Posted on 06/24/2009 8:04:24 AM PDT by metmom
Within minutes, six-year-old Rubjit Thindal went from happily chatting in the back seat of the car to collapsing and dying in her father's arms.
"If we had known it was so serious, we would have called 911,'' Kuldip Thindal, Rubjit's distraught mother, said in Punjabi yesterday. "She just had a stomach ache -- she wasn't even crying.''
Rubjit was pronounced dead at hospital barely 24 hours after showing signs of a fever. Later, doctors told her parents she had the H1N1 influenza virus. She is believed to be the youngest person in Canada with the virus to have died.
(Excerpt) Read more at news.guelphmercury.com ...
Flu symptoms send many students home
Posted: Aug 14, 2009 4:49 PM EDT
Updated: Aug 14, 2009 6:05 PM EDT
Video Gallery
Students go home with flu-like symptoms
3:08
Thomasville, GA (WALB) - With school back in session, hundreds of students and staff in Southwest Georgia are forced leave school in the middle of the day with flu-like symptoms.
Public heath departments are treating the cases as pandemic H1N1 flu clusters. Even though every person who goes home sick has not received positive test results for H1N1, they are being treated that way.
In Thomas County schools, more than 100 kids were sent home Friday. School officials were warned by health officials to expect a wave of swine flu among students, likely during the third week of classes.
[snip]
http://www.walb.com/Global/story.asp?S=10932811&nav=menu37_8_1_3
Updated VACCINE INFO
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/aug1409vaccine.html
Officials lower expectations for size of first novel flu vaccine deliveries
Comment: Looks like they’ll be vaccinating using Plan B (smaller group) first. From ACIP for the USA population:
Quote:
further prioritization only if supply limited: (total 47M):
pregnant women (4M)
Household contacts and caregivers for children younger than 6 months of age (5M)
Healthcare personnel and emergency medical services (14M)
Children aged 6m through 4y (18M)
Children aged 5y through 18 y with chronic medical conditions (6M)
Canadian Press/Branswell: US #swineflu patients on immunosuppressant drugs develop Tamiflu resistance - http://shar.es/UnG7
Thanks for the link , I appreciate it :)
Have A Great Night :)
How ridiculous can this get?
I don’t want to think about that with Obama care & Acorn looming ....
I think it crazy that New York is no longer counting or reporting deaths from the swine flu.....
Commentary
Tamiflu Resistant Pandemic H1N1 in Washington State
Recombinomics Commentary 03:20
August 15, 2009
http://www.recombinomics.com/News/08150901/H274Y_WA.html
On June 1, the patient was enrolled in an influenza antiviral treatment study and he began a 10-day course of oseltamivir.
A novel influenza A (H1N1) virus isolate from a specimen collected on May 31 was identified as susceptible to oseltamivir by pyrosequencing at CDC, but viruses isolated from specimens collected on June 11 and July 14 had the H275Y mutation, indicating oseltamivir resistance.
Antiviral treatment with high-dose oseltamivir (150 mg orally, twice a day) and rimantadine (100 mg orally, twice a day) was administered during June 26—July 1.
On August 10, CDC received other previously collected virus isolates from this patient for testing, and pyrosequencing of a virus isolated from a specimen collected on July 14 had the H275Y mutation, confirming oseltamivir resistance.
The above comments are from today’s MMWR dispatch describing two immune-suppressed patients, who represent the first two confirmed cases of oseltamivir resistance in H1N1 pandemic swine flu in the United States. Both patients were from King County in Washington State and initial isolates from both patients were sensitive. In one patient, virus with H274Y was first detected in a sample collected 10 days after the start of treatment, while in the other patient, resistance was detected in a sample collected 18 days after the start of treatment. Because these patients were symptomatic at the start of treatment, the date of detectable resistance is unknown, in contrast to earlier patients who were asymptomatic at the start of prophylactic treatment and became symptomatic 5-6 days later. In the patients treated prophylatically, the appearance of symptoms in the short time frame after the start of treatment suggests the resistant virus was present as a minor population, and the treatment led to detection.
In the two immune-suppressed patients it is harder to draw a conclusion because of the longer time period between the start of treatment and confirmation of resistance. However, the report of two patients from the same area, who began treatment in June, raises concerns that H1N1 with H274Y is silently circulating. In patients who are not immune-compromised, virus is usually cleared with or without Tamiflu treatment and therefore minor populations with H274Y would go undetected. In immuno-compromised patients, as well as those who are on prophylactic Tamiflu, detections of resistance is more common because of the development of symptoms in patients who were previously asymptomatic, or in patients treated with Tamiflu over and extended time frame.
The report on these two patients follow reports of resistance in Hong Kong this week, as well as Singapore, China, and Thailand last week, in addition to media reports last week of resistance in patients in Texas at widely separated locations along the Mexican border, as well as comments from WHO on reports of resistance in an undisclosed number of patients at undisclosed locations.
These continuing reports of resistance at the same genetic position, H274Y, continue to increase concern of widespread resistance silently circulating as a minor population which is not discovered until patients are treated with oseltamivir.
Doctor, student contract swine flu (India)
http://beta.thehindu.com/news/cities/Kochi/article3634.ece
August 16, 2009
The number of confirmed cases of swine flu in Kerala rose to 71 on Sunday with two more cases reported from Kochi.
A doctor, who was screening air passengers at the Nedumbassery airport, and an engineering college student, who arrived from Pune, were found to have contracted the disease, official sources said.
As of now, about 20 persons are in hospitals in different parts of the State with symptoms of swine flu. Only six of these cases had been confirmed. Others are taking medicine at home.
The Indian Medical Association is organising a workshop for doctors here on Sunday. An expert on swine flu will address them.
Greece: 1,500 A H1N1 cases registered
http://www.emportal.rs/en/news/region/96471.html
16. August 2009
A 28-year-old man was admitted to the intensive-care unit of the Navy Hospital in Athens yesterday suffering from breathing problems caused by swine flu.
The unnamed man had been on vacation on an unspecified Aegean island when he began to feel unwell. Doctors said that he was in a critical condition.
Meanwhile, a 29-year-old German woman who is a member of the crew of the Aida Vita cruise ship was in stable condition at the Metropolitan Hospital in Athens after also contracting the disease.
Lee principal has swine flu (California)
08/16/2009
http://www.dailydemocrat.com/news/ci_13134613
Lee Middle School Principal Garth Lewis has contracted H1N1 flu virus, but officials say the public shouldn’t be concerned.
On Friday, an automated call contacted Lee parents to notify them that Lewis, who is out on sick leave, does have novel H1N1 flu virus, also known as swine flu.
School board President Rosario Ruiz-Dark said she had contacted parents whose children go to Lee and they confirmed they received the message.
Superintendent Debra LaVoi filled in for Lewis on Friday. Lewis will not return to office until his fever goes below 100 degrees for more than 24 hours.
Yolo County Health Officer Dr. Joseph Iser said he had not heard about the situation at Lee because the health department is only notified when people with H1N1 are hospitalized.
Iser said he estimates that there are easily hundreds of cases in Yolo County — at least one case is confirmed in every part of the county. About 50 to 55 were documented so far, five or six resulted in hospitalizations. Yet, due to the fact that it’s a “relatively mild disease” many cases go undocumented.
Parents should not be worried, he said, and advises every to continue following the guidelines provided by the health department found on the county’s Web site.
http://www.nytimes.com/2009/08/16/world/asia/16australia.html?_r=1
Swine Flu’s Risks Increase for Australia’s Aborigines Published: August 15, 2009
NY:
Back-to-flu season: Schools plan for expected rise in swine flu infections
by James T. Mulder / The Post-Standard
Sunday August 16, 2009, 8:12 AM
http://www.syracuse.com/news/index.ssf/2009/08/backtoflu_season_schools_plan.html
Central New York students might get vaccinations in school in the fall to protect them from a resurgence of the H1N1 virus, or swine flu.
That’s one scenario public health and school officials are considering as they plan for an expected spike in H1N1 when schools reopen next month. The novel virus is expected to infect even more people in the fall than it did when it appeared in the spring. Youngsters are particularly vulnerable.
“It’s going to be difficult to get kids who don’t even have insurance immunized,” said Dr. Richard Kulak, director of health services for the Syracuse City School District. “So the schools are very likely going to be a source to try to make sure that occurs.”
No decision has been made to use schools as vaccination sites, according to Dr. Cynthia Morrow, Onondaga County’s health commissioner. But the county is preparing for that possibility, said Morrow, who met Monday with school superintendents to discuss H1N1 planning.
There have been no school-based mass vaccination campaigns since the 1950s, when children lined up to get the polio vaccine.
No one knows when the H1N1 vaccine, which is still being tested, will be ready or how much will be available. The latest estimate is mid- to late-October.
The federal government has been racing to get it ready because novel viruses like H1N1 historically sicken more people during the fall than during the spring. The government’s goal is to have 120 million to 130 million doses available.
Flu normally disappears during the summer. This year, however, low levels of H1N1 have continued to circulate. Once the fall arrives, temperatures drop and people spend more time indoors, making it easier for the virus to spread.
Since the spring, H1N1 has killed more than 430 Americans and resulted in treatment of more than 6,500 in hospitals. In Onondaga County, three people died and 31 were treated in a hospital.
So far, H1N1 has been a mild illness, similar to the seasonal flu. But because influenza is so unpredictable, it could become more severe.
“The greatest challenge is the uncertainty we face,” Morrow said.
Even if H1N1 remains mild, a more widespread outbreak this fall would result in more people being treated in hospitals and more deaths, Morrow said.
The resurgence could come at the same time as the regular seasonal flu.
To further complicate matters, people will probably have to get three shots: two for H1N1 and a separate one for the seasonal flu. The first and second H1N1 shots might have to be spaced three to four weeks apart, according to the federal Centers for Disease Control and Prevention.
The H1N1 and seasonal flu vaccines cannot be combined into one shot because production of the seasonal flu vaccine was well under way when H1N1 appeared in the spring.
Making sure people get all those shots might prove tricky.
Morrow is advising people to get their seasonal flu shots as soon as possible. Most primary-care providers get that seasonal vaccine in September.
The county plans to conduct its seasonal flu shot clinics beginning in October, as usual. If the H1N1 vaccine is available in time, the county will offer it at the same clinics, Morrow said.
The H1N1 vaccine will be distributed by the federal government to state health departments. States, in turn, are expected to dole it out to local health departments and hospitals.
Initially, some of the H1N1 vaccine is expected to flow to pediatricians and obstetrician-gynecologists, because they treat children and pregnant women, two of the groups considered most at risk, Morrow said.
“It’s going to take months to get people vaccinated. We need the public to be patient,” Morrow said. “They need to understand everyone won’t be vaccinated in one or two weeks.”
The federal government is expected to spend about $1 billion on the H1N1 vaccine. While vaccinators will not be able to charge for the vaccine, they will be able to charge an administrative fee that can be billed to insurers. The vaccine will be provided free to people who cannot afford the fee, Morrow said.
Morrow said she expects some people may refuse to get the H1N1 vaccine because of problems associated with the 1976 swine flu vaccine.
The federal government ordered a nationwide vaccination program that year after an outbreak of swine flu struck Fort Dix Army base, in New Jersey, killing a 19-year-old private and infecting hundreds of soldiers.
Some people who were vaccinated developed Guillain-Barre syndrome, a paralyzing nerve disease. More than 30 people died of the condition. Facing protests, federal officials canceled the vaccination program at the end of 1976.
Since that episode, annual flu vaccines have been produced without serious side effects.
“My job will be to tell people this (H1N1) vaccine is being produced the same way the seasonal flu vaccine is produced,” Morrow said.
H1N1 attacks infants, children and young adults much more aggressively than it does older people, she said. Regular seasonal flu tends to target older people.
“The most important thing for parents to do is get your child vaccinated when the vaccine becomes available,” Morrow said.
When H1N1 appeared earlier this year, some Central New York schools closed if the virus was confirmed in just a single student. That will not happen in the fall because the federal Centers for Disease Control and Prevention has changed its guidelines.
Now, schools are discouraged from closing unless there is not enough staff available to teach and care for students.
Another major change involves the amount of time students with flu-like symptoms should be kept out of school. Schools had been telling students to stay home for seven days, regardless of when they started feeling better.
Now, the CDC says they can return to school 24 hours after their fever breaks.
Parents should plan to keep sick children home for about three to five days, Morrow said.
If H1N1 comes back strong in the fall, employers will need to be liberal with their sick-leave policies, according to Morrow.
“A lot of employers are concerned about potential misuse of sick leave,” she said. “But the worst thing you can do is put pressure on people who are sick to come into work. Not only do you have a sick employee, but you have many more employees who will get sick.”
Dr. Jessica Cohen, superintendent of Onondaga-Cortland-Madison BOCES, said school districts will send letters explaining H1N1 planning to parents and employees before school opens.
Working parents should form alternate child-care arrangements just in case, according to Cohen.
“It can be inconvenient and difficult for parents,” she said.
James T. Mulder can be reached at 470-2245 or jmulder@syracuse.com
There has been talk on the Internet, from a variety of sources, for a couple of weeks now that when the FDIC report comes out on August 25, there just may be a "run on the banks" beginning on August 26. Another MAJOR Alabama bank closed on Friday by the FDIC.
So, if we have the rumored "banking holiday" are we prepared? Argentina has closed banks because of the swine flu.
I am working to stock up.
SAfrica swine flu fatalities ‘double in two weeks’
http://www.google.com/hostednews/afp/article/ALeqM5gjPAMSvGov2bDswBwjWj7HueBVqw
South Africa’s swine flu death toll has increased to six in two weeks making the country the worst affected by the epidemic on the continent, health officials said Sunday.
Three people died last week, two pregnant women aged 23 and 27 and a man in his 60s.
“Swine flu fatalities in the country now stand at six, this makes us the leading country in Africa with the most A(H1N1) case load and fatalities,” national health spokesman Fidel Hadebe, told AFP.
He said fatalities were reported from different provinces.
South Africa reported its first infection in June and the country is dealing with some 2800 cases so far, according to the health department.
Commentary
WHO Failure to See Spread of Tamiflu Resistant Pandemic H1N1
Recombinomics Commentary 15:19
August 16, 2009
http://www.recombinomics.com/News/08160901/H274Y_WHO_See_NOT.html
China and Singapore have found Tamiflu-resistant pandemic viruses, Charles Penn, a scientist with the Geneva-based agency, said in an interview with The Canadian Press.
He revealed that the WHO has also been alerted informally to the discovery of a small number of other Tamiflu-resistant viruses. He would not say where they were found or how many there were in total.
“It’s a small number. It certainly doesn’t change the scale of what we’re seeing,” Penn said.
The above comments were issued in response to queries about osletamivir resistance in Singapore and Hunan, China, as indicated by sequences made public at GISAID and Genbank. Those two instances were acknowledged, but the rationale behind the withholding of additional cases remains unclear. At the time Thailand had already acknowledged at least one case, and additional reports from Hong Kong and an MMWR Dispatch describing two immuno-compromised patients in Washington State were made public on Friday. Cases in Texas along the border with Mexico area till being denied, although the initial report included detail on two of the cases, suggesting the denials were largely based on semantics.
The cases in Texas would change the inferred scale, because the cases were at opposite ends of the border and had much in common with the initial H1N1 described in southern California. Those cases were unlinked to each other or swine, yet the sequences were virtually identical, indicating the virus was widespread. The same conclusion could be made from the cases in Texas, which may be related to the withholding of the information associated with these cases.
However, the detail that has come out in the past few days has left little doubt that the WHO’s “scale of what we are seeing” is false. The failure to see the true scale of the H274Y spread is due to the limited testing, which is largely focused on samples collected prior to Tamiflu treatment, which can be “seen” in results from patients on prophylactic Tamiflu treatment or in samples collected a few days after the start of Tamiflu treatment in symptomatic patients.
The Hong Kong case described Friday was another patient who became symptomatic while on prophylactic Tamiflu. Earlier detail on patients in Denmark and Japan indicated they became symptomatic on day 5 of prophylactic treatment. Since the incubation period of influenza is in the range of 2-4 days, the slightly longer time period indicated the H274Y was already present when Tamiflu treatment began, but because it was a minor component, disease onset was delayed by 1-2 days. The recent patient in Hong Kong developed symptoms on day 6.
However, the confirmatory data on silent spread of H274Y came from Singapore, where additional data on first confirmed case was disclosed. The sequence was from a May 30 sample from a 28F, but the detailed reports at the MOH indicated the patient (American working in Singapore who arrived late on May 26 after becoming symptomatic during flight, but passed fever scans, but was hospitalized on May 27 and confirmed on May 28. The recent comments indicated the patient was initially Tamiflu sensitive (May 28 test), and resistance was discovered after patient improved (she was discharged May 31). Thus, the resistance in the May 30 sample was present only a few days after the start of treatment and the sequences (on HA, NA. MP) had no evidence of a mixture, indicating the resistant sequence quickly replaced the wild type sequence, signaling silently spread of H274Y.
Thus, the WHO failure to see the resistance was linked to limited and delayed testing of samples collected a few days after the start of treatment, and the standard testing / sequencing failed to detect the H274Y transmitting as a minor population. The HA Singapore sequence has a polymorphism that was found in isolates in the US, Sweden, China, and Argentina, raising concerns that the H274Y was creating additional problems in Tamiflu treated patients as seen in the two immune-compromised patients in Washington State as well as rising fatalities being reported worldwide.
Doctors on lookout for Guillain-Barré symptoms in swine flu patients
August 16, 2009
http://www.timesonline.co.uk/tol/news/uk/health/Swine_flu/article6798178.ece
Doctors treating swine flu patients have been instructed to monitor the incidence of a rare nerve disease that has been linked to the body’s immune response to flu-like illnesses.
Neurologists will study the occurence of Guillain-Barré syndrome, which affects the nervous system and can cause temporary paralysis, during the swine flu pandemic and vaccination programme.
Health officials stress that there is no evidence linking the syndrome to vaccination, but it is known that there is an increased risk of developing it after a flu-like illness.
The exact cause of Guillain-Barré syndrome — which affects about 1,500 people a year in the UK — is unclear, but it is thought to involve an auto-immune reaction. Many people affected by it have had a viral or bacterial infection a few weeks earlier.
Very slight increases in rates duing vaccination programmes — causing one or two extra cases per million people inoculated — have raised questions about links to the way a vaccine primes the immune system. But studies have shown no evidence of a significant increase in risk of the syndrome for those having a flu jab.
A Health Protection Agency spokesman said that enhanced surveillance was routine when introducing a new vaccine.
More than 13 million people in the UK, including people with asthma, diabetes, heart disease, renal disease or with a compromised immune system will get the jab from October.
The normal seasonal flu vaccine may be given at the same time.
The spokesman said: “Guillain-Barré syndrome has long been identified as a potential adverse event that would require enhanced surveillance following the introduction of a pandemic vaccine but there is no evidence to suggest there is an increased risk of Guillain-Barré syndrome from this vaccine.
“There is robust evidence that no increased risk of Guillain-Barré syndrome arises from seasonal flu vaccination.
“Establishing enhanced surveillance on Guillain-Barré syndrome has always been part of our pandemic plan because there is an increased risk of this disease after a flu-like illness.
“HPA is working in collaboration with the Association of British Neurologists Surveillance Unit and the British Paediatric Surveillance Unit, who will ask clinicians to report each month whether they have seen any cases of Guillain-Barré syndrome.”
A Department of Health spokesman said: “In preparing for a pandemic, appropriate trials to assess safety and the immune responses have been carried out on vaccines very similar to the swine flu vaccine. The vaccines have been shown to have a good safety profile.”
( A.Hun this article has info about people born before 1957 appearing to have some protection from the current swineflu. )
Saturday,15 August 2009 17:2 hrs IST
http://www.manoramaonline.com/cgi-bin/MMOnline.dll/portal/ep/contentView.do?contentType=EDITORIAL&programId=1073750967&articleType=&contentId=5844608
What started as an epidemic of swine flu in Mexico in March 2009 has now spread to 100 countries. The World Health Organization (WHO) has been alerting countries for the past eight years to get prepared for a major influenza outbreak. It seems to have finally arrived.
H1N1 virus moved from pigs and went on to infect humans, facilitated by crowded living conditions. From Mexico it spread to the United States, then to Europe and Asia. In the US, swine flu has so far killed 436 people and infected about 100,000 people. The situation will get worse as winter approaches parts of the world.
India has seen 21 deaths {sic} so far and this is causing panic among the populace. The good news is that the vast majority of the people who contract swine flu influenza are going to recover completely after going through a period of body aches, sore throat and fever.
If the Mexican experience is any guide, the H1N1 swine flu is sometimes lethal in children and young adults. This seems to be the pattern in India also. People born before 1957 appear to have some protection from the current pandemic. In the 1918 pandemic, it is estimated that close to 50 million people perished in different parts of the world.
In 2009, healthcare is very advanced compared to 1918. Tamiflu tablets if taken early may minimise the severity of the disease. But if Tamiflu is used indiscriminately, the virus will adapt and become resistant to the drug. Governments have stock piled millions of tablets to be used in a major outbreak.
The influenza virus sometimes settles down in the lungs and can cause severe respiratory distress requiring mechanical ventilatory support. Of the 2,155 cases of viral pneumonia reported from Mexico, 821 required hospitalisation and 100 died of respiratory failure in spite of mechanical ventilation. Not all viral pneumonia cases need ventilatory support.
Pharmaceutical companies are racing to bring a vaccine that could be effective against the swine flu virus. Pilot clinical studies are going on in America. The vaccine is expected to be available to the public in October of this year. One also needs protection against the regular flu virus which shows up every winter. It is unlikely there will be enough vaccine to vaccinate the entire world population. Pregnant women, children, young adults, healthcare professionals engaged in patient care, military personnel all should get priority.
Public need to remember that every year seasonal influenza causes 30,000 deaths in America especially the elderly with chronic lung disease, heart disease and kidney disease. Death generally happens only when there is severe involvement of both lungs by what is called acute lung injury or acute respiratory distress syndrome. With modern medical amenities, 42 percent of such cases can be saved.
Two classes of drugs are available to minimize the effects of flu on the body. They are Tamiflu (Oseltamivir) and Relenza (Zanamivir). Recently, Japanese scientists have successfully tested CS-8959 in a clinical trial. This drug may be released for public use in Japan next year. This is found to be safer and more efficacious than Tamiflu.
According to a British Medical Journal report, children under the age of 12 should not be given Tamiflu or Relenza. These drugs reduced the length of the flu infection by only one day. More importantly these drugs reduced the transmission of the virus only by eight percent.
The Mexican experience has also revealed the effectiveness of personal protective equipment, to prevent the infection of health care workers. Doctors and nurses taking care of critically ill patients should be given N 95 masks for their safety.
So many people are dying everyday from dengue fever, malaria, tuberculosis and various bacterial and viral infections. Yet, the media by heightening awareness about the disease has unwittingly engendered undue public anxiety.
I took the Swine Flu vaccination in late 1976, or early in 1977, so I should be immune, right——unless this one is BIO-ENGINEERED!
Thanks Mom for the ping.
I missed resistance to it “by that much”! (Born in ‘57!)
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