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Unusual strain of flu from Mexico

More updates:

http://news.yahoo.com/s/ap/20090510/ap_on_he_me/med_swine_flu

US, Costa Rica swine flu deaths reported
By RORY MARSHALL and MARIANELA JIMENEZ, Associated Press Writers Rory Marshall And Marianela Jimenez, Associated Press Writers
56 mins ago

SEATTLE – A Washington state man with underlying heart conditions became the third person infected with swine flu to die in the U.S., health officials said Saturday, while Costa Rica reported the first swine flu death outside North America.

Japanese authorities, meanwhile, scrambled to limit contact with their country's first cases, and Australia and Norway joined the list of nations with confirmed cases of swine flu.

A Snohomish County man in his 30s died on Thursday from what appeared to be complications from swine flu, the state Department of Health said in a statement. The man had underlying heart conditions and viral pneumonia at the time of his death, but swine flu was considered a factor in his death, the statement said.

The man, who was not identified, reportedly began showing symptoms on April 30.

His death and the death of a 53-year-old man in Costa Rica on Saturday brings the global death toll to 53, including 48 in Mexico, three in the United States and one in Canada.

Like other deaths outside Mexico, the Costa Rican man suffered from complicating illnesses, including diabetes and chronic lung disease, the Health Ministry said.


Previously, U.S. authorities reported swine flu deaths of a toddler with a heart defect and a woman with rheumatoid arthritis, and Canadian officials said the woman who died there also had other health problems but gave no details.

In Mexico, where 48 people with swine flu have died, most of the victims have been adults aged 20 to 49, and many had no reported complicating factors. People with chronic illnesses usually are at greatest risk for severe problems from flu, along with the elderly and young children.

The Costa Rican fatality was one of eight swine flu cases in the country confirmed by the U.S. Centers for Disease Control and Prevention, Health Minister Maria Luisa Avila told The Associated Press.

Avila said officials had been unable to determine how the Costa Rican patients became infected, but she said he had not recently traveled abroad. Many flu sufferers in other nations have been linked to recent trips to the United States or Mexico.

Mexico, which raised its count of confirmed cases to 1,626 based on tests of earlier patients, continued to gradually lift a nationwide shutdown of schools, businesses, churches and soccer stadiums.

But an upswing in suspected — though not confirmed — cases in parts of Mexico prompted authorities in at least six of the country's 31 states to delay plans to let primary school students return to class on Monday after a two-week break.


"It has been very stable ... except for those states," Health Department spokesman Carlos Olmos said, referring to states in central and southern Mexico.

Mexican health authorities released a breakdown of the first 45 of the country's 48 flu deaths that showed that 84 percent of the victims were between the ages of 20 and 54. Only 2.2 percent were immune-depressed, and none had a previous history of respiratory disease.

In Japan, authorities quarantined a high school teacher and three teenage students who tested positive in an airport test for swine flu after they returned from a school trip to Canada. Officials said they were working with the World Health Organization to contact at least 13 people on the flight who had gone on to other destinations.

Japanese Health and Welfare Minister Yoichi Masuzoe acknowledged it would be difficult to trace everyone who came into contact with the infected Japanese, who visited Ontario on a home-stay program in a group of about 30 students. The three were isolated and recovering at a hospital near Narita International Airport.

"There are limitations to what we can do, but we will continue to monitor the situation and strengthen or relax such measures as needed," he told reporters.

Public broadcaster NHK TV urged people who were aboard the same Northwest Airlines flight from Detroit to call a special telephone number for consultations. So far, 49 people had been traced and would be monitored for 10 days, officials said.

Australia reported its first case Saturday in a woman it said was no longer infectious. She first noticed her symptoms while traveling in the U.S., federal Health Minister Nicola Roxon told reporters.

New Zealand — the first country in the Asia-Pacific region to confirm cases — reported two more Saturday for a total of seven. The two high school students returned last month from a school trip to Mexico. Six of the country's cases were in students and a teacher on that trip; the seventh traveled on the same plane as the group.

Norway's National Health Directorate reported that country's first two confirmed cases: a man and a woman, both aged 20, who had been studying in Mexico.

In Canada, officials said almost 500 hogs quarantined on an Alberta farm after being diagnosed with swine flu had been killed because animals were becoming overcrowded since the facility was barred from shipping any to market.


"They were not culled for being sick. They were culled because of animal welfare concerns," Dr. Gerald Hauer, the province's chief veterinarian, told reporters. He said about 1,700 pigs remained on the farm.

Authorities have said the pigs apparently became infected from a farm worker who had been in Mexico. Experts say people cannot catch flu from eating pork, but in rare cases people have been infected by contact with a live pig.

___

Marshall reported from Seattle; Jimenez reported from San Jose, Costa Rica; Associated Press writers Yuri Kageyama and Mari Yamaguchi in Tokyo, Jeremiah Marquez in Hong Kong, Ray Lilley in Wellington, New Zealand, Dennis Passa in Sydney and Debby Wu in Taipei, Taiwan, contributed to this report.
 
Ref:  http://vcds.dwan.dnd.ca/vcds-exec/pubs/canforgen/2009/085-09_e.asp

CANFORGEN 085/09 CDS 014/09 081253Z MAY 09
CF INFLUENZA FORCE PROTECTION MEASURES - MESSAGE 2
UNCLASSIFIED


REF. A : PLAN DE CONTINGENCE DES FC ET DU MDN POUR LES MESURES D
INTERVENTION EN CAS D UNE ECLOSION DE GRIPPE PANDEMIQUE, 30 JANVIER
2007



1.  NOTE THAT THIS MESSAGE APPLIES ONLY TO CF PERSONNEL (REG F, CLASS B AND CLASS C RESERVE SERVICE)


2.  GIVEN THE SITUATION EMERGING IN NORTH AMERICA WITH RESPECT TO INFLUENZA A (H1N1), THE CF HAS BEGUN INITIAL PRECAUTIONARY MEASURES INCLUDING IMPLEMENTING THE ALERT (PLANNING) PHASE OF REF A. THESE ACTIONS SHOULD NOT BE CONSTRUED AS AN INDICATOR OF ANY ANTICIPATED ESCALATION OF CONCERN BUT RATHER AS PRUDENT PREPARATION AIMED AT GUARANTEEING FORCE PROTECTION AND CONTINUITY OF OPERATIONS SHOULD THE SITUATION WORSEN. THE WORLD HEALTH ORGANIZATION AND PUBLIC HEALTH CANADA ADVISE THAT THE NUMBER OF INCIDENTS MAY EITHER ESCALATE OR DECREASE IN THE COMING WEEKS


3.  IN LIGHT OF THE FACT THAT ALL A(H1N1) INFLUENZA CASES WITHIN CANADA HAVE A NEXUS ORIGINATING EITHER IN MEXICO, OR FROM DIRECT CONTACT WITH SOMEONE WHO HAS RECENTLY RETURNED FROM MEXICO, PART OF THE CF S PRUDENT PRELIMINARY ACTION IS TO THEREFORE RESTRICT CF PERSONNEL (REG F, CLASS B AND CLASS C RESERVE SERVICE) FROM TRAVELLING TO MEXICO FOR NON-OPERATIONAL PURPOSES UNTIL FURTHER NOTICE, REF B REFERS


4.  THE PURPOSE OF THIS DIRECTION IS TO ENABLE FORCE PROTECTION TO ALLOW THE SUSTAINMENT OF OPERATIONS AS WELL AS TO SUPPORT THE GOVERNMENT OF CANADA (GOC) IN THEIR INFLUENZA MITIGATION AND RESPONSE EFFORTS


5.  ALL CF MEMBERS RETURNING FROM MEXICO ARE TO FOLLOW THE PREVIOUSLY RELEASED GUIDANCE WITHIN REF C


6.  FOR THOSE CF MEMBERS WHO HAVE MADE TRAVEL PLANS IN CONJUNCTION WITH PRE-APPROVED LEAVE AND INCURRED INCREMENTAL EXPENSES, AN APPLICATION CAN BE MADE THROUGH THEIR CHAIN OF COMMAND FOR REIMBURSEMENT OF ANYFINANCIAL LOSSES THAT CAN NOT BE RECOVERED FROM THE TRAVEL ORGANIZATION (AIRLINE, HOTEL, TRAVEL AGENCY)


7.  ALL COMMANDING OFFICERS ARE DIRECTED TO PROMULGATE THE ENCLOSED TRAVEL RESTRICTION MEASURES AND STRESS THE IMPORTANCE OF PREVENTION AS THE BEST DEFENCE TO PREVENT THE SPREAD OF DISEASE


8.  THE CF HEALTH SERVICES WILL ALSO BE INCREASING ITS VIGILANCE ON ALL SUSPECTED INFLUENZA CASES


9.  YOU WILL BE ADVISED OF ANY FURTHER RELEVANT INFORMATION
 
Breaking News - Celebrity Swine Flu Fatality

And we all know who gave it to him…
 
Military says it's prepared if swine flu strikes in Afghanistan

By Patrice Bergeron, THE CANADIAN PRESS
   
 


 

KANDAHAR, Afghanistan - Canada's military says it will be prepared if swine flu strikes soldiers serving in Afghanistan.

Canadian military personnel have put in place testing procedures at the hospital inside the base at Kandahar Airfield.

"Part of our plan is to screen all incoming passengers into the area of responsibility here in Kandahar, so all of the personnel that we have are screened before they arrive," said Lt.-Col. Ron Wojtyk, a Canadian military surgeon and the head physician at the base's NATO hospital.

He said every new arrival is required to fill out a brief questionnaire.

The newcomers are asked if they have a cold, a fever or any muscle aches or pains. They are also asked if they have been to Mexico and if they have come into contact with anyone who has had an influenza-like illness.

"If they say 'Yes' to any of those then they have to see a medical person," Wojtyk said.

In the next few months, 21,000 American soldiers will be deployed in the Kandahar area where they will join more than 1,000 Canadian military personnel.

Around 70,000 foreign soldiers are serving across Afghanistan.

There have been no reported cases of swine flu in the country, which already faces a litany of public health problems.

The only known pig in Afghanistan, a predominantly Muslim country, was quarantined recently at a zoo in Kabul.

"From what I've seen, we're well prepared," said Wojtyk.

If a soldier shows symptoms of influenza, they will be given a test for a general flu.

"If the (general) test is positive, we treat it as if the person is suffering from swine flu, as a preventive measure, to keep the infection from spreading," said Wojtyk, adding that samples will be shipped to labs outside of Kandahar for analysis.

He also said the hospital has an adequate supply of medication to treat the flu if there is an outbreak.

Canadian military lawyer John McKee said the situation could become complicated because there are no laws outlining the responsibilities of NATO armies in the case of a pandemic.

"We've got a lot of new troops coming in now from various nations and what if some bring it?" McKee said.

"We have to look at what the laws are, we have to look at the laws in different nations, we have to look at ... security concerns.

"We think we've got the right answer and it works, but then one of the variables changes, and this is the interesting part of the game."


http://cnews.canoe.ca/CNEWS/Canada/2009/05/13/9448546-cp.html

 
Yikes.

http://ca.news.yahoo.com/s/capress/090517/national/flu_summer_wave

By Helen Branswell, The Canadian Press

TORONTO - Spread of swine flu in North America may not dampen down in coming weeks as was first expected, some health officials and flu experts are now suggesting.


Some are now planning for the possibility the new virus may continue to trigger infections into the summer, not petering out in the way seasonal flu strains typically do as temperatures rise in the Northern Hemisphere.



"This is what worries me," says Dr. Arnold Monto, an influenza expert at the University of Michigan's School of Public Health.


"We are seeing a fair amount of circulation of the swine flu virus. And I'm not yet convinced that it's going to go away completely."


"It may dampen down a bit as schools close. But I think we're still seeing increasing transmission in the U.S. And I think in addition you have far more transmission in Canada than some people are saying - it's not just imported cases and circles around imported cases."


Monto's concern is echoed by Dr. Allison McGeer, an influenza expert at Toronto's Mount Sinai Hospital.


McGeer says abnormal flu activity levels for this time of year are making her question "the delusion that this was actually going to quiet down and we weren't going to have a first wave" over the late spring and summer.


"On a relative scale there's not a lot of it," she says of swine flu transmission in Canada's largest city.


"But it's very clearly starting to increase. I suppose it could shut itself off at any given time. But the last couple of days look like we're going to see a (flu) season," McGeer said.


"In Toronto, at least, I think we're gone."


If the virus were to take a summer hiatus in the Northern Hemisphere, it would give public health officials more time to plan for a possible surge in cases in the fall. The swine flu virus is now causing mild illness in the vast majority of cases, but experts fear that could change as the new virus evolves.


It would also buy time on the vaccine front. Vaccine production has not yet begun and it is expected it would take between four and six months before the first doses would be ready.


The U.S. Centers for Disease Control is now working the possibility of a summer wave into its planning, a senior official with the agency admits.


"CDC is preparing for the possibility that influenza may continue to circulate at present levels through the summer," says Dr. Daniel Jernigan, deputy director of the influenza division.


"For seasonal influenza, activity (during summer) generally drops to a very low level, however, with this new H1N1 strain, we may see some continued activity."


"One strong possibility is that the new strain will begin increasing in activity early this fall, and we want to be prepared for that."


Sunday marked one month since the CDC sounded an international alarm about a new swine flu virus potentially spreading among humans.

The agency had received a virus sample retrieved from a boy in San Diego, Calif., who had been sick with influenza like illness. Testing suggested he was infected with an influenza A virus. But standard diagnostics that look for known human flu strains could not subtype the virus.

The CDC labs confirmed the boy - who had had no contact with pigs - had been infected with a never-before-seen swine flu virus. On April 17, American authorities notified the World Health Organization that a virus with pandemic potential might be circulating in the U.S. Southwest.

In short order the WHO raised the global pandemic alert level to Phase 5, the brink of a pandemic.

By Sunday, laboratories in 39 countries around the globe had confirmed nearly 8,500 cases, a figure that is without doubt only a fraction of the actual infections that have occurred. Late last week the CDC's Jernigan estimated upwards of 100,000 people in the U.S. may have been infected already.

To date four countries have reported a total of 75 deaths due to swine flu infection.

Initially the WHO and authorities in North America predicted rising temperatures and the approaching end of the school year might mean transmission in the Northern Hemisphere would slow to a trickle, with action shifting to the Southern Hemisphere, where the start of flu season is imminent.

For reasons that science can't yet fully explain, human flu viruses don't transmit well during the summers of the Northern or Southern Hemisphere - hence the term "seasonal" influenza viruses.

But it's known from previous pandemics that pandemic viruses can rewrite the rules when they first emerge.

The virus responsible for the Spanish flu pandemic, first spotted in some places in the spring of 1918, returned with a vengeance in late August and early September of that year on the east coast of North America.

That was abnormally early for influenza. Though flu activity can start to pick up in late November, transmission typically takes off around Christmas and peaks sometime in January or February.

- Follow Canadian Press Medical Writer Helen Branswell's flu updates on Twitter at CP-Branswell
 
No Guidance on How to Rein In the Flu, NY Times

As schools shut down because of the flu — with a dozen closed in New York and hundreds in Texas and Japan
— health officials are asking a question for which there is little guidance, even in pandemic plans: what is
the best way to stop an epidemic that spreads mostly in schools rather than in nursing homes?

Many school officials have shut the doors and had the custodians disinfect the empty buildings.

But that leaves parents confused and frustrated. Those whose schools remain open may fear that their
children are in danger, and those with healthy children whose schools close may feel that officials have
overreacted, burdening them with day-care costs and denying their young ones an education.

Even guidance from the top is ambivalent.

On May 4, the acting director of the Centers for Disease Control and Prevention, Dr. Richard E. Besser,
said “closing schools is not effective” at halting the spread. Previously, the centers had advised schools
to shut for up to two weeks if a confirmed case was found.

On Monday, New York City closed four more Queens schools after outbreaks of flu symptoms, bringing
the total to 16 ordered shut since last week. In Texas, hundreds have been closed at various times.

“There’s no right answer,” Mayor Michael R. Bloomberg said at a news conference. “I’ve asked the question,
‘What would you do, Dr. Frieden, if you wanted to prevent the spread of flu around the entire student
population?’ And the answer is, ‘Closing the schools for a month, prohibit all interaction among kids outside
of school, and even then there’s no guarantee that you can do that.’ The bottom line is, case-by-case basis
is probably the right thing.”

(Mr. Bloomberg was referring to Dr. Thomas R. Frieden, the city’s health commissioner, who has just been
nominated to be chief of the C.D.C.)

...

One thing is clear, infection control experts say: disinfecting closed schools is pointless. Flu viruses are
believed to live on objects for perhaps two to eight hours, so a week’s closing will kill them. But when
students return, if a few are sick, every cafeteria table, desk, lab beaker, doorknob, bathroom tap and
basketball will soon be recontaminated.

Washing schools “is done for looks,” said Michael Olesen, a Minnesota infection control specialist. “It’s not
a rational approach.”

The C.D.C.’s swine flu Web sitehas infection-control guidelines for many settings: hospitals, nursing homes,
day-care centers and even dialysis clinics. But it has nothing specific to the core of this outbreak: schools
full of teenagers. Teenagers, experts say, are different from the victims of seasonal influenza. The
bed-ridden, the very ill and infants can be forced to practice good hygiene, or isolated or sent home if
they won’t.

But teenagers resist tedious advice to wash their hands for 20 seconds, cover every cough with a tissue
or sleeve and stay away from other teenagers. If school is closed, they are likely to get together at the
park or the mall. Keeping sick students out of school is the most crucial step, said Dr. Yoko Furuya, an
infection control specialist at NewYork-Presbyterian/Columbia hospital. But that can be impractical. And
students can shed virus for a day before they are sick.

“I’d lean toward getting surgical masks on them and trying to get to the end of the school year,” said
Mr. Olesen, who is reluctant to see schools shut. “The masks capture all those droplets at the point of
release.”

And how, he was asked, could students be made to do that?

“I don’t know how, but they make them do other things,” he said.

Amy D. Nichols, chief of infection control for the University of California at San Francisco Medical Center,
said she would like to see “schools just as awash in alcohol hand rubs as hospitals are, so it’s easy and
quick to clean one’s hands.” Ms. Nichols favors making students disinfect their hands before entering each
class, the gym or the cafeteria.

“In junior high, you want to be like everyone else,” she said. “So schools should have wall-mounted push
dispensers. That way it becomes part of the culture of the schools. The more people push the handle, the
more everybody else does.” She also favors cleaning surfaces as often as is practical, because other risks
like antibiotic-resistant bacteria persist longer than flu.

What to do with sick students whose working parents cannot afford babysitters is another problem. Asked
if schools could set up cots in a gym for ill students, Mr. Olesen demurred. “I don’t know,” he said. “Cots
for kids in puberty with their hormones raging? That’s a whole other public health problem.”

Even if schools make it to summer break, hot weather may slow, but not solve the problem, the C.D.C. said
Monday. “We’d love to see a decrease in cases, but in the past there have been outbreaks of seasonal
influenza even in summer camps,” said Dr. Anne Schuchat, the agency’s interim deputy director for public
health.

Confirming anecdotal observations that this flu concentrates in young people, Dr. Schuchat said preliminary
studies of family transmission showed that when one member gets infected, the most likely to follow are
those under 18, not parents or grandparents. .

In Geneva, swine flu topped the agenda of the annual assembly of world’s health ministers. Britain, Japan and
other countries with many cases argued that World Health Organization pandemic alerts should measure a
virus’s severity, not just its spread. Dr. Margaret Chan, the health organization’s director-general, said she
would consider keeping the alert level at 5, and warned that the virus’s initial mildness had “handed the world
a grace period.”

“I strongly urge you to look closely at anything and everything we can do, collectively, to protect developing
countries from once again bearing the brunt of a global contagion,” Dr. Chan said.

Reporting was contributed by Anemona Hartocollis, David Chen and Sharon Otterman.
 
Mexico City lifts swine flu curbs, Friday, 22 May 2009 05:13 UK

_45807899_waiters_ap226b.jpg

Businesses in Mexico City have been
hit hard by the flu outbreak


Mexico City has lifted all restrictions imposed last month, following an outbreak
of swine flu across Mexico. Mayor Marcelo Ebrard said no new infections had been
reported for a week in the capital and there was no longer a need to wear mask
in public places.

The city virtually ground to a halt at the height of the flu emergency, with schools,
bars and cinemas closed. Mexico's flu death toll rose by three to 78 on Thursday,
officials said. Some 4,000 people have been infected.

Mayor's plea

Authorities in the sprawling capital on Thursday lowered its four-level alert system
from "yellow" to "green" - the lowest level.

"We can calm down now," Mayor Ebrard said. "Now you can come to the city without
any risk," he said, adding that there was "no longer any need" to wear masks in public
places. However, the mayor urged residents of the city to remain.

The World Health Organization said on Thursday that 41 countries had reported 11,034
cases of swine flu , or influenza A (H1N1) infection, including 85 deaths. The world
remains at the second-highest flu alert level, which means an "imminent pandemic".
 
Spread of Swine Flu Puts Japan in Crisis Mode, May 21, 2009


Models’ Projections for Flu Miss Mark by Wide Margin

In the waning days of April, as federal officials were declaring a public health emergency and the world
seemed gripped by swine flu panic, two rival supercomputer teams made projections about the epidemic
that were surprisingly similar — and surprisingly reassuring. By the end of May, they said, there would
be only 2,000 to 2,500 cases in the United States.

May’s over. They were a bit off.

On May 15, the Centers for Disease Control and Prevention estimated that there were “upwards of 100,000”
cases in the country, even though only 7,415 had been confirmed at that point.

The agency declines to update that estimate just yet. But Tim Germann, a computational scientist who
worked on a 2006 flu forecast model at Los Alamos National Laboratory, said he imagined there were
now “a few hundred thousand” cases. (At their peaks, epidemics are thought to double in as little as
three days, which could drive the number into the millions, but Dr. Germann said he would not use
such a rapid doubling rate unless it was a cold November and no countermeasures, like closing
schools, were being taken.)

What went wrong?

The leaders of both the Northwestern University and Indiana University teams seemed a bit abashed
when they were asked that last week. Northwestern’s predictions got the most publicity because of
the eye-catching metric for predicting spread: data from Where’s George?, a Web site that tracks
millions of dollar bills as they move around the country.

Dirk Brockmann, the engineering professor who led the team, said the realization that his initial
estimates had been far too low struck him on May 11, when British, Mexican and World Health
Organization researchers published a study in the journal Science tracing the first days of the
outbreak. They estimated that it had begun in rural La Gloria, Mexico, in mid-February and
that by April 30 there were 6,000 to 32,000 infections throughout Mexico.

“The numbers of reported cases in Mexico that we plugged in at the beginning of our model were
orders of magnitude lower,” Dr. Brockmann said. He is still proud, he said, of how well his model
predicted geographical spread in the United States. He had to adjust it for the unexpected infusion
of cases stemming from students at St. Francis Preparatory School in New York City who brought
the virus back from spring break in Cancún, but otherwise it was accurate in predicting that
California, Texas, Illinois and Florida would be hot spots.

Alessandro Vespignani, the informatics professor who led Indiana’s team, was a little more defensive,
suggesting that he was either misquoted or had misunderstood the question on May 2 when he was
reported as estimating that there would be about 2,500 cases by month’s end. His first model
predicted 9,500 cases by May 24, he said.

Dr. Vespignani said he felt the C.D.C. estimate of 100,000 or more was “a bit of an overshooting.”
However, he pointed out, his adjustment of his figures on May 17 had an upper estimate of 100,000
for the end of May, and if one assumed that the disease centers counted asymptomatic cases and
he did not, then that could stretch to 150,000.

Decisions by the C.D.C. and state health departments to stop confirming most cases in laboratories
“is making our life miserable,” he said, adding, “If you don’t have good data, you don’t make good
predictions.”

Both professors said they would use the experience to refine their models for the future. Dr. Brockman
has not updated his since May 9. “For this disease, we won’t put out another projection,” he said. “Once
it’s in the dispersal phase, exponential growth kicks in. You don’t need a sophisticated model anymore.”
 
WHO: Swine flu 'very close' to pandemic

By THE CANADIAN PRESS
Last Updated: 9th June 2009, 12:45pm

The World Health Organization says it is very close to declaring that the swine flu outbreak is a pandemic.

The WHO’s top flu expert says it’s clear that the virus is spreading in the community in parts of Australia, which is a sign the agency has been looking for to declare the outbreak a pandemic.

Dr. Keiji Fukuda says the WHO is working with countries trying to help them get ready for a pandemic declaration.

He says the WHO is concerned that the declaration not lead to a blossoming of anxiety and that countries not react with actions that aren’t needed at this point.

Fukuda also says the WHO is very concerned about reports from Manitoba where it appears that aboriginal populations are being hard hit by the infection.

He says that is the type of development that was seen in previous pandemics.
 
And it's official, according to the WHO- swine flu is now a global pandemic.

http://www.cbc.ca/world/story/2009/06/11/s...o-pandemic.html

The world is in a swine flu pandemic, WHO tells some members
Last Updated: Thursday, June 11, 2009 | 10:17 AM ET Comments44Recommend28CBC News
The World Health Organization has privately told several countries that the global pandemic level will be raised to Phase 6 before the end of Thursday, as experts held an emergency meeting in Geneva to discuss the spread of the virus.

Health ministries in Thailand and Indonesia said an email alert from WHO advised them that a pandemic would be declared by midnight local time.

WHO director general Margaret Chan called an emergency conference call with leading flu experts to discuss the outbreak of the virus, which has spread to 74 countries.

Chan will hold a press conference at 11:30 a.m. ET, when she is expected to make the official announcement that a pandemic has been declared.

'It is likely in light of sustained community transmission in countries outside of North America — most notably in Australia — that Level 6 will be declared.'
— Scotland's Health Secretary Nicola SturgeonMoving to Phase 6 — the highest level — means a pandemic has been confirmed and the H1N1 virus is spreading from person to person in a sustained manner outside North America, where the outbreak began in April.

A pandemic declaration indicates geographic spread, not the severity of the illness.

The declaration would mark the first pandemic call since 1968, when Hong Kong flu killed about one million people.

Health officials from Scotland, Indonesia and Thailand said the United Nations health agency would raise the pandemic alert level to Phase 6 after the teleconference concluded on Thursday. Officials with the UN have also said they expect the declaration of the global pandemic is imminent.

Some countries alerted already
"It is likely in light of sustained community transmission in countries outside of North America — most notably in Australia — that Level 6 will be declared," Scotland's Health Secretary Nicola Sturgeon told Scottish legislators, adding the announcement would be made Thursday.

"We are ready, because we have the experience with bird flu," Indonesian Health Minister Siti Fadilah Supari told reporters. "The Health Ministry is on the highest alert and people need not panic. We have sent a circular to all hospitals to prepare themselves."

Seasonal flu kills about 250,000 to 500,000 people each year.

The WHO's latest statistics indicate the virus has infected 27,737 people in 74 countries and caused 141 deaths. Most of the cases have been in North America, but Europe and Australia have seen a sharp increase in recent days.

The WHO had been trying to ready the world for a pandemic declaration for some time, saying the new H1N1 virus shows no signs of abating.

A pandemic declaration would prompt drugmakers — which is expected to be ready by the end of year — to speed up the production of a swine flu vaccine, and prompt government to invoke their pandemic plans and increase efforts to contain the virus.

Moderate effects
Countries' individual pandemic plans could include investing more money into health services, imposing quarantines, closing schools, travel bans and trade restrictions.

The WHO has said it does not support travel bans or trade restrictions in the wake of swine flu.

"The disease is pretty moderate in its effects so far, so you wouldn't want to disrupt daily like too much," said WHO spokesman Gregory Hartl. "We're not in an Armageddon scenario."

The spike in infections in Australia is one reason the world would be pushed to the pandemic level. The WHO listed Australia's confirmed cases at 1,224 by late Wednesday.

Dr. Donald Low, medical director of Ontario's public health laboratories, said much of the world has already been treating the virus as though it was a pandemic for several weeks.

"I don't see what would possibly change calling this a pandemic," Low said.

The virus is already widespread across Canada, and he doesn't foresee any panic being triggered by a pandemic declaration, he said.

As of Monday, 2,446 laboratory-confirmed cases of H1N1 flu virus have been reported in all provinces and territories except Newfoundland and Labrador, according to the Public Health Agency of Canada. There have been four deaths related to swine flu in the country.

Earlier this week, the WHO's top flu expert, Dr. Keiji Fukuda, said despite the fact people dismiss the illness as mild, the WHO believes a swine flu pandemic will turn out to be of moderate severity.

Though most cases of the virus have been mild, there are concerns a rash of new infections, especially in the Southern Hemisphere where it is currently winter and flu season, could overwhelm hospitals in poorer countries.

More cases in Asia
Meanwhile, Hong Kong on Thursday ordered all kindergartens and primary schools closed for two weeks after 12 students were found to be infected.

In Duesseldorf, Germany, officials said 26 students at the Japanese International School have tested positive for swine flu.

South Korea reported two new cases Thursday to bring its total to 55, and Vietnam confirmed an additional case for a total of 20.

New Zealand also confirmed four new cases, bringing the country's total to 27, chief adviser to public health Dr. Ashley Bloomfield said Thursday. Three new cases were people who had travelled and became sick after arriving back in New Zealand, and the fourth case was a worker whose travel history or links to a traveller had yet to be confirmed, she said.

Malaysia's Health Ministry said Thursday that two more people had tested positive for swine flu, bringing the country's total to 11 cases.

With files from The Associated Press
 
A Swine Flu Vaccine this soon?

http://www.msnbc.msn.com/id/31269066/ns/health-swine_flu/"

BASEL, Switzerland - Swiss pharmaceuticals company Novartis AG said Friday it has successfully produced a first batch of swine flu vaccine weeks ahead of expectations.

The vaccine was made in cells, rather than grown in eggs as is usually the case with vaccines, the company said.

The announcement comes a day after the World Health Organization declared swine flu, also known as the H1N1 virus, a pandemic. The move indicates that a global outbreak is under way. WHO says drugmakers will likely have vaccines approved and ready for sale after September.
 
PMedMoe said:
Well yeah, who wouldn't want to jump on that money train?

I think a lot of people are more nervous that they should be from what
the pandemic is so far. They probably don't know that the graduation from
the WHO to 6 isn't relate to how much you're gettng sick from that flu,
but to how many people have it officially.

"The World Health Organization recently declared a pandemic following a
sharp increase in the number of cases in Australia."


article on the spead of it in England :

'Unpredictable' swine flu spreads
 
Flu hits Canada's native peoples

_45908930_inuit_ap.jpg

It is unclear why swine flu rates are
higher in Inuit communities


Canada is investigating whether Inuit communities may be particularly badly hit by swine flu,
health officials say.

The World Health Organization thinks there are more cases than expected among young people
in the aboriginal population living in northern Canada. Recent days have seen a spike in H1N1
flu among the Inuit and the country's isolated indigenous communities. The swine flu virus can
have more serious effects on people living in poverty, the WHO says.

Of fewer than 100 people infected in Nunavut, the vast Arctic homeland of Inuits, 10 were
admitted to hospital. In Manitoba province, 16 of the 24 people in intensive care because
of swine flu are from native communities.

The BBC's Lee Carter in Toronto says there are no clear reasons why swine flu rates are higher
in Canada's indigenous communities. But poverty, substandard, overcrowded housing and
underlying health problems are thought to be the most likely culprits, he says.

Canada's federal health minister, Leona Aglukkaq, who is herself Inuit, said additional personnel
and supplies have been sent to the Inuit communities. "This is a concern and we are investigating,"
she said. "We must resist speculation, rely on the science and report only on confirmed cases."

Four people have died from swine flu in Canada though most of the 2,978 confirmed cases have
been mild.
 
Flu outbreak on reserves exposes system flaws, CTV.ca News Staff

With the world now officially facing a flu pandemic, the deplorable situation in the country's northern native
reserves is exposing flaws in the country's pandemic preparedness plan. In northern Manitoba, many
communities are struggling with a severe flu outbreak. Across the province, 24 people with flu symptoms
are breathing with ventilators and two-thirds of them are aboriginal.

In the past week, 11 residents of the Garden Hill First Nation alone have been airlifted to hospitals back
in the city, most with severe flu symptoms. Garden Hill Chief David Harper says the equipment at the
nursing station on his reserve is old or broken and nurses don't have the support of a full medical team
as they would have in an urban clinic.

Phil Fontaine, national chief of the Assembly of First Nations, says one cluster of northern Manitoba reserves
is home to about 10,000 people and doesn't have a single hospital.

Health Canada has put out a tender for nurses to work in 24 isolated reserves but says it's struggling to find
enough nurses to keep medical stations in northern Manitoba open. "Health Canada is having great difficulty
recruiting and retaining employed nurses in the nursing stations and two federal hospitals located in northern
Manitoba on reserves," the tender states. "Without adequate service, the nursing stations and hospitals may
have to close for periods of time which could result in severe medical liability."

Public health officials are saying that while Canada's pandemic preparedness plan includes specific protocols
for First Nations communities, there's been no money attached to it. In Garden Hill, Harper says the band
has already spent $2,900 so it can go and buy its own pandemic supplies, such as masks - supplies that the
federal government was supposed to provide.

Jim Wolfe, the regional director for Health Canada's aboriginal branch, says the government is working
closely with the province and aboriginal leaders to address the issue. Manitoba's chief public health officer,
Dr. Joel Kettner, says the response to swine flu has not been perfect, but has been better than in previous
disease outbreaks.

The virus's spread among Canada's aboriginals caught the attention of the World Health Organization earlier
this week, though the agency also noted that disease can take a harsher toll on people facing poverty,
substandard housing and underlying health problems.

Canadian officials say there is no evidence to support suggestions the virus's impact varies between ethnic
groups. "To make conclusions based on a couple of communities that this is somehow a disease that is
worse in a particular ethnic group -- it's much too early to make any of those kinds of conclusions or
presumptions," Dr. David Butler-Jones, Canada's chief public health officer, said at a news conference
Thursday. "We may find that in the future, but at the moment, evidence is it doesn't matter who you are;
everyone is susceptible," said Butler-Jones.

While the situation in northern native communities is severe, for the rest of Canada, the virus has not been
causing much serious illness. Canada has had 2,978 confirmed cases of the H1N1 flu, and about five per cent
of those have required hospitalization for treatment. While there have been four deaths from the strain, all
of the victims were suffering other health problems.

Infectious disease expert Neil Rau says he believe that many more Canadians have gotten the virus than what
the officials numbers indicate. "The serious cases are only the tip of the iceberg. The rest of people who have
this virus get mild disease or don't even go to the doctor," he told Canada AM Friday. "Granted there have
been some cases of otherwise healthy people getting it and that's what drew the initial alarm. But in Mexico,
perhaps millions of people had seen this virus before those deaths were described."

Canada's health minister says the Thursday's decision by the WHO to declare H1N1 a flu pandemic will do
little to change Canada's response. "I want to reassure Canada... we were prepared for this decision and
this decision does not change our approach in Canada," Health Minister Leona Aglukkaq said at a Thursday
afternoon news conference. "It is primarily a technical decision (by the WHO)," Aglukkaq said. "Thankfully,
the vast majority of illnesses remain mild."

Canada's chief public health officer said the WHO move was "based on the spread of the virus, not the
severity noting that within Canada, "the virus continues to behave like the seasonal flu." "We will continue
to tailor our domestic responses and public health measure to our own situation and to the evolving needs
of Canadians," Butler-Jones said Thursday. Rau says he believe that even globally, nothing has changed,
and the WHO's decision was a technical one based on geographic spread alone.

"The virus has not changed since we've been observing this story. What has changed is the geographic
spread," he said. "Spread alone is not cause for alarm. It's if you have a virulent or serious virus that
is also spreading." "So I'm not sure that I'm more excited about this than seasonal flu. Every year,
seasonal flu also spreads all over the world and we don't call it a pandemic because it would get to be
a kind of a tiring story. So I hope we're dealing with something a little different here, but it's not playing
itself out to be that different so far."

H1N1 has been reported in 74 countries, has caused 145 confirmed deaths and almost 30,000 cases
of illnesses.
 
China produces first A/H1N1 flu vaccines, to hit market in September, People's Daily

China's first batch of A/H1N1 flu vaccines were produced by a pharmaceutical
firm Monday. The vaccines are expected to hit the market in September after
safety tests in labs and clinical tests, said Hualan Biological Engineering Inc.

The company received the seed virus from a World Health Organization (WHO)
lab on June 4.

Source: Xinhua


Isn't a month not enough time to produce a vaccine ?!?
 
Yrys said:
Isn't a month not enough time to produce a vaccine ?!?

A month may seem like a short time, but companies have been making regular flu vaccines for years now.  This one would be very specific but they have the virus already so no guessing.

Besides, China was slow compared to Switzerland:

First batch of swine flu vaccine produced
 
Air traffic patterns used to predict H1N1 spread
Article Link

Physicians at Toronto's St. Michael's Hospital say that by quickly evaluating air traffic patterns around the world, they can predict how the virus will spread globally.

Dr. Kamran Khan, an infectious disease physician at St. Michael's, and colleagues analyzed flight itineraries of more than 2.3 million passengers who departed Mexico on commercial flights in March and April.

The research team found that countries that received more travellers from Mexico were more likely to import cases of the H1N1 flu virus.

As well, the cities that received the largest number of travellers from Mexico were more likely to have imported H1N1 flu cases.

The researchers found that welcoming 1,400 travellers from Mexico put a country at high risk of imported cases of the virus.

"It's intuitive that where people are travelling, infectious diseases are likely to follow in tandem," Khan told CTV Toronto on Monday.

More on link
 
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