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

Israel reports 66th A/H1N1-related death

www.chinaview.cn 2009-12-03 07:29:18
http://news.xinhuanet.com/english/2009-12/03/content_12578749.htm

JERUSALEM, Dec. 2 (Xinhua) — An elderly Israeli patient of the influenza A/H1N1 died on Wednesday, marking the 66th fatal case in the country related to the global epidemic, local news service Ynet reported.

The latest victim, a 77-year-old woman, also suffered from other diseases, while the flu cannot be ruled out as the cause of the death, the Health Ministry was quoted as saying.

The death case came a day after local media revealed that Israelis seemed uninterested in receiving vaccines against the virus, with statistics from health authorities showing that only 1.3 percent of Israeli residents have been vaccinated despite that a much larger number of doses were available.

Earlier this year, local health experts warned that about one quarter of the total Israeli population would contract the virus during a possible outbreak this winter, among whom around 700 would die.

Israeli Prime Minister Benjamin Netanyahu, who is also Health Minister, has already ordered 7.3 million doses of A/H1N1 vaccines, enough for every resident in the country except for newborns.

NM sees 2 more swine flu deaths this week

Associated Press - December 2, 2009 6:15 PM ET
http://www.kvia.com/Global/story.asp?S=11609752

ALBUQUERQUE, N.M. (AP) - New Mexico Health Department officials say two more people have died from swine flu, bringing the statewide total this year to 42 deaths.

The latest deaths include a 78-year-old woman from Bernalillo County with chronic medical conditions and a 59-year-old woman from Luna County whose medical history has not yet been determined.

The Health Department says visits to health care providers for flu-like illness did increase slightly over the last week from 4.9 percent to 5.4 percent. The department says flu-like illness is the best indicator of flu activity in the state.

The department has ordered more than 403,000 does of nasal and injectable swine flu vaccine. It is arriving in small amounts and is being distributed to providers and health clinics statewide.

UOttawa public health policy expert debunks H1N1 myths
Published on December 3rd, 2009 by Dave Weatherall
http://www.gazette.uottawa.ca/article/uottawa_public_health_policy_expert_debunks_h1n1_myths/

As the Canada Research Chair in Public Health Policy at uOttawa, Dr. Kumanan Wilson has been highly sought after by media outlets looking for insight about H1N1 and governmental response to the outbreak. This new role as spokesperson has provided him with a firsthand view of the role the media play during a pandemic.

“I’ve been getting calls from two or three reporters a day and I like to help them try to understand a difficult story as best I can,” he says. “When there’s confusion and uncertainty, it’s up to the media and media commentators to explain to the audience what is happening.”

Dr. Wilson says part of his new role as a pandemic preparation expert is to clarify some of the myths surrounding H1N1. “One of the biggest myths is that seasonal flu deaths can be compared to deaths attributable to H1N1. It’s like comparing apples to oranges.”

Frontline medical workers that Dr. Wilson has spoken with have told him they have seen patients with H1N1 directly fall ill and die from the virus. This is not the case with seasonal flu, where the infection often weakens an already vulnerable individual who then dies from another cause.

“This is an entirely unique phenomenon,” he says. “A seasonal flu death which may be a 20 per cent contributing factor and shorten an elderly person’s life by a year is not equivalent to an H1N1 death which may be the sole cause of death in a young person.”

Ten years ago Dr. Wilson was also on the frontlines of a worldwide pandemic as a clinician during the SARS crisis at the Toronto General, where he said he saw firsthand just how broken the system was.

“I heard about SARS from one of my residents who had been on the phone with her mom who had been watching CNN reporting on the developing story.”

He said information sharing in Canada and internationally has come a long way since that time. “If you look at the H1N1 pandemic, science accurately predicted that we were overdue for a pandemic. In the spring it predicted a second wave and a vaccine was prepared and distributed,” says Wilson.

While significant improvements have been made in terms of information sharing and cooperation among health agencies domestically and abroad, Dr. Wilson said there is still a need for a centralized, national information system to protect Canadians from future public health issues along the lines of H1N1, Walkerton and Listeria. The Public Health Agency of Canada is currently working on a program tentatively called Panorama, which has to be operational by 2012 under binding international law.

“Governments have a social contract to protect their citizens,” he says. “If you look at the Conservatives in Ontario after Walkerton, or the Bush administration after Hurricane Katrina, it’s clear that governments that don’t protect their citizens tend to get kicked out.”

Despite his words of caution, Dr. Wilson is not alarmist in his assessment of the handling of the current H1N1 epidemic.

“If you compare the federal government’s response to H1N1 to the handling of the recent financial crisis, which received considerably more funding to correct its problems, then the H1N1 pandemic has been handled pretty well.”

While continuing his work on improving Canada’s public health policy–he hopes to release an edited book on the role of federalism in public health next year–Dr. Wilson is also currently planning a study to determine whether children with metabolic disorders or vulnerabilities experience adverse affects from vaccinations.

To learn more about Dr. Wilson’s work visit http://www.publichealthpolicy.org/

Commentary

446 Dead in Ukraine - D225G and Deaths Spread

Recombinomics Commentary 02:20
December 2, 2009
http://www.recombinomics.com/News/12030901/Ukraine_446.html

1,937,292 Influenza/ARI

116,982 Hospitalized

446 Dead

The above numbers represent the latest update from the Ukraine Ministry of Health. As the number of cases approach 2 million, the rate of increase has slowed and shifted to the east. The largest daily update was in Donetsk, which rose by 5892 cases to 127,584 (see map). However. Increases in deaths are being report across the eastern border in Russia, were there have been 30 deaths reported in Saratov. Similarly, almost 200 deaths have been reported in Turkey, raising concerns of D225G spread.

The initial data showed strong association of D225G with fatal cases. Of the 9 samples from western Ukraine, all four fatal cases had D225G. In contrast nasal washes from surviving cases were positive for the same sub-clade, but were wild type at position 225, suggesting that infections were mixtures and virus with D225G targeted the lung, while wild type remained in the upper respiratory tract.

This tissue tropism poses surveillance problems, because most sequences come from nasal pharyngeal swabs, which may not reflect D228G in the lung. Currently, only 1% of HA sequences have D225G, although it was present in April in the vaccine target, A/California/7/2009, as a mixture. The version with D225G was selected for the target in the attenuated carrier distributed as a flu mist. In contrast, the killed infected vaccine has the HA version of California/7 with wild type D at position 225, raising concerns that killed vaccine or natural immunity will select for D225G. This concern was increased when Mill Hill labeled Ukraine H1N1 with D225G a low reactor.

The reporting of D225G in all fatal cases in Ukraine should be followed up with additional sequence data on more of the 400+ fatalities. Collections from the upper and lower respiratory tract in fatal cases would help define the significance of D225G in fatal lung cases, and also determine the ratio of components of mixtures with and without D225G.

An increase in the D225G ratio would be cause for concern.
_________________

Iowa Experiences More Deadly Cases of H1N1
http://www.kpth.com/Global/story.asp?S=11610689

The Iowa Department of Public Health has confirmed three more H1N1-related deaths. All three victims were adults from Fremont, Polk, and Union counties.

To date, Iowa has reported 30 confirmed H1M1 deaths and nearly 700 H1N1-related hospitalizations.

For a list of local vaccination clinics coming up in Siouxland you can check out the H1N1 feature of our web site

N.J. reports 2 more swine flu deaths

Wednesday, December 2, 2009
BY LINDY WASHBURN
The Record
STAFF WRITER
http://www.northjersey.com/news/120209_NJ_reports_2_more_swine_flu_deaths.html

New Jersey has reported two more deaths due to swine flu, but additional shipments of vaccine have finally eased the backlog in orders, according to the state Health Department’s weekly report Wednesday.

The deaths included an otherwise healthy 53-year-old man from Middlesex County, who was hospitalized for six days before dying on Nov. 22, and a 73-year-old Hudson County man with underlying medical conditions, who died in the hospital on Nov. 11. The cause of death for each was confirmed through laboratory testing, the state Department of Health said.

Since the epidemic began last April, 31 New Jersey residents have died of H1N1 influenza.

The level of H1N1 activity statewide was described as “widespread” in the report for the week ending last Saturday.

Nationwide, “there’s been a decline in activity, but there’s still lots of flu,” Thomas Frieden, the director of the federal Centers for Disease Control, said earlier this week. New Jersey is one of 32 states reporting widespread activity, a higher level than the “regional” activity reported elsewhere.

The decline in viral activity gives the public a “window of opportunity” to get vaccinated, Frieden said. Shipments of vaccine continue to be shipped in limited, staggered amounts around the country.

New Jersey has received 1,581,000 doses so far, and was able to fulfill its long-standing backlog of orders, according to the state health department. Most of the supply went to county and local health departments, followed by private physician offices.

While the federal government has assured state officials that enough vaccine will be available for everyone who wants to be vaccinated, the current supplies are limited to five target groups. They include pregnant women, parents and caregivers of babies younger than 6 months, children and young people from 6 months to 24 years old, healthcare workers, and adults up to age 65 with underlying medical conditions.

“It’s hard to predict with certainty when there’ll be widespread availability of vaccine,” Frieden said. “We’re a lot closer to that than we were a few weeks ago, but it’s going to be different in different parts of the country.”

New Jersey’s weekly report showed that emergency room visits due to influenza-like illness were down, but school absences were up last week.

E-mail: washburn@northjersey.com

H1N1 death toll hits nine in Qatar

Latest Update: Thursday3/12/2009December, 2009, 01:01 AM Doha Time
http://www.gulf-times.com/site/topics/article.asp?cu_no=2&item_no=329777&version=1&template_id=57&parent_id=56

The Supreme Council of Health (SCH) yesterday reported a new H1N1 flu death, bringing the toll in Qatar to nine.

An official source at the council told Qatar News Agency that the latest victim was a 55-year-old Qatari national. He was admitted to hospital after suffering from myocardial infarction. Clinical tests revealed that he had also been infected with the H1N1 virus. The official said the patient was admitted to the Intensive Care Unit at Hamad Hospital on Monday.
_________________

FL:

Another swine flu death reported in Polk

TBO.com
Published: December 2, 2009
http://www2.tbo.com/content/2009/dec/02/another-swine-flu-death-reported-polk/news-breaking/

Another person has died of the swine flu in Polk County, the county’s seventh H1N1-related death.

The county’s health department reported the 43-year-old woman was not a resident of the county but had been living in the area for several months. She had multiple chronic underlying medical conditions, according to the health department.

Through Nov. 24, Florida has recorded 172 H1N1 flu-related deaths.

TX:

El Paso records 16th H1N1 flu death

Posted: Dec 2, 2009 03:37 PM EST
Updated: Dec 2, 2009 06:20 PM EST
http://www.kvia.com/Global/story.asp?S=11608386&nav=menu193_2

El Paso, Texas - A 61-year-old man from Northeast El Paso became the county’s 16th H1N1 flu-related death this year, the City of El Paso Department of Public Health reported today.

The man had underlying medical conditions and laboratory tests confirmed that he did have the H1N1 virus.

Woman dies of swine flu; Taiwan death toll at 32
http://www.chinapost.com.tw/taiwan/national/national-news/2009/12/03/235062/Woman-dies.htm
December 3, 2009

The Central Epidemics Command Center (CECC) yesterday announced the death of a young woman due to H1N1 influenza, adding up to 32 total deaths in Taiwan.

The woman, 27, was reported to have a medical history of diabetes and kidney disease. In addition, seven more cases were reported. As of Dec. 2, CECC officials reported having 719 confirmed cases in hospitals.

The Department of Health (DOH) has announced a nationwide campaign to give H1N1 flu vaccinations to all people, starting from Dec. 12. The DOH officials were trying to reach an agreement with local department stores and shopping malls to set up vaccination stations, aside from large hospitals. People can then take their IDs and health insurance cards to any vaccination station to receive free shots.

In previous phases, from Nov. 1, the vaccine has made been available to infants, pregnant women, school students and Typhoon Morakot victims. So far, nearly two million residents have received the vaccine shots, including 1.3 million pupils and 52 thousand newborns, which is more than half of the total infants in Taiwan. However, only 11 thousand pregnant women have received the shots. Officials yesterday urged expectant mothers to get the shots as soon as possible.

India:

47th death due to swine flu in state

TNN 3 December 2009, 02:49am

AHMEDABAD: Laxmikumar Premkumar Goswami, a 20-year-old woman from Palanpur in Deesa succumbed to swine flu at Civil Hospital on Wednesday. Goswami is 47th victim of H1N1 in the state.

Doctors at the Civil Hospital said that Goswami had developed symptoms of swine flu including high fever and breathlessness. She was prescribed Tamiflu but her condition deteriorated.

Goswami’s death has raised concerns over the many devotees who had come to Unjha during the Maa Umiya temple celebrations. More than 2,000 NRIs’ had congregated, besides the 45 lakh visitors who had come to the venue from various parts of the country and state in the last five days. Though temple authorities had installed H1N1 scanning centres, the number of suspected cases that were isolated is yet not being revealed by the state government.

So far, 322 positive cases of swine flu have been detected. Meanwhile, three new cases of swine flu were detected on Wednesday which included a seven-year-old girl. One patient has been admitted in Wockhardt Hospital in Rajkot while the other in Sterling Hospital in Ahmedabad.

Government claims that the spread of swine flu has remained fairly contained during of winter. With winter setting in, people need to take more precautions and promptly consult designated swine flu centres if the common viral fever symptoms or cough does not subside.

AP: NH has 7th swine flu-related death

By THE ASSOCIATED PRESS
6 hours, 7 minutes ago
http://www.unionleader.com/article.aspx?headline=AP%3A+NH+has+7th+swine+flu-related+death&articleId=f401b483-8a77-42a9-a5de-4696f0767f1f

CONCORD – A New Hampshire woman has died of complications related to swine flu, bringing the total number of such deaths in the state to seven.

Health and Human Services Department spokeswoman Kris Nielsen said Wednesday a woman from Merrimack County died last week, and that she had underlying medical conditions.

Swine flu vaccination clinics for the highest-risk cases started opening last week. Vaccines are available for free by appointment at the clinics to high-risk people who do not have doctors.

Drug-resistant swine flu reported in Va. and Md.

By Michael Laris
Washington Post Staff Writer
Thursday, December 3, 2009
http://www.washingtonpost.com/wp-dyn/content/article/2009/12/02/AR2009120202759.html?wprss=rss_metro/md

Two swine flu patients in Maryland and one in Virginia were hospitalized with a form of the virus resistant to a commonly used medicine, prompting infectious disease specialists to call for renewed caution even as the intensity of the pandemic has declined nationwide.

Tamiflu is one of the drugs used on the sickest patients, and it is not effective against the H1N1 virus in only a few cases. But epidemiologists said experience with other flu strains shows that resistance can spread quickly, making monitoring and prevention crucial.

“I don’t want to scare the public, but I do want people to be responsible in what they need to be doing, not only for their patients but also for public health,” said Trish Perl, a professor at Johns Hopkins University Hospital.

“It’s been reported in Seattle. It’s been reported at Duke. It’s been reported in our place. All of a sudden, we’re starting to see . . . more resistance than we saw earlier this spring,” she said. “What it calls for is increased vigilance.”

Diane Helentjaris, head of Virginia’s office of H1N1 response, said two state residents have been treated for Tamiflu-resistant swine flu, one at a hospital in Virginia and one in another state.

“It’s not unexpected at all, when you have many, many people taking an antiviral medication,” she said.

Extended treatment of those with immune problems also contributes to drug resistance. “The longer you’re on something the more likely you might develop some resistance,” she said.

The two Hopkins patients, who have since been discharged, had weakened immune systems, and their treatment was consistent with that provided to leukemia patients. Staff members had been vaccinated and wore masks, hospital officials said.

Perl said initial virus samples responded to Tamiflu, but that changed during treatment, leading to a mutated, resistant form. “Under the pressure it can emerge,” she said.

Doctors can try a different drug in such cases.

Perl said Tamiflu should not be over-prescribed because that gives the virus more chances to mutate. She also said people should avoid complacency and should be vaccinated.

In the District, officials confirmed the city’s first swine flu-related death. The patient was an adult male with a preexisting condition, Health Department spokeswoman Dena Iverson said.

Another 25 Indonesian hajj pilgrims die

Thursday, December 3, 2009 09:27

Jedda (ANTARA News) - Twenty-five more Indonesian hajj pilgrims have died since Sunday, bringing to 161 the number of the country`s hajj pilgrims who died during their journey of worship in Saudi Arabia this year.

Some of the hajj pilgrims died of heart disease and respiratory failure, the Religious Affairs Ministry`s integrated hajj communications system (Siskohat) unit said on Thursday.

More than 196,100 Indonesians performed hajj pilgrimage this year. They were flown to the Holy Land in 475 batches.

Islam obliges its adherents who can afford to it to perform hajj pilgrimage once during their lifetime.(*)

http://www.antara.co.id/en/news/1259807247/another-25-indonesian-hajj-pilgrims-die

Severely ill hospital patients need swine flu drug boost: WHO

(AFP) – 7 hours ago
http://www.google.com/hostednews/afp/article/ALeqM5jJzZct5LIo0gwhRXTIpGH-uzUltg

GENEVA — The World Health Organisation on Wednesday recommended boosted antiviral treatment for hospital patients with severely weakened immune systems who contract swine flu, following recent clusters of Tamiflu resistance.

Although the WHO said there was no evidence that the two clusters found in Wales and in North Carolina marked a wider public health threat, it reiterated calls for vigilance and modified treatment advice for the frontline flu drug.

In the two clusters found in single hospital wards in October and November, patients — eight in Wales and four in the United States — were suspected of infecting each other with the Tamiflu-resistant strain.

In such patients with suppressed immune systems, “standard treatment doses and duration for treatment with oseltamivir (Tamiflu) are unlikely to be sufficient,” the WHO said in a briefing note posted on its website.

“Though clinical judgement is important, doses may need to be increased and continued, without interruption, for the duration of acute illness,” it added.

The UN health agency also recommended that the alternative drug to Tamiflu, Zanamivir, “should be considered as the treatment of choice for patients who develop prolonged influenza illness despite treatment with oseltamivir.”

Oseltamivir is sold by pharmaceutical company Novartis under the brand name Tamiflu, while GlaxoSmithKline’s Zanamivir is marketed as Relenza.

The WHO repeated the need for “vigilant monitoring” of the Tamiflu-resistant flu virus.

“Experience with seasonal influenza viruses shows that resistant viruses can quickly spread within the general population and become established, rendering one or more antiviral drugs ineffective,” it cautioned.

Within the past two weeks, the number of documented cases of Tamiflu resistance in those who have contracted A(H1N1) flu has risen from 57 to 96, according to the global health watchdog.

About one third occurred in patients whose immune systems were severely weakened by blood problems, aggressive chemotherapy for cancer, or post-transplant treatment.

WI:

West Allis reports swine flu death

Published Dec. 2, 2009 at 7:51 p.m.
http://metro.onmilwaukee.com/articles/621448-west-allis-reports-swine-flu-death

Health officials in West Allis on Wednesday confirmed the city’s first death related to the H1N1 influenza virus.No information on the victim was provided in a news release from West Allis health commissioner Terry Brandenburg confirming the death.Swine flu appears to be waning around the country, though there remains “considerable H1N1 activity,” in Wisconsin, according to the state Department of Health Services.

Death toll of A/H1N1 flu reaches 22 in Egypt

02.12.2009 22:50
http://en.trend.az/regions/met/arabicr/1592469.html

Egypt reported on Wednesday one more death case of A/H1N1 flu, bringing the country’s death toll from the virus to 22, said Health Ministry in a statement, Xinhua reported.

A 53-year-old man died of A/H1N1 virus in a hospital in Helwan, south of Cairo, who suffered from fever, dyspnea and renal failure, according to the statement.

Up till now, Egypt has reported more than 3,000 cases of the novel flu in the most populous Arab country.

Egypt confirmed on July 19 its first influenza A/H1N1 death case of a 28-year-old Egyptian woman, who came back from Saudi Arabia after making Umrah (pilgrimage to Mecca at any time of the year).

Egypt reported its first A/H1N1 flu case on June 2 of a 12-year- old Egyptian-American girl coming from the United States via the Netherlands.

City calls for blood in swine-flu war

By Cai Wenjun | 2009-12-3
http://www.shanghaidaily.com/article/?id=421501&type=Metro

SHANGHAI health authorities yesterday launched their latest drive in the fight against swine flu, calling on people who have been vaccinated against the virus to donate blood for emergency-treatment storage.

First in the queue will be 34 inoculated medical staff at the Shanghai Public Health Clinical Center, who are expected to donate blood today.

City blood-collection authorities said that general donations were also welcome as supplies were low, particularly of types A and O.

According to experts, a person starts to produce antibodies three weeks after catching swine flu or two weeks after vaccination.

Blood from these people can then be used to treat patients seriously affected by the H1N1 virus.

“Using serum from vaccinated staff to treat serious cases is mentioned in a treatment guide issued by the Ministry of Health,” said Dr Lu Hongzhou, a member of city’s expert panel on swine-flu treatment - and one of the 34 expected donors.

“The technology is safe and we have used it on our patients with good results,” Lu said.

Since carrying out vaccinations on the most at-risk groups of the population, such as medical staff, public servants and students and teachers at primary and middle schools, Shanghai has inoculated more than 800,000 people.

A total of 2.1 million people will be included in the vaccination plan, which has been expanded to university students and people aged 60 and over with local residency.

Zhu Yueguo, director of the Shanghai Blood Administration Office, said the city had fulfilled this year’s initial target of collecting 80,000 liters, but demand in some areas was outweighing supply.

“Types A and O only cover 20 percent of the daily storage, while they should be 30 percent,” Zhu said.

Zhu said so far the office had only taken blood from three people inoculated against swine flu and many more were needed.

By Monday, Shanghai had reported 2,074 incidents of swine flu, including 26 serious cases, since the first one was detected in May.

Two young girls were still in a critical condition in the city yesterday with swine flu, while a Shanghai boy, 6, was off the critical list and on the mend, officials from the Children’s Hospital of Fudan University said.

A migrant girl, 3, from eastern China’s Anhui Province and a Shanghai girl, 6, were still on respiratory machines, the hospital said.

The Anhui girl was showing stronger recovery signs, said Wang Yi, the hospital’s vice president.

Since receiving the first child seriously sickened by swine flu on November 19, the hospital has treated nine patients and three of them have recovered.

“We haven’t used vaccinated people’s serum in treating our child patientsas yet,” Wang said.

Second Winona County swine flu death reported (Minnesota)
http://www.winonadailynews.com/news/local/article_d3d05bca-df89-11de-94fb-001cc4c002e0.html
December 2, 2009

State health officials have categorized a second Winona County death as swine flu-related.

The resident was in his or her 40s, had underlying health conditions and was not hospitalized before dying Oct. 27, data from the Minnesota Department of Health shows. Officials did not release the identity or gender of the person.

The local death was one of seven new H1N1-related deaths MDH officials announced Wednesday, raising the total of swine flu deaths in Minnesota to 39 since the virus was first detected in the state in April.

The announcement of additional deaths comes even as Minnesota health officials announced that swine flu cases continue to decline statewide, with flu activity now occurring mainly in the northwestern part of the state, according to a MDH press release. The time required to confirm H1N1 deaths leads those statistics to lag behind other indicators such as hospitalizations and school outbreaks, state officials have said.

Despite the decrease in flu cases, health officials continue to stress that residents should receive vaccines for both swine flu and seasonal influenza.

Winona County Community Health Services has scheduled three upcoming H1N1 public clinics, including one today.

Those are:

- Today, from 3 to 4:30 p.m., Winona County Community Health Services offices, 60 W. Third St.

- Dec. 10, from 4 to 6 p.m., Winona Middle School, 1570 Homer Road

- Dec. 16, from 3:30 to 5:30 p.m., St. Charles Elementary School, 925 Church Ave.

Seven H1N1 deaths in Lubbock and surrounding counties
http://www.kcbd.com/Global/story.asp?S=11608493
12/2/09

H1N1 deaths are now up to seven for Lubbock and surrounding counties. The Department of State Health Services says there have been five such deaths in Lubbock County, one in Floyd County, one in Cochran County.

A weekly report from the state says 12 people have been critically ill from swine flu in Lubbock County with another 7 who have been critically ill in the 41 county region around Lubbock.

The state health department’s Lubbock region has fewer H1N1 related deaths than any other region of Texas. H1N1 cases are beginning to come down. But state officials say it is still important for people to continue taking precautions, such as good hand washing and vaccinations.