine.

There is no vaccine for domestic animals, such as ferrets, dogs, cats or birds.

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

Thanks again to www.FluTrackers.com for providing this article which is from the Oregon Veterinary
Medicine Assn.

[Mere]

CDC - Q&A - Pneumococcal Disease

Questions and Answers: 2009 H1N1 and Pneumococcal Disease in the News
November 17, 2009, 12:00 PM ET

2009 H1N1 and Seasonal Influenza Infections and Invasive Pneumococcal Disease

What is invasive pneumococcal disease?

Invasive pneumococcal disease is an infection caused by a type of bacteria called Streptococcus pneumoniae (pneumococcus). Invasive disease means that germs invade parts of the body that are normally free from germs, like blood or spinal fluid. When this happens, disease is usually very severe, causing hospitalization or even death. When pneumococcal bacteria invade the lungs, they can cause pneumonia. They can also invade the bloodstream, causing bacteremia, and/or the tissues and fluids surrounding the brain and spinal cord, causing meningitis.

What does CDC know about invasive pneumococcal disease among people who get 2009 H1N1 or seasonal influenza?

Influenza (flu) infections can make people more likely to develop pneumococcal infections. Pneumococcal infections are a complication of 2009 H1N1 and seasonal flu infections and can cause serious complications, including death. CDC tracks pneumococcal disease through Active Bacterial Core surveillance (ABCs), part of the Emerging Infections Program Network (EIP).

What is Active Bacterial Core surveillance (ABCs)?

ABCs is an active laboratory- and population-based system for tracking important invasive bacterial pathogens (germs). For each case of invasive disease in the surveillance population, a case report with basic demographic information (age, sex, ethnicity, etc.) is completed and bacterial isolates are sent to CDC and other reference laboratories for additional laboratory testing. ABCs currently operates in 10 areas across the United States, representing a population of over 38 million persons.

What percentage of people hospitalized with 2009 H1N1 flu have developed invasive pneumococcal disease?

We do not know the exact percentage. Some people who have 2009 H1N1 flu will develop invasive pneumococcal disease; those who do may not develop symptoms of invasive pneumococcal disease until several days or even a week after they experience flu symptoms. Because of this timing and because not everyone is tested for both infections, we don’t know what percentage of people hospitalized with 2009 H1N1 flu go on to develop invasive pneumococcal disease.

Is 2009 H1N1 flu associated with an increase in invasive pneumococcal disease?

Possibly. Some ABCs sites have seen greater than expected numbers of cases of invasive pneumococcal disease coincident with increases in flu-associated hospitalizations. We don't know whether 2009 H1N1 flu actually caused this increase but CDC is pursuing that question with state and local public health officials. For a graphical representation of this data, please see the chart below, which represents one ABCs site.


Please continue reading here.....
http://www.cdc.gov/h1n1flu/vaccination/qa_pneumococcal_disease.htm

[Mere]

WHO - Vaccine - Safety, also Side effects investigated

Safety of pandemic vaccines
Pandemic (H1N1) 2009 briefing note 16

19 NOVEMBER 2009 | GENEVA --

To date, WHO has received vaccination information from 16 of around 40 countries conducting national H1N1 pandemic vaccine campaigns.

Based on information in these 16 countries, WHO estimates that around 80 million doses of pandemic vaccine have been distributed and around 65 million people have been vaccinated.

National immunization campaigns began in Australia and the People’s Republic of China in late September.

Vaccination campaigns currently under way to protect populations from pandemic influenza are among the largest in the history of several countries, and numbers are growing daily.

Given this scale of vaccine administration, at least some rare adverse reactions, not detectable during even large clinical trials, could occur, underscoring the need for rigorous monitoring of safety. Results to date are encouraging.


Continue to read article at this link....
http://www.who.int/csr/disease/swineflu/notes/briefing_20091119/en/index.html

[Mere]

Norway - reporting a mutated form of swine flu virus

Norwegian scientists raise concerns about mutated form of swine flu

 
By Rob Stein
Washington Post Staff Writer
Friday, November 20, 2009; 11:36 AM

Scientists in Norway have identified a mutated form of the swine flu virus that is raising concern because it was found in two patients who died of the flu and a third who was severely ill with the disease, officials announced Friday.

In a statement, the Norwegian Institute of Public Health said the mutation "could possibly make the virus more prone to infect deeper in the airways and thus cause more severe disease," such as pneumonia.

Scientists have analyzed about 70 viruses from confirmed Norwegian swine flu cases and found the mutation in only those three patients, Geir Stene-Larsen, the institute's director general, said in the statement.

"Based on what we know so far, it seems that the mutated virus does not circulate in the population, but might be a result of spontaneous changes which have occurred in these three patients," the statement said.

The institute has been analyzing H1N1 virus from "a number of patients as part of the surveillance of the pandemic flu virus," and has detected several mutations, the statement said. While the existence of mutations is normal, and most "will probably have little or no importance . . . one mutation has caught special interest."

The two patients who had the mutation and died were the first swine flu fatalities in Norway. The third patient found to have the mutated form of the virus also became severely ill.

Continue to read article at this link.....

http://www.washingtonpost.com/wp-dyn/content/article/2009/11/20/AR2009112001820.html

[seahorse]

http://news.yahoo.com/s/ap/20091120/ap_on_he_me/us_med_swine_flu_correction


Tamiflu-resistant swine flu cluster reported in NC

ATLANTA – Health officials say four people in North Carolina have tested positive for a type of swine flu that's resistant to the drug Tamiflu.

(I am bewildered, does this article say that there isn't a vacine for this type of flu?)

[Mere]

seahorse....I read the following information on the FluTrackers United States thread....you
will see your article (the one you read) and a few responses with links to further articles.

http://www.flutrackers.com/forum/showthread.php?t=133970

[Mere]

Three patients with drug-resistant H1N1 died
 

Posted: Today at 2:34 p.m.
Updated: Today at 8:58 p.m.

Durham, N.C. — North Carolina public health officials said Friday that three of four patients at Duke University Hospital with a drug-resistant form of the H1N1 flu virus have died.

The adult patients, treated in an isolated unit of the hospital over the last six weeks, tested positive for a mutation of the virus that was resistant to the drug Tamiflu, one of two medicines that help against H1N1.

Health officials said the cases were rare and the patients were very ill with underlying compromised immune systems and multiple other complex medical conditions. It is not clear whether their deaths were related to the flu infections

The patients that died were identified as two men and a woman. The fourth patient is a woman. The patients were from different parts of the state. Doctors are investigating to see if there is any link between the cases.

Tamiflu is still the most effective treatment for the virus, and a vaccination is the best prevention for contracting the virus, they emphasized Friday. No resistance has been found to Relenza, also known as zanamivir, the other drug approved to treat H1N1, they said.

Please read entire article (and see videos) at this link....
http://www.wral.com/news/local/story/6465698/

[Tibrogargan]

Dogs diagnosed with swine flu

Article from: Agence France-Presse

From correspondents in Beijing

November 30, 2009 12:00am

TWO dogs in Beijing have tested positive for swine flu in the second case of animals catching the disease in China along with pigs in the northeast.

The A(H1N1) virus detected in the dogs is 99 per cent identical to the one circulating in humans, the state-run Beijing Times reported today, quoting China's agriculture ministry.

The news comes 10 days after four pigs in China's Heilongjiang province were diagnosed with the virus, which specialists said might have been caught from humans, the report said.

Countries including the US, Canada and Chile have already reported cases of animals being infected with the A(H1N1) virus.

A cat in the US state of Iowa was diagnosed with swine flu at the beginning of the month in the first known case in the world of the new pandemic strain spreading to the feline population.

The World Health Organisation has called for closer monitoring of farm workers and animals for influenza A viruses following the reported cases.

Citing an official at the Beijing municipal agriculture bureau, the report said the dogs probably contracted the virus from human sufferers who were in close contact with the canines.

"Dogs can infect nearby dogs after they catch A(H1N1) flu," the unidentified official was quoted as saying.

The agriculture ministry and the Beijing agriculture bureau were not immediately available for comment.


http://www.news.com.au/couriermail/story/0,23739,26418749-954,00.html

[Mere]

 

 

 
 

   
 

WHO - H1N1 Update 76 - received 11/30/09

Pandemic (H1N1) 2009 - update 76
Weekly update

27 November 2009 -- As of 22 November 2009, worldwide more than 207 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 7820 deaths.

As many countries have stopped counting individual cases, particularly of milder illness, the case count is likely to be significantly lower than the actual 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.

Situation update:
In temperate regions* of the northern hemisphere, the early arriving winter influenza season continues to be intense across parts of North America and much of Europe. In North America, the Caribbean islands and a limited number of European countries there are signs that disease activity peaked.

In the United States and Canada, influenza transmission remains very active and geographically widespread. In the United States, disease activity appears to have peaked in all areas of the country. In Canada, influenza activity remains similar but number of hospitalisations and deaths is increasing. Most countries in the Caribbean have ILI and SARI levels coming down.

In Europe, widespread and increasing transmission of pandemic influenza virus was observed across much of the continent and most countries that were not yet experiencing elevated ILI activity in the last few weeks, have seen a rapid increase in ILI. Very high activity is seen in Sweden, Norway, Moldova and Italy. Over 99% of subtyped influenza A viruses in Europe were pandemic H1N1 2009. Impact on health care services is severe in Albania and Moldova. Some countries seem to have peaked already: Belgium, Bulgaria, Belarus, Ireland, Luxemburg, Norway, Serbia, Ukraine and Iceland.

In East Asia, influenza transmission remains active. Intense influenza activity continues to be observed in Mongolia but has peaked already. In Japan, influenza activity remains stably elevated, but may be decreasing slightly in populated urban areas.

ILI activity in India and Nepal and Sri Lanka has increased.

In the tropical zone of the Americas and Asia, influenza transmission remains variable but low in many countries. In the tropical areas of Central and South America, most countries continue to report declining influenza activity, with the exception of Ecuador and Venezuela.

In the temperate region of the southern hemisphere, little pandemic influenza activity has been reported.

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.

**Abbreviations: influenza-like-illness (ILI), acute respiratory infection (ARI), and severe acute respiratory infection (SARI)

Qualitative indicators (Week 29 to Week 46: 13 July - 15 November 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 22 November 2009
Map of affected countries and deaths
The countries and overseas territories/communities that have newly reported their first pandemic (H1N1) 2009 confirmed cases since the last web update (No.75): Armenia.

The countries and overseas territories/communities that have newly reported their first deaths among pandemic (H1N1) 2009 confirmed cases since the last web update (No 75): The former Yugoslav Republic of Macedonia, Switzerland, Poland, Tunisia, Morocco and Madagascar.

Region
 Cumulative total
 
as of 22 November 2009
 
 
 Cases*
 Deaths
 
WHO Regional Office for Africa (AFRO)
 15503
 104
 
WHO Regional Office for the Americas (AMRO) **
 190765
 5360
 
WHO Regional Office for the Eastern Mediterranean (EMRO)
 38359
 330
 
WHO Regional Office for Europe (EURO)**
 over 154000
 at least 650
 
WHO Regional Office for South-East Asia (SEARO)
 47059
 738
 
WHO Regional Office for the Western Pacific (WPRO)
 176796
 644
 
 
   
   
 
Total
 over 622482
 at least 7826
 


*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.

**The total number of cases are no longer reported from these regions

 

© WHO 2009 


Information is easier to read at this link....
http://www.who.int/csr/don/2009_11_27a/en/index.html
 

[Mere]

Questions and Answers about CDC’s Guidance for Emergency Shelters for the 2009-2010 Flu Season. November 24, 2009, 2:00 PM ET

About the Guidance for Emergency Shelters
 
What is the purpose of CDC’s Guidance for Emergency Shelters for the 2009-2010 Flu Season?

This new guidance considers the potential for people to be placed in close quarters in an emergency shelter, during a natural or man-made disaster, this 2009-2010 flu season. Prevention and response measures for shelter managers, workers, volunteers, and clients are provided specifically for this flu season.


Continue reading at this link....

http://www.cdc.gov/h1n1flu/guidance/emergencyshelters_qa.htm

[Mere]

CDC Guidance for Emergency Shelters for the 2009-2010 Flu Season
November 24, 2009 1:30 PM ET

This document provides interim guidance specific for U.S.-based emergency shelters used by displaced persons during a natural or man-made disaster during the 2009-2010 influenza (“flu”) season. This document provides guidance to reduce the risk of introducing and transmitting both seasonal and 2009 H1N1 flu in these settings.This document is intended for use by federal, state, local, and tribal jurisdictions in the United States. It should be used in conjunction with existing shelter operation and management plans, procedures, guidance, resources, and systems....


......continue here
http://flu.gov/professional/community/emergencyshelters/guidance.html

[Mere]

Clinical management of human infection with pandemic (H1N1) 2009: revised guidance
Publication date: November 2009

Download the full document [pdf 237kb]
Summary
This guidance provides updated information for health care providers managing patients with suspected or confirmed pandemic (H1N1) 2009. It incorporates knowledge gained about clinical features of pandemic influenza through international consultations.

Key topics:

risk factors for severe disease
signs and symptoms of progressive disease
diagnosis
treatment, both outpatient and in hospitals, and
clinical care for resource-poor settings.
Highlights
Diagnosis
Uncomplicated influenza can be diagnosed based on signs and symptoms presented by patients when influenza is known to be circulating in a community.

All patients should be advised to return to their health care provider for follow-up if they develop signs or symptoms of progressive disease.

Signs of progressive illness can include:

persistent high fever beyond 3 days
shortness of breath or difficulty in breathing, or turning blue
bloody or coloured sputum, chest pain or low blood pressure
in children, fast or laboured breathing
drowsiness, confusion or severe weakness
dehydration, which can cause dizziness, decreased urine output or lethargy.
Diagnostic testing to confirm the pandemic virus should be prioritized for patients at higher risk for severe illness.

However, clinicians who should not delay treatment of a patient with symptoms of an influenza-like illness to wait for laboratory confirmation of H1N1 virus infection.

Treatment
Mild illness continues to characterize most cases, and basic supportive care (to relieve aches or fever) is sufficient for most people. However, health care providers should give all of their patients guidance on how to recognize signs of progressive illness, and when to seek medical attention.

For pregnant women, WHO advises early antiviral treatment for suspected or confirmed pandemic influenza illness.

Infants and very young children (those under 2 years of age), especially those with underlying conditions, should also be treated with antiviral medication if warning symptoms arise.

In general, antiviral treatment recommendations are:

Patients who have severe or progressive illness should be treated with antiviral medication as soon as possible.
People with mild symptoms but who are at higher risk for severe illness (e.g. pregnant women, infants and young children, and those with chronic lung problems) should start antiviral treatment as soon as possible.
Antiviral treatment is not necessary for people have uncomplicated, or mild, illness and are not in a high risk group for severe illness.
Mothers who are breastfeeding can continue breastfeeding while ill and receiving antiviral treatment.

In hospital settings, health providers should monitor oxygen levels closely and supplement oxygen as needed, following guidelines. When pneumonia is present patients should be treated with both antiviral medication and antibiotics as early as possible.

Advice for how to evaluate and care for severely ill patients in hospital settings is explained.

Resource-poor settings
In health care settings where resources are limited, clinical care should focus on early use of primary health care (by the family doctor or at health clinics, for example) to determine what type of care or treatment is necessary for a patient, and to set priorities for who needs hospital care most urgently. Health care decisions should be based on signs and symptoms of illness, and the level of influenza activity in the local area.

Decentralizing stocks of antiviral medications, even if supplies are limited, is important to reach at-risk groups and disadvantaged populations.

Related links
Clinical features of severe cases of pandemic influenza 
 

© WHO 2009 
 

Entire information available at this link....
http://www.who.int/csr/resources/publications/swineflu/clinical_management/en/index.html