Swine Flu Cases Rising With New H3N2 Strain Transmissible Human To Human

Swine flu is making a comeback as a new strain of the virus has begun spreading, with more than 100 U.S. cases reported this year, according to the Centers for Disease Control and Prevention.

The surprising culprit? State and county fairs and doctors warn it has become much easier to transmit among humans.

So far, 145 cases of the influenza A variety of the virus have been found in Indiana, Ohio, Illinois and Hawaii. None of the cases were deadly, but two led to hospitalization. The agency expects the number to increase.

The majority of cases occurred in children and young adults, according to Dr. Joseph Bresee of the CDC's Influenza Division. Most of the cases have been associated with close or indirect exposure to pigs. The wave noticeably coincides with state and county fair season.

"This time of the year is the time when you have fairs around the country ... thousands of them," Bresee told reporters. "That accounts for the increased transmission more than anything else."

Indiana's number of cases has risen by seven to 120 since the CDC released its figures.

"Surprisingly, the greatest, overwhelming percentage (of cases) is in people 16 years and younger," Dr. Gregory Larkin, Indiana state health commissioner, reported.

"As our investigation continues, we're seeing transmission from ill or infected swine, or hogs, to their handlers, which in most of these cases are kids."

Doctors recommend that anyone who comes in close contact with swine wash their hands, avoid
consuming fluids or food around pigs and avoid direct contact with the animals.

The new strain of the virus, H3N2, picked up a gene from the H1N1 virus that caused a pandemic three years ago. The mutation makes it more easily transmissible among humans, with sneeze or coughs spreading the virus among mammals.

Bresee said a vaccine for the H3N2 strain is in the early stages of development.

Virologist Develops Highly Contagious and Lethal Strain of H5N1 Bird Flu Virus

A molecular virologist at Erasmus University in the Netherlands has engineered a new H5N1 bird flu virus so lethal that it would kill 59 percent of those infected.

Dr. Ron Fouchier and his team, who used ferrets as test subjects, found five genetic mutations to the virus. Based on these mutations, they were able to develop a new H5N1 strain that became airborne and infected ferrets in different cages.

The increased rate of infection indicates the new strain can potentially become as contagious as a normal cold. The H5N1 virus, which originally only affected birds, crossed over to humans in 1997 and first struck in Asia.

It eventually spread all over the world until it killed more than 300 people. Considering the 59 percent mortality rate of the new H5N1 strain, many fear that it would result in a pandemic on a global scale.

Read more Virologist Develops Highly Contagious and Lethal Strain of H5N1 Bird Flu Virus

H9N2 Avian flu and H1N1 pandemic: High genetic compatibility and increased pathogenicity of reassortants

H9N2 influenza viruses have been circulating worldwide in multiple avian species and repeatedly infecting mammals, including pigs and humans, posing a significant threat to public health.

The coexistence of H9N2 and pandemic influenza H1N1/2009 viruses in pigs and humans provides an opportunity for these viruses to reassort.

To evaluate the potential public risk of the reassortant viruses derived from these viruses, we used reverse genetics to generate 127 H9 reassortants derived from an avian H9N2 and a pandemic H1N1 virus, and evaluated their compatibility, replication ability, and virulence in mice.

These hybrid viruses showed high genetic compatibility and more than half replicated to a high titer in vitro. In vivo studies of 73 of 127 reassortants revealed that all viruses were able to infect mice without prior adaptation and 8 reassortants exhibited higher pathogenicity than both parental viruses.

All reassortants with higher virulence than parental viruses contained the PA gene from the 2009 pandemic virus, revealing the important role of the PA gene from the H1N1/2009 virus in generating a reassortant virus with high public health risk.

Analyses of the polymerase activity of the 16 ribonucleoprotein combinations in vitro suggested that the PA of H1N1/2009 origin also enhanced polymerase activity.

Our results indicate that some avian H9-pandemic reassortants could emerge with a potentially higher threat for humans and also highlight the importance of monitoring the H9-pandemic reassortant viruses that may arise, especially those that possess the PA gene of H1N1/2009 origin.

Read the full paper at PNAS website:
High genetic compatibility and increased pathogenicity of reassortants derived from avian H9N2 and pandemic H1N1/2009 influenza viruses

H5N1: Influenza detector gene stops virus transmission to humans

Katharine Magor, a U of A associate professor of biology, has identified the genetic detector that allows ducks to live, unharmed, as the host of influenza.

The duck's virus detector gene, called retinoic acid inducible gene -- I, or RIG-I, enables a duck's immune system to contain the virus, which typically spreads from ducks to chickens, where it mutates and can evolve to be a human threat like the H5N1 influenza virus.

The first human H5N1 cases were in Hong Kong in 1997. Eighteen people with close contact to chickens became infected and six died.

Magor's research shows chickens do not have a RIG-I gene. A healthy chicken can die within 18 hours after infection, but researchers have successfully transferred the RIG-I gene from ducks to chicken cells. The chicken's defenses against influenza were augmented and RIG-I reduced viral replication by half.

One potential application of this research could affect the worldwide poultry industry by production of an influenza-resistant chicken created by transgenesis.

The work of Katharine Magor, her U of A PhD candidate Megan Barber, and researchers from the United States (Jerry Aldridge and Robert Webster) was published March 22, in the online, early edition of Proceedings from the National Academy of Sciences.

For further information check out the Univeristy of Alberta website

H5N1 Avian Flu: New Outbreak in Romania

A suspected bird flu outbreak has been reported in a remote Romanian village, the Sanitary and Veterinary Authority said Saturday.

Samples of two dead hens were sent for confirmation of the potentially deadly H5N1 virus to the Animal Health Institute in Bucharest and on to the Weybridge laboratory in Britain, the Authority said.

The poultry in the small private farm at a village on the Danube Delta were slaughtered and the area disinfected.

"There is currently no risk of the disease spreading," the Authority said.

Two weeks ago, a bird flu outbreak was reported in the nearby village of Letea close to the Ukrainian border, the first case in Europe for a year.

The previous case in the European Union had been confirmed in March 2009 in a wild duck shot during a hunt near Starnberg, in Bavaria, southern Germany.

Romania was hit by massive bird flu outbreaks in 2005 and 2006, when more than a million poultry were slaughtered.

Avian influenza or "bird flu" is a highly contagious viral disease which primarily affects birds, but on rare occasions can also be contracted by humans and other mammals.

On Wednesday, the World Health Organisation said the H5N1 virus remains a threat to humans, after bird flu outbreaks killed seven people in several countries since the beginning of the year.

H5N1 Avian flu Bangladesh: 117,000 birds slaughtered to stem infection

At least 117,000 chickens were destroyed in northern Bangladesh Sunday after avian flu outbreak on one of the country's largest poultry farms, a local official said.

The deadly H5N1 strain of flu was detected on Saturday when 400 chickens died suddenly at the Kazi Farms complex in Thakurgaon town, district livestock chief Mosaddekur Rahman reported.

"Tests confirmed presence of the H5N1 bird flu in 15 sheds of the farm and we ordered destruction of all 117,600 layer chickens," he said.

Kazi Farms is Bangladesh's largest poultry bird and egg producer. General manager of the company Ataur Rahman said another 200,000 eggs had also been destroyed in the single largest outbreak of bird flu in the country.

"Our loss will be more than 400 million taka (six million dollars)," he said.

Bangladesh was hit by bird flu in February 2007, when more than one million birds were slaughtered on thousands of farms across the country.

The last major outbreak was in November 2008 when 10,000 birds were culled over a two-month period, with smaller outbreaks detected in 2009.

Bangladesh's poultry industry is one of the world's largest, producing 220 million chickens and 37 million ducks annually.

The country reported its first confirmed human case of bird flu in May 2008, but the government said the 16-month-old baby who contracted the virus recovered.

H5N1 Avian Flu: Labs Producing Virulent Flu Strains

Engineered hybrids of H5N1 bird flu and H1N1 human flu strains have proven virulent in mice, raising the danger that a natural recombination would be deadly to humans.

For years, researchers have worried that H5N1 avian influenza would mix with human flu viruses, evolving into a form that keeps its current lethality but is far more contagious.

That hasn’t happened in the wild yet but the latest findings, published Feb. 22 in the Proceedings of the National Academy of Sciences, show how easily it can happen.

Mind the Gap
“Fortunately, the H5N1 viruses still lack the ability to transmit efficiently among humans.” However, the virus may soon be overcome this obstacle when it mixes with human flu strains. These are the findings of researchers led by University of Wisconsin virologist Yoshihiro Kawaoka. “The next pandemic is inevitable and it will be more devastating than the last.”

Current strains of H5N1 have infected 478 people since 2003, and killed 286 of them. It’s has difficulty transmitting to humans. It requires close contact and exposure to an infected person, bird or animal.

H5N1 in Birds
In birds, however, H5N1 is far more contagious, and here the virus has killed tens of millions of fowl. Fortunately, cases have been concentrated in Africa and Eurasia, but as the swine flu pandemic demonstrated, any flu contagious to humans will quickly spread on a global scale. This is mainly thanks to air travel and the free movement of peoples across state boundaries.

Influenza viruses mutate and swap genes easily, with co-infections turning animals into mobile petri dishes. In 2008, hoping to learn more about how H5N1 might evolve, researchers from the Centers for Disease Control and Prevention combined it with a common human flu strain.

The researchers engineered all 254 possible variants of hybridisation between the deadly H5N1 avian flu strain found in Borneo, and a, H1N1 human flu virus from Tokyo. They identified three strains that were both contagious and deadly, in mice.

The New Pandemic
A flu virus that kills mice won’t necessarily kill humans, but the results are very disturbing. All three killer hybrid strains possessed a protein taken from the human strain. Called PB2, the protein appeared to help the virus survive in the mice’s upper respiratory tract. As of now, bird flu stays in the lower respiratory tract, where it’s less likely to be casually transmitted.

Although the recent H1N1 pandemic has not proved to be as lethal as originally feared, it certainly exposed how unprepared the world is for new influenza strains. At the same time it also exposed the ability of pharmaceutical companies to frighten the WHO, governments and politicians into spending $Millions to stockpile ineffective vaccines.

Source of Infection
In May, Hong Kong University virologist Yi Guan, best known for finding the animal origin of SARS, was asked by Science Insider about the possibility of H5N1 and swine flu mixing.

“If that happens, I will retire immediately and lock myself in a sealed laboratory", said Guan. "But, historically the Chinese mainland would be the most likely source of such a virus."

Global Alert
Unfortunately, in such a situation, the imposed cover-up by local authorities would mean that the virus will have spread with a high rate of cross-infection and will have escaped globally, even before we are alerted to it's existance. We will not be alerted until it has spread to the Western world and many people have become infected and died.

Lethal Viruses Escape
The other issue is the development of virulent and lethal strains in laboratories and institutions. There has been a sad history of viruses erroneously 'escaping' from pharmaceutical labs and there is no reason to believe that this will not happen in the future, despite due diligence.

Mitigation
Should we live our lives in a bubble? No, definitely not but we should be aware of the dangers we are facing and how these may manifest themselves. Yes, there is a lethal danger from a mutant virus but this danger is greater if the world's health authorities are not communicating properly or collaborating on a global scale and this is something that can be mitigated against.

H1N1: WHO Admit drug resistance in influenza mutation

The World Health Organisation said Friday that a mutation had been found in samples of the swine flu virus taken following the first two deaths from the pandemic in Norway. This is not unusual in itself because viruses, by their nature, will and do, mutate.

However, the WHO denied that the mutation had created a more contagious or more dangerous form of influenza A(H1N1) and they admitted that some similar cases observed elsewhere, had been mild. That was certainly the case for the people who did not die from it.

"The Norwegian Institute of Public Health has informed WHO of a mutation detected in three H1N1 viruses," the WHO said in a briefing note. Realistically, influenza viruses are continually undergoing mutations.

It is important to note that some of these are unsustainable and that some of these will succeed in not only being sustained but also in being drug resistant. It is their nature and follows the normal course of natural variation and selection, that all living things are prone to.

"The viruses were isolated from the first two fatal cases of pandemic influenza in the country (Norway) and one patient with severe illness," the report continued, although it added that no further instances were found in tests.

"Norwegian scientists have analysed samples from more than 70 patients with clinical illness and no further instances of this mutation have been detected (in the lab). This finding suggests that the mutation may not be widespread in the country," the UN health agency assumed, optimistically.

WHO spokesman Gregory Haertl said that the global health watchdog did not believe "that this has any significant impact, for the time being." Presumably, if the mutation proliferates over time, then it will become significant.

However, despite their blind faith and optimism, the agency admitted that a similar mutation had been observed in Brazil, China, Japan, Mexico, Ukraine, and the United States, as early as April 2009. Thus, contradicting themselves, whilst confirming the true nature of influenza viruses.

"The mutations appear to occur sporadically and spontaneously (you think!). To date, no links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread," the WHO statement said. Some of those cases also produced mild symptoms, Haertl noted.

The WHO also underlined that there was no evidence of more infections or more deaths as a result, while the antiviral drugs used to treat severe flu, oseltamivir (Tamiflu) and zanamivir (Relenza), were still effective on the mutated virus.

Thus defending their single minded determination to follow this contraversial course of treatment, sponsored by the pharmaceutical agencies involved. Presumably to appear to be doing something in the face of an uncontrollable force of nature.

"Studies show that currently available pandemic vaccines confer(?) protection," it added, as mass vaccine campaigns were slowly gaining ground in the northern hemisphere amid signs of public skepticism in several European nations. (and growing profit margins of pharma companies)

Informed scientists naturally fear that mutations in flu viruses could cause more virulent and deadly pandemic flu. The global health watchdog reiterated a call for close monitoring.

The WHO was still assessing the significance of the latest observation, but it stressed that many such changes in the flu virus do not alter the illness it causes in patients.

"Although further investigation is under way, no evidence currently suggests that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases," it added.

Norwegian authorities reported the country's first swine flu death on September 3, a 52 year-old Danish truck driver who died just over a week earlier.

On Friday, WHO data showed reported that around 6,750 people had died from swine flu since the virus was first uncovered in Mexico and the United States in April.

That represented an increase of about 500 more than a week ago, as the pandemic took hold in the northern hemisphere during the cold season

The WHO estimates that some 250,000 to 500,000 people die every year from standard seasonal variants of swine flu. Oh well! That's alright then. Sorry we troubled you guys. Let's just let you go back to sleep, whilst the rest of the world sits quietly by, watching people suffer and die.

Npw, the only question left in our minds is whether the WHO's approach to the pandemic is based on blatant incompetence or cynical corruption.

H1N1: Rules of Contact and Engagement

“In Samoa, people do not touch when they greet each other,” the linguistic anthropologist Alessandro Duranti says.

There is, of course, a catch: “When people whom they respect highly come into a house, they sit down across from you, and there is an elaborate ceremonial greeting: mentioning each person’s titles and social connections, one at a time, usually for an extended period.”

For those outside Samoa, the era of swine flu poses the thorny challenge of how to express cordiality, friendship, even love — while staying, as the authorities recommend, at least three to five feet away from anyone who coughs, sneezes or might otherwise show signs of infection with the H1N1 virus. Let's hope good sense prevails.

H5N1 Bird flu virus linked to inflamation of the brain

As if fever, aching muscles and a sore throat were not enough, researchers have found that flu may also lead to chronic neurodegenerative diseases like Parkinson's and Alzheimer's.

Most influenza infections affect the respiratory system, but there have long been suspicions that they are also linked to neurological disorders. The H1N1 flu pandemic in 1918 was followed by an outbreak of encephalitis and later by an unusually high number of cases of Parkinson's disease.

Hard evidence of such a link has been hard to find, however. So Richard Smeyne of the St Jude Children's Research Hospital in Memphis, Tennessee, sprayed a solution containing a highly pathogenic subtype of H5N1 avian flu into the noses of 225 mice. The team found that the virus infected nerves in the gut, then entered the brain stem and finally reached the brain. In the brain, it led to chronic activation of the immune system, even long after the viral infection had been cleared.

This immune system activity later led to protein aggregation and neuron loss in the brain, and to symptoms like tremor and loss of coordination – the hallmarks of Parkinson's and Alzheimer's.

Brain strains

"Infection with influenza virus might leave the brain vulnerable to damage from future infections with new influenza strains," says Smeyne, adding that this is more likely to happen in young children or during an flu pandemic.

Smeyne suspects that all flu viruses, including the current H1N1 swine flu pandemic, could cause symptoms of encephalitis, or inflammation of the brain. But he says that there is currently no proof that flu viruses other than the H5N1 he worked with can enter the central nervous system.

Reports of extra encephalitis during outbreaks of seasonal flu in Japan and the US, and most recently of swine flu-infected children hospitalised with neurological symptoms in Dallas, Texas, hint at a related mechanism, however.

"The link between flu infection and neurological disorders has been the elephant in the room [ever since 1918]," says virologist John Oxford, a virologist at Barts and The London School of Medicine and Dentistry, Queen Mary, University of London.

Journal reference: Proceedings of the National Academy of Sciences, DOI: 10.1073/pnas.0900096106

Confusion over giving antivirals to children with flu

Another pertinent study from the BMJ casts doubt over the UK's strategy to combat H1N1 Swine Flu, is well founded.

Specifically, whether all children suspected of having H1N1 Swine flu, should be given antiviral drugs such as oseltamivir (Tamiflu) or zanamivir (Relenza).

The UK government Health Ministers, insist that everyone suspected of having H1N1 Swine flu should be offered antivirals as part of a "safety first" strategy but the BMJ study, published in their journal, suggests the strategy is misguided, at best.

Small help
It concludes that treating children under 12 with antivirals does very little, shortening the duration of disease by just a day or so, and decreasing by just 8 per cent the likelihood that an infected child will spread it to others.

Also, Tamiflu causes additional vomiting in 5 per cent of children already vomiting because of their illness. Nor does it bring any benefits for asthmatics, as implied by advice from the UK government's Health Protection Agency.

"The results show the beneficial effect is fairly small for most children," says Matthew Thompson of the University of Oxford, who led the research.

His team's advice is for parents to treat mild flu symptoms with the usual medicines and the priority is in controlling the high fever, ensuring the patient gets plenty of rest and their fluid intake is maintained.

Beneficial Value unknown
Even if complications develop, the beneficial value of giving antivirals to children is unknown, the researchers say. "What we need are studies large enough to let us know if antivirals reduce the risks of serious complications such as pneumonia or hospitalisation in children," Thompson says.

Another bonus of limiting treatment in children is that it will reduce the risk of the mutating virus developing resistance to the drugs.

UK Government's response
Responding, the British government's Department of Health said that the BMJ study is based on seasonal flu and so may not apply to swine flu. This is a very weak knee-jerk response with little substance.

"Whilst there is doubt about how swine flu affects children, we believe a safety-first approach of offering antivirals to everyone remains a sensible and responsible way forward," said a spokesperson. "However, we will keep this policy under review as we learn more about the virus and its effects."

The government can see their ass-covering strategy diminishing in the face of evidence based criticism.

Viral Influenza A
Thompson accepts that his review only looked at seasonal flu. "But about two-thirds of the studies were influenza A, which is what the current strain is," he says. "So we would expect our results to be applicable to swine flu."

Sharp shooting
Thompson says that other countries are deploying a more considered and targeted approach, unlike the scattergun approach in the UK. "Canada, Ireland and the US are only recommending antivirals for patients at particularly high risk, or with severe illness," he says.

Good Advice
"It may be worth the UK Department of Health taking the new research on board and consider having a more targeted approach to the use of antivirals, or urgently conducting randomised controlled trials of children and adults to identify whether there are subgroups of children who will benefit from antivirals, and whether they do have an impact on severe complications such as pneumonia or hospitalisation," says Thompson.

Fortunately, the decisions lie not only with the UK Government. "I hope the evidence from such trials will help parents and family doctors make sensible decisions about which children to treat."

Results and Conclusions from BMJ Study: BMJ, DOI: 10.1136/bmj.b3172

Review methods: Eligible studies were randomised controlled trials of neuraminidase inhibitors in children aged 12 in the community (that is, not admitted to hospital) with confirmed or clinically suspected influenza. Primary outcome measures were time to resolution of illness and incidence of influenza in children living in households with index cases of influenza.

Results: We identified four randomised trials of treatment of influenza (two with oseltamivir, two with zanamivir) involving 1766 children (1243 with confirmed influenza, of whom 55-69% had influenza A), and three randomised trials for postexposure prophylaxis (one with oseltamivir, two with zanamivir) involving 863 children; none of these trials tested efficacy with the current pandemic strain. Treatment trials showed reductions in median time to resolution of symptoms or return to normal activities, or both, of 0.5-1.5 days, which were significant in only two trials. A 10 day course of postexposure prophylaxis with zanamivir or oseltamivir resulted in an 8% (95% confidence interval 5% to 12%) decrease in the incidence of symptomatic influenza. Based on only one trial, oseltamivir did not reduce asthma exacerbations or improve peak flow in children with asthma. Treatment was not associated with reduction in overall use of antibiotics (risk difference –0.30, –0.13 to 0.01). Zanamivir was well tolerated, but oseltamivir was associated with an increased risk of vomiting (0.05, 0.02 to 0.09, number needed to harm=20).

Conclusions: Neuraminidase inhibitors provide a small benefit by shortening the duration of illness in children with seasonal influenza and reducing household transmission. They have little effect on asthma exacerbations or the use of antibiotics. Their effects on the incidence of serious complications, and on the current A/H1N1 influenza strain remain to be determined.

Tamiflu not suitable for Children: TV Personality's daughter 'almost died'

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Health Secretary Andy Burnham has defended giving swine flu drug Tamiflu to children as TV presenter Andrew Castle said his daughter "almost died" after taking it.

Mr Burnham was confronted by Castle on GMTV after research cast doubt that the anti-viral drug's benefits outweighed its side-effects.

The presenter said: "I can tell you that my child - who was not diagnosed at all - she had asthma, she took Tamiflu and almost died."

Fatal Consequences

Castle said his daughter, Georgina, had a severe reaction, "respiratory collapse" and "suffered very heavily" after being "just handed" the drug without having been properly diagnosed.

All this is in the light of last week, when a 2 yr old child died of Meningitis, after being wrongly diagnosed as having Swine Flu. She and her parents were dismissed and turned away by off-hand, hospital, medical staff.

Sympathy on Offer

Mr Burnham sympathised with Castle, saying it must have been "very worrying", but maintained that the current advice being given to parents to treat swine flu with Tamiflu, remained unchanged, despite the wave of severe doubts and criticisms coming from consultants and specialists alike.

Given that swine flu had a "disproportionate effect" on children, he maintained that Tamiflu was "our only line of defence" or, the only line of defense being considered. A policy that puts children in as much danger from the cure as from the disease.

Specialists Warn against Tamiflu

On Monday, Oxford University researchers made a serious announcement that children should NOT be given the anti-viral drug to combat swine flu. They urged the Department of Health to urgently rethink its policy on giving the drug to youngsters affected by the current flu pandemic.

The study, published in the British Medical Journal (BMJ), warned that Tamiflu can cause severe vomiting in some children, which can lead to dehydration and the need for emergency hospital treatment.

Cure worse than Disease

The researchers stated strongly that children should NOT be given the drug if they have a mild form of the illness. In such cases the cure is worse than the disease. They urged parents and GPs to remain vigilant for signs of complications and to avoid 'off the shelf' solutions and knee-jerk reactions.

50% of Young Children Suffer Side Effects from Tamiflu

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More than half of children taking Tamiflu suffer side-effects such as nausea, insomnia and nightmares, researchers have said.

Two studies from experts at the Health Protection Agency (HPA) showed a "high proportion" of British schoolchildren reporting problems after taking the anti-viral drug.

Data was gathered from children at three schools in London and one in the South West who were given Tamiflu earlier this year after classmates became infected.

The researchers behind one study said that, although children may have attributed symptoms that were due to other illnesses to the use of Tamiflu, "this is unlikely to account for all the symptoms experienced".

Their research, published in Eurosurveillance, looked at side-effects reported by 11 and 12-year-old pupils in one school year in a secondary school in South West England. The school was closed for 10 days in response to a pupil being confirmed with swine flu on return from a holiday in Cancun, Mexico.

A total of 248 pupils took part in the study and were given Tamiflu prophylactically. Compliance with prophylaxis was high, with 77% of children taking the full course, the researchers said. But they added: "Fifty-one per cent experienced symptoms such as feeling sick (31.2%), headaches (24.3%) and stomach ache (21.1%).

The researchers said "likely side-effects were common" and the "burden of side-effects needs to be considered" when deciding on giving Tamiflu to children prophylactically. The researchers concluded that a "high proportion of school children may experience side-effects of oseltamivir (Tamiflu) medication".

No Swine Flu Vaccine for the Elderly

What has happened to the normal adage of Woman and Children first?

Elderly swine flu victims should be sacrificed and sent to the back of the queue for anti-viral treatment, when supplies of the drugs are limited, according to new research in Italy.

Scientists found there were circumstances in which anti-virals such as the relatively ineffective Tamiflu, should be rationed in favour of younger adults.

The controversial strategy could be the most effective way to save lives and prevent illness, it was claimed.

Priorities
It is very interesting because it is not only indicative as to how these organisations think now but it is also how they will respond in the face of a fully blown Pandemic, when lives will be sacrificed and priorities will be established.

Italian Research
The research focused on Italy, which was said to have only enough anti-virals to treat seven million people, or 12% of the population.

Mathematical modeling showed that governments should stockpile enough drugs to treat at least a quarter of their populations, assuming moderate levels of infection. This in itself may lead to strategic prioritisation against the poor and elderly.

If supplies were lower than this, it made sense to ration the anti-virals according to age-specific fatality rates.

Historical Influence
When swine flu followed the pattern of the great 1918 pandemic and was most lethal to younger adults, treatment should not be targeted at the elderly, said the researchers. Instead, it should be reserved for the young.

This is the reverse of the policy adopted during outbreaks of normal seasonal flu, when priority is given to the over-65s. It is also academic because a new and effective ant-viral vaccine has yet to be developed and tested safely, prior to its distribution.

New Vaccine Risks
On release of the new vaccine, the risks are clear; the priority will be given to those deemed to be the youngest and most important; economically and politically powerful and influencial.

Unfortunately, if the vaccine is flawed, this will damage these very same people and cause a shift in the balance of power across the globe, affecting a tidal change in a large number of countries, organisations and populations.

Weathering the Storm
The first ones into the lifeboats to save their sinful souls, may find themselves in further peril at sea. Like rats jumping off the Titanic onto the iceberg for safety. Their fate remains unchanged, just the method is different.

We are all victims in a Pandemic but the great benefit of being economically and politically powerful and influencial is that you can make choices, whereas others can only wait, endure and accept, with stoicism and dignity.

Swine flu - UK absentees from work 'triple in a week'

The number of people calling in sick with swine flu symptoms has tripled in a week, with 130,000 people staying away from work.

Worldwide, 700 people have died!

News of the increase in absenteeism came as the British death toll from the virus rose to 31, with a 51-year-old woman from Wiltshire and the 15-year-old from Glasgow the latest victims.

Greatest Challenge to NHS
Sir Liam Donaldson, the chief medical officer, yesterday warned that swine flu “almost certainly” posed the biggest challenge to the NHS for a generation. Fears of swine flu crisis grow as six-year-old girl and doctor dieAlmost 130,000 people stayed off work with flu, coughs and colds on July 14, up from 45,000 a week before, according to FirstCare, an absence management company.

Absentees triple
While absences tripled, the number of people who have actually contracted the virus is thought to have only doubled over the same period, highlighting how fear of infection is damaging business.

Septic Shock
Meanwhile, it has emerged that Chloe Buckley, the girl thought to have been the first healthy young victim of swine flu, died from septic shock after a bout of tonsillitis, a post mortem examination indicated. The death of Chloe, six, from West Drayton, west London, alarmed parents of young children.

Dr Simon Tanner, London’s regional director of public health, said it was impossible “to say to what degree swine flu contributed to her death”.

Andrew McCombe, a leading surgeon, said it was rare for a child to die from septic shock after contracting tonsillitis. “Normally septic shock affects old people,” he said.

Human Vaccine Trials to Begin
Human trials of a vaccine to protect against the H1N1 swine flu virus have begun in Australia.
Vaxine and CSL have both started injecting human volunteers this week, but it will be at least six weeks before the initial results are known.

Morbidity rate increases
The overall morbidity figure is likely to climb on Thursday when the Department of Health gives its weekly update. Worldwide, more than 700 people have died.

Woman with swine flu dies 'after giving birth'

A woman in the UK who had contracted swine flu, died shortly after giving birth prematurely.

The woman, who died in Whipps Cross Hospital, was named by her brother as Ruptara Miah.She is thought to be from Bangladesh.

Abdul Malik told BBC News his sister had used a wheelchair for 15 years after a road traffic accident but had led a normal life and had brought up six daughters. "We are very, very upset as a family. It has really taken me by shock," he said. "We thought she was going to recover."

His sister, the eldest of 10 children, was admitted to hospital three weeks ago with a cough and chest infection, he said. She was treated in intensive care, where she gave birth to a son prematurely, but never regained full consciousness, he added.

The baby is now in intensive care as a precaution

A spokesman for Whipps Cross said: "Whipps Cross University Hospital NHS Trust can confirm that a 39-year-old woman passed away on July 13 2009, and that she was infected with pandemic H1N1. The trust can confirm that she had underlying health conditions. No further comments can be made at this time."

H1N1 Pandemic in UK: Sudden Increase in Cases

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GPs have seen a leap of almost 50% in the numbers of people contacting them with fears they have swine flu in the last week, new figures reveal.

Around 40,000 people a week in England and Wales are now complaining to their doctor of "flu-like illness", with a dramatic rise in the number of young children being affected.

The Royal College

The figures, from the Royal College of GPs' monitoring system, showed 50.3 people per 100,000 were reporting flu-like illness between June 29 and July 5, but this leapt by 46% to 73.4 people per 100,000 between July 6 and 12.

Financial Times

Almost one in eight workers are likely to be kept at home with the virus in the next few weeks, according to Government figures. This could leave many businesses struggling to run as normal, the Financial Times reported.

Sir Liam Donaldson is expected to announce that 30% of the population is likely to be infected during this first wave of the pandemic, the FT newspaper said.

Young at most Risk
Wednesday's weekly report from the Royal College of GPs said: "National incidence of influenza-like illness increased for all regions and is now evident in all age groups but remains highest in five to 14 age groups."

Central England Hotspot
The study said the highest number of cases was being seen in central England but the North had seen "a marked increase compared to previous weeks".

There has been a small decrease in the number of cases being seen in London although the capital remains a major hot spot for the virus.

Statistics
The rate of influenza-like illness is highest among those aged five to 14, at 159.57 per 100,000 population. The next most affected group is youngsters and babies aged up to four, at 114.12 per 100,00 population. This is followed by people aged 15 to 44, those aged 45 to 64 and then people aged 65 and over.

Ant-viral Vaccine
The Government has insisted that the swine flu vaccine should begin arriving at the end of August, amid genuine fears of a delay in this delivery date, and further delay before people receive jabs.

The UK claims, it is in line to get around 60 million doses of the vaccine - enough to cover half the population - by the end of December, with the rest of the doses following next year.

Vaccine Production Delayed
This is a substantial turn around in their earlier claims and the first phase of the virus should have run its course by then. The mutated second phase will take over and the vaccine will be ineffective against it.

Virus Dictates Timeline
It is impossible to determine how the H1N1 virus will mutate, so scientists are unable to prepare in advance for this strain. Only when the new strain is identified will they be able to start on development of a new anti-viral vaccine.

So, the development, testing and distribution of a second antiviral vaccine will need to start after January 2010 and is therefore unlikely to be in production before the Spring 2010.

H1N1: How Swine Flu kills

As the H1N1 swine flu pandemic continues to spread around the world, most cases are still mild but reports are starting to emerge of people who sicken and die very quickly of what appears to be viral pneumonia. Now two independent groups of scientists have now found out why and it's all down to where the virus binds within the body.

H1N1 swine flu comes from pigs, so it binds well to cell-surface molecules in the respiratory tracts of other mammals, including humans but there are slight differences in the way different flu proteins bind to these receptors.

Two separate teams – one led by Ron Fouchier at Erasmus University in Rotterdam, the Netherlands, and the other by Terrence Tumpey at the Centres for Disease Control in Atlanta, Georgia – both report that the pandemic virus binds deeper than ordinary flu in the respiratory tract of ferrets, the animal most like humans when it comes to flu.

A virus of the same H1N1 family as the pandemic flu has been circulating as ordinary seasonal flu since 1977. Both groups found that the seasonal virus binds almost exclusively to cells in the ferrets' noses. But, the pandemic H1N1 binds deeper, in the lung's trachea, bronchi and bronchioles. The pandemic virus also replicated more, and caused more damage, though none of the ferrets were severely ill.

'New' H1N1 Brazilian flu strain! Don't panic - false alarm

Take a jumpy media, throw in a statement hastily translated from Portuguese, and what have you got? A "new" and potentially deadly strain of H1N1 influenza in Brazil, according to a rash of news stories that appeared earlier today.

"It was not yet known whether the new strain was more aggressive than the current A(H1N1) virus which has been declared pandemic by the World Health Organization," reported Agence France Presse, setting the mood for a new round of pandemic panic.

But this "new" strain is nothing of the sort. In fact, the sequence of its gene for the haemagglutinin surface protein, deposited in the GenBank database, is the same as isolates from several other countries.

"There is nothing new and surprising about it. It is identical to the others," said Richard Webby of St Jude Children's Research Hospital in Memphis, Tennessee.

The scare seems to be based on a misunderstanding of a "technical note" posted on the website of the Adolfo Lutz Institute in Saõ Paulo. It states that researchers led by Terezinha Maria de Paiva sequenced the haemagglutinin and matrix protein genes from a virus isolated from a 26-year-old man who was hospitalized in Brazil in April after a trip to Mexico, finding subtle differences for the haemagglutinin gene from a single reference strain of H1N1 isolated in California.

The note doesn't mention that the sequence is the same as other isolates found elsewhere. Even so, subtle changes from a single reference strain are nothing to get terribly excited about, given the normal rates of mutation in influenza viruses. "It's what you'd expect for influenza," says Adolfo García-Sastre of the Mount Sinai School of Medicine in New York.

Airport Swine Flu (H1N1) Detectors - Smoke and Mirrors

WHEN aviation officials chose Mexico City for a meeting to discuss their response to pandemic outbreaks, they could scarcely have predicted swine flu would intervene. "The irony was amazing," says Tony Evans of the International Civil Aviation Organization (ICAO) in Montreal, Canada. "The meeting will probably go ahead in June unless we get another wave of H1N1."

Future pandemics will almost certainly be spread via air travel, with flights capable of carrying a pathogen across the world in hours. The UN's Convention on International Civil Aviation requires nations to "prevent the spread of communicable diseases by means of air navigation". That is easier said than done, given the confined space of modern aircraft and the use of re-cycled unscrubbed cabin air on all flights, as a fuel and cost saving measure.

CAPSCA - the Cooperative Arrangement for the Prevention of the Spread of Communicable diseases by Air travel.

CAPSCA aims to help airports in developing nations prepare for a pandemic, and its schemes are now getting off the ground in the Americas, Asia-Pacific and Africa. They will be expected to install US manufactured devices and follow the advice of their consultants.

Optimistically CAPSCA state; "When an aircraft arrives with a suspected disease case on board, CAPSCA will make sure you've thought about where you are going to park the plane, how you will deal with the luggage and how are you going to keep in touch with the passengers that haven't got any symptoms (when they boarded the plane)."

All this does is extend the time by which the other passengers and air crew are exposed to the virus and increase the likelihood of them contracting the disease, if they have not already done so on the flight.

Evans says. "You also have to work out which people on the plane are most likely to be infected (if not all) and whether they need prophylactic treatment or admission to hospital. How will you protect air crew and customs officers? Careful planning is crucial and CAPSCA will promote that", Evans explains.

Frankly, this is nothing but hype, rhetoric and grandstanding

Frankly, this is nothing but hype, rhetoric and grandstanding. People who gather in confined spaces and share the same breathing air for hours on end, will contract the disease. Air crew, airport staff and customs officers, will contract the disease.

Immunisation with Tamiflu and other so-called anti-viral inoculations, is less than effective and will not act as a 'barrier' for air crew and airport staff. The virus, by its nature, mutates regularly and the time taken to develop effective anti-viral drugs and put them into large scale production, is 4 - 6 months. The same time taken for the pandemic to burn itself out, without any human or pharmaceutical intervention. Again, it is the nature if viruses.

In the case of an increasing pandemic, effective anti-viral drugs will only be available on a priority basis. Those who decide the priority, will be the first to receive the drugs. The second priority will be given to the forces that will protect the decisions and decision makers. This is what is meant by 'careful planning'. Everyone else should prepare for a long wait.