Thailand records first case of Human- to-Pigs Swine Flu Transmission

Thailand confirmed Thursday its first case of a pig infected with swine flu spread from humans, senior officials said.

Agriculture minister Thira Wongsamut said that one of 80 pigs in a sample group tested for the virus at Kasertsart University farm in the central province of Sara Buri had contracted A(H1N1) influenza.

"It was only in one sample that we found the A(H1N1)," Thira said.

The ministry has quarantined a five kilometre-radius around the farm, where university research is carried out, as a precautionary measure, he said, adding that new health checks would be conducted at the farm every three days.

The ministry's permanent secretary Yukol Limlamthong said that none of the 132 workers at the university farm had contracted swine flu. He could not confirm if a research student had brought the virus in.

"We can not prove that, but the test results show the pig contracted the virus from a human," Yukol said.

Thira said that eating pork did not pose a danger.

"The virus spread from human to pigs, as in several countries. We've had no case of it spreading from pigs to humans," he said.

Since the swine flu outbreak began in April, the ministry said it has tested more than 26,000 pigs for the virus.

It has confirmed 29,741 human cases of the flu and 190 of those were fatal.

The Thai government has a one-million dollar fund set aside to combat swine flu.

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

pa.press.net

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.

Tamiflu & Relenza Resistance is a certainty rather than a risk

Two anti-flu drugs are commonly stockpiled for use in a flu pandemic: oseltamivir, which is sold as Tamiflu, and zanamivir, which is sold as Relenza. Both work by inhibiting an enzyme called neuraminidase (the 'N' in H1N1). The virus needs this enzyme to break down normal cell walls and to replicate using a mutated version of the victims own RNA.

The 2 drugs act on different parts of the enzyme and resistance to one drug does not confer resistance to the other. The Mexican H1N1 strain is currently classed as being 'sensitive' to both drugs. This is not a 'cure' it is simply a 'treatment' and no one knows how long this 'sensitivity' will last.

The Wu team conducted their study after noticing that despite concerns about resistance, many countries stockpile just one drug, usually oseltamivir. There are some exceptions, however, including Australia and the UK, which stockpile both drugs.

Viruses are notorious for their ability to develop resistance to drugs. Last year, an H1N1 flu strain that caused some seasonal flu rapidly developed resistance to oseltamivir. By December, "close to 100 per cent of H1N1 in Australia and the US, and many other parts of the world, were resistant to Tamiflu", says Raina MacIntyre, an infectious disease expert at the University of New South Wales in Sydney, Australia.

H1N1 Swine Flu: very weak viral strain

First genetic analysis of how well this virus transmits from person to person concludes that it spreads barely well enough to keep itself going.

The analysis also suggests the virus may have started circulating as long ago as January. But because there have been so few cases to analyse, the calculation is uncertain. It could have started more recently, or as far back as September.

Nicholas Grassly of Imperial College London and Andrew Rambaut of the University of Edinburgh, UK, have analysed the rate of spread. Their analysis is based on the small mutations that have accumulated in almost two dozen genetic sequences produced so far, from viruses collected from patients in Mexico and the US.

Freely available

In contrast to H5N1 bird flu, all the genetic sequences of this H1N1 are being posted on bulletin boards like GISAID, where scientists can access them and compare preliminary analyses.

The GISAID system was set up in 2006 by scientists who protested that H5N1 sequences were not being made freely available.

"The limited sampling so far gives rise to considerable uncertainty in the estimate," cautions Rambaut. But if the rate at which genes mutate is about the same for this virus as for other H1N1 viruses, the number of mutations that have accumulated so far suggests it has been circulating since January – or even September 2008.

Weak virus

If the new virus spreads from one infected person to the next at about the same speed as ordinary flu, that gives an idea of how many cases there may have been in that time. A mathematical model permits the calculation of an important variable called R₀ – the number of additional people infected, on average, by each case. If R₀ is less than one, an infection dies out.

Grassly also cautions that the estimate is very preliminary. But with the data available now, he gets an R₀ of 1.16 – enough for the virus to keep going, but only just.

This could be good news. In epidemiological theory, at least, the lower the R₀, the easier it may be to snuff the virus out by further hindering its spread.

But it may be too early for celebrations. The 1918 flu pandemic, caused by another H1N1 virus, started with a mild, early wave in spring and early summer. The flu lab at the Los Alamos National Laboratory in the US estimates that the R₀ of the 1918 virus in spring was only 1.45. That shot up, they estimate, to 3.75 when the virus began its lethal second wave the following autumn.

Much may now depend on how quickly the new H1N1 virus from swine adapts to people.

H5N1 Pandemic Flu - breakthrough research

From my previous article on the H5N1 Pandemic flu virus, you will know that the flu virus constantly alters its surface proteins and constantly mutates into variant forms. This means that we can be infected many times over a lifetime and a flu vaccine made last year has but a short period of effectiveness.

Now studies show that this behaviour is just a decoy to guard the virus's more vulnerable parts; a fact that might enable us to make drugs, or a vaccine, that will work on all kinds of flu, year after year.

Flu's main surface protein, haemagglutinin, looks like a lollipop. Our immune systems mostly produce antibodies to its rounded head, and it is this part that changes every year, making immunity short-lived. But in a large library of human antibodies, Wayne Marasco at Harvard University and colleagues found very few that bind its "stalk", which barely changes at all, either through time or between different flu viruses.

To see if this might provide a way to attack the virus, they produced large amounts of the antibodies that home in on the stalk and found that they cured and protected mice from two kinds of H5N1 bird flu, as well as many other flu families including H1N1 pandemic and ordinary flu. The researchers now want to develop the antibodies as a flu drug, possibly to stockpile for pandemics.

The team also plans to test the stalk antibody as a vaccine, so that people produce more of these antibodies themselves. They suspect haemagglutinin's big head is a decoy aimed to attract the immune system's attention and to stop us making many antibodies to the stalk – a delicate bit of molecular machinery that not be so easy to change to evade our immune attacks. In tests on mice, they found that the flu viruses did not evolve to escape the treatment.

Another benefit is that such antibodies stay effective for more than three weeks when injected into people, and in a pandemic could keep people alive long enough to produce their own antibodies to the virus.

H5N1 Bird Flu - Pandemic preparation?

UK to double pandemic flu drug stockpiles in a futile attempt to prepare for a an epidemic of Bird Flu (H5N1) in the UK. I carried out a research project for the European Space agency in 2006 and published a paper of the findings. I still retain an interest in the subject and my attention was drawn to a recent move by the UK government.

Pharmaceutical vaccines
Tamiflu (Oseltamivir) - 1st line vaccine is ineffective against new strains of emerging bird flu

Relenza (Zanamivir) - common flu vaccine, may dampen down the effects or the symptoms of a flu virus

UK Government statement

The UK has awarded contracts to double emergency supplies of flu drugs, promising to treat ‘everyone who is predicted to fall ill in a pandemic’. The government claims that this makes the UK one of the most prepared countries in the world. This will please the pharmaceutical lobby more than the National Health Authority.

Pharmaceutical lobby

The agreements with Roche and GlaxoSmithKline will double antiviral stockpiles, which are expected to be in place by April 2009. The contracts will deliver an additional 7.6 million treatment courses of Tamiflu (Roche) and 10.6 million treatment courses of Relenza (GlaxoSmithKline). Once the extra capacity is in place, there will be 33.5 million ineffective treatment courses of antivirals, with limited shelf life.

High mortality rates

The government states that without antiviral treatment, estimates suggest that up to 750,000 people could die in the UK during a pandemic. Antivirals will play a key role in the clinical response, reducing the severity of the illness and reducing the chance that complications such as pneumonia will set in.The onset of pneumonia is more likely to be a bacterial infection due to the immune system being seriously compromised and the treatment for bacterial pneumonia is antibiotics.

Current status

There are currently enough drugs for a quarter of the population, but the latest cross-government pandemic plan aims to cope with the worst-case scenario of an infection rate that could hit up to half the UK population. The new contracts awarded by the Department of Health is said to ensure that that aim can be met. Unfortunately that is not the case.

H5N1 mutations

The bird flu virus mutates regularly through its RNA and for it to become a pandemic affecting humans, it needs to develop the capability of crossing the species barrier, from birds to humans. It has yet to do this, as far as we are aware. Bird flu has mutated and crossed from birds to other mammals e.g. mice, rats, cats, pigs, etc. The greatest risk will come if the virus mutates from bird to human, using another mammal as an interim host.

Maybe the UK government know better. Because the bird flu has not yet mutated, it has not yet been forensically examined. Therefore, a matching vaccine has not yet been developed i.e. one that specifically targets, a yet to be mutated flu virus. In average, and with maximum effort, it takes scientists and pharmacologists 6 months to develop a new anti-viral vaccine. So we are still in danger, when the time comes, despite noises to the contrary.

UK Public Health Minister

Public Health Minister Dawn Primarolo said:

"The UK is already widely recognised as one of the best prepared countries in the world. The increased flu-drug stockpile means that we should be able to treat everyone who falls ill in a pandemic." I think the key word here is 'treat' not cure. You can treat a broken leg with a band aid but it doesn't help and will not 'cure' it.

Broken umbrella
Dawn continues "Antivirals are an important part of our robust countermeasure strategy and will ensure we respond effectively in the event of a flu pandemic." Nice speech Dawn but a think you had better look behind the pharmaceutical companies' curtains and see the truth for what it is, scary!

Further Information is available from; Roche Pandemic Preparation Toolkit AND GSK Pandemic Preparation page