H5N1

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US: Tamiflu-resistant H1N1 passed person to person

Via Health.com: Tamiflu-Resistant Swine Flu Passed Person-to-Person in U.S. Excerpt:

So far, almost all strains of H1N1 have responded to both oseltamivir (Tamiflu) and another antiviral, zanamivir (Relenza), while displaying resistance to amantadine, a drug in a different class. As a result, Tamiflu and Relenza have been used widely for both the prevention and treatment of H1N1. 

However, in June and July of 2009, 65 campers and staff at a summer camp in North Carolina became ill with H1N1 and were treated with Tamiflu, while 600 other campers and staff took the antiviral to prevent the illness. 

Two females who shared a cabin developed symptoms after starting on Tamiflu and were later found to have a virus with two viral mutations that rendered them resistant to the drug. The mutated virus was not found in other people tested. 

What’s troubling is that one of the females appears to have transmitted the mutated virus to her cabin mate. 

“It is likely that this resistant virus was passed from one camper to the other based on the timing between the illnesses and 2 genetic mutations found in the virus in both campers,” explained Dr. Natalie Janine Dailey, lead author of the study and an epidemic intelligence service officer with the North Carolina Division of Public Health Communicable Disease Branch. 

“A small number of cases of oseltamivir-resistant have been seen in the U.S. so far, but these were the first cases reported in otherwise healthy individuals and the first which appeared to have spread from one person to another.” 

“This suggests that using oseltamivir to prevent influenza in healthy people may increase the risk of resistance,” she said. “If resistance became widespread, oseltamivir would no longer be effective.”

Branswell: Do seasonal flu shots impede little kids' ability to fight off pandemic flu?

Via Google News, Helen Branswell of The Canadian Press raises the question: Do seasonal flu shots impede little kids' ability to fight off pandemic flu? Excerpt (but this is today's must-read):

Just when you thought the issue of seasonal and pandemic flu shots couldn't get any more confusing, European researchers are questioning whether it makes sense to vaccinate little kids against seasonal flu. 

The scientists, from the Erasmus Medical Center in Rotterdam, the Netherlands, argue preventing small children from being infected by - and developing immune responses to - seasonal flu viruses might make them more vulnerable when a flu pandemic rolls around. 

It's not clear the theoretical concern they raise is true. But other scientists counter that even if it is, it makes more sense to try to protect children from a threat they face every year than one they might face every few decades. 

"The simple question is should we let young children suffer from a severe and potentially fatal but easily preventable illness, just because there is a theoretical possibility that withholding vaccination might result in a slightly less severe illness sometime in the future?" a pair of Finnish researchers retorted in a counterpoint published with the perspective piece, in the journal Lancet Infectious Diseases. 

"We believe that the answer to this question is a simple one." 

The argument made by the Dutch researchers may actually support a concern raised by some Canadian scientists about a possible link between getting seasonal flu shots and catching swine flu. 

The research, which has yet to be published, is based on data from four provinces that shows higher rates of mild H1N1 infections among people who got a flu shot last year. 

The purported link, which hasn't been seen in data from several other countries, was first found by flu epidemiologist Dr. Danuta Skowronski of the British Columbia Centre for Disease Control, who noticed it in data from that province. 

The finding led most provinces to delay seasonal flu shot programs until after pandemic vaccination efforts have been completed. 

Internationally, though, the suggested link has been met with skepticism and has been dismissed by some as "the Canadian problem." Even the World Health Organization, which organized a teleconference of experts to explore the issue, has said the consensus of those experts was that the finding was probably due to a problem with the data, not a real risk. 

But the Dutch scientists, who don't refer to the Canadian research in their article, say giving kids aged six months to 59 months flu vaccine prevents them from acquiring a broad immune response to flu viruses that can only be induced by infection. 

Vaccines trigger development of antibodies to the proteins on the surface of flu viruses, proteins that change often to evade the immune system. But when you catch the flu, something called cellular immunity also kicks in. It teaches the body to recognize other parts of a flu virus; those parts don't change as much from one virus subtype to another. 

Without that cellular immunity, the Dutch researchers say, children who experience a pandemic could have more difficulty fighting off the new flu strain. They suggest this may explain why the majority of fatal cases of H5N1 avian influenza have occurred in children and young adults.

Branswell: Do seasonal flu shots impede little kids' ability to fight off pandemic flu?

Via Google News, Helen Branswell of The Canadian Press raises the question: Do seasonal flu shots impede little kids' ability to fight off pandemic flu? Excerpt (but this is today's must-read):

Just when you thought the issue of seasonal and pandemic flu shots couldn't get any more confusing, European researchers are questioning whether it makes sense to vaccinate little kids against seasonal flu. 

The scientists, from the Erasmus Medical Center in Rotterdam, the Netherlands, argue preventing small children from being infected by - and developing immune responses to - seasonal flu viruses might make them more vulnerable when a flu pandemic rolls around. 

It's not clear the theoretical concern they raise is true. But other scientists counter that even if it is, it makes more sense to try to protect children from a threat they face every year than one they might face every few decades. 

"The simple question is should we let young children suffer from a severe and potentially fatal but easily preventable illness, just because there is a theoretical possibility that withholding vaccination might result in a slightly less severe illness sometime in the future?" a pair of Finnish researchers retorted in a counterpoint published with the perspective piece, in the journal Lancet Infectious Diseases. 

"We believe that the answer to this question is a simple one." 

The argument made by the Dutch researchers may actually support a concern raised by some Canadian scientists about a possible link between getting seasonal flu shots and catching swine flu. 

The research, which has yet to be published, is based on data from four provinces that shows higher rates of mild H1N1 infections among people who got a flu shot last year. 

The purported link, which hasn't been seen in data from several other countries, was first found by flu epidemiologist Dr. Danuta Skowronski of the British Columbia Centre for Disease Control, who noticed it in data from that province. 

The finding led most provinces to delay seasonal flu shot programs until after pandemic vaccination efforts have been completed. 

Internationally, though, the suggested link has been met with skepticism and has been dismissed by some as "the Canadian problem." Even the World Health Organization, which organized a teleconference of experts to explore the issue, has said the consensus of those experts was that the finding was probably due to a problem with the data, not a real risk. 

But the Dutch scientists, who don't refer to the Canadian research in their article, say giving kids aged six months to 59 months flu vaccine prevents them from acquiring a broad immune response to flu viruses that can only be induced by infection. 

Vaccines trigger development of antibodies to the proteins on the surface of flu viruses, proteins that change often to evade the immune system. But when you catch the flu, something called cellular immunity also kicks in. It teaches the body to recognize other parts of a flu virus; those parts don't change as much from one virus subtype to another. 

Without that cellular immunity, the Dutch researchers say, children who experience a pandemic could have more difficulty fighting off the new flu strain. They suggest this may explain why the majority of fatal cases of H5N1 avian influenza have occurred in children and young adults.

China: "Endless troubles" without proper flu inoculation

Via Xinhua: China warned of "endless troubles" without proper flu inoculation. Excerpt:

China's top epidemiologist Zeng Guang on Thursday urged more people to be inoculated against A/H1N1 flu while reassuring the public about the vaccine safety.     

"If people do not have themselves vaccinated now, there will be endless troubles in the future," Zeng Guang, chief epidemiologist of the Chinese Center for Disease Control and Prevention (CDC), said in an interview with Xinhua.     

"With the number of patients with severe symptoms growing, China's medical treatment capacity, such as equipment and personnel, is to face huge challenges. We need to prepare in advance."     

He said a peak of the A/H1N1 flu outbreaks in China was expected between this winter and spring.     

An estimated 400,000 people in China had been inoculated with A/H1N1 flu vaccine and no serious adverse reaction had been reported.     

"No vaccine is totally risk-free," he said. "But the benefits of such a vaccine is much greater than its risks."     

Zeng said many technologies China used in producing the A/H1N1 flu vaccines were those being used in producing regular flu vaccines. "They are mature technologies."     

A recent survey by popular web portal sohu.com showed that more than 54 percent of the 2,000 respondents said they did not plan to be vaccinated out of the safety concerns over the shot.

Canada: Vaccine clinic for pregnant women overwhelmed

Via CBCnews.ca, a report from Nova Scotia: Vaccine clinic for pregnant women overwhelmed.

A special H1N1 vaccination clinic for pregnant women at the IWK Health Centre in Halifax was overwhelmed Thursday and started turning people away three hours after it opened. 

The clinic opened at 9:30 a.m. and by 12:30 p.m., it had reached its capacity for the day. 

Women had to be turned away to ensure everyone already in line could get shots during scheduled hours. The women were advised to return Friday when the clinic reopens at 9:30 a.m. 

Silvia Katkin was the first of 238 vaccinated at the special clinic. She is one week past her delivery date and will be induced to give birth to her second child on Friday. 

Katkin said she had no plans to get vaccinated against the H1N1 virus until she heard about a 13-year-old boy in Ontario who died from swine flu. 

"I got really, really scared from all these kids dying around the world and in Canada and the United States," Katkin said. "I was totally against getting vaccinated, but the death of the little boy in Toronto actually changed my mind."

Italy: 5 H1N1 deaths in a day

Via the excellent blog Nuova Influenza: H1N1 - UNDICI VITTIME IN ITALIA - 5 DECESSI IN 24 ORE. [H1N1 - 11 victims in Italy - 5 deaths in 24 hours] My Italian isn't good enough to try a translation, but it does sound serious.

Meanwhile, Corriere della Sera reports 12 deaths, 4 of them in Naples in 48 hours.

Unidentified flu outbreak in Western Ukraine

Thanks to the reader who sent the link to this report in Zik.com.ua: Unidentified flue outbreak in Western Ukraine. Excerpt:

Western Ukraine was hit by a severe epidemic of unidentified influenza, tentatively diagnosed by doctors as viral pneumonia. The number of dead has climbed dramatically. Doctors advise Western Ukrainians to stay at home and use preventive medication. The first pedestrians wearing face masks have been seen on Lviv streets. 

Lviv kindergartens and schools have been closed, and the city council is to have its emergency session soon to address the flue outbreak. So far, the information released by the authorities on the epidemic dimensions spread and preventive measures is scarce, causing panic to spread in the city. 

Here are the latest reports on the situation in other W.Ukraine oblasts: 

Ternopil oblast 

As the number of sick persons increases, the authorities describe the situation as rather serious, says Ternopil oblast chief medical officer Bohdan Onyskiv. 

“In all, 262 patients are treated in hospitals, of these 16 in serious condition.18 children have died in rural areas and 70 in Ternopil,” he says. Onyskiv confirmed that they died from viral pneumonia.

The report goes on to mention six deaths among young people with "severe hemorrhagic pneumonia," which I have never heard of. Can anyone confirm such a condition?

US: NY Governor Paterson declares swine flu emergency

Via AuburnPub.com: Paterson declares swine flu emergency. Excerpt:

Gov. David Paterson declared a state of emergency, saying a recent rise in swine flu cases has created a "disaster" and that certain provisions of state law needed to be set aside to get people vaccinated as quickly as possible. 

The executive order Thursday means that far more health care professionals -- including dentists, dental hygienists, podiatrists, pharmacists, midwives and physicians assistants -- will be permitted to administer swine flu and seasonal flu vaccines with only brief training. 

The declaration will help avoid overwhelming hospitals, clinics and other health care facilities with swine flu cases, according to Paterson's order. 

It also allows health centers in schools, which have been particularly hard hit, to vaccinate children and adults.

India: 463 deaths

Via Prokerala.com: Six swine flu deaths in India raise toll to 463. Excerpt:

Six swine flu deaths, including five in Karnataka alone, were recorded Thursday, taking the total toll due to the Influenza A (H1N1) virus to 463 in India, health authorities said here. 

Apart from the five deaths in Karnataka, one death was also recorded in Maharashtra. With the five deaths, the total number of people who have died due to the contagious virus in Karnataka has climbed up to 117. 

However, Maharashtra continues to top the list of states that record the highest number of deaths in the country since the first one was recorded Aug 3. With the one death, the toll has now risen to 197 in the state, where over 3600 people have been affected with the flu. 

Also, the country reported 75 new cases, taking the number of people affected with the flu to 13,722.