H1N1 flu victim collapsed on way to hospital [Latest H1N1 updates downthread]

Swine flu infects cells deep in lungs: study

PARIS (AFP) –- Swine flu can infect cells deeper in the lungs than seasonal flu, thus helping to boost the severity of the illness, a study said.

The paper provides the first laboratory corroboration of reports from front-line doctors that some patients with A(H1N1) virus suffer worse symptoms compared to those with run-of-the-mill seasonal flu.

Influenza viruses penetrate cells by attaching themselves to molecules called receptors, located on the outside of the cell wall.

The virus’ docking spike and the receptor are like a key and a lock. Some viruses only open a few cells, while others have something rather closer to a pass key, making it possible to infect a larger cell variety.

Once inside, the virus uses the cell’s machinery to replicate, eventually bursting the cell and going on to attack others.

Seasonal strains attach themselves almost exclusively to cells found in the nose, throat and upper airway, producing a some of influenza’s signature symptoms: runny nose, scratchy throat, a dry cough.

But the new research, published in the journal Nature Biotechnology, shows that the new swine flu — by sticking to a greater range of receptors — can also breach cells deep in the lungs.

Lab-dish experiments were carried out by Ten Feizi of Imperial College London and colleagues in which 86 different receptors were exposed to both seasonal and pandemic flu.

The seasonal strains only locked onto the kind of receptors found in the upper respiratory track.

But the swine flu virus was also able to latch onto receptors found deep inside the lungs, albeit more weakly. The adhesion results in a more severe lung infection.

Feizi spelt out the risk of what could happen if natural selection encourages viral strains that favor this deep-lung penetration.

“If the flu virus mutates in the future, it may attach to the receptors deep inside the lungs more strongly, and this could mean that more people would experience severe symptoms,” said Feizi.

“We think scientists should be on the lookout for these kinds of changes in the virus so we can try to find ways to minimize the impact.”

Using a statistical technique, epidemiologists sifting through data from other countries have found similarly disquieting patterns.

French epidemiologist Antoine Flahault has reported a 100-fold increase, compared to seasonal flu, in the number of swine flu deaths in Mauritius and New Caledonia attributed directly to the virus itself rather than secondary bacterial infections or underlying conditions.

Many of those deaths were caused by acute respiratory disease syndrome (ARDS), which requires intensive-care treatment for an average of three weeks. Only 50 percent of ARDS patients survive.

http://www.tehrantimes.com/index_View.asp?code=203357

Swine Flu: H1N1 Virus More Dangerous Than Suspected, Except To Survivors Of The 1918 Pandemic Flu Virus
ScienceDaily (July 14, 2009) — A new, highly detailed study of the H1N1 flu virus shows that the pathogen is more virulent than previously thought.

See also:
Health & Medicine
•Influenza
•Bird Flu
•Cold and Flu
Plants & Animals
•Bird Flu Research
•Virology
•Microbes and More
Reference
•Flu vaccine
•Spanish flu
•Avian flu
•Pandemic
Writing in a fast-tracked report published July 13, 2009 in the journal Nature, an international team of researchers led by UW-Madison virologist Yoshihiro Kawaoka provides a detailed portrait of the pandemic virus and its pathogenic qualities.

In contrast with run-of-the-mill seasonal flu viruses, the H1N1virus exhibits an ability to infect cells deep in the lungs, where it can cause pneumonia and, in severe cases, death. Seasonal viruses typically infect only cells in the upper respiratory system.

“There is a misunderstanding about this virus,” says Kawaoka, a professor of pathobiological sciences at the UW-Madison School of Veterinary Medicine and a leading authority on influenza. “People think this pathogen may be similar to seasonal influenza. This study shows that is not the case. There is clear evidence the virus is different than seasonal influenza.”

The ability to infect the lungs, notes Kawaoka, is a quality frighteningly similar to those of other pandemic viruses, notably the 1918 virus, which killed tens of millions of people at the tail end of World War I. There are likely other similarities to the 1918 virus, says Kawaoka, as the study also showed that people born before 1918 harbor antibodies that protect against the new H1N1 virus.

And it is possible, he adds, that the virus could become even more pathogenic as the current pandemic runs its course and the virus evolves to acquire new features. It is now flu season in the world’s southern hemisphere, and the virus is expected to return in force to the northern hemisphere during the fall and winter flu season.

To assess the pathogenic nature of the H1N1 virus, Kawaoka and his colleagues infected different groups of mice, ferrets and non-human primates — all widely accepted models for studies of influenza — with the pandemic virus and a seasonal flu virus. They found that the H1N1 virus replicates much more efficiently in the respiratory system than seasonal flu and causes severe lesions in the lungs similar to those caused by other more virulent types of pandemic flu.

“When we conducted the experiments in ferrets and monkeys, the seasonal virus did not replicate in the lungs,” Kawaoka explains. “The H1N1 virus replicates significantly better in the lungs.”

The new study was conducted with samples of the virus obtained from patients in California, Wisconsin, the Netherlands and Japan.

The new Nature report also assessed the immune response of different groups to the new virus. The most intriguing finding, according to Kawaoka, is that those people exposed to the 1918 virus, all of whom are now in advanced old age, have antibodies that neutralize the H1N1 virus. “The people who have high antibody titers are the people born before 1918,” he notes.

Kawaoka says that while finding the H1N1 virus to be a more serious pathogen than previously reported is worrisome, the new study also indicates that existing and experimental antiviral drugs can form an effective first line of defense against the virus and slow its spread.

There are currently three approved antiviral compounds, according to Kawaoka, whose team tested the efficacy of two of those compounds and the two experimental antiviral drugs in mice. “The existing and experimental drugs work well in animal models, suggesting they will work in humans,” Kawaoka says.

Antiviral drugs are viewed as a first line of defense, as the development and production of mass quantities of vaccines take months at best.

http://www.sciencedaily.com/releases/2009/07/090713212231.htm

Freeper DoughtyOne Why don’t you contact this newspaper , the writer , & the doctor Dr. Sherif Zaki who commented in this article who is ( the chief of infectious diseases pathology at the U.S. Centers for Disease Control )

Have you contacted the CDC and taken them to task for the two studies they use for claiming 36,000 deaths per year from influenza and complications brought on by it?

I’m sure your medical knowledge is quite more impressive then Dr. Sherif Zaki...

I've never made that claim, but it doesn't surprise me to see you jump to one more eronious conclusion.

Dr. Sherif Zaki is only the chief of infectious diseases pathology at the U.S. Centers for Disease Control.

That's impressive. Let's see what he has to say.

Lungs of fatal swine flu patients badly damaged
http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090903/h1n1_lungs_090903/20090903
Sep. 3 2009

The lungs of people who have died from swine flu look more like those of the victims of H5N1 avian influenza than those of people who succumb to regular flu, the chief of infectious diseases pathology at the U.S. Centers for Disease Control says.

What of the lungs of the people who didn't die? Why didn't those people die too?

Study of about 70 fatal H1N1 cases so far also reveals there may be more incidences of co-infections with bacteria than was earlier thought, Dr. Sherif Zaki told The Canadian Press in an interview.

Does this mean that there were pre-existing condiditons that it would be hard to identify? Or does this mean that the H1N1 lowered the immune system so that the barriers to these bacteria were lowered? That's an important question. I don't see it addressed. Do you?

The damage to lung tissue is consistent with that inflicted by ARDS or acute respiratory distress symptom, Zaki says, referring to an often-fatal, difficult-to-treat syndrome that can have a number of causes. The U.S. National Heart, Lung and Blood Institute estimates about 30 per cent of people who develop ARDS die.

This would be interesting if the percentage of patients contracting H1N1 who died, was similar to that of ARDS. It isn't. 60% of the people who contracted ARDS, died. That being the case, it's somewhat irresponsible to compare H1N1 to ARDS, without clarifying the differences.

“In terms of the disease, yes, it (H1N1) is remarkably different than seasonal flu,” Zaki says. “The pathology looks very similar to H5(N1).”

The pathology is not the same. If it were, the mortality rates for the two would be similar. The mortality rates I have been able to find, peg the number at less than 1% for H1N1, but even that esitmation is noted to exclude the people who never reported having contracted the H1N1, that saw it through and returned to good health. Therefore the actual mortality rate is thought to be much lower than can be documented. Is that mentioned here?

The dangerous avian flu virus has killed 60 per cent of the 440 people known to have been infected with it. To date, though, the virus hasn’t acquired the capacity to spread easily from person to person. The swine flu patients who went on to die suffered lung damage and changes in the lungs that would have made it difficult to deliver enough oxygen into their bloodstreams, Zaki says. That reflects the observation of intensive care doctors who’ve struggled to save these profoundly ill patients. “That’s what they saw in Winnipeg,” Dr. Paul Hebert, an intensive care physician and editor of the Canadian Medical Association Journal, said recently of how hard it is to oxygenate swine flu patients who become gravely ill. “They have everybody on experimental ventilators and techniques. They can barely keep them alive.”

Mortality rates are nowhere near comparable for H1N1 to H5N1, yet here the two are discussed at length, just no disqualifiers inclued to remind folks or inform the public that mortality rates are vastly different for the two.

A number of doctors who have treated novel H1N1 patients — and colleagues who haven’t yet — were meeting in Winnipeg this week discussing what steps hospitals and ICUs need to take to get ready for an expected increase in pandemic flu cases this fall and winter. Zaki says finding ways to prevent cases from progressing to severe illness should be the goal, “because once it happens in these patients . . . it’s very difficult to treat.” Strikingly high levels of virus were spotted in the lungs of people who died rapidly from swine flu, he says, though less is seen in those who die after a longer battle with the virus. “Some people die very quickly of it, within days. And some have more protracted illness, maybe two, three weeks,” he says. “It’s surprising the amounts (of virus) that you see.... But it’s not unheard of,” he adds, pointing to what was seen with SARS. Earlier studies conducted in tissue culture and in ferrets — the best animal model for human flu — found the new virus is drawn to tissue found deep in the lung. That’s a penchant it shares with H5N1. Seasonal flu viruses attack the upper airways. Zaki says about a third of the fatal cases his team has reviewed involved co-infection with a bacterium, though the culprit varies. Sometimes it is Staphylococcus aureus — the drug-resistant kind, known by the nickname MRSA and antibiotic-sensitive varieties as well. Some cases have involved group A Streptococcus. And some have been co-infection with Streptococcus pneumoniae. “Those are the main three that we found.” “It was not very clear initially,” Zaki adds of the frequency with which co-infection seems to occur in these cases. “But the more we studied, the more we realized that these do happen.” He suggests pneumococcal vaccine, used in the elderly to lower the risk of pneumonia, could be a useful tool if given to younger people. The highest numbers of deaths so far have been in people in their late 30s and 40s. Some of the cases of co-infection have been in people who were hospitalized for an extended period, which wouldn’t be all that surprising. But some were seen in people who weren’t hospitalized. With the new virus causing severe disease in only a small portion of cases, public health authorities have been criticized for overreacting and overhyping the threat swine flu poses. Some critics have suggested the new flu isn’t really much worse than seasonal influenza.
From Zaki’s vantage point, however, this is not regular flu.

This is a clever ploy used to make H1N1 sound more ominious. Zaki says, "...this is not regular flu." Okay. I agree. It's not. The writer wrote this to make it seem that H1N1 was worse than it might be. Note: Some critics have suggested the new flu isn't really much worse than season influenza. Zaki: This is not regular flu. Note that Zadi didn't say, this will kill many more than the seasonal flu. What he said did not contradict the premise that H1N1 isn't really much worse, or will not cause more deaths.

Once again, all this talk about H1N1 in conjumction with H5N1 and SARS as it related to the people who actually died. There's no mention of the vast differences in mortal outcomes in the separate groups. H1N1 is tied to the much more devistating influenza versions, without bringing it all into perspective. PERSPECTIVE

“This is a new virus. It causes a different disease than what we’re used to,” he says. “So I don’t think anybody can predict exactly, but it would be foolish not to be trying to study the disease more.”

I wouldn't argue with that. What I would do is caution these public physicians to be careful what they say in public. Linking two infectuous diseases (even if some similarity can be sited) with vastly different overall mortaility outcomes is only appropriate if the mortaility rate differences are clarified as part of the process. Linking H1N1 with a mortality rate less than 1% to an infectuous disease with mortality rates around 60%, without clarification is negligent to the max.

This guy should know better than that.

What he says behind closed doors to people in the field who have background information, should be considerably different that what he would say for public desminination to people who have no background with which to judge this information rationally.

A casual parousel of this information, could easily cause someone to come away with a very distorted perception of H1N1.

Dr. Sherif Zaki agrees with me that this IS NOT like the regular flu :)

Please feel free to post any article showing Dr. Sherif Zaki ( the chief of infectious diseases pathology at the U.S. Centers for Disease Control )

is a liar :)

From Zaki’s vantage point, however, this is not regular flu.

“This is a new virus. It causes a different disease than what we’re used to,” he says. “So I don’t think anybody can predict exactly, but it would be foolish not to be trying to study the disease more.”

Lungs of fatal swine flu patients badly damaged
http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090903/h1n1_lungs_090903/20090903
Sep. 3 2009

Please post me any article of a healthy person

who died from the flu during the years 1969- 2008 :)

Earlier studies conducted in tissue culture and in ferrets — the best animal model for human flu — found the new virus is drawn to tissue found deep in the lung. That’s a penchant it shares with H5N1. Seasonal flu viruses attack the upper airways.

Lungs of fatal swine flu patients badly damaged
http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090903/h1n1_lungs_090903/20090903
Sep. 3 2009

This thread now has become flooded with unnecessary ‘stuff’ as is the case with many FR threads.

It’s difficult to navigate for the ‘news’

Some people have too much time on their hands for arguing.

:(

Dr. Sherif Zaki agrees with me that this IS NOT like the regular flu :)
<>And I quote myself from my last post to you in response. "Zaki says, "...this is not regular flu." Okay. I agree. It's not."

Please feel free to post any article showing Dr. Sherif Zaki ( the chief of infectious diseases pathology at the U.S. Centers for Disease Control )

is a liar :) The inference is that I ever intimated anything of the kind. Conversely, you re welcome to post any comment by me that said directly or intimated he was a liar.

From Zaki’s vantage point, however, this is not regular flu. I never argued otherwise. Yawn.

“This is a new virus. It causes a different disease than what we’re used to,” he says. “So I don’t think anybody can predict exactly, but it would be foolish not to be trying to study the disease more.”

Quoting to you once again from my last post to you...

Preceeding comment: “This is a new virus. It causes a different disease than what we’re used to,” he says. “So I don’t think anybody can predict exactly, but it would be foolish not to be trying to study the disease more.”

I wouldn't argue with that."

Lungs of fatal swine flu patients badly damaged
http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090903/h1n1_lungs_090903/20090903
Sep. 3 2009

And what of the lungs of all the survivors, more than 99% of those who came down with H1N1, and returned to good health?

I just go back to posting articles WestCoastGal .

Thanks :)

The mortality rate for H1N1 is less than 1%.

The mortality rate for H5N1 is 60%.

Are these then two very compatible diseases, with comparable outcomes?

Is that revealed in the article in Zaki’s comments? No.

He talks about the similarities of those who die, then skips the mention that less than 1% of the H1N1 infected people die.

Strangely enough, it is mentioned in the article that 60% of those who contract H1N5 die. Why provide the worst outcome percentage that you have just tied H1N1 to, without providing the same figure for H1N1, namely less than 1%?

Posted: 11:04 PM Oct 2, 2009

Alabama deaths from swine flu rises to 15
State health officials have announced four new swine flu deaths in Alabama.

http://www.wtvynews4.com/alabamanews/headlines/63365107.html

And I will leave. Thanks for putting up with me.

Later...

U.S. report predicts 30,000 to 90,000 H1N1 deaths
Updated 8/24/2009 9:17 PM
By Steve Sternberg, USA TODAY

http://www.usatoday.com/news/health/2009-08-24-swine-flu-vaccine_N.htm

The U.S. Centers for Disease Control and Prevention estimates that nearly 2 million people nationwide have been infected with the virus and 522 have died.

April through September: Mortality rate: 0.02610%

Paragraph Five (depending how you count them)

http://www.usatoday.com/news/health/2009-08-24-swine-flu-vaccine_N.htm

At this mortaility rate...

30,000 deaths at 0.02610% would require 115 million cases to materialize

90,000 deaths at 0.02610% would require 345 million cases to materialize

Influenza–Associated Pediatric Mortality

Four new influenza-associated pediatric deaths are included in this report. The first death occurred during week 37 in a 3-year-old resident of HSR 6/5S with significant underlying medical conditions. A specimen from the child was positive by rapid test for influenza A (not subtyped). The second death occurred in week 37 in a 14-year-old resident of HSR 8 with no underlying medical conditions; however, a sputum specimen collected from the child was positive for methicillin-resistant Staphylococcus aureus (MRSA). The child had a positive PCR test for novel influenza A (H1N1). The third death occurred during week 38 in a 16-year-old resident of HSR 2/3 with significant underlying medical conditions. A specimen from the child tested positive for novel influenza A (H1N1) by PCR. The fourth death occurred in week 38 in an 8-month-old resident of HSR 8 with a significant underlying medical condition. The child’s specimen was positive by PCR for novel influenza A (H1N1). Texas has reported 22 influenza-associated pediatric fatalities during the 2008-09 influenza season.

http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2009/

http://www.sciencedaily.com/releases/2009/09/090909103009.htm

ScienceDaily (Sep. 10, 2009) — Scientists in China have discovered that roots of a plant used a century ago during the great Spanish influenza pandemic contains substances with powerful effects in laboratory experiments in killing the H1N1 swine flu virus that now threatens the world. The plant has a pleasant onion-like taste when cooked, but when raw it has sap so foul-smelling that some call it the “Dung of the Devil” plant.
In the study, Fang-Rong Chang and Yang-Chang Wu and colleagues note that the plant, Ferula assa-foetida, grows mainly in Iran, Afghanistan and mainland China. People used it as a possible remedy during the1918 Spanish flu pandemic that killed between 20 to 100 million people. Until now, however, nobody had determined whether the plant does produce natural antiviral compounds.
Chang and Wu identified a group of chemical compounds in extracts of the plant that showed greater potency against influenza A (H1N1) than a prescription antiviral drug available for the flu. “Overall, the present study has determined that sesquiterpene coumarins from F. assa-foetida may serve as promising lead components for new drug development against influenza A (H1N1) viral infection,” the authors write.

More on that story ...

Hospital defends actions in care of Utah flu victim
By Brooke Adams

The Salt Lake Tribune

Updated: 06/16/2009 10:09:36 AM MDT

http://www.sltrib.com/news/ci_12594446

Critical care doctors want escalated pandemic planning

Laura Eggertson
Ottawa, Ont.

http://www.cmaj.ca/cgi/content/full/181/5/253

It’s exceedingly likely that come the late summer, early fall, there is going to be much more H1N1-A and the absolute number of patients are going to be a lot higher. It may very well exceed our capacity and our plan to care for them,” says Dr. Rob Fowler, a critical care physician at Sunnybrook Hospital in Toronto, Ontario. “Our response needs to be escalated substantially more than we’re doing right now.”

Fowler, a member of the Canadian Critical Care Trials Group, is gathering case descriptions of critically ill patients in ICUs across the country. His report will describe the patients’ clinical presentation, treatment challenges and outcomes. About half the patients whose data Fowler and colleague Dr. Anand Kumar have collected were treated in Manitoba. Quebec, Ontario and Alberta have seen the next largest concentrations of critically ill patients. In addition, Fowler has access to data from Mexico’s critical care group. The picture emerging from Mexico is of an influenza that largely affects people aged 10–55, with a core group of patients typically in their 40s who have developed acute lung injuries and hypoxic respiratory failure.

“We’re seeing a very similar thing, and in a subset of patients, severe lung injury requiring extraordinary support in intensive care, with means to oxygenate that a lot of the world doesn’t have, and is in limited supply in Canada,” Fowler says.

These patients have required aggressive and unconventional means of oxygenation, often staying on ventilators for weeks at a time, says Kumar, who describes many of the Winnipeg patients he treated as “the most difficult patients in terms of ventilator management that I’ve ever seen in my 20 years of practice.”

“To a great extent, among adults, this is an ICU disease,” Kumar notes. Many of those who were admitted needed high-frequency oscillatory ventilation — a jet-like ventilation that oscillates oxygen into patients at the rate of 300 times a minute or more. This therapy also requires nitrous oxide and airway pressure relief, as well as other advanced ventilation techniques, he adds. About half a dozen Canadian patients also had to be placed on heart-lung bypass machines to give them extra-corporeal membrane oxygenation or likely would have died.

Most hospitals in Canada do not have oscillating ventilators, and there are only a few centres that can do heart-lung bypass. That has left critical care physicians concerned about the country’s readiness if a second pandemic (H1N1) 2009 wave hits in the fall.

“I don’t think that everybody realizes that the pandemic stores, the emergency store of ventilators that a lot of people are depending upon in case of emergency, simply aren’t advanced enough to take care of these patients,” says Kumar.

Ventilators made more than 15 years ago and those routinely used in emergency rooms aren’t advanced enough for this type of therapy, he adds. However, older ventilators may be useful for the less severely injured.

In a written response to CMAJ questions, the Public Health Agency of Canada (PHAC) confirmed that of the additional 370 ventilators it is trying to purchase as part of its National Emergency Stockpile System, none are oscillating ventilators. PHAC does not have a stockpile of heart-lung bypass machines.

Nurses and respiratory technologists will be as critical if Canadian hospitals see even 3.5 times more cases of pandemic (H1N1) 2009 patients with lung injuries in a second wave — and that is a conservative estimate, says Dr. Allison McGeer, director of infection control at Toronto’s Mount Sinai Hospital. Like Kumar and Fowler, she is concerned that ICUs may become the choke point in the health care system come fall.

Unlike ICUs in the United States, which routinely keep some beds empty and ventilators free, Canadian units normally run at 90%–95% full —sometimes more, with patients waiting in emergency before being admitted. “It’s very efficient from a systems point of view, but it means we have no surge capacity in our ICUs in Canada,” says McGeer. Even so, “I am less worried about the ventilator supplies than I am about the staff resources to care for them,” she adds.

Hospitals should also be stockpiling sedatives, paralytics and antibiotics, because the ventilated patients with pandemic (H1N1) 2009 often require “massive” sedation.

Administrators should also be making plans to designate staff to make tough triage choices, Kumar says. “The idea of, how you triage 2 young people to a single ventilator — that’s a very difficult issue.”

Fowler is also worried that Canadian hospitals will have to limit resources to people who are very sick because of inadequate capacity. “That’s a position we haven’t found ourselves in throughout the history of medicare in Canada.”

With each province and region developing its own pandemic plan, the Canadian Critical Care Society is concerned that “from a national perspective, there’s no coordinated effort to help with resource utilization and sharing that sort of resource planning,” says Dr. John Granton, a Toronto ICU physician and the Society’s president.

Pandemic planning has largely been devoted to securing a vaccine and rolling out immunization, but federal oversight is needed to ensure provincial licensing requirements are waived and malpractice insurance is extended so that, if necessary, health care professionals and medical equipment can be shared between jurisdictions, Granton says.

More Md. Students Confirmed To Have H1N1 Reporting
Suzanne Collins BALTIMORE (WJZ)

The H1N1 vaccine is on its way to Maryland, but it’s not coming soon enough for worried parents.

Local emergency rooms are being flooded with patients worried they have the swine flu.

Suzanne Collins reports doctors now say there’s another vaccine you may also want to consider.

“I’m scared to death about this virus,” said David Matthews.

Matthews has a four-year-old with flu-like symptoms. He’s worried his two-year-old will too.

Like hundreds of parents, Matthews rushed them to the emergency room.

“I’m hearing stories about two little girls dying at schools near where we live. It’s sad man because it acts like a cold then they’re deathly sick,” said Matthews.

Doctors say 15 to 20 percent of the Union Memorial ER is filled with patients concerned they have the H1N1 flu, which may do more harm than good.

“You also run the risk of getting the flu if you’re coming to the ER because there are a lot of people who have it right now,” said Kathryn Burroughs, Union Memorial.

Contracting the flu, whether it’s seasonal or H1N1, weakens a person’s immune system, making it easy for outside bacteria to harm the body. That’s exactly why doctors say you might want to get another type of vaccine this season.

“These people are at much increased risk for pneumococcal infection,” said Dr. Bill Howard, Union Memorial.

Howard says that infection can lead to a host of other illnesses.

Destinee Parker, 14, died on Tuesday from the virus. Family members say physicians diagnosed her with pneumonia, but one shot can prevent the bacteria from attacking.

“It really is the best way to go. It doesn’t seem to cause any complications,” said Howard.

As for the H1N1 vaccine, Maryland is expected to receive it’s first shipment next week with enough for just one percent of the high risk population.

“I hope when it comes, they’ll have enough for everyone especially in the schools,” said Bonita Brown.

Meanwhile medical authorities get ready for the worst.

“We have weekly meetings on updates, so we are prepared for anything that’s changing. We have back up plans in place for our beds,” said Burroughs.

Maryland health officials are tuning emergency preparedness plans in case a massive H1N1 outbreak sweeps the state.

They are also getting mobile hospital beds ready to use

http://wjz.com/local/destinee.parker.h1n1.2.1225870.html

http://www.cdc.gov/media/transcripts/2009/t091001.htm

Follow the link above for the whole briefing.

Originally Posted by www.cdc.gov
We’re able to give a little bit of an update about the H1N1 influenza disease in pregnant women. I know that’s been an interest to a lot of people. We’ve updated our numbers, and through late august, we can report that about 100 pregnant women in the United States have required intensive care unit hospitalization for H1N1 flu. Sadly, 28 pregnant women in the U.S. have died so far from the H1N1 influenza. These are really upsetting numbers, I know. And I just want to remind women and doctors and nurse midwives that antiviral medicine can be a very important treatment for pregnant women who have respiratory illness.

Our scientists reviewed autopsy material from 77 fatal H1N1 influenza patients and found that bacteria were present in terms of bacterial pneumonia in about a third of those fatalities. The good news is the leading bacteria was streptococcus pneumonia, and we have a vaccine for that. Adults are recommended to receive the pneumococcal vaccine if they have chronic medical conditions, like asthma, diabetes, chronic heart disease, chronic lung disease, immunodepression and so forth. Sadly, only about one in five non-elderly adults take advantage of that vaccine. So when people are going in for their seasonal flu vaccines right now, those very same people, we urge them to consider the pneumococcal vaccine which is available right now.

Secretary Sebelius released about 300,000 courses of liquid Tamiflu for children to be made available to the states who may need this. So far, basically each state that needs their proportion of that supply will receive this Tamiflu over the next week. Based on requests we’ve already received. Texas and Colorado received their proportions today. The amounts, there are about 22,000 pediatric liquid Tamiflu courses for Texas, and about 4,600 of those courses for Colorado. Now, some of the liquid formulations of Tamiflu will have an expiration date that may have passed, but we want people to know that the FDA has extended the expiration date of those courses, after careful testing. Everything that is being released has gone through that sort of testing. I do want to remind people about our guidance on antiviral medicine used. Because this is such an important tool we have to reduce illness complications of influenza, whether it’s the H1N1or regular flu. People who have severe illness, who are hospitalized or who have other warning signs can greatly benefit from antiviral medicine. People who have the influenza-like symptoms and have conditions that make it possible they would have a worse time with flu should also receive antiviral medicine. That includes pregnant women, people with asthma, diabetes, immunosuppression, and the very old and the very young. [b]There are important warning signs that people should know about, in particular parents. These include fast breathing, or difficulty breathing, trouble taking fluids, difficulty being woken up or if our child looking a little blue or a little gray. And importantly, getting better and then getting worse. Those are warning signs that really it’s time to seek care. And we know that parents are concerned about the flu, and we want them to know about those signs.

States and the large cities that are part of our program began placing orders yesterday. I can report to you that 25 of these areas placed orders yesterday, and they placed orders for about 600,000 doses of H1N1 vaccine. I want to describe to you the process going forward about how we’ll catch you up about where we are with the ordering, and the shipments and all of that. Every Friday we will be updating through either the media press conference or definitely always with our website a couple facts and figures for you. We’re going to let you know how much vaccine was available for ordering, and then we’re going to let you know how much was shipped to each of the states or large cities by that day. And it will basically be information gathered through Wednesday, and it will be coming out on every Friday. Important to say, we’re at the beginning, and we’ll be getting more vaccine regularly, and the states and large cities will be ordering regularly. So this is really just the beginning. We expect the vaccine that was ordered yesterday should be arriving out to the sites by Tuesday.

The first doses that are going to be available out there on Tuesday will be the nasal spray for inhalation. It’s a good vaccine, but it’s one that it can’t be used in absolutely everyone. It’s indicated for people 2 years of age through 49 who do not have conditions like pregnancy or chronic medical conditions. It’s safe and effective. And we think it’s important to get that vaccine out as soon as we’ve — as soon as it has become available. The state and large cities have been making plans about how to use the vaccines as they come available in the communities. And they — with the doses that we have right now, what they’re doing is making practical targeted plans for the best use of the doses that we have. We believe that a lot of the states will be directing these early doses to health care workers. There’s a bit of a myth out there that the workers shouldn’t get the live vaccine, but that’s a myth. Most health care workers who are under 50 and don’t have those chronic conditions can receive the nasal spray.

Ferula assa-foetida

mmmmm mmmmmmmm mmmmm!